Centimetre-scale perovskite solar cells with fill factors of more than 86 per cent.

Owing to rapid development in their efficiency1 and stability2, perovskite solar cells are at the forefront of emerging photovoltaic technologies. State-of-the-art cells exhibit voltage losses3-8 approaching the theoretical minimum and near-unity internal quantum efficiency9-13, but conversion efficiencies are limited by the fill factor (<83%, below the Shockley-Queisser limit of approximately 90%). This limitation results from non-ideal charge transport between the perovskite absorber and the cell's electrodes5,8,13-16. Reducing the electrical series resistance of charge transport layers is therefore crucial for improving efficiency. Here we introduce a reverse-doping process to fabricate nitrogen-doped titanium oxide electron transport layers with outstanding charge transport performance. By incorporating this charge transport material into perovskite solar cells, we demonstrate 1-cm2 cells with fill factors of >86%, and an average fill factor of 85.3%. We also report a certified steady-state efficiency of 22.6% for a 1-cm2 cell (23.33% ± 0.58% from a reverse current-voltage scan).

Effectiveness and long-term stability of outpatient cognitive behavioural therapy (CBT) for children and adolescents with anxiety and depressive disorders under routine care conditions.

BACKGROUND: Randomised controlled trials (RCTs) have provided considerable evidence for the short-term efficacy of cognitive behavioural therapy (CBT) in children and adolescents with depressive and anxiety disorders. However, the effectiveness and long-term stability of treatment effects under routine care conditions remain unproven. AIMS: This observational study investigates the effectiveness and stability of CBT under routine care conditions within a large sample of clinically referred youth with depressive and anxiety disorders. METHOD: Two hundred and twenty former patients (age 6-18 years at start of treatment) underwent a follow-up assessment (follow-up interval: M=5.3 years, SD=2.47). Parent and self-ratings of behavioural and emotional problems were obtained at the beginning and end of treatment and at follow-up. Additionally, at follow-up, a telephone interview and questionnaires exploring other mental symptoms and life satisfaction were administered. RESULTS: A repeated measures ANOVA yielded statistically significant, medium to large pre- post symptom reductions (ηp2=.15 to ηp²=.47) and small to medium post-follow-up symptom reductions (ηp²=.03 to ηp²=.19). At follow-up, between 57 and 70% of the sample reported a decrease in different emotional symptoms since the end of treatment, and 80% reported improved life satisfaction. CONCLUSIONS: These findings provide evidence for the effectiveness and stability of treatment effects of CBT in youth with depressive and anxiety disorders under routine care conditions. Due to the lack of a direct control condition and a substantial proportion of missing data, the results must be interpreted with caution.

The surgical treatment of subaxial acute cervical spine facet dislocations in adults: a systematic review and meta-analysis.

Adult cervical spine traumatic facet joint dislocations occur when excessive traumatic forces displace the vertebrae's facets, leading to loss of joint congruence. Reduction requires either cranial traction or open surgical procedures. This study aims to appraise the effects of different surgical techniques in the treatment of subaxial cervical spine acute traumatic facet blocks in adults. This study was based on a systematic literature review and meta-analysis, registered in Prospero (CRD42021279249). The PICO question was composed of adults with acute cervical spine traumatic facet dislocations submitted to anterior or posterior surgical approaches, associated or not with cranial traction for reduction. Each surgical technique was compared to the other. The primary clinical outcomes included neurological improvement or worsening and surgical success/failure rates. The anterior approach without cranial traction was efficient in reducing facet displacements. Skull traction was an efficient and immediate method to achieve spine dislocation reductions. Differences were not present among techniques regarding neurological improvement. There were no surgical failures in patients operated on via the posterior approach. The need to decompress and stabilize the cervical spine can be achieved by anterior or posterior surgical approaches, and there is no clear answer as to which initial approach is superior to the other.

Effectiveness of Usual-Care Cognitive Behavioral Therapy for Adolescents with School Absenteeism.

Objective: Highly-controlled, randomized controlled trials have provided considerable evidence for the efficacy of outpatient cognitive-behavioral therapy (CBT) for patients with school absenteeism and anxiety disorders. However, the effectiveness of outpatient CBT under routine-care conditions for youth with school absenteeism remains unproven. Methods: This observational study used file records to analyze the changes under routine CBT in a sample of n = 49 clinically referred adolescents aged 11 to 18 years with school absenteeism and mental disorders who were being treated in a university outpatient clinic. At the start and end of treatment, we assessed the severity of school absenteeism as well as mental health problems as rated by parents and by the adolescents themselves. Results: The analysis yielded a statistically highly significant decline in school absenteeism (large effect, Cohen's r = 0.80) and in mental health problems (small-to-large effect, Cohen's d = 0.33 to d = 0.82). However, a substantial proportion of the sample remained in the clinical range at the end of treatment. Conclusions: These findings suggest that CBT is effective for adolescents with school absenteeism when administered under routine-care conditions, though the results must be interpreted with caution because of the lack of a control condition.

Effectiveness of usual-care cognitive-behavioral therapy for adolescents with depressive disorders rated by parents and patients - an observational study.

BACKGROUND: Depressive disorders are common in adolescence and are associated with a wide range of negative long-term outcomes. Highly controlled randomized controlled trials (RCT) provide considerable evidence for the efficacy of cognitive-behavioral therapy (CBT) as a treatment for depression, but studies examining the effectiveness of CBT in clinical settings are very rare . METHODS: In the present observational study, the changes achieved through routine CBT in adolescents with depressive disorders treated in a clinical setting in terms of a university outpatient clinic were analyzed, and compared to a historical control group of adolescents with depressive disorders who had received treatment as usual. At the start and end of treatment (pre- and post-assessment), parent and self-ratings of the German versions of the Youth Self-Report (YSR), the Child Behavior Checklist (CBCL) and rating scales for depressive symptoms (FBB-DES, SBB-DES) were assessed. A total of 331 adolescents aged 11-18 years with complete data were assessed for the main analysis. RESULTS: The analysis yielded small to large pre-post effect sizes (Cohen's d) for the total sample (d = 0.33 to d = 0.82) and large effect sizes for adolescents who were rated in the clinical range on each (sub) scale at the start of treatment (d = 0.85 to d = 1.30). When comparing patients in the clinical range with historical controls, medium to large net effect sizes (d = 0.53 to d = 2.09) emerged for the total scores in self- and parent rating. However, a substantial proportion of the sample remained in the clinical range at the end of treatment. CONCLUSIONS: These findings suggest that CBT is effective for adolescents with depressive disorders when administered under routine care conditions, but the results must be interpreted with caution due to the lack of a direct control condition. TRIAL REGISTRATION: DRKS, DRKS00021518 . Registered 27 April 2020 - Retrospectively registered, http://drks.de.

Progress feedback in children and adolescents with internalizing and externalizing symptoms in routine care (OPTIE study): study protocol of a randomized parallel-group trial.

BACKGROUND: Progress feedback provides therapists with progress notes on a regular basis through the continuous assessment of participants throughout their treatment (e.g., symptoms, therapeutic alliance). While for adults the evidence base has increased over the years, progress feedback in the therapy of children and adolescents has not been sufficiently investigated. This manuscript describes the trial protocol of the OPTIE study: a randomized trial that tests the efficacy of a progress feedback system in children and adolescents under conditions of routine care. METHODS: The study is based on a randomized parallel-group trial with two treatment groups (routine, feedback) at an outpatient unit of a university hospital. The target sample size is 439 families consisting of children and adolescents aged 6 to17 years old with internalizing and/or externalizing symptoms. Both the patients and the therapists are independently assigned to the treatment groups by stratified block randomization. In both treatment groups patients receive routine care behavioral therapy for a study-related 12 months; additionally, in the feedback group, a progress feedback system with three components is applied (monitoring, report, and supervision). For three informants (caregiver, child [≥ 11 years], therapist) surveys are conducted every 6 weeks (e.g., symptoms, goals, motivation). For both treatment groups, comparison data is collected at baseline and at six and 12 months after the beginning of the intervention (pre, inter, post), and includes five informants (blinded clinician, therapist, caregiver, child [≥ 11 years], teacher). DISCUSSION: The OPTIE study will contribute to the evidence base of progress feedback in children and adolescents and has the potential to uncover treatments' effects in the small to medium range. Noteworthy features are the inclusion of children younger than 10 years old and the consideration of a blinded clinician rating. TRIAL REGISTRATION: German Clinical Trials Register (DRKS) DRKS00016737 ( https://www.drks.de/DRKS00016737 ). Registered 17 September, 2019.

Parent- and therapist-rated treatment satisfaction following routine child cognitive-behavioral therapy.

This observational study examined treatment satisfaction (TS) following routine outpatient cognitive-behavioral therapy (CBT) in a large sample of children (n = 795; aged 6 to 10 years). TS was investigated in parent and therapist rating. Means, standard deviations and inter-rater correlations were calculated to investigate TS. Regression analysis was conducted to examine potential correlates of TS (patient-related variables, mental disorder characteristics, socio-demographic factors and treatment variables). High TS in parent and therapist rating was found, with therapists showing a lower degree of TS than parents (completely or predominantly satisfied: parent rating 94.1%, therapist rating 69.5%). A statistically significant, moderate inter-rater correlation was found. Regression analysis explained 21.8% of the variance in parent rating and 57.2% in therapist rating. Most of the TS variance was explained by mental disorder characteristics (parent-rated symptoms and therapist-rated global impairment at treatment end) and by treatment variables (especially the therapist-rated cooperation of parents and patients), whereas socio-demographic and patient-related variables did not show any relevant associations with TS. Based on these results, to optimize TS, therapists should concentrate on establishing a sustainable cooperation of parents and children during therapy, and work to achieve a low global impairment at treatment end.

In Situ Formation of Mixed-Dimensional Surface Passivation Layers in Perovskite Solar Cells with Dual-Isomer Alkylammonium Cations.

Dimensional engineering of perovskite solar cells has attracted significant research attention recently because of the potential to improve both device performance and stability. Here, a novel 2D passivation scheme for 3D perovskite solar cells is demonstrated using a mixed cation composition of 2D perovskite based on two different isomers of butylammonium iodide. The dual-cation 2D perovskite outperforms its single cation 2D counterparts in surface passivation quality, resulting in devices with an impressive open-circuit voltage of 1.21 V for a perovskite composition with an optical bandgap of ≈1.6 eV, and a champion efficiency of 23.27%. Using a combination of surface elemental analysis and valence electron spectra decomposition, it is shown that an in situ interaction between the 2D perovskite precursor and the 3D active layer results in surface intermixing of 3D and 2D perovskite phases, providing an effective combination of defect passivation and enhanced charge transfer, despite the semi-insulating nature of the 2D perovskite phase. The demonstration of the synergistic interaction of multiple organic spacer cations in a 2D passivation layer offers new opportunities for further enhancement of device performance with mixed dimensional perovskite solar cells.

Chaotic Image Encryption Using Hopfield and Hindmarsh-Rose Neurons Implemented on FPGA.

Chaotic systems implemented by artificial neural networks are good candidates for data encryption. In this manner, this paper introduces the cryptographic application of the Hopfield and the Hindmarsh-Rose neurons. The contribution is focused on finding suitable coefficient values of the neurons to generate robust random binary sequences that can be used in image encryption. This task is performed by evaluating the bifurcation diagrams from which one chooses appropriate coefficient values of the mathematical models that produce high positive Lyapunov exponent and Kaplan-Yorke dimension values, which are computed using TISEAN. The randomness of both the Hopfield and the Hindmarsh-Rose neurons is evaluated from chaotic time series data by performing National Institute of Standard and Technology (NIST) tests. The implementation of both neurons is done using field-programmable gate arrays whose architectures are used to develop an encryption system for RGB images. The success of the encryption system is confirmed by performing correlation, histogram, variance, entropy, and Number of Pixel Change Rate (NPCR) tests.

Physiological Response and Multi-Elemental Content in Lichens Growing on Agricultural Fences: A Pilot Study Comparing No-Tillage and Organic Cropping.

The objective of this study is to compare the physiological response (content and degradation of photosynthetic pigments, membrane oxidation products and soluble proteins) and multi-element content of Ramalina celastri (lichenized fungi) growing on agricultural fences with no-tillage (associated with transgenic crops and agrochemical application), organic cropping and a non-cultivated area. We found that R. celastri did not differ in its physiological response to agricultural practices, except for the contents of chlorophyll b and phaeophytin a which were high in both cultivated areas. Lichens growing in organic cropping fields have higher arsenic, chromium, uranium and internal transition elements common in the earth's crust, possibly due to the greater resuspension of the material during soil tillage. Lichens that grow on posts close to no-tillage field had higher bromine contents (present in numerous pesticides). We found evidence that R. celastri behaves as a tolerant species to air pollution in agricultural environments.

Treatment satisfaction following routine outpatient cognitive-behavioral therapy of adolescents with mental disorders: a triple perspective of patients, parents and therapists.

The present study investigates treatment satisfaction (TS) rated by multiple informants (patient, parent, therapist) following routine outpatient cognitive-behavioral therapy (CBT) within a large sample (n = 965) of clinically referred adolescents aged 11-20 years. Moreover, potential predictors of TS were analyzed (patient-related variables, mental disorder characteristics, socio-demographic factors and treatment variables). Overall, our results show a high treatment satisfaction in patient, parent and therapist ratings, with the therapists being the most critical raters (completely/predominantly satisfied: 87.8% in patient, 92.0% in parent, and 64.0% in therapist ratings). Correlations between the three raters were only small to moderate, but statistically significant. Regression analysis examining differential effects found that mental disorder characteristics (parent- and patient-reported symptoms at post) and treatment variables (especially cooperation of patients and parents as rated by therapists) explained most of the variance in TS, whereas patient-related or socio-demographic variables did not emerge as relevant predictors of TS. The amounts of explained variance were R adj. 2 = 0.594 in therapist rating, R adj. 2 = 0.322 in patient rating and R adj. 2 = 0.203 in parent rating.

Parent- and Teacher-Rated Effectiveness of Cognitive-Behavioral Therapy for Children and Adolescents Under Usual Care Conditions in a University Outpatient Clinic.

Compared to randomized controlled trials, studies examining the effectiveness of cognitive behavioral therapy (CBT) in children and adolescents with mental disorders are rare, and a teacher perspective is scarce. The present study investigated the effectiveness of routine CBT in 519 patients aged 6-18 years with mental disorders. Changes in mental health problems were assessed in teacher (Teacher Report Form, TRF) and parent rating (Child Behavior Checklist, CBCL) and were analyzed within the total sample, yielding statistically significant, small to medium effect sizes (teacher rating: d = .74-2.39; parent rating: d = .65-1.18). Changes in a subgroup of patients with elevated symptom scores at treatment start were compared to a historical control group receiving weekly academic tutoring. Net total score effect sizes lay between d = 0.98 and d = 1.29 for teacher rating (parent rating: d = 0.84 to d = 1.01). Nevertheless, a substantial number of patients remained in the clinical range. Symptom changes during family- and patient-based CBT interventions did not differ from treatments including additional school-based interventions, as was also the case for the comparison of treatments with and without additional pharmacotherapy.

Effectiveness of outpatient cognitive-behavioral therapy for adolescents under routine care conditions on behavioral and emotional problems rated by parents and patients: an observational study.

Few studies have examined the effectiveness of outpatient cognitive-behavioral therapy (CBT) delivered in routine care settings for children and adolescents with mental disorders. This observational study examined changes in behavioral and emotional problems of adolescents with mental disorders during routine outpatient CBT delivered at a university outpatient clinic and compared them with a historical control group of youths who received academic tutoring of comparable length and intensity. Assessments were made at the start and end of treatment (pre- and post-assessment) using parent ratings of the German versions of the Child Behavior Checklist (CBCL) and self-ratings of the Youth Self-Report (YSR) scale. For the main analysis, 677 adolescents aged 11‒21 years had complete data. Changes from pre- to post-assessment showed significant reductions in mental health problems on both parent- and self-ratings. Pre- to post-effect sizes (Cohen's d) were small-to-medium for the total sample (d = 0.23 to d = 0.62) and medium-to-large for those adolescents rated in the clinical range on each (sub)scale at the start of treatment (d = 0.65 to d = 1.48). We obtained medium net effect sizes (d = 0.69) for the CBCL and YSR total scores when patients in the clinical range were compared to historical controls. However, a substantial part of the sample remained in the clinical range at treatment end. The results suggest that CBT is effective for adolescents with mental disorders when administered under routine care conditions but must be interpreted conservatively due to the lack of a direct control condition.

[Identity Diffusion Among Adolescents - Validation of the Inventory of Personality Organization in a Clinical Adolescent Sample (IPO-A)]. / Identitätsdiffusion im Jugendalter ­ Validierung eines Fragebogens zur Erfassung der Persönlichkeitsorganisation (IPO) bei klinisch behandelten Jugendlichen.

Identity Diffusion Among Adolescents - Validation of the Inventory of Personality Organization in a Clinical Adolescent Sample (IPO-A) The main objective of the current study was to analyze the psychometric properties of the German version of the Inventory of Personality Organization for Adolescents (IPO-A). The instrument consisting of 91 items is based on the theoretical structural model by Kernberg and investigates the severity of identity diffusion, reality testing and defense mechanisms in order to determine the level of personality organization. The factor structure, the internal consistency and the convergent validity was measured among 144 inpatients aged between 13 and 18 years drawn from the Child and Adolescent Psychiatry of the University Clinic of Cologne. The investigation revealed a five factor structure: identity diffusion, reality testing, defense mechanisms, aggression and instability of goals. Moreover, testing the psychometric properties of the instrument showed a high internal consistency and meaningful significant correlations with well-validated youth self-report instruments assessing personality pathology and psychopathology. Thus, the results indicate that the IPO-A can be considered to be a reliable instrument that measures personality organization and identity diffusion in adolescents with personality disorders.

[Effectiveness of cognitive-behavioral therapy in children and adolescents with obsessive-compulsive disorders treated in an outpatient clinic]. / Alltagswirksamkeit kognitiver Verhaltenstherapie bei Kindern und Jugendlichen mit Zwangsstörungen in einer Ausbildungsambulanz.

Background: Cognitive-behavioral therapy (CBT) is considered as treatment of first choice for children and adolescents with obsessive-compulsive disorders (OCD). However, its effectiveness has so far mostly been examined in randomized controlled trials with strictly manualized interventions. Only few studies have examined whether the effectiveness of CBT for juvenile OCD generalizes to clinical practice. Method: To test the effectiveness of CBT under routine care conditions, data of n = 53 patients with parent-ratings and n = 53 patients with self-ratings that were treated in a university-based outpatient clinic for child and adolescent psychotherapy was analyzed. Pre-post-mean-comparisons, effect sizes and the clinical significance of changes of the symptoms were examined. Results: OCD and comorbid symptoms were significantly reduced during treatment. Strong effect sizes (Cohen's d) were found for parent rated (d = 0.91) and patient rated (d = 0.88) OCD symptoms. Moderate to strong pre-post-effect sizes were found for the reduction of parent rated (d = 0.55 to d = 0.87) and patient rated (d = 0.46 to d = 0.74) comorbid symptoms. The percentage of children and adolescents who achieved clinically significant improvements and no longer showed dysfunctional OCD symptoms post-treatment was 46.3 % according to the parent-ratings and 59.4 % according to the self-ratings. Concerning comorbid symptoms the same was reached for between 22.5 % and 45.5 % of the patients (parent-ratings) and between 32.0 % and 81.8 % (self-ratings) respectively. Conclusions: Significant reductions in both OCD and comorbid symptoms were demonstrated over the course of cognitive-behavioral therapy of juvenile OCD disorders in a university outpatient clinic for child and adolescent psychotherapy. These results indicate that routine CBT treatment is an effective way to treat juvenile OCD disorders in clinical practice.

Psychometric properties of a German parent rating scale for oppositional defiant and conduct disorder (FBB-SSV) in clinical and community samples.

The Fremdbeurteilungsbogen für Störungen des Sozialverhaltens (FBB-SSV) is a commonly used DSM- and ICD-based rating scale for disruptive behaviour problems in Germany. This study examined the psychometric properties of the FBB-SSV rated by parents in both a clinical sample (N = 596) and a community sample (N = 720) of children aged 4-17 years. Results indicate that the FBB-SSV is internally consistent (α = .69-.90). Principal component analyses produced two-factor structures that are largely consistent with the distinction between oppositional defiant disorder (ODD) and conduct disorder (CD). Diagnostic accuracy was examined using receiver operating characteristic analyses, which showed that the FBB-SSV is excellent at discriminating children with ODD/CD from those in the community sample (AUC = .91). It has satisfactory diagnostic accuracy for detecting ODD/CD in the clinical sample (AUC = .76). Overall, the results show that the FBB-SSV is a reliable and valid instrument. This finding provides further support for the clinical utility of DSM- and ICD-based rating scales.

The effect of cue length and position on noticing and learning of determiner agreement pairings: Evidence from a cue-balanced artificial vocabulary learning task.

The importance of cues in language learning has long been established and it is clear that cues are an essential part of both first language (L1) and second/additional language (L2/A) acquisition. The effects of cue reliability and frequency, along with the competition between cues have been shown to significantly impact learners' pace of acquisition of these language-specific patterns. However, natural languages do not allow for a clear picture of how the forms of cues themselves affect their perception, uptake, and generalizability. In this study, we developed an artificial vocabulary consisting of determiners and nouns. Within these nouns, completely reliable cues were developed and equally distributed as long and short cues over three possible positions: beginning, middle, or end. Through a word-pair learning study, we show that length and position of cues variably affects agreement accuracy, and that noticing of cues during training is less important for known words, and more important for novel ones when deciding on inter-word gender-like agreement.

Effect of on-farm poultry litter composting processes on physicochemical, biological, and toxicological parameters and reduction of antibiotics and antibiotic-resistant Escherichia coli.

Poultry litter is a valuable source of nutrients for crop production, but its use in agriculture can lead to environmental and public health concerns due to the presence of pollutants, antibiotic-resistant bacteria (ARB) and antibiotic-resistant genes (ARGs). We compared the effect of different on-farm poultry litter composting processes on physicochemical, biological, and toxicological parameters, as well as on the occurrence of antibiotics and resistant Escherichia coli. The composting treatments consisted of passively-aerated piles C:N = 19 (PAC19), mechanically-aerated piles C:N = 19 (MAC19), and mechanically-aerated piles C:N = 30 (MAC30). Poultry litter composting led to a significant reduction of antibiotic residues, enteroparasites and antibiotic resistant E. coli. The conditions of the process, such as extra C source and mechanical aeration influence the quality of the final product. MAC19 is a low-cost effective method to reduce the potential risks associated with poultry litter use in agriculture and produce good quality compost.

Predicting outcome of inpatient CBT for adolescents with anxious-depressed school absenteeism.

Predictors of outcome of inpatient treatment based on manualized cognitive-behavioural therapy (CBT) were examined for 147 adolescents with anxious-depressed school absenteeism assessed at discharge and at 2 months after the end of treatment. Outcome measures were regular school attendance and a wide variety of mental health problems rated by adolescents and parents. Socio-demographic data, clinical ratings/diagnosis and adolescent-reported and parent-reported mental health problems were examined as predictors. Regression analyses indicated that none of the variables were able to predict regular school attendance in a clinically relevant way. Adolescent-reported and parent-reported mental health problems at intake predicted these symptoms at both discharge and follow-up (R(2) between 0.31 and 0.61).