Directional Changes Research Articles

Nationwide analysis of Medicare expenditure and utilization of EGFR inhibitors from 2018-2022.

112 Background: EGFR inhibitors are used extensively for treatment of metastatic colorectal cancer ranging from first line drugs in combination with chemotherapy to monotherapy for refractory disease. As we increasingly move towards targeted treatments for cancer, financial implications of these drugs must be taken into consideration. In this study we aim to analyze changes in Medicare spending for Cetuximab and Panitumumab to better understand the financial impact of these therapies. Methods: We obtained data from the publicly available Medicare Part D database from Centers for Medicare and Medicaid Services. Data on total spending, total claims, total beneficiaries, average spending per claim, and average spending per beneficiary was extracted from the database. We adjusted the data for 2018 for 2022 using a standard annual inflation rate. Percentage change was calculated using the adjusted data. Results: For Cetuximab, we saw a sharp increase in total spending by 38.77%, from $4,912,903.87 in 2018 to $6,811,781.05 in 2022. The number of claims rose by 31.96%, while the total number of beneficiaries saw a modest increase of 2.44%. Average spending per claim increased by 16.04%, and average spending per beneficiary grew by 49.44%. Panitumumab showed a similar rise in total spending by 43.23%, from $1,594,347.66 in 2018 to $2,283,142.83 in 2022. Claims increased by 25.42%, and beneficiaries grew by 47.83%. Average spending per claim increased by 25.97%, and average spending per beneficiary saw a substantial rise of 65.75%. Conclusions: Our results indicate a significant increase in the financial burden related to EGFR inhibitors. As we move away from chemotherapy and shift our focus to targeted therapies, it is imperative to explore generic alternatives and direct policy changes to ensure equitable access across various racial and socio-economic groups. These findings highlight the need for further research into healthcare policy reforms to ease the burden on our health system. Drug Year Total Spending ($) Total Claims Total Beneficiaries Avg Spending/Claim ($) Avg Spending/Beneficiary ($) Cetuximab 2018 4,912,903.87 551 123 8,072.80 36,163.51 2022 6,811,781.05 727 126 9,369.71 54,061.75 % Change 0.3877 0.3196 0.0244 0.1604 0.4944 Panitumumab 2018 1,594,347.66 5,955 184 242.72 30,714.91 2022 2,283,142.83 7,470 272 305.81 50,736.51 % Change 0.4323 0.2542 0.4783 0.2597 0.6575

The lean body mass to visceral fat mass ratio is negatively associated with cardiometabolic disorders: a cross-sectional study

The literature has documented conflicting and inconsistent associations between muscle-to-fat ratios and metabolic diseases. Additionally, different adipose tissues can have contrasting effects, with visceral adipose tissue being identified as particularly harmful. This study aimed to explore the relationship between the ratio of the lean mass index (LMI) to the visceral fat mass index (VFMI) and cardiometabolic disorders, including dyslipidemia, hypertension, and diabetes, as previous research on this topic is lacking. This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted in the United States and included 10,867 individuals. Logistic regression was employed to explore the association between LMI/VFMI and cardiometabolic disorders. Generalized additive models were utilized to examine the nonlinear relationships between variables. Data analysis revealed a consistent inverse association between ln(LMI/VFMI) and dyslipidemia, hypertension, and diabetes. Each 2.7-fold increase in LMI/VFMI (one unit of ln[LMI/VFMI]) was associated with lower odds ratios (ORs) for these conditions. In men, the ORs were 0.21 (95% CI 0.17–0.25) for dyslipidemia, 0.37 (95% CI 0.30–0.45) for hypertension, and 0.16 (95% CI 0.10–0.23) for diabetes. Similarly, in women, the ORs were 0.22 (95% CI 0.19–0.26), 0.51 (95% CI 0.42–0.61), and 0.19 (95% CI 0.13–0.27). Quartile analysis showed that participants in the highest quartile (Q4) had significantly lower ORs compared to those in the lowest quartile (Q1). In men, Q4 ORs were 0.18 (95% CI 0.14–0.23) for dyslipidemia, 0.30 (95% CI 0.23–0.39) for hypertension, and 0.11 (95% CI 0.06–0.20) for diabetes. In women, Q4 ORs were 0.12 (95% CI 0.10–0.15), 0.39 (95% CI 0.29–0.52), and 0.12 (95% CI 0.06–0.25), respectively. Dyslipidemia and diabetes demonstrated nonlinear patterns, while a linear association was found for hypertension. Subgroup analyses across various characteristics confirmed these findings with no substantial directional changes. Maintaining an appropriate ratio of LMI to VFMI may be associated with favorable metabolic health.

Narrative review of long-standing groin pain in athletes. Retrospective analysis of over 12 000 patients.

This article critically examines long-standing groin pain (LSGP) in physically active adults related to sports overload by analyzing terminology, pathophysiology, and treatment. This review is based on data from over 10,000 patients managed through a multidisciplinary algorithm. (LSGP) has been variably labeled, using terms that have led to inconsistencies in understanding its origin and management. Terms such as "Pubic Inguinal Pain Syndrome," "Sportsman's Groin," and "Athletic Pubalgia" have been proposed to standardize terminology and unify the classification of (LSGP). Pathophysiologically, (LSGP) is often due to tendinopathies affecting major tendons in the groin region, such as the adductors, iliopsoas, conjoint tendon, and inguinal ligament, often associated with weakness in the posterior wall of the inguinal canal. This condition frequently arises in sports involving abrupt directional changes and high-energy loads in the groin. Tendinopathies progress through reactive, reparative, or degenerative stages of tendinosis. Literature supports a multidisciplinary approach involving surgeons, physiotherapists, sports medicine physicians, and orthopedists for accurate diagnosis and effective treatment. Our algorithm focuses on both anatomical and functional factors in managing (LSGP). Initial conservative therapies aim to support tendon regeneration and load correction, while surgical interventions, such as laparoscopic hernioplasty, are reserved for non-responsive cases. From 2004 to 2024, 12,144 patients completed this protocol, with only 14% requiring surgery. Long-term follow-up demonstrated a low recurrence rate of tendinopathy and an absence of severe complications. Standardizing terminology, understanding pathophysiology, and utilizing a multidisciplinary approach are essential for optimizing the diagnosis and management of sports-related (LSGP).

ATHLETIC RUNNER’S QUALITY OF LIFE WITH GROIN STRAIN- A CROSS-SECTIONAL STUDY

Background: Groin pain is a common and debilitating issue among athletes, particularly those engaged in high-intensity sports involving kicking, sprinting, and rapid directional changes. It accounts for approximately 6% of all athletic injuries, with prevalence increasing to 13% in specific sports like soccer. The condition often leads to impaired mobility, reduced quality of life, and suboptimal athletic performance. Despite its impact, there is limited evidence regarding its prevalence and effects on athletic runners. Objective: To evaluate the prevalence of hip pain and assess the quality of life in athletic runners with groin strain using validated measurement tools. Methods: This cross-sectional study was conducted using non-probability convenience sampling. A total of 150 athletes aged 18-35 years with groin strain were recruited from various sports physiotherapy clinics. Participants were evaluated using the Visual Analog Scale (VAS), the Copenhagen Hip and Groin Outcome Score (HAGOS), and the Lower Extremity Functional Scale (LEFS) to assess hip pain and quality of life. Data were analyzed using SPSS version 24, and correlations were determined with a significance level of p < 0.05. Results: Of the participants, 64.7% were male, and 35.3% were female, with a mean age of 25 ± 4.6 years. The prevalence of hip pain was 88%. Pain intensity levels included no pain (12%), mild pain (38.7%), moderate pain (31.3%), and severe pain (18%). Functional impairment was evident, with 38.1% scoring less than 40 on LEFS. A significant negative correlation (p < 0.05) was observed between hip pain and quality of life, indicating the adverse impact of groin strain on athletic performance. Conclusion: Groin strain significantly impairs quality of life in athletic runners, reducing physical function, general well-being, and athletic performance. Early diagnosis and tailored rehabilitation protocols are essential to mitigate these effects.

Network Clustering for Multi-task Learning

The Multi-Task Learning (MTL) technique has been widely studied by worldwide researchers. The majority of current MTL studies adopt the hard parameter sharing structure, where hard layers tend to learn general representations over all tasks and specific layers are prone to learn specific representations for each task. Since the specific layers directly follow the hard layers, the MTL model needs to estimate this direct change (from general to specific) as well. To alleviate this problem, we introduce the novel cluster layer, which groups tasks into clusters during training procedures. In a cluster layer, the tasks in the same cluster are further required to share the same network. By this way, the cluster layer produces the general presentation for the same cluster, while produces relatively specific presentations for different clusters. The cluster layers are used as transitions between the hard layers and the specific layers. Thus, the MTL model can learn general representations to specific representations gradually. We evaluate our model with MTL document classification, and the results demonstrate the cluster layer is quite efficient in MTL.

Hamstring Strain in Sprinting Athletes: Biomechanics, Risk Factors, and Injury Prevention Strategies

Hamstringrelated injuries, primarily hamstring strain, frequently affect both recreational and professional athletes, especially in sports that involve running, jumping, kicking, and sudden directional changes. This study presents a comprehensive analysis of HSIs, covering anatomical and biomechanical factors, kinematics, diagnostic methods, and strategies for prevention and treatment. Although the exact mechanism of HSIs during sprinting remains uncertain, no specific phase of the running cycle has been identified as presenting the highest risk. Stretch-induced HSIs, often triggered by excessive hip flexion and knee hyperextension, place significant stress on the proximal tendon and musculotendinous junction, particularly affecting the semimembranosus muscle. Risk factors for HSIs are categorized as non-modifiable (age, previous injuries, playing position) and modifiable (muscle weakness, fatigue, imbalances, limited flexibility, and poor neuromuscular control). Physiotherapy approaches that emphasize eccentric strength trainingprogressing through flexibility, stabilization, and specific strength phasesreduce injury rates, especially when integrated with concentric training in sprinting related sports

Youth participatory action research (YPAR) to promote educational equity

The article uses theory and qualitative evidence to show how youth participatory action research (YPAR) can advance educational equity. YPAR engages young people and adult allies in research and action on issues in their schools and communities. Interviews with over two dozen YPAR researchers—students and partner teachers—elaborate the mechanisms through which school-based YPAR can affect equity, including through direct changes to policy and practice as a result of YPAR actions, a school culture that values student experiences, transformative teacher-student relationships, and improved individual outcomes for participants. To help theorize a theory of change, we draw on Doreen Massey’s space theory to explain how YPAR done in schools can transform culture, relationships, practice, and policy. Further, we suggest how YPAR can be infused in schools.

V4O7 microcubes as an alternative to peroxidase/TMB for colorimetric detection of H2O2: Development of glucose sensing method.

The study focuses on the synthesis of V4O7 microcubes for the non-enzymatic colorimetric determination of H2O2.Vanadium oxide nanostructures are known for their redox activity and layered structures, making V4O7 a valuable material for sensing applications. The characterization of the prepared sample was done using XPS, XRD, Raman spectroscopy, and SEM techniques. The V4O7 microcube showed a rapid response to H2O2 through direct color change without the need for peroxidase enzymes or TMB. Upon exposure to H2O2, the mixed valence V4O7 oxidized to produce V2O5, enabling sensitive detection of H2O2. The V4O7 sensing system exhibited a wide linear response range from 0.025 to 300µM with a low detection limit of 7.6nM for H2O2 detection. When combined with glucose oxidase, the system could detect glucose levels as low as 18nM within a linear range of 0.05µM to 300µM. The proposed sensor demonstrated high selectivity and robust potential for sensing H2O2 in biological samples. The system offers advantages such as fast response, simple operation, naked-eye observation, and cost-effectiveness. The novel sensing system holds promise for visual detection in H2O2 diagnostic clinics, highlighting its potential for practical applications in healthcare settings.

A Symmetrical Leech-Inspired Soft Crawling Robot Based on Gesture Control.

This paper presents a novel soft crawling robot controlled by gesture recognition, aimed at enhancing the operability and adaptability of soft robots through natural human-computer interactions. The Leap Motion sensor is employed to capture hand gesture data, and Unreal Engine is used for gesture recognition. Using the UE4Duino, gesture semantics are transmitted to an Arduino control system, enabling direct control over the robot's movements. For accurate and real-time gesture recognition, we propose a threshold-based method for static gestures and a backpropagation (BP) neural network model for dynamic gestures. In terms of design, the robot utilizes cost-effective thermoplastic polyurethane (TPU) film as the primary pneumatic actuator material. Through a positive and negative pressure switching circuit, the robot's actuators achieve controllable extension and contraction, allowing for basic movements such as linear motion and directional changes. Experimental results demonstrate that the robot can successfully perform diverse motions under gesture control, highlighting the potential of gesture-based interaction in soft robotics.

Bicycle-inspired simple balance control method for quadruped robots in high-speed running.

This paper explores the applicability of bicycle-inspired balance control in a quadruped robot model. Bicycles maintain stability and change direction by intuitively steering the handle, which induces yaw motion in the body frame and generates an inertial effect to support balance. Inspired by this balancing strategy, we implemented a similar mechanism in a quadruped robot model, introducing a yaw trunk joint analogous to a bicycle's steering handle. Simulation results demonstrate that the proposed model achieves stable high-speed locomotion with robustness against external disturbances and maneuverability that allows directional changes with only slight speed reduction. These findings suggest that utilizing centrifugal force plays a critical role in agile locomotion, aligning with the movement strategies of cursorial animals. This study underscores the potential of bicycle balance control as an effective and straightforward control approach for enhancing the agility and stability of quadruped robots as well as potentially offering insights into animal motor control mechanisms for agile locomotion.

The potential of interleaved TMS-fMRI for linking stimulation-induced changes in task-related activity with behavioral modulations.

The simultaneous combination of TMS with fMRI has emerged as a promising means to investigate the direct interaction between stimulation-induced changes at the behavioral and neural activity level. This enables the investigation of whole brain neurobehavioral interactions underlying cognitive disruption or facilitation. Yet to date, the literature on interleaved TMS-fMRI in cognitive neuroscience is sparse and neuromodulatory patterns of different TMS protocols are still poorly understood. Here, we synthesize interleaved TMS-fMRI studies on the relationship between direct stimulation-induced changes on task related neural activity and behavior. The following main findings are discussed. First, approximately half of the studies report a relationship between neural activity and behavioral changes as a marker for network excitation or inhibition. Secondly, task difficulty and stimulation timing are crucial factors that impact the interaction between neural activity changes and behavior. Third, stimulation-induced changes in remote, connected areas seem to be stronger associated with facilitation effects at the behavioral level. A better understanding of the relationship between stimulation-induced changes at the neural and behavioral level will increase the current understanding of the neuromodulatory potential of TMS at different levels and may help to develop more efficient stimulation protocols for basic and applied research.

Rapid riparian vegetation development and channel stabilization linked to glacier retreat within a large transboundary watershed

AbstractRiver floodplains are dynamic mosaics of aquatic and riparian habitats maintained by flow regimes and sediment processes, but these floodplains may be rapidly shifting with climate change. Specifically, previous work has highlighted that glacier retreat can be associated with river channel and floodplain change. Within a large and glacially influenced watershed, the Taku Watershed of northwestern British Columbia and southeastern Alaska, we used remote sensing and Geographic Information System (GIS) to quantify four decades of annual floodplain habitat composition and river channel patterns in 16 subwatersheds that naturally varied in their glacier coverage and other landscape (e.g., floodplain elevation, slope) and climate variables (e.g., temperature, precipitation). We discovered rapid development of floodplain vegetation and increased habitat stability in subwatersheds with higher glacial coverage, and a lack of directional change in other subwatersheds. Floodplain vegetation coverage almost doubled over 38 years in subwatersheds with the highest glacier coverage. Focal analyses revealed that river channel structure also shifted in glacierized subwatersheds, with decreases in habitat turnover rate, water occupancy and some evidence for decreasing levels of channel braiding. A large landslide (1.5 km runout, 130 ha) during the study period caused a local disturbance to one of the floodplains, but with little immediate broader impacts at the scale of the entire floodplain. Collectively, climate change and associated glacier retreat are leading to the rapid transformation of floodplain ecosystems, with major implications for the habitat of important species such as migratory salmon.

The Directional Changes in the Webtoon <Lookism> by Time Period

The Directional Changes in the Webtoon <Lookism> by Time Period

Assessing the Compensating and Equivalent Variations of Human Welfare Impact Resulting From Fuel Subsidy Removal in Southwest, Nigeria

The study assessed the compensating and equivalent variations in human welfare resulting from the removal of fuel subsidies in southwest Nigeria. The analysis reveals significant welfare implications, with indirect effects having a greater impact on household welfare than direct price changes. Policymakers must carefully examine both direct and indirect impacts to develop effective mitigation strategies to cushion the effects of fuel subsidy removal.

CHARACTERISTICS OF RELATIONSHIPS BETWEEN BIOCHEMICAL INDICATORS OF CORD BLOOD OF NEWBORNS FROM MOTHERS IN THE RISK GROUP FOR THE DEVELOPMENT OF HEMOLYTIC DISEASE OF NEWBORNS

A hemolytic disease of the newborn may occur when the mother and fetus are incompatible according to the AB0 system or the Rh factor. Hemolytic disease is primarily observed in instances where the mother has blood group 0(I) according to the AB0 system, and in the fetus or newborn, according to the degree and frequency of inheritance, it is A(II), B(III). It is the most prevalent manifestation of the newborn nosology, with the initial stage being growth itself, and the level of total bilirubin (its indirect fraction). It is probable that other clinical and biochemical indicators undergo direct metabolic changes in response not only to the state of progressive hyperbilirubinemia, but also as an adaptive mechanism even in the absence of hemolytic disease in children of this group. The aim of the study. To conduct an analysis of the relationships between the biochemical indicators of umbilical cord blood from mothers with 0(I) blood group and with a negative Rh(D) factor, regardless of the blood group, without signs of hemolytic disease (HDN). Research materials and methods. This work involved the analysis of 30 umbilical cord blood samples, as well as the determination of the infant group (according to the AB0 system) and rhesus blood affiliation. The objective was to assess the main biochemical indicators of the newborn's functional state. The analysis included total and direct bilirubin, total protein, albumin, the calculation of the albumin-globulin coefficient, glucose, urea, creatinine, and the activity of a group of enzymes (ALT, AST, γ-GT, AF, total LDH (LDHtotal)). The statistical calculation of the obtained results was carried out using the Pearson correlation test (rxy). Group comparisons were carried out using the Wilcoxon-Mann-Whitney-Test (for the coincidence of the Rhesus characteristics of maternal and cord blood) and the The Kruskal–Wallis test for comparing the average values ​​of three or more samples (for the coincidence of maternal and cord blood groups when inheriting this characteristic). The ratio of groups and rhesus was evaluated according to Fisher's comparative test (F-distribution). Research results and their discussion. In the correlation analysis of the obtained data, a positive correlation was noted according to the Pearson test between the level of albumin and total protein (rxy=0.867, p=0.000). In the format of nitrogenous exchange, probable changes are also observed between the concentration of urea and total protein (p=0.023), between urea and albumin (p=0.033), and between creatinine and urea (p=0.025). Our studies show positive correlations between the activity of AF and AST (rхy=0.914, р=0.000), between LDHtotal and AST (rхy=0.637, р=0.000), as well as between LDHtotal and AF (rхy=0.517, p=0.004). All these indicators are important for a comprehensive assessment of biochemical homeostasis. It was found that the inheritance from mother to child of the rhesus and group traits also affects the value of ALT, AST, creatinine. Concusions. The analysis of umbilical cord blood indicators in a small group of samples (30) indicates probable changes and correlational relationships between them. To enhance the reliability and significance of the data, we intend to expand the number of samples under study. This will enable us to either substantiate or invalidate the current findings and, in due course, establish reference values for the Bukovyna region.

IOF-Tracker: A Two-Stage Multiple Targets Tracking Method Using Spatial-Temporal Fusion Algorithm

Multi-object tracking aims to track multiple objects across consecutive frames in a video, assigning a unique classifier to each object. However, issues such as occlusions, directional changes, or shape alterations can cause appearance variations, leading to detection and matching problems that in turn result in frequent ID switches. To solve these issues, this paper proposes a two-stage multi-object tracking framework based on a spatial and temporal fusion algorithm. First, the video frames are processed by a detector to identify objects and form rectangular detection areas. Meanwhile, an estimator predicts the target rectangular areas in the next frame. Then, we extract the optical flow of the target pixels within the detection and prediction areas, and then a temporal information model is established by calculating the average of the target pixels’ optical flow. Afterward, we present a spatial information model using the R-IoU (Reverse of Intersection over Union) between the detection and prediction areas. This spatial and temporal information is combined with weighted matrix fusion, which achieves the feature matching and association task. Finally, we implement a two-stage association multi-object tracking model using the mentioned fusion algorithm. Experiments on the MOTChallenge dataset using the official detector show that our two-stage multi-object tracking method based on the spatial and temporal fusion algorithm is robust in handling occlusions and ID switch issues. As of the submission of this paper, the proposed method has achieved the top ranking in the MOT17 benchmark when evaluated with the official detector.

Evolution of sexual size dimorphism in tetrapods is driven by varying patterns of sex-specific selection on size.

Sexual size dimorphism (SSD) is highly prevalent in nature. Several hypotheses aim to explain its evolution including sexual selection, differential equilibrium and ecological niche divergence. Disentangling the causal mechanism behind the evolution of SSD is challenging, as selection arising from multiple pressures on fitness may act simultaneously to generate observed patterns. Here, we use phylogenetic comparative methods to study the evolution of SSD across tetrapods globally. We estimate directional changes in body size evolution, and compare the number, phylogenetic position and magnitude of size changes between sexes. We find evidence that directional changes in size associated with SSD are typically more common in males-even in lineages where females are larger. However, underlying mechanisms differ among lineages-whereas SSD in amphibians becomes more male-biased with greater increases in male size and mammalian SSD becomes more female-biased with greater decreases in male size. Thus, differing mechanisms of directional body size evolution across sexes are essential to explain observed SSD patterns.

Late Holocene cooling drove drastic decreases in cladoceran diversity in a subarctic lake

Subarctic lakes are sentinels of climate change, showing responses in their physical, chemical, and biological properties. However, climate-induced changes in invertebrate diversity and their underlying mechanisms are not fully understood. We explored the relationship between past climate change and taxonomic composition of subfossil cladocerans in a subarctic lake during the last ca. 5700 years. The Cladocera community shifted from specialist to generalist species at ca. 3500 cal years BP, corresponding to the long-term cooling period between the Holocene Thermal Maximum and the Late Holocene. Taxonomic diversity declined driven by the collapse of the keystone herbivorous Daphnia longispina group, pelagic and littoral predators, and phytophilous benthic species, therefore resulting in a simplification of the food web and a reduction of trophic levels. Furthermore, the shift in cladoceran composition was associated with the decline of aquatic primary producers and the development of birch forest, suggesting a potential causal link between dissolved organic carbon dynamics and cladoceran community composition. This study provides empirical evidence of the response of cladocerans to climatic fluctuations and their underlying mechanisms through catchment-mediated processes and direct temperature-induced changes.

Frequency and intensity of change of directions in German Bundesliga soccer

ABSTRACT The aim of this study was to investigate the change of direction (COD) frequencies and intensities of high-performance soccer players of the German Bundesliga independent of tactical and match context. COD data were collected from 18 German Bundesliga soccer teams (season 2016–2017; 308 fixtures) by an optical tracking system (OTS) (TRACAB). CODs were tracked using a modified algorithm and were sub-categorized by entry velocity (<3.0 m⋅s−1, 3.0–5.5 m⋅s−1, 5.5–7.0 m⋅s−1 and >7.0 m⋅s−1) and COD angle (20–59°, 60–119° and 120–180°). COD metric frequencies were compared between playing positions (goalkeepers, centre backs, full-backs, central midfielders, wide midfielders, and strikers). In general, regardless of entry velocity or COD angle, central midfielders consistently executed the highest number of COD actions during matches compared to the other playing positions. About ≈ 55% and ≈ 38% of CODs were <3.0 m⋅s−1 and <5.5 m⋅s−1, whereas ≈ 7% were >5.5 m⋅s−1. The distribution of COD angle types was ≈ 5% for 20–59°, ≈25% 60–119° and ≈ 70% for 120–180° COD angles. Our data provide insights into the COD demands of high-performance soccer in the German Bundesliga in terms of entry velocity and COD angles and their combination based on a large dataset of OTS data, which provides insights to facilitate the development of physical conditioning strategies, position-specific external load management, and multidirectional speed training with adequate test battery selection and return-to-play protocols for soccer players.

Identifying predictors of long-term treatment outcomes using narratives from written exposure therapy and cognitive processing therapy for PTSD.

Cognitive processing therapy (CPT), a 12-session, gold-standard treatment for posttraumatic stress disorder (PTSD), and written exposure therapy (WET), a brief, five-session treatment, have similar treatment efficacy. The aim of the present study was to identify predictors of long-term treatment outcomes of WET and CPT using clients' written narratives. Narratives from both treatments were coded with the Change and Growth Experiences Scale coding system to identify predictors of long-term PTSD symptom outcomes. Participants were 113 adults with PTSD randomly assigned to receive WET (n = 60) or CPT (n = 53). In WET, higher average levels of accommodated (balanced, healthy) beliefs predicted lower PTSD symptoms at the 60-week endpoint, as well as a decrease in symptoms over the follow-up symptom slope. In CPT, higher average negative emotions and positive view of self predicted better 60-week PTSD symptom outcomes, as did lower hopelessness, which also predicted a decrease in PTSD symptoms over the follow-up period. Even without direct cognitive change techniques, adaptive processing of traumatic experiences occurred in WET and predicted PTSD long-term symptom improvement. Both emotional engagement and cognitive change might help to sustain treatment gains in CPT. (PsycInfo Database Record (c) 2024 APA, all rights reserved).