Positive Effect Research Articles

Thermal Dehydrogenation Impact on Positive Bias Stability of Amorphous InSnZnO Thin-Film Transistors.

Recently, the growing demand for amorphous oxide semiconductor thin-film transistors (AOS TFTs) with high mobility and good stability to implement ultrahigh-resolution displays has made tracking the role of hydrogen in oxide semiconductor films increasingly important. Hydrogen is an essential element that contributes significantly to the field effect mobility and bias stability characteristics of AOS TFTs. However, because hydrogen is the lightest atom and has high reactivity to metal and oxide materials, elucidating its impact on AOS thin films has been challenging. Therefore, in this study, we propose controlling the hydrogen quantities in amorphous InSnZnO (a-ITZO) thin films through thermal dehydrogenation to precisely reveal the hydrogen influences on the electrical characteristics of a-ITZO TFTs. The as-deposited device containing 15.69 × 1015 atoms/cm2 of hydrogen exhibited a relatively low saturation mobility of 18.1 cm2/V·s and poor positive bias stress stability. However, depending on the extent of thermal dehydrogenation, not only did the hydrogen quantity and interface defect density (DIT) decrease but also the conductivity and surface energy increased due to the rise in oxygen vacancies and hydroxyl groups in a-ITZO thin films. As a result, the a-ITZO TFT with a hydrogen amount of 4.828 × 1015 atoms/cm2 showed that the saturation mobility improved up to 36.8 cm2/V·s, and positive bias stress stability was remarkably enhanced. Hence, we report the ability to manage the hydrogen quantity with thermal dehydrogenation and demonstrate that high-performance a-ITZO TFTs can be realized when an appropriate hydrogen concentration is achieved.

Global application of a regional frequency analysis to extreme sea levels

Abstract. Coastal regions face increasing threats from rising sea levels and extreme weather events, highlighting the urgent need for accurate assessments of coastal flood risk. This study presents a novel approach to estimating global extreme sea level (ESL) exceedance probabilities using a regional frequency analysis (RFA) approach. The research combines observed and modelled hindcast data to produce a high-resolution (∼1 km) dataset of ESL exceedance probabilities, including wave setup, along the entire global coastline (excluding Antarctica). The methodology presented in this paper is an extension of the regional framework of Sweet et al. (2022), with innovations introduced to incorporate wave setup and apply the method globally. Water level records from tide gauges and a global reanalysis of tide and surge levels are integrated with a global ocean wave reanalysis. Subsequently, these data are regionalised, normalised, and aggregated and then fit with a generalised Pareto distribution. The regional distributions are downscaled to the local scale using the tidal range at every location along the global coastline obtained from a global tide model. The results show 8 cm of positive bias at the 1-in-10-year return level when compared to individual tide gauges. The RFA approach offers several advantages over traditional methods, particularly in regions with limited observational data. It overcomes the challenge of short and incomplete observational records by substituting long historical records with a collection of shorter but spatially distributed records. These spatially distributed data not only retain the volume of information but also address the issue of sparse tide gauge coverage in less populated areas and developing nations. The RFA process is illustrated using Cyclone Yasi (2011) as a case study, demonstrating how the approach can improve the characterisation of ESLs in regions prone to tropical cyclone activity. In conclusion, this study provides a valuable resource for quantifying the global coastal flood risk, offering an innovative global methodology that can contribute to preparing for – and mitigating against – coastal flooding.

THz generation by AlGaAs/GaAs heterostructured p-i-n diode

The generation of terahertz radiation by heterostructure p-i-n AlxGa1−xAs/GaAs diodes excited by femtosecond optical pulses was studied experimentally and using the Monte Carlo method. It is shown that when the reverse bias varies, the terahertz generation mechanism changes. With a positive bias on the p-i-n diode, the THz generation mechanism is due to the reflection of the photoexcited electrons from the interface. With a large internal electric field, THz generation in the p-i-n diode occurs due to the acceleration of electrons at the ballistic stage of their movement in the electric field to velocities significantly exceeding the steady state velocity (“velocity overshoot”). The subsequent sharp decrease in velocity of electrons is associated with their inter-valley transitions from the Γ-valley to the L-valley of the conduction band. At electric fields less than 22 kV/cm, the effect of electric field screening by photoexcited carriers has a significant impact on the formation of photocurrent and, accordingly, on the THz generation mechanism. As the reverse bias decreases, this effect leads to a shift in the maximum of the THz pulse toward shorter times and it begins to dominate at electric fields less than 10 kV/cm.

How to Support People with Hearing Impairment beyond Hearing aid Provision - A Systematic Review on Self-Management Interventions

People with hearing handicap have to use a whole range of strategies to cope with everyday challenges - they have to self-manage their hearing impairment. While the support of self-management is well established in foreign language audiological rehabilitation programs, there are no recommendations in Germany yet. Therefore, the aim of this systematic review is first to give an overview of existing self-management interventions for people with hearing handicap and then to suggest possible applications in the German care system. A systematic literature search was conducted on PubMed. The articles dealt with self-management interventions for people with hearing impairment. This eligibility criterion was applied to titles, abstracts, and full texts. If eligible, information on the publication, intervention, and evaluation were extracted and qualitatively summarized. The methodological quality of studies was investigated using the NIH assessment tool for interventional studies. 23 papers could be included and show a high heterogeneity regarding methodological quality, applied intervention, and design of evaluation. The interventions pursuing various goals include a wide range of content (e. g., communication improvement or psychosocial aspects) and have been implemented on a group-based, individual-based, or self-administered level. Despite a few studies that failed to demonstrate intervention effects, most evaluations found positive ef-fects of the intervention on hearing impairment, psychological well-being, and communication. The included studies present a high heterogeneity with regard to methodological quality, the intervention conducted, and the evaluation design. Therefore, a summary of the findings was only possible in a qualitative manner. Possibilities of adapting existing intervention programs as well as chances and limits of an implementation in the German health care system are to be discussed in the following. Overall, interventions including self-management support seem to be a profitable complement to sole technical device supply and should be further fostered in German-speaking countries as well.

Validation of cool-season snowfall forecasts at a high-elevation site in Utah’s Little Cottonwood Canyon

Abstract Producing a quantitative snowfall forecast (QSF) typically requires a model quantitative precipitation forecast (QPF) and snow-to-liquid ratio (SLR) estimate. QPF and SLR can vary significantly in space and time over complex terrain, necessitating fine-scale or point-specific forecasts of each component. Little Cottonwood Canyon (LCC) in Utah’s Wasatch Range frequently experiences high-impact winter storms and avalanche closures that result in substantial transportation and economic disruptions, making it an excellent testbed for evaluating snowfall forecasts. In this study, we validate QPFs, SLR forecasts, and QSFs produced by or derived from the Global Forecast System (GFS) and High-Resolution Rapid Refresh (HRRR) using liquid precipitation equivalent (LPE) and snowfall observations collected during the 2019/20 – 2022/23 cool seasons at the Alta–Collins snow-study site (2945 m MSL) in upper LCC. The 12-h QPFs produced by the GFS and HRRR underpredict the total LPE during the four cool seasons by 33% and 29%, respectively, and underpredict 50th, 75th, and 90th percentile event frequencies. Current operational SLR methods exhibit mean absolute errors of 4.5 – 7.7. In contrast, a locally trained random forest algorithm reduces SLR mean absolute errors to 3.7. Despite the random forest producing more accurate SLR forecasts, QSFs derived from operational SLR methods produce higher critical success indices since they exhibit positive SLR biases that offset negative QPF biases. These results indicate an overall underprediction of LPE by operational models in upper LCC and illustrate the need to identify sources of QSF bias to enhance QSF performance.

Validation of cool-season snowfall forecasts at a high-elevation site in Utah’s Little Cottonwood Canyon

Abstract Producing a quantitative snowfall forecast (QSF) typically requires a model quantitative precipitation forecast (QPF) and snow-to-liquid ratio (SLR) estimate. QPF and SLR can vary significantly in space and time over complex terrain, necessitating fine-scale or point-specific forecasts of each component. Little Cottonwood Canyon (LCC) in Utah’s Wasatch Range frequently experiences high-impact winter storms and avalanche closures that result in substantial transportation and economic disruptions, making it an excellent testbed for evaluating snowfall forecasts. In this study, we validate QPFs, SLR forecasts, and QSFs produced by or derived from the Global Forecast System (GFS) and High-Resolution Rapid Refresh (HRRR) using liquid precipitation equivalent (LPE) and snowfall observations collected during the 2019/20 – 2022/23 cool seasons at the Alta–Collins snow-study site (2945 m MSL) in upper LCC. The 12-h QPFs produced by the GFS and HRRR underpredict the total LPE during the four cool seasons by 33% and 29%, respectively, and underpredict 50th, 75th, and 90th percentile event frequencies. Current operational SLR methods exhibit mean absolute errors of 4.5 – 7.7. In contrast, a locally trained random forest algorithm reduces SLR mean absolute errors to 3.7. Despite the random forest producing more accurate SLR forecasts, QSFs derived from operational SLR methods produce higher critical success indices since they exhibit positive SLR biases that offset negative QPF biases. These results indicate an overall underprediction of LPE by operational models in upper LCC and illustrate the need to identify sources of QSF bias to enhance QSF performance.

High-Performance Tin Oxide Thin-Film Transistors Realized by Codoping and Their Application in Logic Circuits.

Tin oxide is a promising channel material, offering the advantages of being low-cost and environmentally friendly and having a wide band gap. However, despite the high electron mobility of SnO2 in bulk, the corresponding thin-film transistors (TFTs) generally exhibit moderate performance, hindering their widespread application. Herein, we proposed a codoping strategy to improve both the electrical property and the stability of SnO2 TFTs. A comparative analysis between doped and undoped SnO2 was conducted. It is observed that taking advantage of the difference in ionic radii between two dopants (indium and gallium) and the tin ions in the host lattice can effectively reduce impurity-induced strain. Additionally, we investigated the effect of codoping content on SnO2 TFTs. The optimal codoped SnO2 (TIGO) TFTs demonstrate high performance, featuring a field-effect mobility of 15.9 cm2/V·s, a threshold voltage of 0.2 V, a subthreshold swing of 0.5 V/decade, and an on-to-off current ratio of 2.2 × 107. Furthermore, the devices show high stability under both positive and negative bias stress conditions with a small threshold voltage shift of 1.8 and -1.2 V, respectively. Utilizing the TIGO TFTs, we successfully constructed a resistor-loaded unipolar inverter with a high gain of 10.76. This study highlights the potential of codoped SnO2 TFTs for advanced applications in electronic devices.

Improved oxidation resistance of AIP NiCrAlYSi coatings by applying positive bias

The NiCrAlYSi coatings with a bias voltage of −30 V (N-coating) and + 5 V (P-coating) applied on the DD6 superalloy substrate were prepared by arc ion plating (AIP). The microstructure evolution and the oxidation resistance at 1100 °C of the two coatings were investigated. The results show that the positive bias could maintain the Al content from the target material through to the coating by enhancing droplet deposition proportion and resulting in better oxidation resistance. The as-deposited P-coating consists of γ-Ni, γ’-Ni3Al and α-Cr phases with significantly lower pores and ~ 1.1 wt% higher Al content than N-coating. The larger size (1.5 to 3.5 μm) block β-NiAl grains formed within P-coating after annealing at 1050 °C for 2 h, while it was not found in the N-coating. The oxidation parabolic rate constant at 1100 °C of annealed P-coating was confirmed as 3.54 × 10−3 mg2/(cm4·h), ~ 27.6 % lower than N-coating.

How Do They See Themselves? The Self-Concept of Students with Intellectual or Behavioural Disabilities in Special Education

ABSTRACT Research into the self-concept of students with an intellectual disability (ID) or social, emotional and behavioural difficulties (SEBD) educated in special education is relatively scarce. This, whilst many students with ID or students with SEBD still reside in special rather than inclusive school settings. This study aimed to gain insight into the self-concept of students with either ID or SEBD in special education and examined variables that might relate to the self-concept of these students. A total of 171 students educated in special schools filled out the Self-Perception Profile for Children (SPPC). T-tests utilising bootstrapping and variance analyses were used to analyse the data. The results indicate that girls with ID and boys with SEBD assess their self-concept more negatively than typically developing students. Gender, age and formally assessed classifications of ASD or ADHD yielded different self-concept scores in both groups of students on different dimensions of self-concept. The expected positive illusory bias was not found in this study. The results of the study are discussed in light of the educational setting of the students with ID or students with SEBD. This study demonstrates that interventions are needed to improve the self-concept of students with ID or students with SEBD in special education.

Method comparison between hematopoietic progenitor cell and CD34+ cell counts in hematopoietic stem cell collection.

The reference method for hematopoietic stem cell enumeration is flow cytometric CD34+ cell analysis. We evaluated using the hematopoietic progenitor cell (HPC) count on the Sysmex hematology analyzer to safely replace some flow cytometric measurements performed in peripheral blood samples to guide apheresis timing. We compared HPC and CD34+ cell counts in 133 preharvest peripheral blood samples and 124 apheresis products. Pre-apheresis HPC counts ≥24 × 106/L in healthy donors and ≥36 × 106/L in lymphoma patients predicted adequate mobilization with 100% specificity and positive predictive value, saving 79% and 63% of flow cytometry analyses, respectively. Due to a positive bias (mean bias 50.26; 95% CI 36.24-64.29), a higher threshold was needed in multiple myeloma patients (HPC 132 × 106/L), saving only 24% of flow cytometry analyses. When the HPC count is above the corresponding threshold, apheresis could be safely initiated without waiting for the flow cytometry result, thereby reducing time-to-decision. Lower HPC values, however, require confirmation by flow cytometry.

Effect of interface defects on electrical characteristics of a-ITGZO TFTs under bottom, top, and dual gatings

Here, we investigate the effects of interface defects on the electrical characteristics of amorphous indium-tin-gallium-zinc oxide (a-ITGZO) thin-film transistors (TFTs) utilizing bottom, top, and dual gatings. The field-effect mobility (27.3 cm2/V∙s) and subthreshold swing (222 mV/decade) under a dual gating is substantially better than those under top (12.6 cm2/V∙s, 301 mV/decade) and bottom (11.1 cm2/V∙s, 487 mV/decade) gatings. For an a-ITGZO TFT, oxygen deficiencies are more prevalent in the bottom-gate dielectric interface than in the top-gate dielectric interface, and they are less prevalent inside the channel layer than at the interfaces, indicating that the presence of oxygen deficiencies significantly affects the field-effect mobility and subthreshold swing. Moreover, the variation in the electrical characteristics due to the positive bias stress is discussed here.

High-mobility and high-reliability Zn-incorporated amorphous In2O3-based thin-film transistors

Abstract Polycrystalline indium oxide-based thin film transistors (In2O3 TFTs) have attracted considerable attention because of high field effect mobility (μFE ~100 cm2 V−1 s−1). However, In2O3 TFTs exhibit poor reliability owing to the adsorption and/or desorption of gas molecules at the grain boundaries. The incorporation of Zn suppresses the crystallization of In2O3. Herein, we systematically studied the effect of Zn incorporation into In2O3 TFTs. The crystallization of In2O3 was suppressed when the Zn concentration ranging from 25% to 68%. Amorphous IZO TFTs with 25% Zn exhibited the highest μFE of 41 cm2 V−1 s−1 and excellent reliability. In contrast, polycrystalline IZO TFTs showed a low μFE <12 cm2 V−1 s−1 due to the formation of grain boundaries, and poor reliability after positive gate bias, mostly due to electron trapping at the polycrystalline/insulator interface. These results render an approach to realize In2O3 TFTs that show reasonably high μFE and excellent reliability.

Suitability of the CICE sea ice model for seasonal prediction and positive impact of CryoSat-2 ice thickness initialization

Abstract. The Los Alamos Community Ice CodE (CICE) sea ice model is being tested in standalone mode to identify biases that limit its suitability for seasonal prediction, where it is driven by atmospheric forcings from the NCEP Climate Forecast System Reanalysis (CFSR) and a built-in mixed-layer ocean model in CICE. The initial conditions for the sea ice and mixed-layer ocean are also from CFSR in the control experiments. The simulated sea ice extent agrees well with observations during the warm season at all lead times up to 12 months, in both the Arctic and the Antarctic. This suggests that CICE is able to provide useful sea ice edge information for seasonal prediction. However, the model's initial conditions have ice that is too thick in the Beaufort Sea, resulting in excessive ice extent in the Arctic at 6-month lead forecasts and errors in ice volume at all lead times when compared to available observations. To address this limitation, additional CS2_IC experiments were conducted, where the Arctic ice thickness was initialized using CryoSat-2 satellite observations while keeping all other initial fields the same as in the control experiments. This reduced the positive bias in the ice thickness in the initial conditions, leading to improvements in both the simulated ice edge and the ice thickness at the seasonal timescale. This indicates that CICE has the potential to improve its seasonal forecast skill and provide more accurate predictions of sea ice extent and thickness when initialized with a more realistic sea ice thickness. This study highlights that the suitability of CICE for seasonal prediction depends on various factors, including initial conditions such as sea ice thickness, in addition to sea ice coverage, as well as oceanic and atmospheric conditions.

Particle composition-specific approach to estimate the particulate organic carbon concentration off the coastal areas of Guangdong and eastern Hainan Island

High optical complexity caused by the variability of marine particles poses a major challenge to the development of bio-optical algorithms for particulate organic carbon (POC) concentration retrievals from optical measurements in coastal waters. Here, we developed a particle composition-specific approach to estimate POC off the coastal areas of Guangdong and eastern Hainan Island, China. The ratio of phytoplankton absorption to detritus absorption coefficient aph(443)/ad(443) was used to optically discriminate water types. The samples with aph(443)/ad(443) ≤ 4.9 showed a significant correlation between POC and absorption line height at 676 nm aLH(676) (R2 = 0.75, n = 70, p < 0.01). In contrast, aph-dominant samples with aph(443)/ad(443) > 4.9 had a high covariance between POC and particle scattering coefficient at 675 nm bp(675) (R2 = 0.85, n = 37, p < 0.01). Validation with an independent dataset yielded a small positive bias (R2 = 0.81, APD = 23.10%, RMSE = 29.01 mg m–3, RPD = 16.31%). The approach provided a better estimation of POC concentration in coastal waters compared with univariate algorithms. A depth-resolved index aLH(676)/bbp(442) was defined as the ratio of absorption line height to particle backscattering coefficient. Using the depth-resolved index instead of aph(443)/ad(443) for optical water type classification can be utilized to represent the vertical variations of POC in 1 m bins, and can complement remote sensing observations to accurately characterize the three-dimensional structure of POC distribution in the oceans.

Efficacy of Homoeopathy In PCOS- A Review

Introduction: To evaluate the usefulness of homeopathy for the treatment of PCOS through a literature review and to develop a strategy for future research. Method: A comprehensive search was done in electronic databases, including general medical databases MEDLINE, CENTRAL, Science Direct, specialised database for homeopathy CORE-Hom, CAM databases LILACS Chiro ACCESS, AYUSH Research Portal, Google Scholar, Research gate net, clinical trial registry, aimed to target the available literature of observational studies, randomized trials, controlled trials, case reports on PCOS in homeopathy and limited to the English language. The inclusion criteria are the studies with a full-text present in mentioned databases, studies with experimental or quasi-experimental designs published in peer-reviewed or partial peer-reviewed journals and studies with humans as their samples. Result: A literary search through databases helped to identify a few significant studies, such as one placebo-controlled trial, one comparative clinical study, one retrospective study, three clinical studies, and nine case reports. A retrospective study showed positive results for the role of homeopathic medicines in PCOS. The placebo-controlled trial showed a difference in outcome between the two groups. The verum group showed a positive effect in the regularization of menses. The comparative clinical study showed that both homeopathic medicines (Cal. carb, Lycopodium) appeared to be effective. Three clinical studies showed the effectiveness of homeopathic medicines in improving and curing PCOS. Nine case reports showed a positive effect of homeopathy in improving PCOS, out of which three cases showed positive outcomes also in infertility with PCOS. Conclusion: The results showed that Homoeopathy has positive effects on the management of PCOS in women. In the future, high-quality randomized controlled trials (RCT), comparative studies of homeopathy with conventional therapy, and in-vitro and animal model studies will be required to support the effectiveness of homeopathic therapeutics in PCOS.

On Bootstrap Algorithms in Survey Sampling

Objective: The aim of this paper is to present bootstrap algorithms for measuring the accuracy of estimation and prediction in design-based and model-based approaches in survey sampling and small area estimation. Three proposals of prediction-mean squared error estimators are also examined. Research Design & Methods: Various bootstrap procedures are shown and used to estimate the design- and prediction-mean squared errors based on real data. Computations are supported by two R packages. Findings: Three prediction-mean squared error estimators are proposed. Implications / Recommendations: The bootstrap algorithms used in the design-based approach give similar results for the considered data for the variance estimates of the considered estimator, implying that the speed of the algorithms may be important for practitioners in cases of similar properties. The proposed estimators of the prediction mean squared error produce higher estimates than other estimators in the model-based approach, indicating a positive bias that can be interpreted as a pessimistic accuracy estimate. Contribution: All the presented bootstrap algorithms are easily applicable using two R packages available at R CRAN and GitHub. Three double bootstrap prediction-MSE estimators are proposed and analysed in the real-data application.

On Bootstrap Algorithms in Survey Sampling

Objective: The aim of this paper is to present bootstrap algorithms for measuring the accuracy of estimation and prediction in design-based and model-based approaches in survey sampling and small area estimation. Three proposals of prediction-mean squared error estimators are also examined. Research Design & Methods: Various bootstrap procedures are shown and used to estimate the design- and prediction-mean squared errors based on real data. Computations are supported by two R packages. Findings: Three prediction-mean squared error estimators are proposed. Implications / Recommendations: The bootstrap algorithms used in the design-based approach give similar results for the considered data for the variance estimates of the considered estimator, implying that the speed of the algorithms may be important for practitioners in cases of similar properties. The proposed estimators of the prediction mean squared error produce higher estimates than other estimators in the model-based approach, indicating a positive bias that can be interpreted as a pessimistic accuracy estimate. Contribution: All the presented bootstrap algorithms are easily applicable using two R packages available at R CRAN and GitHub. Three double bootstrap prediction-MSE estimators are proposed and analysed in the real-data application.

Evolutionary unmasking Resuscitative therapeutics potential of centhaquin citrate in hypovolemic shock.

Hypovolemic shock (HS), a clinical condition of insufficient blood perfusion and oxygenation in body tissues, is associated with immense morbidity and mortality. Treatment approaches include fluid replacement and surgical repair of reversible causes of hemorrhage; however, they cause irreversible blood perfusion loss, systemic inflammation, multiple organ failure, and death. Centhaquin citrate (CC) is an innovative centrally acting cardiovascular active agent that is initially intended as an antihypertensive drug. However, due to its positive ionotropic effect, Centhaquin citrate is being tested clinically as a resuscitative agent for the management of hypovolemic shock It acts at the α2B-adrenergic receptor to produce venous constriction followed by an increase in venous return to the heart. These actions are assumed to be capable of resuscitative activity observed by centhaquin citrate, through an increase in cardiac output and tissue perfusion. Pharmacokinetics investigations in animals and humans have shown that centhaquin citrate is well tolerated and has insignificant side effects. Therefore, centhaquin citrate seems to be a promising entity and gaining the interest of researchers to develop it as a resuscitative agent in HS. The review gives insight into the development of centhaquin citrate as a resuscitative agent and provides insight into the associated mechanism of action and molecular signalling to foster future research on CC for its clinical use in HS.

Motivational Interviewing as an Intervention to Improve Antiretroviral Treatment Initiation among People who Inject Drugs (PWID): A Pilot Study in Jakarta and Bandung, Indonesia.

Progress towards the 95-95-95 target among People Who Inject Drugs (PWID) with Human Immunodeficiency Virus (HIV) infection was considerably low. A behavioral approach, such as motivational interviewing (MI), has been recognized as an effective strategy for improving HIV treatment outcomes among PWID. This study aimed at assessing the impact of MI counselling to improve ARV initiation among HIV-positive PWID. A cohort design pilot study was performed, and participants were recruited using a convenience sampling technique. Participants were PWID with HIV who accessed healthcare facilities in two Indonesian cities. Selected participants were assigned to an intervention group and a control group. The intervention group followed MI counselling, while the control group received ART following the standard of care. The participants were assigned to each group based on their preferences. The data was collected between January 2018 and January 2019. In total, 115 PWID with HIV participated in this study in the intervention (n=30) and control (n=85) groups. All but one intervention group's participants started ART, while 68/85 in the control group did so. Receiving MI counselling significantly contributed to ART initiation. In addition, the participants were followed-up until 12 months after ARV initiation. During this period, we found that similar proportions of participants in both groups discontinued the treatment, and only a small number achieved HIV viral suppression. The positive effect of MI counselling on ART initiation provides insight into the possibility of its wider implementation. Further studies are needed to gain a deeper understanding of MI counselling and its effect on other outcomes of the HIV treatment cascade.

Intrathecal Baclofen Infusion-Botulinum Toxin Combined Treatment Efficacy in the Management of Spasticity due to Cerebral Palsy.

Cerebral Palsy (CP) is a group of permanent, but not unchanging, disorders of movement and/or posture and motor function, which are due to a non-progressive interference, lesion, or abnormality of the developing/immature brain. One clinical presentation is muscle spasticity, which leads to a significant impact on the individual's functionality and quality of life. Spasticity treatment is multidisciplinary and includes pharmacological and physical intervention; intrathecal baclofen shows a positive effect in severe spasticity and suboptimal response to oral drugs, while local injection of Botulinum toxin type A (BTXA) improves muscle tone, motion and pain. The aim of this study was to evaluate the efficacy of the combined intrathecal baclofen infusion (ITB) - botulinum toxin treatment in the management of spasticity in CP. 8 patients with spastic tetraparesis were enrolled. All patients were treated with intrathecal Baclofen; in lower limbs, no spastic symptoms appeared, while marked spasticity was noted in upper limbs. We injected the right and left Biceps Brachial (BB) and Flexor Digitorum Superficialis (FDS) muscles with botulinum toxin type A. All patients underwent Myometric measurement, Ashworth Scale, Numerical Rating Scale, and Visual Analogic Scale evaluation before infiltration (T0), 30 days after injection (T1), 60 days after injection (T2), and 90 days after treatment (T3). All data demonstrated an improvement in spasticity, pain, quality of life, and self-care during the study, with p < 0.05. No side effects appeared. This study demonstrated the efficacy and safety of intrathecal baclofen infusion and botulinum toxin combined treatment in the management of spasticity, pain, quality of life, and selfcare in CP patients.