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George Allen

Apr 18, 2023

Edited: Apr 18, 2023

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A comprehensive systematic review was conducted to (1) survey multimodal biopsychosocial training programs with at least one CAM/IM component for the self-management of emotional stress across all populations; (2) assess the quantity and quality of the research and programs; and (3) characterize the results by type of program and strength of evidence on stress-related outcome measures. Due to the massive amount of the literature included, the full report of this review will be detailed in a much larger report, not suitable for detailing in one paper. The purpose of this current report is to (1) focus on those studies that were scored as high quality and demonstrated statistically significant results between groups (i.e., intervention group versus control or comparison group) on outcomes of emotional stress for controlled trial study designs; (2) describe the multimodal programs available and their characteristics; (3) describe the results of outcomes related to emotional stress; and (4) discuss what the authors believe to be the resource requirements needed to incorporate these programs into a military setting for service members and their families. The authors have chosen to report this subset of data since studies assessed as high quality according to internal validity criteria are the least likely to have introduced bias, are more likely replicable, and can be trusted to show a valid effect for the intervention and population being studied [15, 16]. If these studies are generalizable to other populations, then it is reasonable to anticipate that an effective program, if implemented in a military environment, could show equivalent benefits for this highly stressed population.

Self-management techniques are techniques in which skills are used independently by an individual without ongoing reliance on a trainer or therapist. The authors excluded interventions where patients solely learn and integrate therapies by themselves (such as through a book or online material) or ones that are trainer or therapist dependent (i.e., psychotherapy that requires a therapist to lead the sessions).

These interventions are defined as those ones that have two or more interventions (at least one of which is CAM modality) that require an initial training period with a therapist or trainer in which skills are learned, all of which can be transferred into self-management techniques. The authors only included programs that have multimodal interventions. An example is a program that includes relaxation, exercise, and behavioral techniques to reduce stress. The thought here was that multimodal programs would allow for more of a biopsychosocial approach to treating the whole person for the complexities of emotional stress.

The A320 Autothrust will manage speed during approach automatically and will reduce speed further with each flap setting. In real life and also when flying with Online ATC like VATSIM we need to expect that ATC instructs us to stay at a certain speed (e.g. 160 knots until 5 NM to the runway). In this case we would use Selected Speed Mode (select a speed in the FCU and pull the knob) until the instructed distance to the runway where we would then go back to Managed Speed Mode and drop the gear then as well as setting flaps to 3 and flaps to full - see below.

At about 30ft we start our flare by pulling back on the sidestick carefully. We only need a few degrees in positive pitch and hold the aircraft there. Too much flare will cause the aircraft to float down the runway, too little will cause a harder landing.

In real life the A320 will have two pilots which can actually do things in parallel. Talking to ATC, taxiing the aircraft and do the after landing tasks. In the simulation we are typically alone so it is absolutely ok to stop once we have fully vacated the runway and do these things one after the other. Talking to ATC and getting taxi instruction, do the after landing tasks and checklist, taxiing to gate.

Limitations regarding this study include the following: (a) the KMD survey data may not be fully representative because of the low response rate of KMD [15, 16]. However, in the case of KMD, methods other than email survey were impossible owing to limitations of the research budget and survey system used by the Association of Korean Medicine [17]. (b) Additionally, the results may not be appropriate for the current situation because the analytical data was collected in 2008. However, this was the best option given the lack of available data. Moreover, this study has great significance for the first comparison of differences in the needs and priorities of the public and KMD using two types of independent nationwide survey data. 1e1e36bf2d

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Alia Rani

Oct 01

MMOexp-Diablo 4: Chaos Powers Transforming Season 10 Meta

Season 10 of Diablo 4 has arrived, and it's shaping up to be the most diverse season yet. Thanks to Chaos Powers and a wave of buffs, we're looking at the largest pool of viable builds the game has ever seen. Instead of just one or two "meta" setups dominating the ladder, nearly every class now has multiple powerful, endgame-worthy options Diablo IV gold.

But here's the thing: not everyone plays Diablo 4 just to grind 15-minute Pit runs and watch health bars chip away. Some players want raw power, others want speed, and plenty just want something that's fun to play without sacrificing too much performance. This article highlights the strongest build per class for Season 10 as well as one fun alternative for players who care more about enjoyment than spreadsheets.

Let's dive in.

Sorcerer-Ball Lightning Overload

The Sorcerer wins the prize this season for having a build that is both the strongest and the most fun: the infamous Ball Lightning setup, often nicknamed "Blue Balls of Lightning."

Why It Works

This build has always been strong, but Season 10's Chaos Powers catapult it into absurd territory. The key power, Advanced Techniques, allows you to stack over 50 ranks into Ball Lightning. That alone translates into trillions of damage potential, and when paired with the Banished Lord's Talisman, each cast can Overpower for ridiculous numbers thanks to the naturally high mana cost of the skill.

To offset the massive mana drain, Sorcerers gain access to Mana Shield, which redirects damage to your mana pool instead of life while also granting astronomical mana regeneration. Combined with Flame Shield for immunity windows, Sorcerers can keep themselves topped up while dishing out catastrophic damage.

Playstyle Variations

Pit Pushing Setup: Optimized for survivability and burst damage using Strike of Stormhorn to further multiply DPS.

Okun Variant: A "spin-to-win" version where Ball Lightnings orbit around you. Pair this with Flickerstep boots and near-permanent Teleport for a lightning-fast, aggressive playstyle.

Bottom line: whether you're chasing leaderboards or just mowing down demons at high speed, Ball Lightning is the Sorcerer build to beat in Season 10.

Rogue-Death Trap vs. Spin-to-Win Poison

Rogues have two standout archetypes this season: the classic Death Trap setup and a surprisingly powerful Poison Trap spin build.

Strongest Build: Death Trap Rogue

Despite Blizzard's repeated attempts to nerf it, Death Trap remains the Rogue's premier high-end build. It has everything-damage, speed, and clear-but it's harder to bring online now.

Previously, the Aftermath passive instantly restored energy, letting you spam skills without worry. In Season 10, Aftermath only grants a fraction of that energy, forcing players to juggle resource regeneration with cooldown reduction. The build still works, but it requires significant endgame investment to shine.

Fun Build: Spin-to-Win Poison Trap

This is where things get spicy. Thanks to a rework of Bursting Venoms, Poison Trap now procs off rapid-fire lucky hits, turning the once-meme build into a top-tier option. With Bands of Icarus Rose doubling your trap throws and Scoundrel's Leathers converting traps into core skills, the build scales into something monstrous.

Add in Chaos Powers like Hit and Run, which stacks huge multipliers as you zip around the battlefield, and you've got a build that's fast, flashy, and devastating. Just remember to temper for "Traps Arm Faster," or you'll outpace your own damage.

Necromancer-Shadowblight and Bone Splinters

Necromancers have a full arsenal of viable builds this season: Blood Wave, Bone Spirit, Boner Spear, Minions-you name it. But the crown jewel is Shadowblight.

Strongest Build: Shadowblight

The Shadowblight passive has been giga-buffed. Every eighth source of shadow damage now triggers a devastating explosion with a 5.5x multiplier that can crit and double-dip with shadow bonuses. When combined with Alter the Balance, which makes ultimate skills spammable, Necromancers can keep Soul Rift rolling indefinitely for constant Shadowblight procs.

It's simple, it's powerful, and it melts Pit 100s with ease.

Fun Build: Bone Splinters

If you want something flashier, Bone Splinters is back thanks to the new Gospel of the Devote, which finally gives the projectiles piercing. Paired with the Shattered Spirits Aspect, each Bone Spirit cast sprays out up to 36 splinters with a 10x multiplier.

It's not an early-game setup-you'll need endgame cooldown reduction and tempering-but once online, it feels explosive and stylish.Druid-Pulverize and Ravens Rise

Druids are thriving in Season 10, and while the Pulverize Druid remains the undisputed king, another long-forgotten build has finally taken flight.

Strongest Build: Pulverize

Pulverize was the top build last season, and Chaos Powers only make it stronger. Overabundance boosts damage while Brawn Over Brains (buffed since the PTR) makes you both immortal and absurdly powerful. Add in Rotting Lightbringer to free up your weapon slot, and you're stacking multipliers on multipliers.

From level one to endgame, Pulverize is consistent, reliable, and now even more broken.

Fun Build: Ravens

Yes, Ravens. After 10 seasons of being a joke, they're finally viable. The new Kilt of Blackwing grants raven ranks, double-damage chances, and lets you spam the skill whenever you shapeshift or use companions. With Savagery, companion skills become core skills, enabling massive damage scaling.

The result? A fresh, unique Druid build that feels fun, flexible, and competitive with Pulverize.

Barbarian-Lunging Strike and Hammer of the Ancients

Barbarians are entering Season 10 with a huge variety of viable builds-up to ten capable of clearing Pit 100. Still, two stand out: Lunging Strike for raw strength and Hammer of the Ancients (HotA) for pure fun.

Strongest Build: Lunging Strike

This setup dominates thanks to insane speed and clear potential. The big Season 10 change is the return of Battle Trance, which now lets you stack Frenzy charges without using Frenzy directly. This translates to huge multipliers and attack speed buffs. Pair it with Ramaldni's Sword or even run Frenzy to auto-trigger Lunging Strike for bonus bleed and berserk uptime.

Fun Build: Hammer of the Ancients

HotA has been meme-tier for seasons, but buffs have finally resurrected it. Now it scales with fury spent again, synergizes with Frenzy changes, and benefits from Ramaldni reworks that grant its crit bonuses without needing the weapon.

The end result? A powerhouse that feels as fun as it is effective. If you've missed smashing the ground with massive crits, HotA is back in business.

Spiritborn-Harambe and Evade Spirit

The new Spiritborn class is off to a wild start, with plenty of potential but some clunky builds. The standout for pushing Pits is the Kelei Touch of Death, though it's not the smoothest to play. Instead, two fun alternatives shine bright.

Fun Build #1: Harambe

Focused entirely on gorilla skills, this build thrives thanks to new gear granting up to 15 ranks in gorilla abilities and doubling damage during the Harambe ultimate. With Chaos Powers, you can tweak it in multiple directions, but even the basic version farms Pit 100s with ease.

Fun Build #2: Evade Spirit

If speed is your thing, look no further. Evade Spirit grants near-permanent mobility, with Chaos Powers like Elacrity reducing evade cooldowns and buffs to eagle spirits adding extra damage. The kicker? You can now equip three two-handed weapons at once, stacking insane multipliers. Bind evade to your scroll wheel on PC, and you'll be zipping across the screen nonstop while shredding enemies.

Final Thoughts

Season 10 of Diablo 4 has completely changed the landscape. For the first time, nearly every class has multiple builds capable of clearing high-tier content, with a healthy balance between raw power and fun factor.

Sorcerer: Ball Lightning reigns supreme.

Rogue: Death Trap is still king, but Spin-to-Win Poison steals the spotlight for fun.

Necromancer: Shadowblight dominates, while Bone Splinters adds flair.

Druid: Pulverize remains broken, but Ravens finally shine.

Barbarian: Lunging Strike is unmatched, and HotA makes a glorious comeback.

Spiritborn: Harambe and Evade Spirit deliver chaotic fun Buy Diablo 4 materials.

Whether you're aiming for Pit 120 pushes or just want a build that feels satisfying to play, Season 10 has something for everyone.