Long-term follow-up of a multimodal day clinic, group-based treatment program for patients with very high risk for complex posttraumatic stress disorder, and for patients with non-complex trauma-related disorders

Objective: The present study examined the follow-up of a multimodal day clinic group-based therapy program for patients with trauma-related disorders and investigated potential differences for patients with classic PTSD versus cPTSD. Method: Sixty-six patients were contacted 6 and 12 months after discharge of our 8-week program and completed various questionnaires (Essen Trauma Inventory (ETI), Beck Depression Inventory-Revised (BDI-II), Screening scale of complex PTSD (SkPTBS), Patient Health Questionnaire (PHQ)-Somatization, as well as single items to therapy utilization and life events in the interim period). Due to organizational reasons a control group could not be included. Statistical analyses included repeated-measures ANOVA with cPTSD as between-subject factor. Results: The reduction of depressive symptoms at discharge was persistent at 6 and 12 months follow-up. Somatization symptoms were increased at discharge, but were leveled out at 6 months follow-up. The same effect was found for cPTSD symptoms in those patients with non-complex trauma-related disorders: Their increase of cPTSD symptoms was flattened at 6 months follow-up. Patients with a very high risk for cPTSD showed a strong linear reduction of cPTSD symptoms from admission to discharge and 6 months follow-up. cPTSD patients had a higher symptom load compared to patients without cPTSD on all time points and scales. Conclusion: Multimodal, day clinic trauma-focused treatment is associated with positive changes even after 6 and 12 months. Positive therapy outcomes (reduced depression, reduced cPTSD symptoms for patients with a very high risk for cPTSD) could be maintained. However, PTSD symptomatology was not significantly reduced. Increases in somatoform symptoms were leveled out and can therefore be regarded as side effects of treatment, which may be connected with actualization of trauma in the intensive psychotherapeutic treatment. Further analyses should be applied in larger samples and a control group

Disruption of Broca's Area Alters Higher-order Chunking Processing during Perceptual Sequence Learning

Because Broca's area is known to be involved in many cognitive functions, including language, music, and action processing, several attempts have been made to propose a unifying theory of its role that emphasizes a possible contribution to syntactic processing. Recently, we have postulated that Broca's area might be involved in higher-order chunk processing during implicit learning of a motor sequence. Chunking is an information-processing mechanism that consists of grouping consecutive items in a sequence and is likely to be involved in all of the aforementioned cognitive processes. Demonstrating a contribution of Broca's area to chunking during the learning of a nonmotor sequence that does not involve language could shed new light on its function. To address this issue, we used offline MRI-guided TMS in healthy volunteers to disrupt the activity of either the posterior part of Broca's area (left Brodmann's area [BA] 44) or a control site just before participants learned a perceptual sequence structured in distinct hierarchical levels. We found that disruption of the left BA 44 increased the processing time of stimuli representing the boundaries of higher-order chunks and modified the chunking strategy. The current results highlight the possible role of the left BA 44 in building up effector-independent representations of higher-order events in structured sequences. This might clarify the contribution of Broca's area in processing hierarchical structures, a key mechanism in many cognitive functions, such as language and composite actions

A multiphysics and multiscale software environment for modeling astrophysical systems

We present MUSE, a software framework for combining existing computational tools for different astrophysical domains into a single multiphysics, multiscale application. MUSE facilitates the coupling of existing codes written in different languages by providing inter-language tools and by specifying an interface between each module and the framework that represents a balance between generality and computational efficiency. This approach allows scientists to use combinations of codes to solve highly-coupled problems without the need to write new codes for other domains or significantly alter their existing codes. MUSE currently incorporates the domains of stellar dynamics, stellar evolution and stellar hydrodynamics for studying generalized stellar systems. We have now reached a "Noah's Ark" milestone, with (at least) two available numerical solvers for each domain. MUSE can treat multi-scale and multi-physics systems in which the time- and size-scales are well separated, like simulating the evolution of planetary systems, small stellar associations, dense stellar clusters, galaxies and galactic nuclei. In this paper we describe three examples calculated using MUSE: the merger of two galaxies, the merger of two evolving stars, and a hybrid N-body simulation. In addition, we demonstrate an implementation of MUSE on a distributed computer which may also include special-purpose hardware, such as GRAPEs or GPUs, to accelerate computations. The current MUSE code base is publicly available as open source at http://muse.liComment: 24 pages, To appear in New Astronomy Source code available at http://muse.l

Risk factors for venous thromboembolism in immunoglobulin light chain amyloidosis

Patients with immunoglobulin light chain amyloidosis are at risk for both thrombotic and bleeding complications. While the hemostatic defects have been extensively studied, less is known about thrombotic complications in this disease. This retrospective study examined the frequency of venous thromboembolism in 929 patients with immunoglobulin light chain amyloidosis presenting to a single referral center, correlated risk of venous thromboembolism with clinical and laboratory factors, and examined complications of anticoagulation in this population. Sixty-five patients (7%) were documented as having at least one venous thromboembolic event. Eighty percent of these patients had events within one year prior to or following diagnosis. Lower serum albumin was associated with increased risk of VTE, with a hazard ratio of 4.30 (CI 1.60–11.55; P=0.0038) for serum albumin less than 3 g/dL compared to serum albumin greater than 4 g/dL. Severe bleeding complications were observed in 5 out of 57 patients with venous thromboembolism undergoing treatment with anticoagulation. Prospective investigation should be undertaken to better risk stratify these patients and to determine the optimal strategies for prophylaxis against and management of venous thromboembolism

Reflection on the Groceries to Graduate scholarship program at Missouri Southern State University

In recent years, myriad universities have sought measures to alleviate the burden of nutrition inse­curity among undergraduate in order to improve student health and academic success, as the preva­lence of nutrition insecurity on college campuses has gained attention from researchers. At Missouri Southern State University (MSSU), faculty launched the Lion Co-op Center for Nutrition Security (LCCNS) in 2018, which focused on research and included a free food and personal hygiene pantry that all students, staff, and faculty were eligible to use. In 2020, the LCCNS piloted the Groceries to Graduate (G2G) scholarship program, which provides advanced undergraduate students (those who have earned 60+ credit hours) in good standing and with finan­cial need with scholarship tokens that can be used as currency at the Webb City Farmers Market, located three miles north of campus. The objective of this program was to increase low-income under­graduate access to fresh produce and reduce their financial burden of purchasing high quality food, therefore improving academic outcomes. This reflective essay examines the preliminary findings we obtained about the first two years of the schol­arship program. It assesses the methods of com­municating with students about the scholarship program, token usage, availability of fresh produce, and student academic success. The initial findings suggest that while the model needs improvement, the scholarships are meeting student needs for access to nutritional food. This market-based solu­tion gives students currency (tokens) so that they can buy directly from local merchants, a model that with some revision may provide a workable model for small universities to address nutritional insecu­rity among students

Disruption of Broca's Area Alters Higher-order Chunking Processing during Perceptual Sequence Learning

Because Broca's area is known to be involved in many cognitive functions, including language, music, and action processing, several attempts have been made to propose a unifying theory of its role that emphasizes a possible contribution to syntactic processing. Recently, we have postulated that Broca's area might be involved in higher-order chunk processing during implicit learning of a motor sequence. Chunking is an information-processing mechanism that consists of grouping consecutive items in a sequence and is likely to be involved in all of the aforementioned cognitive processes. Demonstrating a contribution of Broca's area to chunking during the learning of a nonmotor sequence that does not involve language could shed new light on its function. To address this issue, we used offline MRI-guided TMS in healthy volunteers to disrupt the activity of either the posterior part of Broca's area (left Brodmann's area [BA] 44) or a control site just before participants learned a perceptual sequence structured in distinct hierarchical levels. We found that disruption of the left BA 44 increased the processing time of stimuli representing the boundaries of higher-order chunks and modified the chunking strategy. The current results highlight the possible role of the left BA 44 in building up effector-independent representations of higher-order events in structured sequences. This might clarify the contribution of Broca's area in processing hierarchical structures, a key mechanism in many cognitive functions, such as language and composite actions

Risk factors for venous thromboembolism in immunoglobulin light chain amyloidosis ARTICLE

P atients with immunoglobulin light chain amyloidosis are at risk for both thrombotic and bleeding complications. While the hemostatic defects have been extensively studied, less is known about thrombotic complications in this disease. This retrospective study examined the frequency of venous thromboembolism in 929 patients with immunoglobulin light chain amyloidosis presenting to a single referral center, correlated risk of venous thromboembolism with clinical and laboratory factors, and examined complications of anticoagulation in this population. Sixty-five patients (7%) were documented as having at least one venous thromboembolic event. Eighty percent of these patients had events within one year prior to or following diagnosis. Lower serum albumin was associated with increased risk of VTE, with a hazard ratio of 4.30 (CI 1.60-11.55; P=0.0038) for serum albumin less than 3 g/dL compared to serum albumin greater than 4 g/dL. Severe bleeding complications were observed in 5 out of 57 patients with venous thromboembolism undergoing treatment with anticoagulation. Prospective investigation should be undertaken to better risk stratify these patients and to determine the optimal strategies for prophylaxis against and management of venous thromboembolism. Risk factors for venous thromboembolism in immunoglobulin light chain amyloidosi

Risk factors for venous thromboembolism in immunoglobulin light chain amyloidosis Risk factors for venous thromboembolism in immunoglobulin light chain amyloidosis

documented as having at least one venous thromboembolic event. Eighty percent of these patients had events within one year prior to or following diagnosis. Lower serum albumin was associated with increased risk of VTE, with a hazard ratio of 4.30 (CI 1.60-11.55, p=0.0038) for serum albumin less than 3g/dL compared to serum albumin greater than 4g/dL. Severe bleeding complications were observed in 5 out of 57 patients with venous thromboembolism undergoing treatment with anticoagulation. Prospective investigation should be undertaken to better risk stratify these patients and to determine the optimal strategies for prophylaxis against and management of venous thromboembolism