Study protocol for a non-inferiority randomised controlled trial of SKY breathing meditation versus cognitive processing therapy for PTSD among veterans

Introduction Post-traumatic stress disorder (PTSD) is a debilitating, highly prevalent condition. Current clinical practice guidelines recommend trauma-focused psychotherapy (eg, cognitive processing therapy; CPT) as the first-line treatment for PTSD. However, while these treatments show clinically meaningful symptom improvement, the majority of those who begin treatment retain a diagnosis of PTSD post-treatment. Perhaps for this reason, many individuals with PTSD have sought more holistic, mind–body, complementary and integrative health (CIH) interventions. However, there remains a paucity of high-quality, active controlled efficacy studies of CIH interventions for PTSD, which precludes their formal recommendation. Methods and analyses We present the protocol for an ongoing non-inferiority parallel group randomised controlled trial (RCT) comparing the efficacy of a breathing meditation intervention (Sudarshan Kriya Yoga [SKY]) to a recommended evidence-based psychotherapy (CPT) for PTSD among veterans. Assessors are blinded to treatment group. The primary outcome measure is the PTSD Checklist-Civilian Version and a combination of clinical, self-report, experimental and physiological outcome measures assess treatment-related changes across each of the four PTSD symptom clusters (re-experiencing, avoidance, negative cognitions or mood and hyperarousal/reactivity). Once the RCT is completed, analyses will use both an intent-to-treat (using the ‘last observation carried forward’ for missing data) and a per-protocol or ‘treatment completers’ procedure, which is the most rigorous approach to non-inferiority designs. Ethics and dissemination To the best of our knowledge, this is this first non-inferiority RCT of SKY versus CPT for PTSD among veterans. The protocol is approved by the Stanford University Institutional Review Board. All participants provided written informed consent prior to participation. Results from this RCT will inform future studies including larger multi-site efficacy RCTs of SKY for PTSD and other mental health conditions, as well as exploration of cost-effectiveness and evaluation of implementation issues. Results will also inform evidence-based formal recommendations regarding CIH interventions for PTSD

Tractable non-local correlation density functionals for flat surfaces and slabs

A systematic approach for the construction of a density functional for van der Waals interactions that also accounts for saturation effects is described, i.e. one that is applicable at short distances. A very efficient method to calculate the resulting expressions in the case of flat surfaces, a method leading to an order reduction in computational complexity, is presented. Results for the interaction of two parallel jellium slabs are shown to agree with those of a recent RPA calculation (J.F. Dobson and J. Wang, Phys. Rev. Lett. 82, 2123 1999). The method is easy to use; its input consists of the electron density of the system, and we show that it can be successfully approximated by the electron densities of the interacting fragments. Results for the surface correlation energy of jellium compare very well with those of other studies. The correlation-interaction energy between two parallel jellia is calculated for all separations d, and substantial saturation effects are predicted.Comment: 10 pages, 6 figure

Interfaces with a single growth inhomogeneity and anchored boundaries

The dynamics of a one dimensional growth model involving attachment and detachment of particles is studied in the presence of a localized growth inhomogeneity along with anchored boundary conditions. At large times, the latter enforce an equilibrium stationary regime which allows for an exact calculation of roughening exponents. The stochastic evolution is related to a spin Hamiltonian whose spectrum gap embodies the dynamic scaling exponent of late stages. For vanishing gaps the interface can exhibit a slow morphological transition followed by a change of scaling regimes which are studied numerically. Instead, a faceting dynamics arises for gapful situations.Comment: REVTeX, 11 pages, 9 Postscript figure

Friction force on a vortex due to the scattering of superfluid excitations in helium II

The longitudinal friction acting on a vortex line in superfluid $^4$He is investigated within a simple model based on the analogy between such vortex dynamics and that of the quantal Brownian motion of a charged point particle in a uniform magnetic field. The scattering of superfluid quasiparticle excitations by the vortex stems from a translationally invariant interaction potential which, expanded to first order in the vortex velocity operator, gives rise to vortex transitions between nearest Landau levels. The corresponding friction coefficient is shown to be, in the limit of elastic scattering (vanishing cyclotron frequency), equivalent to that arising from the Iordanskii formula. Proposing a simple functional form for the scattering amplitude, with only one adjustable parameter whose value is set in order to get agreement to the Iordanskii result for phonons, an excellent agreement is also found with the values derived from experimental data up to temperatures about 1.5 K. Finite values of the cyclotron frequency arising from recent theories are shown to yield similar results. The incidence of vortex-induced quasiparticle transitions on the friction process is estimated to be, in the roton dominated regime, about 50 % of the value of the friction coefficient, $\sim$8 % of which corresponds to roton-phonon transitions and $\sim$42 % to roton $R^+\leftrightarrow R^-$ ones.Comment: 15 pages, 4 figures; typos corrected, to be published in PR

From Fractional Chern Insulators to a Fractional Quantum Spin Hall Effect

We investigate the algebraic structure of flat energy bands a partial filling of which may give rise to a fractional quantum anomalous Hall effect (or a fractional Chern insulator) and a fractional quantum spin Hall effect. Both effects arise in the case of a sufficiently flat energy band as well as a roughly flat and homogeneous Berry curvature, such that the global Chern number, which is a topological invariant, may be associated with a local non-commutative geometry. This geometry is similar to the more familiar situation of the fractional quantum Hall effect in two-dimensional electron systems in a strong magnetic field.Comment: 8 pages, 3 figure; published version with labels in Figs. 2 and 3 correcte

Randomised clinical non-inferiority trial of breathing-based meditation and cognitive processing therapy for symptoms of post-traumatic stress disorder in military veterans

Objective Test whether Sudarshan Kriya Yoga (SKY) was non-inferior to cognitive processing therapy (CPT) for treating symptoms of post-traumatic stress disorder (PTSD) among veterans via a parallel randomised controlled non-inferiority trial. Setting Outpatient Veterans Affairs healthcare centre. Participants 85 veterans (75 men, 61% white, mean age 56.9) with symptoms of PTSD participated between October 2015 and March 2020: 59 participants completed the study. Interventions SKY emphasises breathing routines and was delivered in group format in a 15-hour workshop followed by two 1-hour sessions per week for 5 weeks. CPT is an individual psychotherapy which emphasises shifting cognitive appraisals and was delivered in two 1-hour sessions per week for 6 weeks. Measures The primary outcome measure was the PTSD Checklist-Civilian Version (PCL-C). The secondary measures were the Beck Depression Inventory-II (BDI-II) and Positive and Negative Affect Scale (PANAS). Results Mean PCL-C at baseline was 56.5 (±12.6). Intent-to-treat analyses showed that PCL-C scores were reduced at 6 weeks (end of treatment) relative to baseline (SKY, −5.6, d=0.41, n=41: CPT, −6.8, d=0.58, n=44). The between-treatment difference in change scores was within the non-inferiority margin of 10 points (−1.2, 95% CI −5.7 to 3.3), suggesting SKY was not inferior to CPT. SKY was also non-inferior at 1-month (CPT–SKY: −2.1, 95% CI −6.9 to 2.8) and 1-year (CPT–SKY: −1.8, 95% CI −6.6 to 2.9) assessments. SKY was also non-inferior to CPT on the BDI-II and PANAS at end of treatment and 1 month, but SKY was inferior to CPT on both BDI-II and PANAS at 1 year. Dropout rates were similar (SKY, 27%, CPT, 34%: OR=1.36, 95% CI 0.51 to 3.62, p=0.54). Conclusions SKY may be non-inferior to CPT for treating symptoms of PTSD and merits further consideration as a treatment for PTSD

Classical Open String Models in 4-Dim Minkowski Spacetime

Classical bosonic open string models in fourdimensional Minkowski spacetime are discussed. A special attention is paid to the choice of edge conditions, which can follow consistently from the action principle. We consider lagrangians that can depend on second order derivatives of worldsheet coordinates. A revised interpretation of the variational problem for such theories is given. We derive a general form of a boundary term that can be added to the open string action to control edge conditions and modify conservation laws. An extended boundary problem for minimal surfaces is examined. Following the treatment of this model in the geometric approach, we obtain that classical open string states correspond to solutions of a complex Liouville equation. In contrast to the Nambu-Goto case, the Liouville potential is finite and constant at worldsheet boundaries. The phase part of the potential defines topological sectors of solutions.Comment: 25 pages, LaTeX, preprint TPJU-28-93 (the previous version was truncated by ftp...