Guided self-help cognitive behavioral intervention for VoicEs (GiVE): study protocol for a pilot randomized controlled trial

Background: Cognitive behavior therapy for psychosis (CBTp) is an effective intervention for people who hear distressing voices (auditory hallucinations). However, there continues to be a problem of poor access to CBTp. Constraints on health care funding require this problem to be addressed without a substantial increase in funding. One solution is to develop guided self-help forms of CBTp to improve access, and a symptom-specific focus on, for example, distressing voices (auditory verbal hallucinations) has the potential to enhance effectiveness. We term this cognitive behavior therapy for distressing voices (CBTv). Methods/design: This trial is an external pilot randomized controlled trial comparing the effects of 12 week guided self-help CBTv (with eight therapist support sessions) with a wait list control condition. Informed consent will be obtained from each participant. Half of the 30 participants will be randomized to receive guided self-help CBTv immediately; the remaining half will receive the intervention after a 12-week delay. All participants will continue with their usual treatment throughout the study. Outcomes will be assessed using questionnaires completed at baseline and 12 weeks postrandomization. Interviews will be offered to all those who receive therapy immediately to explore their experiences with the intervention. Discussion: The outcomes of this trial, both quantitative and qualitative, will inform the design of a definitive randomized controlled trial of guided self-help CBTv. If this intervention is effective, it could help to increase access to CBT for those who hear distressing voices

Effect of copper fungicide on Colletotrichum gloeosporioides and other microorganisms on avocado leaves and fruit

An investigation into the effect of copper fungicide on non-target microorganisms on avocado (cvv. Hass and Nabal) showed that populations of filamentous fungi, yeasts, and bacteria on leaves were at least 10-fold less after a single application of copper than on unsprayed leaves. This detrimental effect of copper on microorganisms on the phylloplane was confirmed in random samples collected from 5 commercial avocado orchards with regular pesticide spray programs but where isolated unsprayed trees were also available. An intensive 16-month study was carried out on 2 adjacent orchards, 1 that was sprayed with copper fungicide at monthly intervals from October to April each year, and the other that had not been sprayed for at least 6 years. Populations of filamentous fungi, yeasts, and bacteria on leaves and fruit were 10–100-fold lower in the sprayed orchard than in the unsprayed orchard. However, populations in the sprayed orchard recovered during the winter non-spray periods to levels comparable to the unsprayed orchard. In 1993 and 1994, fruit were harvested from both orchards, ripened, and assessed for anthracnose caused by Colletotrichum gloeosporioides. In both years, there was significantly less disease in unsprayed fruit (mean disease rating 1.13 and 0.32, respectively) than in sprayed fruit (mean disease rating 1.83 and 2.18, respectively). These results show that copper fungicide is detrimental to phylloplane microorganisms and suggest that those organisms are providing some natural suppression of C. gloeosporioides on avocado

Galactose-Functionalized PolyHIPE Scaffolds for Use in Routine Three Dimensional Culture of Mammalian Hepatocytes

Three-dimensional (3D) cell culture is regarded as a more physiologically relevant method of growing cells in the laboratory compared to traditional monolayer cultures. Recently, the application of polystyrene-based scaffolds produced using polyHIPE technology (porous polymers derived from high internal phase emulsions) for routine 3D cell culture applications has generated very promising results in terms of improved replication of native cellular function in the laboratory. These materials, which are now available as commercial scaffolds, are superior to many other 3D cell substrates due to their high porosity, controllable morphology, and suitable mechanical strength. However, until now there have been no reports describing the surface-modification of these materials for enhanced cell adhesion and function. This study, therefore, describes the surface functionalization of these materials with galactose, a carbohydrate known to specifically bind to hepatocytes via the asialoglycoprotein receptor (ASGPR), to further improve hepatocyte adhesion and function when growing on the scaffold. We first modify a typical polystyrene-based polyHIPE to produce a cell culture scaffold carrying pendent activated-ester functionality. This was achieved via the incorporation of pentafluorophenyl acrylate (PFPA) into the initial styrene (STY) emulsion, which upon polymerization formed a polyHIPE with a porosity of 92% and an average void diameter of 33 μm. Histological analysis showed that this polyHIPE was a suitable 3D scaffold for hepatocyte cell culture. Galactose-functionalized scaffolds were then prepared by attaching 2′-aminoethyl-β-D-galactopyranoside to this PFPA functionalized polyHIPE via displacement of the labile pentafluorophenyl group, to yield scaffolds with approximately ca. 7−9% surface carbohydrate. Experiments with primary rat hepatocytes showed that cellular albumin synthesis was greatly enhanced during the initial adhesion/settlement period of cells on the galactose-functionalized material, suggesting that the surface carbohydrates are accessible and selective to cells entering the scaffold. This porous polymer scaffold could, therefore, have important application as a 3D scaffold that offers enhanced hepatocyte adhesion and functionality

Panton-Valentine leukocidin associated staphylococcal disease: a cross-sectional study at a London hospital, England

AbstractRecently, there has been international concern at the rapid emergence of highly pathogenic strains of Staphylococcus aureus associated with a toxin called Panton–Valentine leukocidin (PVL). In the UK, these strains are considered to be rare and mainly severe. We estimate the proportion of staphylococcal infections that are caused by strains containing the PVL genes, and describe risk factors for these infections. Three hundred and ninety consecutive S. aureus clinical isolates, submitted for routine diagnostic purposes were screened for PVL genes. Risk factors for infection were identified from the patient medical record. 9.7% (95% CI 7.0–13.1%) of clinical isolates and 20.8% of skin and soft tissue specimens contained the genes for PVL. Methicillin-resistant S. aureus with PVL was rare (0.8% of all isolates) but PVL with methicillin-sensitive S. aureus was common (9.0% of all specimens). PVL infection was more frequent in males (OR 3.0, 95% CI 1.3–7.0), and in young adults aged 20–39 years (OR 3.7, 95% CI 1.3–10.4). Over half of PVL positive S. aureus infections originated in patients based in the community. Community-onset PVL-associated disease is common in the UK and mainly causes skin and soft tissue infections that do not require admission to hospital. Consideration should be given to current infection control strategy, which advocates household contact screening and decolonization on the assumption that PVL-associated disease is rare

Trends in sexually transmitted infections in general practice 1990-2000: population based study using data from the UK general practice research database

Objective: To describe the contribution of primary care to the diagnosis and management of sexually transmitted infections in the United Kingdom, 1990-2000, in the context of increasing incidence of infections in genitourinary medicine clinics. Design: Population based study. Setting: UK primary care. Participants: Patients registered in the UK general practice research database. Main outcome measures: Incidence of diagnosed sexually transmitted infections in primary care and estimation of the proportion of major such infections diagnosed in primary care. Results: An estimated 23.0% of chlamydia cases in women but only 5.3% in men were diagnosed and treated in primary care during 1998-2000, along with 49.2% cases of non-specific urethritis and urethral discharge in men and 5.7% cases of gonorrhoea in women and 2.9% in men. Rates of diagnosis in primary care rose substantially in the late 1990s. Conclusions: A substantial and increasing number of sexually transmitted infections are diagnosed and treated in primary care in the United Kingdom, with sex ratios differing from those in genitourinary medicine clinics. Large numbers of men are treated in primary care for presumptive sexually transmitted infections

Entropy in the RST Model

The RST Model is given boundary term and Z-field so that it is well-posed and local. The Euclidean method is described for general theory and used to calculate the RST intrinsic entropy. The evolution of this entropy for the shockwave solutions is found and obeys a second law.Comment: 10 pages, minor revisions, published version in Late

Prelamin A mediates myocardial inflammation in dilated and HIV-associated cardiomyopathies

Cardiomyopathies are complex heart muscle diseases that can be inherited or acquired. Dilated cardiomyopathy can result from mutations in LMNA, encoding the nuclear intermediate filament proteins lamin A/C. Some LMNA mutations lead to accumulation of the lamin A precursor, prelamin A, which is disease causing in a number of tissues, yet its impact upon the heart is unknown. Here, we discovered myocardial prelamin A accumulation occurred in a case of dilated cardiomyopathy, and we show that a potentially novel mouse model of cardiac-specific prelamin A accumulation exhibited a phenotype consistent with inflammatory cardiomyopathy, which we observed to be similar to HIV-associated cardiomyopathy, an acquired disease state. Numerous HIV protease therapies are known to inhibit ZMPSTE24, the enzyme responsible for prelamin A processing, and we confirmed that accumulation of prelamin A occurred in HIV+ patient cardiac biopsies. These findings (a) confirm a unifying pathological role for prelamin A common to genetic and acquired cardiomyopathies; (b) have implications for the management of HIV patients with cardiac disease, suggesting protease inhibitors should be replaced with alternative therapies (i.e., nonnucleoside reverse transcriptase inhibitors); and (c) suggest that targeting inflammation may be a useful treatment strategy for certain forms of inherited cardiomyopathy

Electromagnetic waves in a wormhole geometry

We investigate the propagation of electromagnetic waves through a static wormhole. It is shown that the problem can be reduced to a one-dimensional Schr\"odinger-like equation with a barrier-type potential. Using numerical methods, we calculate the transmission coefficient as a function of the energy. We also discuss the polarization of the outgoing radiation due to this gravitational scattering.Comment: LaTex file, 5 pages, 2 figures, one reference added, accepted for publication in PR

Newtonian Analysis of Gravitational Waves from Naked Singularity

Spherical dust collapse generally forms a shell focusing naked singularity at the symmetric center. This naked singularity is massless. Further the Newtonian gravitational potential and speed of the dust fluid elements are everywhere much smaller than unity until the central shell focusing naked singularity formation if an appropriate initial condition is set up. Although such a situation is highly relativistic, the analysis by the Newtonian approximation scheme is available even in the vicinity of the space-time singularity. This remarkable feature makes the analysis of such singularity formation very easy. We investigate non-spherical even-parity matter perturbations in this scheme by complementary using numerical and semi-analytical approaches, and estimate linear gravitational waves generated in the neighborhood of the naked singularity by the quadrupole formula. The result shows good agreement with the relativistic perturbation analysis recently performed by Iguchi et al. The energy flux of the gravitational waves is finite but the space-time curvature carried by them diverges.Comment: 23 pages, 8 figure

Energy Distribution in f(R) Gravity

The well-known energy problem is discussed in f(R) theory of gravity. We use the generalized Landau-Lifshitz energy-momentum complex in the framework of metric f(R) gravity to evaluate the energy density of plane symmetric solutions for some general f(R) models. In particular, this quantity is found for some popular choices of f(R) models. The constant scalar curvature condition and the stability condition for these models are also discussed. Further, we investigate the energy distribution of cosmic string spacetime.Comment: 15 pages, accepted for publication in Gen. Relativ. & Gra