Development and Evaluation of a Pragmatic Measure of Adherence to Dialectical Behavior Therapy: The DBT Adherence Checklist for Individual Therapy

This paper presents two studies conducted to develop and evaluate a new pragmatic measure of therapist adherence to Dialectical Behavior Therapy (DBT): the DBT Adherence Checklist for Individual Therapy (DBT AC-I). Study 1 used item response analysis to select items from the gold standard DBT Adherence Coding Scale (DBT ACS) using archival data from 1271 DBT sessions. Items were then iteratively refined based on feedback from 33 target end-users to ensure relevance, usability, and understandability. Study 2 examined the psychometric properties of the DBT AC-I as a therapist self-report and observer-rated measure in 100 sessions from 50 therapist-client dyads, while also evaluating predictors of therapist accuracy in self-rated adherence. When used as a therapist self-report measure, concordance between therapist and observer ratings was at least moderate (AC1≥0.41) for all DBT AC-I items but overall concordance (ICC=0.09) as well as convergent (r=0.05) and criterion validity (AUC=0.54) with the DBT ACS were poor. Higher therapist accuracy was predicted by greater DBT knowledge and adherence as well as more severe client suicidal ideation. When used by trained observers, the DBT AC-I had excellent interrater reliability (ICC=0.93), convergent validity (r=0.90), and criterion validity (AUC=0.94). While therapists’ self-rated adherence on the DBT AC-I should not be assumed to reflect their actual adherence, some therapists may self-rate accurately. The DBT AC-I offers an effective and relatively efficient method of evaluating adherence to DBT when used by trained observers

Electroviscous effects of simple electrolytes under shear

On the basis of a hydrodynamical model analogous to that in critical fluids, we investigate the influences of shear flow upon the electrostatic contribution to the viscosity of binary electrolyte solutions in the Debye-H\"{u}ckel approximation. Within the linear-response theory, we reproduce the classical limiting law that the excess viscosity is proportional to the square root of the concentration of the electrolyte. We also extend this result for finite shear. An analytic expression of the anisotropic structure factor of the charge density under shear is obtained, and its deformation at large shear rates is discussed. A non-Newtonian effect caused by deformations of the ionic atmosphere is also elucidated for $\tau_D\dot{\gamma}>1$. This finding concludes that the maximum shear stress that the ionic atmosphere can support is proportional to $\lambda_D^{-3}$, where $\dot{\gamma}$, $\lambda_D$ and $\tau_D=\lambda_D^2/D$ are, respectively, the shear rate, the Debye screening length and the Debye relaxation time with $D$ being the relative diffusivity at the infinite dilution limit of the electrolyte.Comment: 13pages, 2figure

Kinetic formulation and global existence for the Hall-Magneto-hydrodynamics system

This paper deals with the derivation and analysis of the the Hall Magneto-Hydrodynamic equations. We first provide a derivation of this system from a two-fluids Euler-Maxwell system for electrons and ions, through a set of scaling limits. We also propose a kinetic formulation for the Hall-MHD equations which contains as fluid closure different variants of the Hall-MHD model. Then, we prove the existence of global weak solutions for the incompressible viscous resistive Hall-MHD model. We use the particular structure of the Hall term which has zero contribution to the energy identity. Finally, we discuss particular solutions in the form of axisymmetric purely swirling magnetic fields and propose some regularization of the Hall equation

Inflammatory fibroid polyp of the ileum presenting with small bowel obstruction in an adult patient: a case report

<p>Abstract</p> <p>Introduction</p> <p>Inflammatory fibroid polyps are rare benign tumors of the gastrointestinal tract with the gastric antrum being the most common site, followed by the ileum. Histogenesis is still unknown and controversial. Inflammatory fibroid polyps are one of the rare benign conditions leading to intestinal obstruction in adults.</p> <p>Case presentation</p> <p>A 54-year-old Caucasian man presented with acute abdomen pain and a two month history of intermittent cramping and lower abdominal pain. Computed tomography imaging demonstrated a partial intestinal obstruction in the location of the terminal ileum. An ileo-ileal intussusception due to a mass lesion 15 cm proximal to the caecum was found on exploratory laparotomy. Intussusception was spontaneously reduced during exploration and a wedge resection was performed to the affected bowel segment. Histopathologic examination showed the mass to be an inflammatory fibroid polyp.</p> <p>Conclusion</p> <p>Although inflammatory fibroid polyps are rare and benign, in the case of intestinal obstruction the only solution is a surgical approach.</p

Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis

Background: There has been debate regarding whether Complex Posttraumatic Stress Disorder (Complex PTSD) is distinct from Borderline Personality Disorder (BPD) when the latter is comorbid with PTSD. Objective: To determine whether the patterns of symptoms endorsed by women seeking treatment for childhood abuse form classes that are consistent with diagnostic criteria for PTSD, Complex PTSD, and BPD. Method: A latent class analysis (LCA) was conducted on an archival dataset of 280 women with histories of childhood abuse assessed for enrollment in a clinical trial for PTSD. Results: The LCA revealed four distinct classes of individuals: a Low Symptom class characterized by low endorsements on all symptoms; a PTSD class characterized by elevated symptoms of PTSD but low endorsement of symptoms that define the Complex PTSD and BPD diagnoses; a Complex PTSD class characterized by elevated symptoms of PTSD and self-organization symptoms that defined the Complex PTSD diagnosis but low on the symptoms of BPD; and a BPD class characterized by symptoms of BPD. Four BPD symptoms were found to greatly increase the odds of being in the BPD compared to the Complex PTSD class: frantic efforts to avoid abandonment, unstable sense of self, unstable and intense interpersonal relationships, and impulsiveness. Conclusions: Findings supported the construct validity of Complex PTSD as distinguishable from BPD. Key symptoms that distinguished between the disorders were identified, which may aid in differential diagnosis and treatment planning

Effect of Silver Annealing Conditions on the Performance of Electrolytic Silver/Silver Chloride Electrodes used in Harned Cell Measurements of pH

We have studied the long and short term stability of electrolytic Ag/AgCl electrodes fabricated from Ag wire that has been subjected to a range of different annealing conditions. At elevated temperatures, the presence of oxygen during the annealing process has been shown to be detrimental to the performance of electrodes produced. This phenomenon has been attributed to the dissolution of oxygen in the Ag lattice leading to structural changes in the Ag/AgCl electrode material. Electrodes prepared from Ag wire annealed in the absence of oxygen have shown no appreciable change in performance throughout the temperature range employed. This work has resulted in an improved understanding of the optimum annealing conditions required for Ag used in the preparation of electrolytic Ag/AgCl reference electrodes. This work has positive implications for the accuracy of Harned cell measurements of pH

Intracellular connections between basal bodies promote the coordinated behavior of motile cilia

Hydrodynamic flow produced by multiciliated cells is critical for fluid circulation and cell motility. Hundreds of cilia beat with metachronal synchrony for fluid flow. Cilia-driven fluid flow produces extracellular hydrodynamic forces that cause neighboring cilia to beat in a synchronized manner. However, hydrodynamic coupling between neighboring cilia is not the sole mechanism that drives cilia synchrony. Cilia are nucleated by basal bodies (BBs) that link to each other and to the cell\u27s cortex via BB-associated appendages. The intracellular BB and cortical network is hypothesized to synchronize ciliary beating by transmitting cilia coordination cues. The extent of intracellular ciliary connections and the nature of these stimuli remain unclear. Moreover, how BB connections influence the dynamics of individual cilia has not been established. We show by focused ion beam scanning electron microscopy imaging that cilia are coupled both longitudinally and laterally in the ciliat

Sensitivities of Key Parameters in the Preparation of Silver/Silver Chloride Electrodes Used in Harned Cell Measurements of pH

A questionnaire was completed by fourteen world leading national metrology institutes to study the influence of several variables in the preparation of Ag/AgCl electrodes on the accuracy of Harned cell measurements of pH. The performance of each institute in the last decade has been assessed based on their results in eight key comparisons, organized by the Bureau International des Poids et Measures Consultative Committee for Amount of Substance, involving the measurement of pH of phosphate, phthalate, carbonate, borate and tetroxalate buffer solutions. The performance of each laboratory has been correlated to the results of the questionnaire to determine the critical parameters in the preparation of Ag/AgCl electrodes and their sensitivities with respect to the accuracy of pH measurement. This study reveals that the parameters most closely correlated to performance in comparisons are area of electrode wire exposed to the electrolyte, diameter and porosity of the Ag sphere prior to anodisation, amount of Ag converted to AgCl during anodisation, stability times employed for electrodes to reach equilibrium in solution prior to measurement, electrode rejection criteria employed and purity of reagents