A Randomized Controlled Clinical Trial of Dialogical Exposure Therapy versus Cognitive Processing Therapy for Adult Outpatients Suffering from PTSD after Type I Trauma in Adulthood

Background: Although there are effective treatments for posttraumatic stress disorder (PTSD), there is little research on treatments with non-cognitive-behavioural backgrounds, such as gestalt therapy. We tested an integrative gestalt-derived intervention, dialogical exposure therapy (DET), against an established cognitive-behavioural treatment (cognitive processing therapy, CPT) for possible differential effects in terms of symptomatic outcome and drop-out rates. Methods: We randomized 141 treatment-seeking individuals with a diagnosis of PTSD to receive either DET or CPT. Therapy length in both treatments was flexible with a maximum duration of 24 sessions. Results: Dropout rates were 12.2% in DET and 14.9% in CPT. Patients in both conditions achieved significant and large reductions in PTSD symptoms (Impact of Event Scale - Revised;Hedges' g = 1.14 for DET and d = 1.57 for CPT) which were largely stable at the 6-month follow-up. At the posttreatment assessment, CPT performed statistically better than DET on symptom and cognition measures. For several outcome measures, younger patients profited better from CPT than older ones, while there was no age effect for DET. Conclusions: Our results indicate that DET merits further research and may be an alternative to established treatments for PTSD. It remains to be seen whether DET confers advantages in areas of functioning beyond PTSD symptoms. (c) 2015 S. Karger AG, Base

Bildung funktioneller Typgruppen des Phytoplanktons: Integration von Modell-, Freiland - und Laborarbeiten

Phytoplankter sind die bedeutendsten Primärproduzenten in aquatischen Ökosystemen und leisten ca. 45 % der globalen Primärproduktion. Sie weisen eine hohe taxonomische Diversität mit vielfältigen morphologischen und physiologischen Eigenschaften auf. Funktionelle Eigenschaften, die das licht-, temperatur- und nährstoffabhängige Wachstum sowie Verlustgrößen (Fraß, Sedimentation) beschreiben, sind eine Möglichkeit Phytoplankter zu klassifizieren. Diese Einteilung gewinnt für das Verständnis und die Modellierung der Phytoplanktonsukzession (z.B. in Wassergütemodellen) immer mehr an Bedeutung, da nicht taxonomische, sondern funktionelle Eigenschaften das Vorkommen der Phytoplankter im Gewässer bestimmen. Das Wassergütemodell SALMO ist ein mechanistisches, dynamisches, vertikales 1D-Modell, welches Nährstoffe, Sauerstoff, Detritus, 4 funktionelle Phytoplanktontypen und eine Zooplanktonmischgruppe simuliert. Bei der Modellanwendung wurde ersichtlich, dass die vorhandenen funktionellen Typgruppen teilweise nicht ausreichen, um die funktionelle Diversität der realen Phytoplanktongemeinschaften adäquat widerzuspiegeln. Deshalb wird eine Erweiterung der funktionellen Typgruppen in SALMO angestrebt. Eine empirische Freilanddatenanalyse an zwei morphologisch und trophisch verschiedenen Talsperren ergab insgesamt 10 funktionelle Phytoplanktontypen (Typgruppen 1, 2 und 4 bereits in SALMO vorhanden). Die bestehenden funktionellen Eigenschaften wurden erweitert und teilweise verändert (insgesamt 10 funktionelle Eigenschaften). Die neue funktionelle Typgruppe 6 (unbewegliche, koloniale, gelatinöse Chlorophyceen) wurde in lichtabhängigen Wachstumsversuchen und Fraßversuchen mit Daphnia galeata × hyalina genauer untersucht. Als stellvertretende Art für diese Typgruppe wurde Sphaerocystis schroeteri gewählt. Die Wachstumsversuche bei 20 °C kennzeichneten Sphaerocystis als Starklichtart mit einer relativ hohen Wachstumsrate (Iopt = 250 µmol m-2 s-1; µmax = 0.96 d-1; 12:12 h Hell-Dunkelzyklus). Eigene Nährmediumsversuche wiesen auf eine Abhängigkeit von freiem CO2 hin. Dies bietet eine Erklärung für ihr häufiges Auftreten in oligo- bis mesotrophen Gewässern. Bei Anwesenheit von Daphnia konnte nach 96 h Versuchsdauer eine signifikante Erhöhung der Koloniegröße (Anteil nicht fressbarer Kolonien 3-74 %), im Vergleich zur Kontrolle (Anteil nicht fressbarer Kolonien 0-5 %), festgestellt werden. Dies stellt einen effektiven Fraßschutz gegen größenselektiv filtrierendes Zooplankton wie z.B. Daphnia dar und kann bei hohem Fraßdruck zur Dominanz der Typgruppe führen (z.B. Klarwasserphase in eutrophen Gewässern). Der Effekt war nicht durch Infochemikalien induzierbar. Aus Literaturdaten wurde eine relativ hohes Topt von 27 °C, eine nur mäßige Konkurrentstärke um Phosphor (mittlerer KP-Wert) sowie eine Brutto-Sinkgeschwindigkeit von 1.5 m d-1 entnommen werden.Phytoplankter are the most important primary producer in aquatic ecosystems and contribute about 45 % to global primary production. Phytoplankton communities usually show an enormous taxonomical diversity. However, besides taxonomical diversity, a phytoplankton can also be characterised by its functional diversity by means of functional traits like resource-dependent growth characteristics (e.g. KI-, KP-, KN-values) or sensitivity to zooplankton grazing and sedimentation. Since functional, and not taxonomic, traits drive the phytoplankton succession, a functional classification of phytoplankton is recognised to be increasingly important for the ecological understanding and modelling of plankton succession (e.g. in water quality models). The mechanistic, dynamic, vertical 1D water quality model SALMO simulates the dynamics of nutrient concentrations (P, N), oxygen, detritus, 4 functional phytoplankton types and 1 mixed zooplankton group. Different model applications showed that the number of phytoplankton types in SALMO was sometimes not sufficient for accounting for the observed functional diversity in phytoplankton communities. Therefore, the aim of this thesis is to extend the functional diversity of phytoplankton types in SALMO. After careful evaluation of empirical data from two reservoirs with different morphology and trophic state 10 functional phytoplankton types are proposed (types 1, 2 and 4 remained unchanged). Existing functional traits in SALMO were extended and partly changed (in total 10 functional traits). For the new functional phytoplankton type 6 (non motile, colonial gelatinous green algae) light-dependent growth rates were measured and grazing experiments with Daphnia galeata × hyalina were carried out in the laboratory. For these experiments, Sphaerocystis schroeteri was chosen as representative species for this group. It is characterised by high light demand and relative high growth rates at 20 °C (µmax = 0.96 d-1, Iopt = 250 µmol m-2 s-1, 12:12 h light-dark cycle). Their growth depends on the availability of free CO2. This explains the common occurrence in oligo-mesotrophic water bodies. The range of the colony sizes of Sphaerocystis increased in the presence of Daphnia significantly (portion of inedible colonies 3-74 %) in contrast to the control (portion of inedible colonies 0-5 %). This was induced by direct size-selective grazing and not by infochemicals. Thus, Sphaerocystis has evolved an effective defence mechanism against size-selective filter-feeding zooplankton and is competitive superior at high zooplankton grazing pressure (e.g. clear water stage in eutrophic waters). The lack of experimentally derived parameters for temperature- and phosphorus-depending growth (Tmin, Topt, KP-value) as well as gross sinking velocity was complemented with literature data. The alga is only moderately competitive for phosphorus and exhibits relatively high minimal and optimal growth temperatures (Tmin = 7 °C, Topt = 27 °C). Since type 6 consists of large, non motile species, gross sinking velocity was estimated to be about 1.5 m d-1

Reliability, Validity and Responsiveness of the EQ-5D-5L in Assessing and Valuing Health Status in Adolescents and Young Adults with Posttraumatic Stress Disorder: a Randomized Controlled Trail

To validate the EQ-5D-5L health-related quality of life (HrQoL) questionnaire in adolescents and young adults with posttraumatic stress disorder (PTSD) after sexual and/or physical abuse. We used data from a randomized controlled trial of 87 participants with PTSD aged 14-21 years. The discriminative ability was evaluated by comparing participants scores on the descriptive system of the EQ-5D-5L with general population scores. Furthermore, the discriminative ability between subgroups of participants with different disease severity levels was estimated. Correlations between the EQ-5D index and clinical parameters were used to measure construct validity. Test-retest reliability was measured by intraclass correlation coefficients (ICC) between baseline, posttreatment and 3-month follow-up scores of participants with stable symptoms. Finally, the responsiveness of the EQ-5D was calculated by mean differences, effect sizes and receiver operating characteristic (ROC) analyses for participants with improved symptoms. Participants reported significantly more problems on the dimensions "mobility", "usual activities", "pain/discomfort" and "anxiety/depression" than the general population. The EQ-5D-5L was able to discriminate between different disease severity levels. The EQ-5D index and clinical scales were significantly correlated with absolute values of correlation coefficients varying between 0.21 and 0.59. Furthermore, ICCs between 0.65 and 0.91 indicated good test-retest reliability for the EQ-5D index. The ICCs for the EQ-VAS between baseline and 3-month follow-up, and posttreatment and 3-month follow-up were statistically significant with 0.71 and 0.87, respectively, whereas the ICC between baseline and posttreatment was 0.08 and not statistically significant. Effect sizes to measure the responsiveness ranged between -0.008 and 0.40 for the EQ-5D index and - 0.32 and 0.40 for the EQ-VAS. Furthermore, the area under the curve in ROC analyses was between 0.40 and 0.64 for the EQ-5D index and 0.60 and 0.70 for the EQ-VAS. Discriminative ability, test-retest reliability and construct validity of the EQ-5D-5L were good, whereas the responsiveness was rather weak. Nevertheless, the EQ-5D-5L can be used to measure HrQoL in adolescents and young adults with PTSD. German Clinical Trials Register identifier: DRKS00004787; date of registration: 18th March 2013; https://www.drks.d

Health-Related Quality of Life and Costs of Posttraumatic Stress Disorder in Adolescents and Young Adults in Germany

Background Posttraumatic stress disorder (PTSD) is one of the psychopathological consequences of sexual and/or physical abuse. The economic burden is assumed to be high, whereas health-related quality of life and education is negatively affected. This study aims to determine health care costs, health-related quality of life, and educational interruption in adolescents and young adults with PTSD after sexual and/or physical abuse in Germany. Methods This analysis used data of 87 participants aged 14-21 years of a randomized controlled trial. Health care utilization, health-related quality of life (EQ-5D-5L), sick leave days, productivity, and delay or failure to achieve educational aims were assessed. Health care costs from a payer perspective were calculated using unit costs for the year 2014. Results Mean health care costs for a six-month period were 5,243euro (SE 868euro). In particular, costs of inpatient stays in psychiatric hospitals, general hospitals and rehabilitation as well as child welfare institutions were high. In addition, health-related quality of life was lower due to anxiety/depression, resulting in a mean EQ-5D index and EQ-VAS score of 0.70 and 61.0, respectively. Furthermore, participants reported on average 27 sick leave days, a productivity loss of 61%, and a delay in education attainment as well as having been unable to achieve educational aims. Conclusion PTSD in adolescents and young adults is associated with a high economic burden. Health-related quality of life was substantially reduced. Furthermore, delay and productivity losses in education were observed

Identification and circumvention of bottlenecks in CYP21A2-mediated premedrol production using recombinant Escherichia coli

Synthetic glucocorticoids such as methylprednisolone are compounds of fundamental interest to the pharmaceutical industry as their modifications within the sterane scaffold lead to higher inflammatory potency and reduced side effects compared with their parent compound cortisol. In methylprednisolone production, the complex chemical hydroxylation of its precursor medrane in position C21 exhibits poor stereo‐ and regioselectivity making the process unprofitable and unsustainable. By contrast, the use of a recombinant E. coli system has recently shown high suitability and efficiency. In this study, we aim to overcome limitations in this biotechnological medrane conversion yielding the essential methylprednisolone‐precursor premedrol by optimizing the CYP21A2‐based whole‐cell system on a laboratory scale. We successfully improved the whole‐cell process in terms of premedrol production by (a) improving the electron supply to CYP21A2; here we use the N‐terminally truncated version of the bovine NADPH‐dependent cytochrome P450 reductase (bCPR−27) and coexpression of microsomal cytochrome b5; (b) enhancing substrate access to the heme by modification of the CYP21A2 substrate access channel; and (c) circumventing substrate inhibition which is presumed to be the main limiting factor of the presented system by developing an improved fed‐batch protocol. By overcoming the presented limitations in whole‐cell biotransformation, we were able to achieve a more than 100% improvement over the next best system under equal conditions resulting in 691 mg·L−1·d−1 premedrol

The 2021 German Federal Election on Social Media: Analysing Electoral Risks Created by Twitter and Facebook

Safeguarding democratic elections is hard. Social media plays a vital role in the discourse around elections and during electoral campaigns. The following article provides an analysis of the ‘systemic electoral risks’ created by Twitter and Facebook and the mitigation strategies employed by the platforms. It is based on the 2020 proposal by the European Commission for the new Digital Services Act (DSA) in the context of the 2021 German federal elections. This article focuses on Twitter and Facebook and their roles during the German federal elections that took place on 26 September 2021. We analysed three systemic electoral risk categories: 1) the dissemination of illegal content, 2) negative effects on electoral rights, and 3) the influence of disinformation and developed systematic categories for this purpose. In conclusion, we discuss how to respond to these challenges as well as avenues for future research

Genome assembly and gene expression in the American black bear provides new insights into the renal response to hibernation.

The prevalence of chronic kidney disease (CKD) is rising worldwide and 10-15% of the global population currently suffers from CKD and its complications. Given the increasing prevalence of CKD there is an urgent need to find novel treatment options. The American black bear (Ursus americanus) copes with months of lowered kidney function and metabolism during hibernation without the devastating effects on metabolism and other consequences observed in humans. In a biomimetic approach to better understand kidney adaptations and physiology in hibernating black bears, we established a high-quality genome assembly. Subsequent RNA-Seq analysis of kidneys comparing gene expression profiles in black bears entering (late fall) and emerging (early spring) from hibernation identified 169 protein-coding genes that were differentially expressed. Of these, 101 genes were downregulated and 68 genes were upregulated after hibernation. Fold changes ranged from 1.8-fold downregulation (RTN4RL2) to 2.4-fold upregulation (CISH). Most notable was the upregulation of cytokine suppression genes (SOCS2, CISH, and SERPINC1) and the lack of increased expression of cytokines and genes involved in inflammation. The identification of these differences in gene expression in the black bear kidney may provide new insights in the prevention and treatment of CKD

Identifying rare variants from exome scans: the GAW17 experience

Genetic Analysis Workshop 17 (GAW17) provided a platform for evaluating existing statistical genetic methods and for developing novel methods to analyze rare variants that modulate complex traits. In this article, we present an overview of the 1000 Genomes Project exome data and simulated phenotype data that were distributed to GAW17 participants for analyses, the different issues addressed by the participants, and the process of preparation of manuscripts resulting from the discussions during the workshop

Pro Libris: Lubuskie Pismo Literacko-Kulturalne, nr 3 (2008)

152 s. : il.

P2P, ad hoc and sensor networks – All the different or all the same?

Currently, data management technologies are in the process of finding their way into evolving networks, i.e. P2P, ad hoc and wireless sensor networks. We examine the properties, differences and commonalities of the different types of evolving networks, in order to enable the development of adequate technologies suiting their characteristics. We start with presenting definitions for the different network types, before arranging them in a network hierarchy, to gain a clear view of the area. Then, we analyze and compare the example applications for each of the types using different design dimensions. Based on this work, we finally present a comparison of P2P, ad hoc and wireless sensor networks