Client Factors That Predict the Therapeutic Alliance in a Chronic, Complex Trauma Sample

This investigation aimed to examine how specific client characteristics of individuals with chronic, complex trauma are associated with the type coping strategies they employ and the quality of the therapeutic alliance. Fifty-nine adult participants with diagnostic levels of posttraumatic stress disorder (PTSD) and who attended therapy for complex trauma in Northern Ireland were obtained via opportunity sampling. Participants completed self-report measures of client attachment style, alexithymia, coping strategies, and the therapeutic alliance. Preoccupied attachment factors such as “Need for Approval” and “Preoccupation with Relationships” were related to use of maladaptive coping strategies. In contrast, the adaptive coping strategies of “Acceptance” and “Instrumental Support” were significant predictors of a positive therapeutic alliance, whereas established psychological and traumatogenic factors (e.g., attachment, number of traumatic events) did not significantly predict the therapeutic alliance. The findings have implications for understanding the relationship between client characteristics and the therapeutic alliance within complex trauma populations, as well as developing protocols to assist this process

Induction of Germinal Centers by MMTV Encoded Superantigen on B Cells

It has not been established whether an endogenous superantigen (SAg) expressed on B cells can induce germinal centers (GCs). An interesting model is that of mammary tumor virus encoded viral SAgs, which induce vigorous T cell proliferation and are predominantly expressed on activated B cells. We have used this model to analyze the possibility that direct stimulation of Mtv7+ DBA/2 B cells by vSAg-responsive (Vβ6+) BALB/c T cells can give rise to GCs. Injection of BALB/c SCID mice iv with 2 × 106 DBA/2 B cells, together with LPS, followed by 2 × 106 BALB/c T cells induces numerous large splenic GCs within 3–5 days. The GCs are still large on day 7, but are very much reduced by day 10. B cell activation with LPS is needed for this effect. These GCs form in spite of the apparent absence of follicular dendritic cells (FDCs) as judged by staining for several FDC surface markers. Control mice receiving either BALB/c T or DBA/2 B cells + LPS alone or DBA/2 T + B cells + LPS fail to exhibit any GCs on days 3–7. Numerous small clusters of PNA+ cells, but few large GCs are observed when TNF-R(p55)-Ig is also injected, whereas LTβR-Ig treatment impeded the formation of aggregations of these cells even further, leaving scattered PNA+ single cells and very small clumps throughout the white pulp of the spleens. Anti-TNFα had no effect. These results suggest that endogenous vSAg mediated GC formation is independent of antigen trapping by FDCs

Argonne National Laboratory Reports

Test E8 simulated a hypothetical $3/s transient overpower accident in an LMFBR using seven (plutonium, uranium) oxide fuel elements of the FTR type. The test elements were pre-irradiated in the PNL-10 assembly in EBR-II to 5 at.% burnup at 30 kW/m. The pre-irradiation in EBR-II caused a fuel-restructuring range characteristic of a low-to-moderate power microstructure for FTR. Failure predictions indicated that fuel with this microstructural characteristic would fail at a lower energy deposition than fuel irradiated at higher power. Data from test-vehicle sensors, hodoscope, and postmortem examinations were used to construct the sequence of events occurring within the test zone. The sequence occurred incoherently across the test cluster, the initial event occurring abruptly at about 29 times nominal power level at an estimated stored energy of about 925 kJ/kg with 50% of the fuel above the solidus at the suspected failure site. After the initial failure, about 2% of the total mass of test fuel was ejected above the original top of the active fuel column. Sodium voiding occurred rapidly. A fuel-debris blockage also apparently prevented further fuel dispersal. Inherent test-vehicle limitations, loss of flow-tube geometry, and nontypical power generation after failure may have caused a departure from the fuel motion predicted for FTR conditions. No violent fuel-coolant interaction or associated work-energy conversion to the coolant was observed

Trade unions and precariat in Europe : representative claims

Trade unions have been charged with neglecting labour market ‘outsiders’, while alternative actors have emerged to represent these. In response, unions have stepped up their claim to be representative of all workers, without distinction. We review the theoretical and policy debates on this issue, and argue that representation as such has been under-theorized. We draw on Saward’s concept of ‘representative claims’ to analyse the different grounds for competing assertions of representativeness. We identify four main forms of claims, and illustrate these with empirical examples. We conclude that these different claims are mutually reinforcing in stimulating attention to the outsiders, and in their interaction with institutional settings, they have a performative effect in defining new social actors

Multivariate Modelling of Pedestrian Fatality Risk Through on the Spot Accident Investigation

Pedestrians are the most vulnerable users of public roads and represent one of the largest groups of road casualties; their death rate around the world due to vehicle-pedestrian collisions is high and tending to rise. In Spain, as in other countries of the European Union, steps have been taken to reduce the number and consequences of such accidents, with encouraging results in recent years. A key to countering this concern is the accident research activity that has obtained remarkable achievements in different fields, especially when multidisciplinary approaches are taken. This paper describes the development of a multivariate model that is able to detect the most influential parameters on the consequences of vehicle-pedestrian collision and to quantify their impact on pedestrian fatality risk. First, an accident database containing detailed information and parameters of vehicle-pedestrian collisions in Madrid has been developed. The accidents were investigated on the spot by INSIA accident investigation teams and analyzed using advanced reconstruction techniques. The model was then developed with two components: (1) a classification tree that characterizes and selects the explanatory variables, identifying their interactions, and (2) a binary logistic regression to quantify the influence of each variable and interaction resulting from the classification tree. The whole model represents an important tool for identifying, quantifying and predicting the potential impact of measures aimed at reducing injuries in vehicle-pedestrian collisions

Pseudomonas aeruginosa quorum sensing molecules correlate with clinical status in cystic fibrosis

ABSTRACT Pseudomonas aeruginosa produces quorum sensing signal molecules that are potential biomarkers for infection. A prospective study of 60 cystic fibrosis patients with chronic P. aeruginosa, who required intravenous antibiotics for pulmonary exacerbations, was undertaken. Clinical measurements and biological samples were obtained at the start and end of the treatment period. Additional data were available for 29 of these patients when they were clinically stable. Cross-sectionally, quorum sensing signal molecules were detectable in the sputum, plasma and urine of 86%, 75% and 83% patients, respectively. They were positively correlated between the three biofluids. Positive correlations were observed for most quorum sensing signal molecules in sputum, plasma and urine, with quantitative measures of pulmonary P. aeruginosa load at the start of a pulmonary exacerbation. Plasma concentrations of 2-nonyl-4-hydroxy-quinoline (NHQ) were significantly higher at the start of a pulmonary exacerbation compared to clinical stability ( p<0.01). Following the administration of systemic antibiotics, plasma 2-heptyl-4-hydroxyquinoline ( p=0.02) and NHQ concentrations (p<0.01) decreased significantly. In conclusion, quorum sensing signal molecules are detectable in cystic fibrosis patients with pulmonary P. aeruginosa infection and are positively correlated with quantitative measures of P. aeruginosa. NHQ correlates with clinical status and has potential as a novel biomarker for P. aeruginosa infection

The prevalence and long-term health effects of Long Covid among hospitalised and non-hospitalised populations: A systematic review and meta-analysis

BACKGROUND: The aim of this study was to systematically synthesise the global evidence on the prevalence of persistent symptoms in a general post COVID-19 population. METHODS: A systematic literature search was conducted using multiple electronic databases (MEDLINE and The Cochrane Library, Scopus, CINAHL, and medRxiv) until January 2022. Studies with at least 100 people with confirmed or self-reported COVID-19 symptoms at ≥28 days following infection onset were included. Patient-reported outcome measures and clinical investigations were both assessed. Results were analysed descriptively, and meta-analyses were conducted to derive prevalence estimates. This study was pre-registered (PROSPERO-ID: CRD42021238247). FINDINGS: 194 studies totalling 735,006 participants were included, with five studies conducted in those <18 years of age. Most studies were conducted in Europe (n = 106) or Asia (n = 49), and the time to follow-up ranged from ≥28 days to 387 days. 122 studies reported data on hospitalised patients, 18 on non-hospitalised, and 54 on hospitalised and non-hospitalised combined (mixed). On average, at least 45% of COVID-19 survivors, regardless of hospitalisation status, went on to experience at least one unresolved symptom (mean follow-up 126 days). Fatigue was frequently reported across hospitalised (28.4%; 95% CI 24.7%-32.5%), non-hospitalised (34.8%; 95% CI 17.6%-57.2%), and mixed (25.2%; 95% CI 17.7%-34.6%) cohorts. Amongst the hospitalised cohort, abnormal CT patterns/x-rays were frequently reported (45.3%; 95% CI 35.3%-55.7%), alongside ground glass opacification (41.1%; 95% CI 25.7%-58.5%), and impaired diffusion capacity for carbon monoxide (31.7%; 95% CI 25.8%-3.2%). INTERPRETATION: Our work shows that 45% of COVID-19 survivors, regardless of hospitalisation status, were experiencing a range of unresolved symptoms at ∼ 4 months. Current understanding is limited by heterogeneous study design, follow-up durations, and measurement methods. Definition of subtypes of Long Covid is unclear, subsequently hampering effective treatment/management strategies. FUNDING: No funding

Fresolimumab Treatment Decreases Biomarkers and Improves Clinical Symptoms in Systemic Sclerosis Patients

BACKGROUND. TGF-β has potent profibrotic activity in vitro and has long been implicated in systemic sclerosis (SSc), as expression of TGF-β–regulated genes is increased in the skin and lungs of patients with SSc. Therefore, inhibition of TGF-β may benefit these patients. METHODS. Patients with early, diffuse cutaneous SSc were enrolled in an open-label trial of fresolimumab, a high-affinity neutralizing antibody that targets all 3 TGF-β isoforms. Seven patients received two 1 mg/kg doses of fresolimumab, and eight patients received one 5 mg/kg dose of fresolimumab. Serial mid-forearm skin biopsies, performed before and after treatment, were analyzed for expression of the TGF-β–regulated biomarker genes thrombospondin-1 (THBS1) and cartilage oligomeric protein (COMP) and stained for myofibroblasts. Clinical skin disease was assessed using the modified Rodnan skin score (MRSS). RESULTS. In patient skin, THBS1 expression rapidly declined after fresolimumab treatment in both groups (P = 0.0313 at 7 weeks and P = 0.0156 at 3 weeks), and skin expression of COMP exhibited a strong downward trend in both groups. Clinical skin disease dramatically and rapidly decreased (P \u3c 0.001 at all time points). Expression levels of other TGF-β–regulated genes, including SERPINE1 and CTGF, declined (P = 0.049 and P = 0.012, respectively), and a 2-gene, longitudinal pharmacodynamic biomarker of SSc skin disease decreased after fresolimumab treatment (P = 0.0067). Dermal myofibroblast infiltration also declined in patient skin after fresolimumab (P \u3c 0.05). Baseline levels of THBS1 were predictive of reduced THBS1 expression and improved MRSS after fresolimumab treatment. CONCLUSION. The rapid inhibition of TGF-β–regulated gene expression in response to fresolimumab strongly implicates TGF-β in the pathogenesis of fibrosis in SSc. Parallel improvement in the MRSS indicates that fresolimumab rapidly reverses markers of skin fibrosis

The unexpected resurgence of Weyl geometry in late 20-th century physics

Weyl's original scale geometry of 1918 ("purely infinitesimal geometry") was withdrawn by its author from physical theorizing in the early 1920s. It had a comeback in the last third of the 20th century in different contexts: scalar tensor theories of gravity, foundations of gravity, foundations of quantum mechanics, elementary particle physics, and cosmology. It seems that Weyl geometry continues to offer an open research potential for the foundations of physics even after the turn to the new millennium.Comment: Completely rewritten conference paper 'Beyond Einstein', Mainz Sep 2008. Preprint ELHC (Epistemology of the LHC) 2017-02, 92 pages, 1 figur