Emdr y el modelo de procesamiento adaptativo de la información (pai) mecanismos potenciales de cambio

Eye movement desensitization and reprocessing (EMDR) is a therapeutic approach guided by the adaptive information processing (AIP) model. This article provides a brief overview of some of the major precepts of AIP. The basis of clinical pathology is hypothesized to be dysfunctionally stored memories,with therapeutic change resulting from the processing of these memories within larger adaptive networks. Unlike extinction-based exposure therapies, memories targeted in EMDR are posited to transmute during processing and are then again stored by a process of reconsolidation. Therefore, a comparison and contrast to extinction-based information processing models and treatment is provided, including implications for clinical practice. Throughout the article a variety of mechanisms of action are discussed, including those inferred by tenets of the AIP model, and the EMDR procedures themselves, including the bilateral stimulation. Research suggestions are offered in order to investigate various hypotheses.La desensibilización y reprocesamiento mediante movimientos oculares (EMDR) es un abordaje terapéutico que está guiado por el modelo de procesamiento adaptativo de la información (PAI). Este artículo proporciona una breve visión de conjunto de algunos de los principales preceptos del PAI. Se plantea la hipótesis de que la base de la patología clínica radicaría en los recuerdos almacenados disfuncionalmente, derivándose los resultados terapéuticos obtenidos del procesamiento de tales recuerdos dentro de redes adaptativas mayores. A diferencia de las terapias de exposición basadas en la extinción, se postula que los recuerdos considerados como diana en el EMDR pueden sufrir la transmutación durante el procesamiento para ser luego almacenados nuevamente durante el proceso de reconsolidación. Por ello, se proporciona una comparación y un contraste con los modelos de procesamiento de la información basados en la extinción como así también el tratamiento, que incluye las repercusiones que puede tener para la práctica clínica. A lo largo del artículo se comenta una diversidad de mecanismos de acción, incluidos aquellos que se deducen de los principios del modelo PAI como de los propios procedimientos del EMDR, entre los que figura la estimulación bilateral. A fin de investigar las diversas hipótesis, se ofrecen sugerencias de investigación

When Can Antibiotic Treatments for Trachoma Be Discontinued? Graduating Communities in Three African Countries

Trachoma, the major cause of infectious blindness in the world, occurs when repeated infections of the ocular strains of Chlamydia trachomatis lead to a cascade of conjunctival scarring, in-turned eyelids and eyelashes, and eventually blindness due to corneal opacity. To reduce the prevalence of infection, the World Health Organization (WHO) advocates at least three annual community-wide distributions of oral antibiotics in affected areas. This approach has proven effective, but there is room to explore other treatment strategies which reduce the use of antibiotics. Here, we used mathematical models and data from three trachoma-endemic countries (Tanzania, The Gambia, and Ethiopia) to analyze different treatment strategies. In the simulations, we show that a graduation strategy can reduce antibiotic distributions more than 2-fold in moderately affected areas. Both treatment strategies provide favorable results in reducing the prevalence of ocular chlamydia, but high costs and the potential for resistance are important issues to consider when administering mass doses of antibiotics

Molecular gas in high-velocity clouds: revisited scenario

We report a new search for 12CO(1-0) emission in high-velocity clouds (HVCs) performed with the IRAM 30 m telescope. This search was motivated by the recent detection of cold dust emission in the HVCs of Complex C. Despite a spatial resolution which is three times better and sensitivity twice as good compared to previous studies, no CO emission is detected in the HVCs of Complex C down to a best 5 sigma limit of 0.16 K km/s at a 22'' resolution. The CO emission non-detection does not provide any evidence in favor of large amounts of molecular gas in these HVCs and hence in favor of the infrared findings. We discuss different configurations which, however, allow us to reconcile the negative CO result with the presence of molecular gas and cold dust emission. H2 column densities higher than our detection limit, N(H2) = 3x10^{19} cm^{-2}, are expected to be confined in very small and dense clumps with 20 times smaller sizes than the 0.5 pc clumps resolved in our observations according to the results obtained in cirrus clouds, and might thus still be highly diluted. As a consequence, the inter-clump gas at the 1 pc scale has a volume density lower than 20 cm^{-3} and already appears as too diffuse to excite the CO molecules. The observed physical conditions in the HVCs of Complex C also play an important role against CO emission detection. It has been shown that the CO-to-H2 conversion factor in low metallicity media is 60 times higher than at the solar metallicity, leading for a given H2 column density to a 60 times weaker integrated CO intensity. And the very low dust temperature estimated in these HVCs implies the possible presence of gas cold enough (< 20 K) to cause CO condensation onto dust grains under interstellar medium pressure conditions and thus CO depletion in gas-phase observations.Comment: 9 pages, 4 figures, Accepted for publication in A&

Evaluation of a communication skills program for first-year medical students at the University of Toronto

Abstract Background Effective doctor-patient communication has been linked to numerous benefits for both patient and physician. The purpose of this study was to evaluate the effectiveness of the University of Toronto's Therapeutic Communication Program (TCom) at improving first-year medical students' communication skills. Methods Data were collected during the 1996/97, 1997/98, 1998/99 and 1999/00 academic years. The study used a repeated measures design with a waiting list control group: students were randomly assigned to groups starting the educational intervention in either September (N = 38) or February (N = 41), with the latter being used as a control for the former. Communication skills were assessed at the pre- and post-intervention times and at the end of the academic year from the perspectives of student, standardized patient and external rater. Results Only the external rater, using an instrument designed to assess the students' empathy based on their written responses, showed a time × group interaction effect (p = 0.039), thereby partially supporting the hypothesis that TCom improved the students' communication skills. Students rated themselves less positively after participation in the program (p = 0.038), suggesting that self-evaluation was an ineffective measure of actual performance or that the program helped them learn to more accurately assess their abilities. Conclusion The lack of strong findings may be partly due to the study's small sample sizes. Further research at other medical or professional schools could assess the effectiveness of similar courses on students' communication skills and on other capacities that were not measured in this study, such as their understanding of and comfort with patients, their management of the doctor-patient relationship, and their ability to give and receive feedback

Metal-substituted protein MRI contrast agents engineered for enhanced relaxivity and ligand sensitivity

Engineered metalloproteins constitute a flexible new class of analyte-sensitive molecular imaging agents detectable by magnetic resonance imaging (MRI), but their contrast effects are generally weaker than synthetic agents. To augment the proton relaxivity of agents derived from the heme domain of cytochrome P450 BM3 (BM3h), we formed manganese(III)-containing proteins that have higher electron spin than their native ferric iron counterparts. Metal substitution was achieved by coexpressing BM3h variants with the bacterial heme transporter ChuA in Escherichia coli and supplementing the growth medium with Mn3+-protoporphyrin IX. Manganic BM3h variants exhibited up to 2.6-fold higher T1 relaxivities relative to native BM3h at 4.7 T. Application of ChuA-mediated porphyrin substitution to a collection of thermostable chimeric P450 domains resulted in a stable, high-relaxivity BM3h derivative displaying a 63% relaxivity change upon binding of arachidonic acid, a natural ligand for the P450 enzyme and an important component of biological signaling pathways. This work demonstrates that protein-based MRI sensors with robust ligand sensitivity may be created with ease by including metal substitution among the toolkit of methods available to the protein engineer.National Institutes of Health (U.S.) (NIH Grant R01-DA28299 )National Institutes of Health (U.S.) (NIH NRSA Fellowship (Award F32-GM087102))California Institute of Technology (Caltech Jacobs Grant

Deep observations of CO line emission from star-forming galaxies in a cluster candidate at z=1.5

We report results from a deep Jansky Very Large Array (JVLA) search for CO 1-0 line emission from galaxies in a candidate galaxy cluster at z~1.55 in the COSMOS field. We target 4 galaxies with optical spectroscopic redshifts in the range z=1.47-1.59. Two of these 4 galaxies, ID51613 and ID51813, are nominally detected in CO line emission at the 3-4 sigma level. We find CO luminosities of 2.4x10^10 K km/s pc^2 and 1.3x10^10 K km/s pc^2, respectively. Taking advantage from the clustering and 2-GHz bandwidth of the JVLA, we perform a search for emission lines in the proximity of optical sources within the field of view of our observations. We limit our search to galaxies with K<23.5 (AB) and z_phot=1.2-1.8. We find 2 bright optical galaxies to be associated with significant emission line peaks (>4 sigma) in the data cube, which we identify with the CO line emission. To test the reliability of the line peaks found, we performed a parallel search for line peaks using a Bayesian inference method. Monte Carlo simulations show that such associations are statistically significant, with probabilities of chance association of 3.5% and 10.7% for ID 51207 and ID 51380, respectively. Modeling of their optical/IR SEDs indicates that the CO detected galaxies and candidates have stellar masses and SFRs in the range (0.3-1.1)x10^11 M_sun and 60-160 M_sun/yr, with SFEs comparable to that found in other star-forming galaxies at similar redshifts. By comparing the space density of CO emitters derived from our observations with the space density derived from previous CO detections at z~1.5, and with semi-analytic predictions for the CO luminosity function, we suggest that the latter tend to underestimate the number of CO galaxies detected at high-redshift. Finally, we argue about the benefits of future blind CO searches in clustered fields with upcoming submm/radio facilities.Comment: Accepted for publication in MNRAS. Abstract has been slightly shortened compared to original pdf versio

A First- and Second-Order Motion Energy Analysis of Peripheral Motion Illusions Leads to Further Evidence of “Feature Blur” in Peripheral Vision

Anatomical and physiological differences between the central and peripheral visual systems are well documented. Recent findings have suggested that vision in the periphery is not just a scaled version of foveal vision, but rather is relatively poor at representing spatial and temporal phase and other visual features. Shapiro, Lu, Huang, Knight, and Ennis (2010) have recently examined a motion stimulus (the “curveball illusion”) in which the shift from foveal to peripheral viewing results in a dramatic spatial/temporal discontinuity. Here, we apply a similar analysis to a range of other spatial/temporal configurations that create perceptual conflict between foveal and peripheral vision.To elucidate how the differences between foveal and peripheral vision affect super-threshold vision, we created a series of complex visual displays that contain opposing sources of motion information. The displays (referred to as the peripheral escalator illusion, peripheral acceleration and deceleration illusions, rotating reversals illusion, and disappearing squares illusion) create dramatically different perceptions when viewed foveally versus peripherally. We compute the first-order and second-order directional motion energy available in the displays using a three-dimensional Fourier analysis in the (x, y, t) space. The peripheral escalator, acceleration and deceleration illusions and rotating reversals illusion all show a similar trend: in the fovea, the first-order motion energy and second-order motion energy can be perceptually separated from each other; in the periphery, the perception seems to correspond to a combination of the multiple sources of motion information. The disappearing squares illusion shows that the ability to assemble the features of Kanisza squares becomes slower in the periphery.The results lead us to hypothesize “feature blur” in the periphery (i.e., the peripheral visual system combines features that the foveal visual system can separate). Feature blur is of general importance because humans are frequently bringing the information in the periphery to the fovea and vice versa

Haptoglobin improves shock, lung injury, and survival in canine pneumonia

During the last half-century, numerous antiinflammatory agents were tested in dozens of clinical trials and have proven ineffective for treating septic shock. The observation in multiple studies that cell-free hemoglobin (CFH) levels are elevated during clinical sepsis and that the degree of increase correlates with higher mortality suggests an alternative approach. Human haptoglobin binds CFH with high affinity and, therefore, can potentially reduce iron availability and oxidative activity. CFH levels are elevated over approximately 24-48 hours in our antibiotic-treated canine model of S. aureus pneumonia that simulates the cardiovascular abnormalities of human septic shock. In this 96-hour model, resuscitative treatments, mechanical ventilation, sedation, and continuous care are translatable to management in human intensive care units. We found, in this S. aureus pneumonia model inducing septic shock, that commercial human haptoglobin concentrate infusions over 48-hours bind canine CFH, increase CFH clearance, and lower circulating iron. Over the 96-hour study, this treatment was associated with an improved metabolic profile (pH, lactate), less lung injury, reversal of shock, and increased survival. Haptoglobin binding compartmentalized CFH to the intravascular space. This observation, in combination with increasing CFHs clearance, reduced available iron as a potential source of bacterial nutrition while decreasing the ability for CFH and iron to cause extravascular oxidative tissue injury. In contrast, haptoglobin therapy had no measurable antiinflammatory effect on elevations in proinflammatory C-reactive protein and cytokine levels. Haptoglobin therapy enhances normal host defense mechanisms in contrast to previously studied antiinflammatory sepsis therapies, making it a biologically plausible novel approach to treat septic shock

Constraints on Galactic Intermediate Mass Black Holes

Intermediate Mass Black Holes (IMBHs; 10^1.3-5 M_sun) are thought to form as relics of Population III stars or from the runaway collapse of stars in young clusters; their number and very existence are uncertain. We ran N-body simulations of Galactic IMBHs, modelling them as a halo population distributed according to a Navarro, Frenk & White (NFW) or a more concentrated Diemand, Madau & Moore (DMM) density profile. As IMBHs pass through Galactic molecular/atomic hydrogen regions, they accrete gas, thus becoming X-ray sources. We constrain the density of Galactic IMBHs, Omega_IMBH, by comparing the distribution of simulated X-ray sources with the observed one. From the null detections of Milky Way Ultra-Luminous X-ray sources, and from a comparison of simulations with unidentified sources in the IBIS/ISGRI catalogue we find a strong upper limit Omega_IMBH <= 10^-2 Omega_b (<= 10^-1 Omega_b) for a DMM (NFW) profile, if IMBHs accrete via ADAF disks. Slightly stronger constraints (Omega_IMBH <= 10^-3 Omega_b for a DMM profile; Omega_IMBH <= 10^-2 Omega_b for a NFW profile) can be derived if IMBHs accrete with higher efficiency, such as by forming thin accretion disks. Although not very tight, such constraints are the most stringent ones derived so far in the literature.Comment: 12 pages, 5 figures; MNRAS, in pres

HIV and pre-neoplastic and neoplastic lesions of the cervix in South Africa: a case-control study

BACKGROUND: Cervical cancer and infection with human immunodeficiency virus (HIV) are both major public health problems in South Africa. The aim of this study was to determine the risk of cervical pre-cancer and cancer among HIV positive women in South Africa. METHODS: Data were derived from a case-control study that examined the association between hormonal contraceptives and invasive cervical cancer. The study was conducted in the Western Cape (South Africa), from January 1998 to December 2001. There were 486 women with invasive cervical cancer, 103 control women with atypical squamous cells of undetermined significance (ASCUS), 53 with low-grade squamous intraepithelial lesions (LSIL), 50 with high-grade squamous intraepithelial lesions (HSIL) and 1159 with normal cytology. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multiple logistic regression. RESULTS: The adjusted odds ratios associated with HIV infection were: 4.4 [95% CI (2.3 – 8.4) for ASCUS, 7.4 (3.5 – 15.7) for LSIL, 5.8 (2.4 – 13.6) for HSIL and 1.17 (0.75 – 1.85) for invasive cervical cancer. HIV positive women were nearly 5 times more likely to have high-risk human papillomavirus infection (HR-HPV) present compared to HIV negative women [OR 4.6 (95 % CI 2.8 – 7.5)]. Women infected with both HIV and high-risk HPV had a more than 40 fold higher risk of SIL than women infected with neither of these viruses. CONCLUSION: HIV positive women were at an increased risk of cervical pre-cancer, but did not demonstrate an excess risk of invasive cervical cancer. An interaction between HIV and HR-HPV infection was demonstrated. Our findings underscore the importance of developing locally relevant screening and management guidelines for HIV positive women in South Africa