5,016 research outputs found
The clinical effectiveness of concise cognitive behavioral therapy with or without pharmacotherapy for depressive and anxiety disorders; a pragmatic randomized controlled equivalence trial in clinical practice
Background: Depressive and anxiety disorders contribute to a high disease burden. This paper investigates whether concise formats of cognitive behavioral- and/or pharmacotherapy are equivalent with longer standard care in the treatment of depressive and/or anxiety disorders in secondary mental health care. Methods: A pragmatic randomized controlled equivalence trial was conducted at five Dutch outpatient Mental Healthcare Centers (MHCs) of the Regional Mental Health Provider (RMHP) \u27Rivierduinen\u27. Patients (aged 18-65 years) with a mild to moderate anxiety and/or depressive disorder, were randomly allocated to concise or standard care. Data were collected at baseline, 3, 6 and 12 months by Routine Outcome Monitoring (ROM). Primary outcomes were the Brief Symptom Inventory (BSI) and the Web Screening Questionnaire (WSQ). We used Generalized Estimating Equations (GEE) to assess outcomes. Results: Between March 2010 and December 2012, 182 patients, were enrolled (n = 89 standard care; n = 93 concise care). Both intention-to-treat and per-protocol analyses demonstrated equivalence of concise care and standard care at all time points. Severity of illness reduced, and both treatments improved patient\u27s general health status and subdomains of quality of life. Moreover, in concise care, the beneficial effects started earlier. Discussion: Concise care has the potential to be a feasible and promising alternative to longer standard secondary mental health care in the treatment of outpatients with a mild to moderate depressive and/or anxiety disorder. For future research, we recommend adhering more strictly to the concise treatment protocols to further explore the beneficial effects of the concise treatment
Π Π½Π΅ΠΊΠΎΡΠΎΡΡΡ ΡΠ΅Π½Π΄Π΅Π½ΡΠΈΡΡ , ΠΎΡΠ»ΠΎΠΆΠ½ΠΈΠ²ΡΠΈΡ Π² Π½Π°ΡΠ°Π»Π΅ Π₯Π₯I Π²Π΅ΠΊΠ° ΠΏΠ΅ΡΡΠΏΠ΅ΠΊΡΠΈΠ²Ρ ΠΊΡΡΠΎΡΡΠ½ΠΎ-ΡΠ΅ΠΊΡΠ΅Π°ΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΡΡΠΌΠ°
Π¦Π΅Π»ΡΡ ΡΠ°Π±ΠΎΡΡ ΡΠ²ΠΈΠ»ΡΡ Π°Π½Π°Π»ΠΈΠ· Π²Π·Π°ΠΈΠΌΠΎΠ²Π»ΠΈΡΠ½ΠΈΡ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ², ΡΡΠΆΠ°ΡΡΠΈΡ
ΠΏΠΎΡΠ΅Π½ΡΠΈΠ°Π» ΡΡΡΠΈΡΡΡΠΊΠΎ-ΡΠ΅ΠΊΡΠ΅Π°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΏΡΠΈΠ²Π»Π΅ΠΊΠ°ΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΠΡΡΠΌΠ°, Π΄Π»Ρ ΡΡΠΎΡΠ½Π΅Π½ΠΈΡ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠ΅ΠΉ ΠΎΠ±ΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π΅Π³ΠΎ ΠΏΠ΅ΡΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΡΠ°Π·Π²ΠΈΡΠΈΡ
Quantitative screening of an extended oxidative coupling of methane catalyst library
A comprehensive microkinetic model, including catalyst descriptors, that accounts for the homogeneous as well as heterogeneously catalyzed reaction steps in Oxidative Coupling of Methane (OCM) was used in the assessment of large kinetic datasets acquired on five different catalytic materials. The applicability of the model was extended from alkali magnesia catalysts represented by Li/MgO and Sn-Li/MgO and alkaline earth lanthana catalysts represented by Sr/La2O3 to rare earth-promoted alkaline earth calcium oxide catalysts, represented by LaSr/CaO, and to a Na-Mn-W/SiO2 catalyst. The model succeeded in adequately simulating the performance of all five investigated catalysts in terms of reactant conversion and product selectivities in the entire range of experimental conditions. It was found that the activity of Sr/La2O3, in terms of methane conversion, is approximately 2, 5, 30 and 33 times higher than over the La-Sr/CaO, Sn-Li/MgO, Na-Mn-W/SiO2 and Li/MgO catalysts, respectively, under identical operating conditions. This was attributed mainly to the high stability of adsorbed hydroxyls, the high stability of adsorbed oxygen and the high concentration of active sites of Sr/La2O3. The selectivity towards C2 products was found to depend on the methyl radical sticking coefficient and the stability of the adsorbed oxygen and was the highest on the Na-W-Mn/SiO2 catalyst, that is 75% at about 1% methane conversion and 1023 K, 190 kPa and inlet molar CH4/O2 ratio of 4
Increased epidermal thickness and abnormal epidermal differentiation in keloid scars
Background: The pathogenesis underlying keloid formation is still poorly understood. Research has focused mostly on dermal abnormalities, while the epidermis has not yet been studied.
Objectives: To identify differences within the epidermis of mature keloid scars compared with normal skin and mature normotrophic and hypertrophic scars.
Methods: Rete ridge formation and epidermal thickness were evaluated in tissue sections. Epidermal proliferation was assessed using immunohistochemistry (Ki67, keratins 6, 16 and 17) and with an in vitro proliferation assay. Epidermal differentiation was evaluated using immunohistochemistry (keratin 10, involucrin, loricrin, filaggrin, SPRR2, SKALP), reverse-transcriptase polymerase chain reaction (involucrin) and transmission electron microscopy (stratum corneum).
Results: All scars showed flattening of the epidermis. A trend of increasing epidermal thickness correlating to increasing scar abnormality was observed when comparing normal skin, normotrophic scars, hypertrophic scars and keloids. No difference in epidermal proliferation was observed. Only the early differentiation marker involucrin showed abnormal expression in scars. Involucrin was restricted to the granular layer in healthy skin, but showed panepidermal expression in keloids. Normotrophic scars expressed involucrin in the granular and upper spinous layers, while hypertrophic scars resembled normotrophic scars or keloids. Abnormal differentiation was associated with ultrastructural disorganization of the stratum corneum in keloids compared with normal skin.
Conclusions: Keloids showed increased epidermal thickness compared with normal skin and normotrophic and hypertrophic scars. This was not due to hyperproliferation, but possibly caused by abnormal early terminal differentiation, which affects stratum corneum formation. Our findings indicate that the epidermis is associated with keloid pathogenesis and identify involucrin as a potential diagnostic marker for abnormal scarring
Distribution and kinematics of the HCN(3-2) emission down to the innermost region in the envelope of the O-rich star W Hya
We report high angular resolution observations of the HCN (3-2) line emission
in the circumstellar envelope of the O-rich star W Hya with the Submillimeter
Array. The proximity of this star allows us to image its molecular envelope
with a spatial resolution of just ~40 AU, corresponding to about 10 times the
stellar diameter. We resolve the HCN (3-2) emission and find that it is
centrally peaked and has a roughly spherically symmetrical distribution. This
shows that HCN is formed in the innermost region of the envelope (within ~10
stellar radii), which is consistent with predictions from pulsation-driven
shock chemistry models, and rules out the scenario in which HCN forms through
photochemical reactions in the outer envelope. Our model suggests that the
envelope decreases steeply in temperature and increases smoothly in velocity
with radius, inconsistent with the standard model for mass-loss driven by
radiative pressure on dust grains. We detect a velocity gradient of ~5 km/s in
the NW--SE direction over the central 40 AU. This velocity gradient is
reminescent of that seen in OH maser lines, and could be caused by the rotation
of the envelope or by a weak bipolar outflow.Comment: accepted for publication in ApJ
Speed Matters: Relationship between Speed of Eye Movements and Modification of Aversive Autobiographical Memories
Eye movement desensitization and reprocessing (EMDR) is an efficacious treatment for post-traumatic stress disorder. In EMDR, patients recall a distressing memory and simultaneously make eye movements (EM). Both tasks are considered to require limited working memory (WM) resources. Because this leaves fewer resources available for memory retrieval, the memory should become less vivid and less emotional during future recall. In EMDR analogue studies, a standardized procedure has been used, in which participants receive the same dual task manipulation of 1 EM cycle per second (1 Hz). From a WM perspective, the WM taxation of the dual task might be titrated to the WM taxation of the memory image. We hypothesized that highly vivid images are more affected by high WM taxation and less vivid images are more affected by low WM taxation. In study 1, 34 participants performed a reaction time task, and rated image vividness, and difficulty of retrieving an image, during five speeds of EM and no EM. Both a high WM taxing frequency (fast EM; 1.2 Hz) and a low WM taxing frequency (slow EM; 0.8 Hz) were selected. In study 2, 72 participants recalled three highly vivid aversive autobiographical memory images (n = 36) or three less vivid images (n = 36) under each of three conditions: recall + fast EM, recall + slow EM, or recall only. Multi-level modeling revealed a consistent pattern for all outcome measures: recall + fast EM led to less emotional, less vivid and more difficult to retrieve images than recall + slow EM and recall only, and the effects of recall + slow EM felt consistently in between the effects of recall + fast EM and recall only, but only differed significantly from recall + fast EM. Crucially, image vividness did not interact with condition on the decrease of emotionality over time, which was inconsistent with the prediction. Implications for understanding the mechanisms of action in memory modification and directions for future research are discussed
Pulsations and Long-Term Light Variability of Three Candidates to Protoplanetary Nebulae
We present new photometric data and analysis of the long-duration UBV
photoelectric observations for three candidates to protoplanetary objects -
F-supergiants with IR-excesses located at large galactic latitudes, IRAS
18095+2704, IRAS 19386+0155, and IRAS 19500-1709. All three stars have revealed
quasiperiodic low-amplitude variabilities caused by pulsations observed against
the long-term trends of brightnesses. For IRAS 18095+2704=V887 Her we have
found a pulsation period of 109 days and a linear trend of brightness under the
constant colours if being averaged over the year timescale. The light curve of
IRAS 19386+0155=V1648 Aql over 2000-2008 can be approximated by a wave with a
main period of 102 days which is modulated by close frequency, with a period of
98 days, that results in brightness oscillations with a variable amplitude.
V1648 Aql has also shown synchronous reddening together with a persistent rise
of brightness in the V-band. IRAS 19500-1709=V5112 Sgr experiences irregular
pulsations with the periods of 39 and 47 days. The long-term component of the
variability of V5112 Sgr may be related to the binary character of this star.Comment: 11 pages, 6 figures, accepted for publication in Pis'ma Astron. Z
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