“It’s like uprooting trees”: responsive treatment for a case of complex post-traumatic stress disorder following multiple rapes

This systematic case study documents 27 sessions of assessment and treatment with cognitive therapy of Bongi (23)who presented with major depression, posttraumatic stress disorder and borderline traits. Bongi had been raised in a punitive environment, had been raped three times, the first time at age 9, and had been in a series of abusive relationships. The treatment illustrates the importance of therapist responsiveness in addressing this kind of complex presentation, the importance of drawing on case formulation to guide the course of treatment and the range of different interventions that need to be incorporated into an integrative treatment of a complex case. Self-report measures of depression, anxiety and posttraumatic stress indicators provided evidence that the therapy contributed to positive changes and the qualitative therapy narrative gives details of the nature of some of those changes. Although treatment was not complete when Bongi moved away, Bongi herself judged that the therapy had been a valuable experience which had resulted in her feeling more alive, more confident, and better able to take care of herself

Conned by Conn’s Syndrome

Conn’s Syndrome is a rare entity amongst hypertensive patients and imaging of the aldosterone producing adenoma (APA) can prove challenging but is none the less very important for surgical planning and cure. We present two patients with MRI confirmation of APA with negative and equivocal computed tomography (CT) scans

Docking Haptics: Extending the Reach of Haptics by Dynamic Combinations of Grounded and Worn Devices

Grounded haptic devices can provide a variety of forces but have limited working volumes. Wearable haptic devices operate over a large volume but are relatively restricted in the types of stimuli they can generate. We propose the concept of docking haptics, in which different types of haptic devices are dynamically docked at run time. This creates a hybrid system, where the potential feedback depends on the user's location. We show a prototype docking haptic workspace, combining a grounded six degree-of-freedom force feedback arm with a hand exoskeleton. We are able to create the sensation of weight on the hand when it is within reach of the grounded device, but away from the grounded device, hand-referenced force feedback is still available. A user study demonstrates that users can successfully discriminate weight when using docking haptics, but not with the exoskeleton alone. Such hybrid systems would be able to change configuration further, for example docking two grounded devices to a hand in order to deliver twice the force, or extend the working volume. We suggest that the docking haptics concept can thus extend the practical utility of haptics in user interfaces

Generation and Characterization of Fmr1 Knockout Zebrafish

Fragile X syndrome (FXS) is one of the most common known causes of inherited mental retardation. The gene mutated in FXS is named FMR1, and is well conserved from human to Drosophila. In order to generate a genetic tool to study FMR1 function during vertebrate development, we generated two mutant alleles of the fmr1 gene in zebrafish. Both alleles produce no detectable Fmr protein, and produce viable and fertile progeny with lack of obvious phenotypic features. This is in sharp contrast to published results based on morpholino mediated knock-down of fmr1, reporting defects in craniofacial development and neuronal branching in embryos. These phenotypes we specifically addressed in our knock-out animals, revealing no significant deviations from wild-type animals, suggesting that the published morpholino based fmr1 phenotypes are potential experimental artifacts. Therefore, their relation to fmr1 biology is questionable and morpholino induced fmr1 phenotypes should be avoided in screens for potential drugs suitable for the treatment of FXS. Importantly, a true genetic zebrafish model is now available which can be used to study FXS and to derive potential drugs for FXS treatment

Generation of human induced pluripotent stem cell lines (LUMCi051-A,B and LUMCi052-A,B,C) of two patients with Spinocerebellar ataxia type 7

Spinocerebellar Ataxia Type 7 (SCA7) is an autosomal dominantly inherited disorder, primarily characterized by cerebellar ataxia and visual loss. SCA7 is caused by a CAG repeat expansion in exon 3 of the ATXN7 gene. We generated human induced pluripotent stem cells (hiPSCs) from peripheral blood-derived erythroblasts from two SCA7 patients (LUMCi051-A,B and LUMCi052-A,B,C) using integration-free episomal vectors. All hiPSC clones express pluripotency factors, show a normal karyotype, and can differentiate into the three germ layers. These lines can be used for in vitro disease modeling and therapy testing.</p

Connected pathway relative permeability from pore-scale imaging of imbibition

Pore-scale images obtained from a synchrotron-based X-ray computed micro-tomography (µCT) imbibition experiment in sandstone rock were used to conduct Navier–Stokes flow simulations on the connected pathways of water and oil phases. The resulting relative permeability was compared with steady-state Darcy-scale imbibition experiments on 5 cm large twin samples from the same outcrop sandstone material. While the relative permeability curves display a large degree of similarity, the endpoint saturations for the µCT data are 10% in saturation units higher than the experimental data. However, the two datasets match well when normalizing to the mobile saturation range. The agreement is particularly good at low water saturations, where the oil is predominantly connected. Apart from different saturation endpoints, in this particular experiment where connected pathway flow dominates, the discrepancies between pore-scale connected pathway flow simulations and Darcy-scale steady-state data are minor overall and have very little impact on fractional flow. The results also indicate that if the pore-scale fluid distributions are available and the amount of disconnected non-wetting phase is low, quasi-static flow simulations may be sufficient to compute relative permeability. When pore-scale fluid distributions are not available, fluid distributions can be obtained from a morphological approach, which approximates capillary-dominated displacement. The relative permeability obtained from the morphological approach compare well to drainage steady state whereas major discrepancies to the imbibition steady-state experimental data are observed. The morphological approach does not represent the imbibition process very well and experimental data for the spatial arrangement of the phases are required. Presumably for modeling imbibition relative permeability an approach is needed that captures moving liquid-liquid interfaces, which requires viscous and capillary forces simultaneously

Rainfall, geology and landscape position generate large-scale spatiotemporal fire pattern heterogeneity in an African savanna

Fire is considered a critical management tool in fire prone landscapes. Often studies and policies relating to fire focus on why and how the fire regime should be managed, often neglecting to subsequently evaluate management’s ability to achieve these objectives over long temporal and large spatial scales. This study explores to what extent the long-term spatio-temporal fire patterns recorded in the Kruger National Park, South Africa has been influenced by management policies and to what extent it was dictated by underlying variability in the abiotic template. This was done using a spatially explicit fire-scar database from 1941 to 2006 across the 2 million hectare Park. Fire extent (hectares burnt per annum) (i) is correlated with rainfall cycles (ii) exhibits no long-term trend and (iii) is largely non-responsive to prevailing fire management policies. Rainfall, geology and distance from the closest perennial river and the interactions between these variables influence large-scale fire pattern heterogeneity: areas with higher rainfall, on basaltic substrates and far from rivers are more fire prone and have less heterogeneous fire regimes than areas with lower rainfall, on granitic substrates and closer to rivers. This study is the first to illustrate that under a range of rainfall and geological conditions, perennial rivers influence long-term, landscape-scale fire patterns well beyond the riparian zone (typically up to 15 km from the river). It was concluded that despite fire management policies which historically aimed for largely homogeneous fire return regimes, spatially and temporally heterogeneous patterns have emerged. This is primarily because of differences in rainfall, geology and distance from perennial rivers. We postulate that large-scale spatio-temporal fire pattern heterogeneity is implicit to heterogeneous savannas, even under largely homogenizing fire policies. Management should be informed by these patterns, embracing the natural heterogeneity-producing template. We therefore suggest that management actions will be better directed when operating at appropriate scales, nested within the broader implicit landscape patterns, and when focusing on fire regime parameters over which they have more influence (e.g. fire season).http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1600-0587hb201