161 research outputs found

    Delivering Acceptance and Commitment Therapy for Weight Self-Stigma through Guided Self-Help: Results from an Open Pilot Trial

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    Weight self-stigma is a promising target for innovative interventions seeking to improve outcomes among overweight/obese individuals. Preliminary research suggests acceptance and commitment therapy (ACT) may be an effective approach for reducing weight self-stigma, but a guided self-help version of this intervention may improve broad dissemination. This pilot open trial sought to evaluate the potential acceptability and efficacy of a guided self-help ACT intervention, included coaching and a self-help book, with a sample of 13 overweight/obese individuals high in weight self-stigma. Results indicated a high degree of program engagement (77% completed the intervention) and satisfaction. Participants improved on outcomes over time including weight self-stigma, emotional eating, weight management behaviors, health-related quality of life, and depression. Although not a directly targeted outcome, participants improved on objectively measured weight, with an average of 4.18 pounds lost over 7 weeks, but did not improve on self-reported weight at 3-month follow-up. Processes of change improved over time, including psychological inflexibility, valued action and reasons to lose weight. Coaching effects indicated greater retention and improvements over time with one coach vs. the other, suggesting characteristics of coaching can affect outcomes. Overall, these results provide preliminary support for the acceptability and efficacy of a guided self-help ACT program for weight self-stigma. Implications of these results and how to address clinical challenges with guided self-help are discussed

    Advanced Manned Launch System (AMLS) study

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    To assure national leadership in space operations and exploration in the future, NASA must be able to provide cost effective and operationally efficient space transportation. Several NASA studies and the joint NASA/DoD Space Transportation Architecture Studies (STAS) have shown the need for a multi-vehicle space transportation system with designs driven by enhanced operations and low costs. NASA is currently studying an advanced manned launch system (AMLS) approach to transport crew and cargo to the Space Station Freedom. Several single and multiple stage systems from air-breathing to all-rocket concepts are being examined in a series of studies potential replacements for the Space Shuttle launch system in the 2000-2010 time frame. Rockwell International Corporation, under contract to the NASA Langley Research Center, has analyzed a two-stage all-rocket concept to determine whether this class of vehicles is appropriate for the AMLS function. The results of the pre-phase A study are discussed

    BioDEX: Large-Scale Biomedical Adverse Drug Event Extraction for Real-World Pharmacovigilance

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    Timely and accurate extraction of Adverse Drug Events (ADE) from biomedical literature is paramount for public safety, but involves slow and costly manual labor. We set out to improve drug safety monitoring (pharmacovigilance, PV) through the use of Natural Language Processing (NLP). We introduce BioDEX, a large-scale resource for Biomedical adverse Drug Event Extraction, rooted in the historical output of drug safety reporting in the U.S. BioDEX consists of 65k abstracts and 19k full-text biomedical papers with 256k associated document-level safety reports created by medical experts. The core features of these reports include the reported weight, age, and biological sex of a patient, a set of drugs taken by the patient, the drug dosages, the reactions experienced, and whether the reaction was life threatening. In this work, we consider the task of predicting the core information of the report given its originating paper. We estimate human performance to be 72.0% F1, whereas our best model achieves 62.3% F1, indicating significant headroom on this task. We also begin to explore ways in which these models could help professional PV reviewers. Our code and data are available: https://github.com/KarelDO/BioDEX.Comment: 28 page

    Human cytomegalovirus protein RL1 degrades the antiviral factor SLFN11 via recruitment of the CRL4 E3 ubiquitin ligase complex.

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    Human cytomegalovirus (HCMV) is an important human pathogen and a paradigm of viral immune evasion, targeting intrinsic, innate, and adaptive immunity. We have employed two orthogonal multiplexed tandem mass tag-based proteomic screens to identify host proteins down-regulated by viral factors expressed during the latest phases of viral infection. This approach revealed that the HIV-1 restriction factor Schlafen-11 (SLFN11) was degraded by the poorly characterized, late-expressed HCMV protein RL1, via recruitment of the Cullin4-RING E3 Ubiquitin Ligase (CRL4) complex. SLFN11 potently restricted HCMV infection, inhibiting the formation and spread of viral plaques. Overall, we show that a restriction factor previously thought only to inhibit RNA viruses additionally restricts HCMV. We define the mechanism of viral antagonism and also describe an important resource for revealing additional molecules of importance in antiviral innate immunity and viral immune evasion

    Spatial distribution and trypanosome infection of tsetse flies in the sleeping sickness focus of Zimbabwe in Hurungwe District

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    Abstract Background In Zimbabwe, cases of human African trypanosomiasis (HAT) are caused by the unicellular protozoan Trypanosoma brucei, sub-species T. b. rhodesiense. They are reported from the tsetse-infested area in the northern part of the country, broadly corresponding to the valley of the Zambezi River. Tsetse-transmitted trypanosomes, in particular T. congolense and T. vivax, also cause morbidity and mortality in livestock, thus generating poverty and food insecurity. Two species of tsetse fly, Glossina morsistans morsitans and G. pallidipes, are known to be present in the Zambezi Valley, although their distributional patterns and densities have not been investigated in detail. The present study tries to address this gap by providing some insight into the dynamics of trypanosomiasis in humans and livestock. Methods Tsetse distribution and trypanosome infections were studied using traps and fixed fly rounds located at 10 km intervals along a 110 km long transect straddling the southern escarpment of the Zambezi Valley. Three km long fly rounds were conducted on 12 sites, and were repeated 11 times over a 7-month period. Additional traps were deployed and monitored in selected sites. Microscopic examination of 2092 flies for trypanosome infections was conducted. Results Surveys confirmed the presence of G. morsitans morsitans and G. pallidipes in the Zambezi Valley floor. Moving south, the apparent density of tsetse flies appears to peak in the vicinity of the escarpment, then drops on the highlands. Only one fly was caught south of the old game fence separating protected and settled areas. A trypanosome infection rate of 6.31% was recorded in tsetse flies dissected. Only one infection of the T. brucei-type was detected. Conclusions Tsetse fly distribution in the study area appears to be driven by ecological factors such as variation in land use and altitude-mediated climatic patterns. Although targeted control of tsetse flies have played a role in determining distribution, no major control operations have been implemented in the area for 15 years. Trypanosome infections in tsetse flies are consistent with HAT epidemiological data, which considers the situation to be generally ‘low risk’. Nonetheless, underreporting is likely to conceal the true epidemiological picture, and efforts are needed to strengthen the diagnostic capacities of health facilities

    Sensory attenuation is modulated by the contrasting effects of predictability and control.

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    Self-generated stimuli have been found to elicit a reduced sensory response compared with externally-generated stimuli. However, much of the literature has not adequately controlled for differences in the temporal predictability and temporal control of stimuli. In two experiments, we compared the N1 (and P2) components of the auditory-evoked potential to self- and externally-generated tones that differed with respect to these two factors. In Experiment 1 (n = 42), we found that increasing temporal predictability reduced N1 amplitude in a manner that may often account for the observed reduction in sensory response to self-generated sounds. We also observed that reducing temporal control over the tones resulted in a reduction in N1 amplitude. The contrasting effects of temporal predictability and temporal control on N1 amplitude meant that sensory attenuation prevailed when controlling for each. Experiment 2 (n = 38) explored the potential effect of selective attention on the results of Experiment 1 by modifying task requirements such that similar levels of attention were allocated to the visual stimuli across conditions. The results of Experiment 2 replicated those of Experiment 1, and suggested that the observed effects of temporal control and sensory attenuation were not driven by differences in attention. Given that self- and externally-generated sensations commonly differ with respect to both temporal predictability and temporal control, findings of the present study may necessitate a re-evaluation of the experimental paradigms used to study sensory attenuation

    Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial.

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    BACKGROUND: Staphylococcus aureus bacteraemia is a common cause of severe community-acquired and hospital-acquired infection worldwide. We tested the hypothesis that adjunctive rifampicin would reduce bacteriologically confirmed treatment failure or disease recurrence, or death, by enhancing early S aureus killing, sterilising infected foci and blood faster, and reducing risks of dissemination and metastatic infection. METHODS: In this multicentre, randomised, double-blind, placebo-controlled trial, adults (≥18 years) with S aureus bacteraemia who had received ≤96 h of active antibiotic therapy were recruited from 29 UK hospitals. Patients were randomly assigned (1:1) via a computer-generated sequential randomisation list to receive 2 weeks of adjunctive rifampicin (600 mg or 900 mg per day according to weight, oral or intravenous) versus identical placebo, together with standard antibiotic therapy. Randomisation was stratified by centre. Patients, investigators, and those caring for the patients were masked to group allocation. The primary outcome was time to bacteriologically confirmed treatment failure or disease recurrence, or death (all-cause), from randomisation to 12 weeks, adjudicated by an independent review committee masked to the treatment. Analysis was intention to treat. This trial was registered, number ISRCTN37666216, and is closed to new participants. FINDINGS: Between Dec 10, 2012, and Oct 25, 2016, 758 eligible participants were randomly assigned: 370 to rifampicin and 388 to placebo. 485 (64%) participants had community-acquired S aureus infections, and 132 (17%) had nosocomial S aureus infections. 47 (6%) had meticillin-resistant infections. 301 (40%) participants had an initial deep infection focus. Standard antibiotics were given for 29 (IQR 18-45) days; 619 (82%) participants received flucloxacillin. By week 12, 62 (17%) of participants who received rifampicin versus 71 (18%) who received placebo experienced treatment failure or disease recurrence, or died (absolute risk difference -1·4%, 95% CI -7·0 to 4·3; hazard ratio 0·96, 0·68-1·35, p=0·81). From randomisation to 12 weeks, no evidence of differences in serious (p=0·17) or grade 3-4 (p=0·36) adverse events were observed; however, 63 (17%) participants in the rifampicin group versus 39 (10%) in the placebo group had antibiotic or trial drug-modifying adverse events (p=0·004), and 24 (6%) versus six (2%) had drug interactions (p=0·0005). INTERPRETATION: Adjunctive rifampicin provided no overall benefit over standard antibiotic therapy in adults with S aureus bacteraemia. FUNDING: UK National Institute for Health Research Health Technology Assessment
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