Cost-effectiveness of cognitive-behavioral group therapy for dysfunctional fear of progression in cancer patients

Anxiety and fear are often associated with chronic conditions such as cancer. This paper targets the cost-effectiveness analysis of a cognitive-behavioral group therapy (CBT) in comparison to a client-centered, supportive-experiential group therapy (SET) in cancer patients with dysfunctional fear of progression. An incremental cost-effectiveness analysis was performed using data from a randomized controlled trial among cancer patients receiving inpatient rehabilitation. The means, 95% confidence intervals [95% CI], incremental cost-effectiveness graphic and acceptability curve were obtained from 1,000 bootstrap replications. A total of 174 patients were included in the economic evaluation. The estimated means [95% CI] of direct costs and reduction of fear of progression were €9,045.03 [6,359.07; 12,091.87] and 1.41 [0.93; 1.92] for patients in the SET and €6,682.78 [4,998.09; 8,440.95] and 1.44 [1.02; 1.09] for patients in the CBT. The incremental cost-effectiveness ratio [95% CI] amounts to minus €78,741.66 [−154,987.20; 110,486.32] for an additional unit of effect. Given the acceptability curve, there is a 92.4% chance that the CBT, compared with the SET, is cost-effective without the need of additional costs to payers. Our main result is the superior cost-effectiveness of the cognitive-behavioral intervention program in comparison to the non-directive encounter group for our sample of cancer patients with high levels of anxiet

Semiconductor charge qubit relaxation due to two-phonon processes

We theoretically study the relaxation of electron orbital states of a double quantum dot system due to two-phonon processes. In particular, we calculate how the relaxation rates depend on the separation distance between the quantum dots, the strength of quantum dot confinement, and the lattice temperature. Enhancement of the rates by specific inter-dot distances and lattice temperatures, and the relative strength of different scattering channels are discussed. Our results show that although at low temperatures ($T \sim 1$ K) two-phonon processes are almost four orders of magnitude weaker compared to one-phonon processes in relaxing electron orbital states, at room temperature they are as important as one-phonon processes.Comment: Submitted to PR

Redox states of glutathione and ascorbate in root tips of poplar (Populus tremula×P. alba) depend on phloem transport from the shoot to the roots

Glutathione (GSH) and ascorbate (ASC) are important antioxidants that are involved in stress defence and cell proliferation of meristematic root cells. In principle, synthesis of ASC and GSH in the roots as well as ASC and GSH transport from the shoot to the roots by phloem mass flow is possible. However, it is not yet known whether the ASC and/or the GSH level in roots depends on the supply from the shoot. This was analysed by feeding mature leaves with [14C]ASC or [35S]GSH and subsequent detection of the radiolabel in different root fractions. Quantitative dependency of root ASC and GSH on shoot-derived ASC and GSH was investigated with poplar (Populus tremula×P. alba) trees interrupted in phloem transport. [35S]GSH is transported from mature leaves to the root tips, but is withdrawn from the phloem along the entire transport path. When phloem transport was interrupted, the GSH content in root tips halved within 3 d. [14C]ASC is also transported from mature leaves to the root tips but, in contrast to GSH, ASC is not removed from the phloem along the transport path. Accordingly, ASC accumulates in root tips. Interruption of phloem transport disturbed the level and the ASC redox state within the entire root system. Diminished total ASC levels were attributed mainly to a decline of dehydroascorbate (DHA). As the redox state of ASC is of particular significance for root growth and development, it is concluded that phloem transport of ASC may constitute a shoot to root signal to coordinate growth and development at the whole plant level

Unique Properties of Thermally Tailored Copper: Magnetically Active Regions and Anomalous X-ray Fluorescence Emissions

When high-purity copper (≥99.98%wt) is melted, held in its liquid state for a few hours with iterative thermal cycling, then allowed to resolidify, the ingot surface is found to have many small regions that are magnetically active. X-ray fluorescence analysis of these regions exhibit remarkably intense lines from “sensitized elements” (SE), including in part or fully the contiguous series V, Cr, Mn, Fe, and Co. The XRF emissions from SE are far more intense than expected from known impurity levels. Comparison with blanks and standards show that the thermal “tailoring” also introduces strongly enhanced SE emissions in samples taken from the interior of the copper ingots. For some magnetic regions, the location as well as the SE emissions, although persistent, vary irregularly with time. Also, for some regions extraordinarily intense “sensitized iron” (SFe) emissions occur, accompanied by drastic attenuation of Cu emissions

Cancer patients' expectations when undergoing extensive molecular diagnostics—A qualitative study

Objective: Precision cancer medicine (PCM) aims at identifying tumor-driving molecular characteristics to improve therapy. Despite early successes for some cancers, the approach faces manifold challenges. Patients undergoing extensive molecular diagnostics (MD) may hope for personal benefit, although chances are small. In order to offer suitable support to this group, health-care professionals need to gain insight into patients' experience. Thus, this study sought to explore the expectations of cancer patients undergoing MD of their tumor. Methods: In two German Comprehensive Cancer Centers, 30 patients with advanced-stage cancer who had exhausted conventional treatment and had consented to extensive, research-oriented MD (whole-genome sequencing n = 24, panel sequencing n = 6) participated in semi-structured interviews. Following thematic content analysis by Kuckartz, the interview transcripts were coded for expectations of MD participation and topics closely related. Moreover, patients completed questionnaires on their sociodemographic characteristics, medical history, and psychosocial distress. Results: Patients reported to be expecting (a) an improvement of their treatment, (b) a contribution to research, and/or (c) additional insight to their own cancer. Further, they described to feel individually appreciated and to have a reason to maintain hope for cure or recovery by participating in MD. Conclusions: Molecular diagnostics participation led patients to feel treated in a more “personalized” way, allowing them a greater sense of control in their situation of severe illness. Oncologists and psycho-oncologists need to ensure comprehensive information and empathetic support for patients undergoing extensive MD to balance their expectations and actual chances of clinical benefit

Wie beeinflusst Sorption die Metabolisierung von Alanin durch mikrobielle Gruppen?

Mikrobieller Abbau ist ein wesentlicher Transformationsprozess der organischen Bodensubstanz. Sorption von niedermolekularen organischen Substanzen wie Alanin an Mineraloberflächen kann diese vor dem mikrobiellen Abbau und Mineralisierung schützen. Somit wäre Sorption ein entscheidender Stabilisierungsprozess für die organische Bodensubstanz. Dennoch ist es für Mikroorganismen möglich, niedermolekulare organische Substanzen von Mineraloberflächen zu desorbieren. Das exakte Prozessgefüge dieser Desorption und mikrobiellen Verwertung, aber auch die involvierten mikrobiellen Gruppen sind jedoch weitestgehend unbekannt. Wir verwendeten positionsspezifisch C-13-markiertes Alanin, dessen Mineralisation zu CO2 und dessen Einbau in Phospholipid-Fettsäuren (PLFAs) quantifiziert wurde, um die mikrobielle Verwendung von sorbiertem und nicht-sorbiertem Alanin im Boden zu unterscheiden. Um die durch die Sorption bedingten Veränderungen der Verfügbarkeit und Metabolisierung des Alanins zu erfassen, wurden einheitlich- und positionsspezifisch C-13- und C-14-markiertes Alanin in einem Ap-Horizont einer lehmigen Parabraunerde über 10 Tage inkubiert. Das CO2 aus der Respiration wurde in NaOH-Fallen erfasst und dessen C-14-Aktivität bestimmt. Die Verwendung der funktionellen Gruppen des Alanins durch die verschiedenen mikrobiellen Gruppen wurde mittels C-13-PLFA Analyse ermittelt. Keine der mikrobiellen Gruppen bevorzugte das unsorbierte Alanin gegenüber dem sorbierten – der Großteil der Gruppen inkorporierte die gleiche Menge in ihre PLFAs. So zeigten beispielsweise Gram negative Bakterien eine hohe Wettbewerbsfähigkeit hinsichtlich des Alanins, allerdings keine Präferenz bezüglich des Unsorbierten. Nur die Gruppe der Pilze inkorporierten signifikant mehr sorbiertes Alanin: Sie sind prädestiniert dafür, Mineraloberfläche zu umwachsen und daran sorbierte Substanzen mit ihren Hyphen aufzunehmen. Diese Präferenz ist mit einem veränderten Abbauweg, der über Glukoneogenese und den Pentose-Phosphat-Weg führt, verbunden. Sorption kann zu einer kurzfristigen Verzögerung des Abbaus kleiner geladener Moleküle führen, jedoch ist kein langfristiger Stabilisierungseffekt erkennbar. Die meisten mikrobiellen Gruppen nehmen sowohl sorbiertes und nicht-sorbiertes Alanin im gleichen Maße auf und nur einzelne Gruppen, wie Pilze, haben sich auf die präferentielle Aufnahme sorbierter Substanzen spezialisiert

Effect of atomic transfer on the decay of a Bose-Einstein condensate

We present a model describing the decay of a Bose-Einstein condensate, which assumes the system to remain in thermal equilibrium during the decay. We show that under this assumption transfer of atoms occurs from the condensate to the thermal cloud enhancing the condensate decay rate

A Laser System for the Spectroscopy of Highly-Charged Bismuth Ions

We present and characterize a laser system for the spectroscopy on highly-charged ^209Bi^82+ ions at a wavelength of 243.87 nm. For absolute frequency stabilization, the laser system is locked to a near-infra-red laser stabilized to a rubidium transition line using a transfer cavity based locking scheme. Tuning of the output frequency with high precision is achieved via a tunable rf offset lock. A sample-and-hold technique gives an extended tuning range of several THz in the UV. This scheme is universally applicable to the stabilization of laser systems at wavelengths not directly accessible to atomic or molecular resonances. We determine the frequency accuracy of the laser system using Doppler-free absorption spectroscopy of Te_2 vapour at 488 nm. Scaled to the target wavelength of 244 nm, we achieve a frequency uncertainty of \sigma_{244nm} = 6.14 MHz (one standard deviation) over six days of operation.Comment: Contribution to the special issue on "Trapped Ions" in "Applied Physics B