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This study explored whether treatment outcomes in a trial on the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) vs. Supportive Psychotherapy (SP) for patients with early-onset chronic depression differ between alliance patterns.Session-to-session ratings of the therapeutic alliance (Helping Alliance Questionnaire (HAQ)) from 254 outpatients with chronic depression (CBASP 134; SP 120) who took part in a multicenter randomized controlled trial of CBASP vs. SP were used to categorize patients into three alliance pattern categories for the patients' and therapists' rating separately. Based on the reliable change in the HAQ from one session to the next categories were no rupture, unrepaired rupture, rupture-repair. Depression severity (24-item Hamilton Rating Scale for Depression) at post-treatment, at 12- and 24- months follow-up was the outcome.The alliance pattern categories for therapists and patients did not differ between CBASP and SP. Only the alliance patterns calculated for patients were associated with outcome in the unrepaired rupture category, patients had higher HRSD-ratings across time points (p = 0.047).CBASP was not associated with more or fewer ruptures or repairs as compared to SP in the treatment of chronic depression. The study highlights the need to resolve ruptures to avoid poor outcomes.Trial registration ClinicalTrials.gov identifier NCT00970437.Intervertebral disc degeneration (IDD) is the primary pathological mechanism that underlies low back pain. Overloading-induced cell death, especially endogenous stem cell death, is the leading factor that undermines intrinsic repair and aggravates IDD. Previous research has separately studied the effect of oxygen concentration and mechanical loading in IDD. However, how these two factors synergistically influence endogenous repair remains unclear. Therefore, we established in vitro and in vivo models to study the mechanisms by which hypoxia interacted with overloading-induced cell death of the nucleus pulposus derived stem cells (NPSCs). We found the content of HIF1A (hypoxia inducible factor 1 subunit alpha) and the number of NPSCs decreased with disc degeneration in both rats and human discs. Hence, we isolated this subpopulation from rat discs and treated them simultaneously with hypoxia and excessive mechanical stress. Our results demonstrated that hypoxia exerted protective effect on NPSCs under compress SLC2A1/GLUT1 solute carrier family 2 member 1; SQSTM1/p62 sequestosome 1; TEK/TIE2 TEK receptor tyrosine kinase; TEM transmission electron microscopy; TUBB tubulin beta class I.Progesterone (P4) is contained naturally in animal tissue, and it is also used as a veterinary drug in cattle for treatment purposes. To assess the risk from P4 residues in beef derived from treated cattle, it is essential to quantify the P4 contained naturally in cattle tissue (endogenous P4). Therefore, we performed a method validation for the quantification of endogenous P4 (method quantification limit = 0.06 ng g-1) by using isotope-labelled P4s, and investigated the P4 contents in Japanese beef (n= 112; 0.07 to 121 ng g-1). The P4 contents in cattle muscle ranged from 0.07 to 54.3 ng g-1 in males, and from 0.27 to 121 ng g-1 in females. Our investigation also indicated that the developed method using both 13C- and deuterium-labelled P4 standards could be used to certify the recovery of P4 from cattle muscle containing various amounts of intramuscular fat, and enabled the determination of the P4 content in all Japanese beef samples that exceeded the method quantification limit.A trauma bond is an emotional attachment between an abuser and victim. Trauma bonds in sex trafficking compel victims to submit to continued exploitation and protect the trafficker. This scoping review examines trauma bonds in sex trafficking situations, its conceptualizations, and key characteristics. Ten databases were searched using sex trafficking AND trauma bonding-related terms; sex trafficking AND Stockholm syndrome, attachment, coercion, and manipulation. Articles were included if they featured trauma bonding, were published in English after 2013, or featured sex trafficking victims or traffickers in a Western country. Fifteen articles were included. The features of trauma bonding identified in these articles were (1) imbalance of power that favors trafficker, (2) traffickers' deliberate use of positive and negative interactions, (3) victim's gratitude for positive interactions and self-blame for the negative, and (4) victim's internalization of perpetrator's view. We also identified four aspects related to trauma bonding (1) prior trauma made victims vulnerable, (2) victim's feelings of love remained even after exiting trafficking, (3) love is why victims do not prosecute traffickers, and (4) traffickers' intentional cultivation of the trauma bond. No article indicated how trauma bonds could be severed and replaced with healthy attachments. These findings reveal the need for practitioners and law enforcement and criminal justice professionals to address trauma bonding in both trafficking and posttrafficking situations. The findings also represent potential targets for urgently needed interventions that promote the replacement of trauma bonds with healthy attachments.Medical communications (MedComms) agencies serve the varied needs of the pharmaceutical industry and other healthcare-related organizations. These agencies present a unique practice opportunity for pharmacists who possess the requisite knowledge and skillset to flourish and grow professionally in this environment. Published information about this sector of the industry is limited. To this end, this article provides an overview of the MedComms agency setting and describes the services provided by such agencies. These include the development of branded and/or unbranded communications materials in the form of publications, oral and video presentations, slide decks, and other materials. MedComms professionals also facilitate and support professional meetings and presentations, such as congresses, symposia, and advisory boards. Other services that MedComms agencies provide include engaging key opinion leaders, providing clinical trial services, and brand identification or positioning. The article describes the opportunities for pharmacists in this field, key characteristics and skills needed to succeed in this industry, and the pathway for pharmacists to enter this field.The primary objective of this paper is to propose a conceptual checklist to assess crisis communication efforts during pandemics and in their aftermath. No consolidated checklist exists for assessing the effectiveness of crisis communication at all levels during pandemics. click here A literature review was conducted, encompassing articles on crisis communication during SARS, swine flu, H1N1, ZIKA, Ebola, and/or COVID-19. Based on the review, a comprehensive checklist was developed to enable researchers and evaluators to assess and review all important aspects of crisis communication during pandemics. The final Assessment tool for Crisis Communication during Pandemics (ACCP) consists of 30 criteria. Further research is suggested to validate the checklist.The inhalation route is a relatively novel drug delivery route for biotherapeutics and, as a result, there is a paucity of published data and experience within the toxicology/pathology community. In recent years, findings arising in toxicology studies with inhaled biologics have provoked concern and regulatory challenges due, in part, to the lack of understanding of the expected pathology, mechanisms, and adversity induced by this mode of delivery. In this manuscript, the authors describe 12 case studies, comprising 18 toxicology studies, using a range of inhaled biotherapeutics (monoclonal antibodies, fragment antigen-binding antibodies, domain antibodies, therapeutic proteins/peptides, and an oligonucleotide) in rodents, nonhuman primates (NHPs), and the rabbit in subacute (1 week) to chronic (26 weeks) toxicology studies. Analysis of the data revealed that many of these molecules were associated with a characteristic pattern of toxicity with high levels of immunogenicity. Microscopic changes in the airways consisted of a predominantly lymphoid perivascular/peribronchiolar (PV/PB) mononuclear inflammatory cell (MIC) infiltrate, whereas changes in the terminal airways/alveoli were characterized by simple ("uncomplicated") increases in macrophages or inflammatory cell infiltrates ranging from mixed inflammatory cell infiltration to inflammation. The PV/PB MIC changes were considered most likely secondary to immunogenicity, whereas simple increases in alveolar macrophages were most likely secondary to clearance mechanisms. Alveolar inflammatory cell infiltrates and inflammation were likely induced by immune modulation or stimulation through pharmacologic effects on target biology or type III hypersensitivity (immune complex disease). Finally, a group of experts provide introductory thoughts regarding the adversity of inhaled biotherapeutics and the basis for reasonable differences of opinion that might arise between toxicologists, pathologists, and regulators.
To describe the frequency, factors associated with, and significance of surgical dissection maneuvers of the distal internal carotid artery (ICA) during carotid endarterectomy (CEA).
In this retrospective analysis of prospectively collected information in patients undergoing CEA, we recorded information on demographics, risk factors and comorbidities, dissection maneuvers of the distal ICA, other operative variables and neurological outcome measures.
During the period July 2008 and February 2020 inclusive, 218 consecutive patients (180 males, median age 69.5 years) underwent 240 CEAs. In 117 (48.8%) of them, CEA was performed for a symptomatic stenosis. Dissection maneuvers of the distal ICA were required in 77 cases (32.1%), including division and ligation of the sternocleidomastoid vessels in 66 cases (27.5%), mobilization of the XII cranial nerve in 69 cases (28.7%, with concomitant transection of the superior root of the ansa cervicalis in 11 cases, 4.6%) and division of the posterior belly of the drequired to accomplish dissection of the distal ICA beyond the point of atherosclerotic disease. When dictated by operative findings, such maneuvers are deemed safe.
We aimed to investigate the mechanism of the regulatory axis of miR-196b/AQP4 underlying the invasion and migration of lung adenocarcinoma (LUAD) cells.
LUAD miRNA and mRNA expression profiles were downloaded from TCGA database and then differential analysis was used to identify the target miRNA. Target gene for the miRNA was obtained via prediction using 3 bioinformatics databases and intersection with the differentially expressed mRNAs searched from TCGA-LUAD. Then, qRT-PCR and western blot were used to validate the expression of miR-196b and AQP4. Dual-luciferase reporter assay was performed to confirm the targeting relationship between miR-196b and AQP4. Transwell assay was used to investigate the migration and invasion of LUAD cells.
MiR-196b was screened out by differential and survival analyses, and the downstream target gene AQP4 was identified. In LUAD, miR-196b was highly expressed while AQP4 was poorly expressed. Besides, overexpression of miR-196b promoted cell invasion and migration, while overexpression of AQP4 had negative effects.
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