Abstract Objectives Patients' ideas about the nature, cause, and treatment of their illnesses are part of the complex process of coping with illness. To date, limited research on subjective theories ...of illness in patients with irritable bowel syndrome (IBS) has been performed. The aim of the study was to investigate patients' subjective theories of illness and how these are related to clinical and psychological outcome criteria, in particular IBS symptom severity and quality of life. Methods Eighty-eight patients with IBS, as defined by Rome III criteria, were administered a battery of questionnaires to collect the following data: sociodemographic variables, subjective theories of illness (Subjektive Krankheitstheorien, Cause Questionnaire), anxiety (Hospital Anxiety and Depression Scale), depression (Beck Depression Inventory), quality of life (SF-12), and IBS symptoms (Questionnaire for Gastrointestinal Symptoms). Results Almost all patients reported theories of illness reflecting their subjective causal assumptions. The most frequently mentioned causal factors were physical illness, intrapsychic factors, and stress. Patients with mainly somatic attributions had higher IBS symptoms scores ( P <.05) and reduced physical quality of life. Intrapsychic attributions were associated with reduced mental quality of life and enhanced physical quality of life ( P <.01). All correlations were independent of gender, age, and irritable bowel subgroups. Conclusions Subjective theories of illness can have significant implications for IBS symptom severity, as well as for physical and mental quality of life.
SARS-CoV-2 variants accumulating immune escape mutations provide a significant risk to vaccine-induced protection against infection. The novel variant of concern (VoC) Omicron BA.1 and its ...sub-lineages have the largest number of amino acid alterations in its Spike protein to date. Thus, they may efficiently escape recognition by neutralizing antibodies, allowing breakthrough infections in convalescent and vaccinated individuals in particular in those who have only received a primary immunization scheme. We analyzed neutralization activity of sera from individuals after vaccination with all mRNA-, vector- or heterologous immunization schemes currently available in Europe by in vitro neutralization assay at peak response towards SARS-CoV-2 B.1, Omicron sub-lineages BA.1, BA.2, BA.2.12.1, BA.3, BA.4/5, Beta and Delta pseudotypes and also provide longitudinal follow-up data from BNT162b2 vaccinees. All vaccines apart from Ad26.CoV2.S showed high levels of responder rates (96-100%) towards the SARS-CoV-2 B.1 isolate, and minor to moderate reductions in neutralizing Beta and Delta VoC pseudotypes. The novel Omicron variant and its sub-lineages had the biggest impact, both in terms of response rates and neutralization titers. Only mRNA-1273 showed a 100% response rate to Omicron BA.1 and induced the highest level of neutralizing antibody titers, followed by heterologous prime-boost approaches. Homologous BNT162b2 vaccination, vector-based AZD1222 and Ad26.CoV2.S performed less well with peak responder rates of 48%, 56% and 9%, respectively. However, Omicron responder rates in BNT162b2 recipients were maintained in our six month longitudinal follow-up indicating that individuals with cross-protection against Omicron maintain it over time. Overall, our data strongly argue for booster doses in individuals who were previously vaccinated with BNT162b2, or a vector-based primary immunization scheme.
Abstract
Objective
Many randomized controlled trials (RCTs) have demonstrated the efficacy and benefits of exposure therapy in the treatment of health anxiety. However, the application of these ...research results to routine care has not been considered sufficiently. The aim of this study is to analyze the effectiveness of exposure therapy in the routine treatment of health anxiety patients.
Method
Data were available for 35 patients, who repeatedly filled in comprehensive general questionnaires, and those specific to health anxiety.
Results
The data analysis showed that health anxiety symptoms decreased significantly both posttreatment (Cohen's
d
= 0.97–1.00) and at follow‐up (Cohen's
d
= 1.33–1.34). In addition, the scores of depressiveness, somatic symptoms, and psychological distress showed improvements with effect sizes of
d
= 0.35–0.51. Regarding the primary outcome measures for health anxiety, response rates were 51%–63%, and remission rates were 29%–43%.
Conclusion
Exposure therapy is effective and sustainable regarding the treatment of health anxiety, even under naturalistic conditions, whereas response and remission rates are lower than for RCT.
Individual Ni3Al nanocubes under pressure are investigated by comparing the compressive strength of both dislocation‐free and irradiated Ni3Al nanocubes. The results are dicussed in light of the ...size‐dependent and size‐independent strength of face‐centered cubic (fcc) nanocrystals in the framework of dislocation nucleation at free surfaces. This study sheds more light on the understanding of fundamental deformation mechanisms and size‐affected strength in dislocation‐free metallic nanocrystals.
We report direct measurements of displacement jump velocities in deforming nano- and microcrystals. These velocities exhibit large scatter and no correlation with plastic strain, crystal size or ...applied stress. Statistical analysis for the displacement jump velocities shows a cubic power-law decay, with a shoulder at low velocities. Our results indicate that the collective motion of dislocations in the deforming crystals is dominated by statistical fluctuations within the internal stresses, rather than by a mobility law that depends on the externally applied stress.
Traffic noise is interfering during day- and nighttime causing distress and adverse physiological reactions in large parts of the population. Railway noise proved less annoying than aircraft noise in ...surveys which were the bases for a so called 5dB railway bonus regarding noise protection in many European countries.
The present field study investigated railway noise-induced awakenings during sleep, nighttime annoyance and the impact on performance the following day. Comparing these results with those from a field study on aircraft noise allowed for a ranking of traffic modes concerning physiological and psychological reactions.
33 participants (mean age 36.2years±10.3 (SD); 22 females) living alongside railway tracks around Cologne/Bonn (Germany) were polysomnographically investigated. These data were pooled with data from a field study on aircraft noise (61 subjects) directly comparing the effects of railway and aircraft noise in one random subject effects logistic regression model. Annoyance was rated in the morning evaluating the previous night.
Probability of sleep stage changes to wake/S1 from railway noise increased significantly from 6.5% at 35dB(A) to 20.5% at 80dB(A) LAFmax. Rise time of noise events had a significant impact on awakening probability. Nocturnal railway noise led to significantly higher awakening probabilities than aircraft noise, partly explained by the different rise times, whereas the order was inversed for annoyance. Freight train noise compared to passenger train noise proved to have the most impact on awakening probability. Nocturnal railway noise had no effect on psychomotor vigilance.
Nocturnal freight train noise exposure in Germany was associated with increased awakening probabilities exceeding those for aircraft noise and contrasting the findings of many annoyance surveys and annoyance ratings of our study. During nighttime a bonus for railway noise seems not appropriate.
► Railway noise leads to higher awakening probabilities than aircraft noise. ► Aircraft noise is more annoying than railway noise evaluating the previous night. ► Freight train noise is more sleep disturbing than passenger train noise. ► During nighttime a bonus for railway noise seems not appropriate.
Medulloblastomas with extensive nodularity are cerebellar tumors characterized by two distinct compartments and variable disease progression. The mechanisms governing the balance between ...proliferation and differentiation in MBEN remain poorly understood. Here, we employ a multi-modal single cell transcriptome analysis to dissect this process. In the internodular compartment, we identify proliferating cerebellar granular neuronal precursor-like malignant cells, along with stromal, vascular, and immune cells. In contrast, the nodular compartment comprises postmitotic, neuronally differentiated malignant cells. Both compartments are connected through an intermediate cell stage resembling actively migrating CGNPs. Notably, we also discover astrocytic-like malignant cells, found in proximity to migrating and differentiated cells at the transition zone between the two compartments. Our study sheds light on the spatial tissue organization and its link to the developmental trajectory, resulting in a more benign tumor phenotype. This integrative approach holds promise to explore intercompartmental interactions in other cancers with varying histology.
Spinal ependymal tumors form a histologically and molecularly heterogeneous group of tumors with generally good prognosis. However, their treatment can be challenging if infiltration of the spinal ...cord or dissemination throughout the central nervous system (CNS) occurs and, in these cases, clinical outcome remains poor. Here, we describe a new and relatively rare subgroup of spinal ependymal tumors identified using DNA methylation profiling that is distinct from other molecular subgroups of ependymoma. Copy number variation plots derived from DNA methylation arrays showed
MYCN
amplification as a characteristic genetic alteration in all cases of our cohort (
n
= 13), which was subsequently validated using fluorescence in situ hybridization. The histological diagnosis was anaplastic ependymoma (WHO Grade III) in ten cases and classic ependymoma (WHO Grade II) in three cases. Histological re-evaluation in five primary tumors and seven relapses showed characteristic histological features of ependymoma, namely pseudorosettes, GFAP- and EMA positivity. Electron microscopy revealed cilia, complex intercellular junctions and intermediate filaments in a representative sample. Taking these findings into account, we suggest to designate this molecular subgroup spinal ependymoma with MYCN amplification, SP-EPN-MYCN. SP-EPN-MYCN tumors showed distinct growth patterns with intradural, extramedullary localization mostly within the thoracic and cervical spine, diffuse leptomeningeal spread throughout the whole CNS and infiltrative invasion of the spinal cord. Dissemination was observed in 100% of cases. Despite high-intensity treatment, SP-EPN-MYCN showed significantly worse median progression free survival (PFS) (17 months) and median overall survival (OS) (87 months) than all other previously described molecular spinal ependymoma subgroups. OS and PFS were similar to supratentorial ependymoma with RELA-fusion (ST-EPN-RELA) and posterior fossa ependymoma A (PF-EPN-A), further highlighting the aggressiveness of this distinct new subgroup. We, therefore, propose to establish SP-EPN-MYCN as a new molecular subgroup in ependymoma and advocate for testing newly diagnosed spinal ependymal tumors for
MYCN
amplification.
This review summarizes the evidence of bereavement groups for symptoms of grief and depression. The literature search using Web of Science, EBSCO, PubMed, CINAHL, and MEDLINE yielded 14 studies (N = ...1519) meeting the inclusion criteria (i.e., randomized-controlled trials, bereaved adults, bereavement group, validated measures). Overall, bereavement groups were marginally more effective than control groups post-treatment (gG = 0.33, gD = 0.22) but not at follow-up. Although tertiary interventions yielded larger effect sizes than secondary interventions, the difference was not significant. The results imply that the evidence for bereavement groups is weak, although the large heterogeneity of concepts for intervention and control groups limits the generalizability.
PDF
