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Sample records for integrated dual disorders

  1. Use of integrated dual disorder treatment via assertive community treatment versus clinical case management for persons with co-occurring disorders and antisocial personality disorder.

    Science.gov (United States)

    Frisman, Linda K; Mueser, Kim T; Covell, Nancy H; Lin, Hsiu-Ju; Crocker, Anne; Drake, Robert E; Essock, Susan M

    2009-11-01

    We conducted secondary analyses of data from a randomized trial testing the effectiveness of Assertive Community Treatment (ACT) in delivery of integrated dual disorder treatment (IDDT) to explore the impact of IDDT delivered through ACT teams compared with standard clinical case management for dually-disordered persons with and without antisocial personality disorder (ASPD). This analysis included 36 individuals with ASPD and 88 individuals without ASPD. Participants with ASPD assigned to ACT showed a significantly greater reduction in alcohol use and were less likely to go to jail than those in standard clinical case management, whereas participants without ASPD did not differ between the 2 case management approaches. There were no significant differences for other substance use or criminal justice outcomes. This study provides preliminary evidence that persons with co-occurring serious mental illness, substance use disorders, and ASPD may benefit from delivery of IDDT through ACT teams.

  2. Dual fermion approach to disordered correlated systems

    International Nuclear Information System (INIS)

    Haase, Patrick

    2015-01-01

    Disorder is ubiquitous in real materials and influences the physical properties like the conductivity to varying degrees. If electron-electron interactions are strong, theoretical and numerical treatment of these systems becomes challenging. In this thesis a numerical approach is developed to address these systems, treating both interactions and disorder on equal footing. The approach is based on the dual fermion approach for interacting systems developed by Rubtsov et al. Terletska et al. applied the ideas of the dual fermion approach to disordered non-interacting systems. In this approach, the replica trick is used to integrate out the disorder in favor of an effective electron-electron interaction. We extended the approach from Terletska et al. to treat disordered interacting systems. Dual Fermions allow to take into account non-local fluctuations by means of a perturbative expansion around an impurity problem. The impurity reference system is determined self-consistently, analogously to the dynamical mean-field theory. The perturbative expansion is expected to yield good results for small and large values of interaction strength and disorder. A priori, it is not clear what to expect for intermediate values, but experience shows that oftentimes good results are obtained for this region. An advantage of the dual fermion approach is that there is no sign-problem for a single orbital model if quantum Monte Carlo is used to solve the interacting reference system. Additionally, perturbation theory is usually numerically much cheaper than fully solving an interacting lattice or cluster problem. Thus, the dual fermion approach allows to address regions of parameter space that are not accessible to lattice quantum Monte Carlo calculations or cluster extension of dynamical mean-field theory. Cluster extensions of the dynamical mean-field theory are for example the dynamical cluster approximation or the cellular dynamical mean-field theory. The new approach is benchmarked

  3. Dual Disorders in Adolescent Populations

    NARCIS (Netherlands)

    van West, D.; Vermeiren, R.R.J.M.

    2015-01-01

    Psychiatric comorbidity in adolescents who abuse substances is the rule rather than the exception, and common comorbidities include depression, anxiety disorder, bipolar disorder, conduct disorder, and Attention Deficit Hyperactivity Disorder (ADHD). Among adolescents, the presence of both mental

  4. [LONG-TERM SURVIVAL OF DUAL DISORDERS PATIENTS AFTER MIXED CARE IN DUAL DISORDERS AND STANDARD WARDS VERSUS CARE ONLY IN DUAL DISORDERS WARD].

    Science.gov (United States)

    Gimelfarb, Yuri; Wolf, Aviva; Ben-Tzarfati, Mashit

    2017-01-01

    Dual disorders (co-occurring mental illness and substance abuse disorders in the same person) are extremely common among patients receiving mental health services. Integrated treatment has been proposed as the standard of care and it describes a flexible combination of treatments from the mental health and addiction fields that are blended together in the therapy. Scientific evidence for survival of dual disorders patients (DDPs), who had integrated dual disorders inpatient care, is lacking. To determine the long term survival rates following integrated care (Integrated Dual Diagnosis Treatment Ward [IDDTW] only) versus mixed care (IDDTW and psychiatric wards) during the life-time of DDPs. The charts of 333 subjects admitted to IDDTW during the period January 2002 - June 2006 were assessed at least 8 years after the first admission. Psychiatric diagnoses have been established and grouped according to international classification of diseases and health-related problems -10th edition (ICD-10). The Kaplan-Meier survival analysis was used to estimate the cumulative survival rates in all the subpopulations, and the predictive values of different variables were assessed by Cox proportional-hazards regression model. The total all-cause 12-year, unadjusted mortality was 21.1% in integrated care versus 24.6% in mixed care (pintegrated care as a predictive factor for all-cause mortality. The findings showed that there was no consistent evidence to support integrated inpatient care over mixed care, as measured by long-term survival. More studies are required in order to address the challenges posed in the treatment of DDPs.

  5. Toward Personalized Sexual Medicine (Part 1) : Integrating the “Dual Control Model” into Differential Drug Treatments for Hypoactive Sexual Desire Disorder and Female Sexual Arousal Disorder

    NARCIS (Netherlands)

    Bloemers, J.; van Rooij, K.; Poels, S.; Goldstein, I.; Everaerd, W.; Koppeschaar, H.; Chivers, M.; Gerritsen, J.; van Ham, D.; Olivier, B.; Tuiten, A.

    In three related manuscripts we describe our drug development program for the treatment of Hypoactive Sexual Desire Disorder (HSDD). In this first theoretical article we will defend the hypothesis that different causal mechanisms are responsible for the emergence of HSDD: low sexual desire in women

  6. Automatically sweeping dual-channel boxcar integrator

    International Nuclear Information System (INIS)

    Keefe, D.J.; Patterson, D.R.

    1978-01-01

    An automatically sweeping dual-channel boxcar integrator has been developed to automate the search for a signal that repeatedly follows a trigger pulse by a constant or slowly varying time delay when that signal is completely hidden in random electrical noise and dc-offset drifts. The automatically sweeping dual-channel boxcar integrator improves the signal-to-noise ratio and eliminates dc-drift errors in the same way that a conventional dual-channel boxcar integrator does, but, in addition, automatically locates the hidden signal. When the signal is found, its time delay is displayed with 100-ns resolution, and its peak value is automatically measured and displayed. This relieves the operator of the tedious, time-consuming, and error-prone search for the signal whenever the time delay changes. The automatically sweeping boxcar integrator can also be used as a conventional dual-channel boxcar integrator. In either mode, it can repeatedly integrate a signal up to 990 times and thus make accurate measurements of the signal pulse height in the presence of random noise, dc offsets, and unsynchronized interfering signals

  7. Body Integrity Identity Disorder

    NARCIS (Netherlands)

    Blom, Rianne M.; Hennekam, Raoul C.; Denys, Damiaan

    2012-01-01

    Introduction: Body Integrity Identity Disorder (BIID) is a rare, infrequently studied and highly secretive condition in which there is a mismatch between the mental body image and the physical body. Subjects suffering from BIID have an intense desire to amputate a major limb or severe the spinal

  8. Bipolar disorder and substance use disorders. Madrid study on the prevalence of dual disorders/pathology.

    Science.gov (United States)

    Arias, Francisco; Szerman, Nestor; Vega, Pablo; Mesías, Beatriz; Basurte, Ignacio; Rentero, David

    2017-06-28

    Given its prevalence and impact on public health, the comorbidity of bipolar and substance use disorders is one of the most relevant of dual diagnoses. The objective was to evaluate the characteristics of patients from community mental health and substance abuse centres in Madrid. The sample consisted of 837 outpatients from mental health and substance abuse centres. We used the Mini International Neuropsychiatric Interview (MINI) and Personality Disorder Questionnaire (PDQ4+) to evaluate axis I and II disorders. Of these patients, 174 had a lifetime bipolar disorder, 83 had bipolar disorder type I and 91 had type II. Most patients had dual pathology. Of the 208 participants from the mental health centres, 21 had bipolar disorder and 13 (61.9%) were considered dually-diagnosed patients, while 33.2% of non-bipolar patients had a dual diagnoses (p = 0.03). Of the 629 participants from the substance abuse centres, 153 patients (24.3%) had a bipolar diagnosis. Bipolar dual patients had higher rates of alcohol and cocaine dependence than non-bipolar patients. Moreover, age at onset of alcohol use was earlier in bipolar duallydiagnosed patients than in other alcoholics. Bipolar dually-diagnosed patients had higher personality and anxiety disorder comorbidities and greater suicide risk. Thus, alcohol and cocaine are the drugs most associated with bipolar disorder. Given the nature of the study, the type of relationship between these disorders cannot be determined.

  9. Body integrity identity disorder.

    Science.gov (United States)

    Blom, Rianne M; Hennekam, Raoul C; Denys, Damiaan

    2012-01-01

    Body Integrity Identity Disorder (BIID) is a rare, infrequently studied and highly secretive condition in which there is a mismatch between the mental body image and the physical body. Subjects suffering from BIID have an intense desire to amputate a major limb or severe the spinal cord in order to become paralyzed. Aim of the study is to broaden the knowledge of BIID amongst medical professionals, by describing all who deal with BIID. Somatic, psychiatric and BIID characteristic data were collected from 54 BIID individuals using a detailed questionnaire. Subsequently, data of different subtypes of BIID (i.e. wish for amputation or paralyzation) were evaluated. Finally, disruption in work, social and family life due to BIID in subjects with and without amputation were compared. Based on the subjects' reports we found that BIID has an onset in early childhood. The main rationale given for their desire for body modification is to feel complete or to feel satisfied inside. Somatic and severe psychiatric co-morbidity is unusual, but depressive symptoms and mood disorders can be present, possibly secondary to the enormous distress BIID puts upon a person. Amputation and paralyzation variant do not differ in any clinical variable. Surgery is found helpful in all subjects who underwent amputation and those subjects score significantly lower on a disability scale than BIID subjects without body modification. The amputation variant and paralyzation variant of BIID are to be considered as one of the same condition. Amputation of the healthy body part appears to result in remission of BIID and an impressive improvement of quality of life. Knowledge of and respect for the desires of BIID individuals are the first steps in providing care and may decrease the huge burden they experience.

  10. Body integrity identity disorder.

    Directory of Open Access Journals (Sweden)

    Rianne M Blom

    Full Text Available INTRODUCTION: Body Integrity Identity Disorder (BIID is a rare, infrequently studied and highly secretive condition in which there is a mismatch between the mental body image and the physical body. Subjects suffering from BIID have an intense desire to amputate a major limb or severe the spinal cord in order to become paralyzed. Aim of the study is to broaden the knowledge of BIID amongst medical professionals, by describing all who deal with BIID. METHODS: Somatic, psychiatric and BIID characteristic data were collected from 54 BIID individuals using a detailed questionnaire. Subsequently, data of different subtypes of BIID (i.e. wish for amputation or paralyzation were evaluated. Finally, disruption in work, social and family life due to BIID in subjects with and without amputation were compared. RESULTS: Based on the subjects' reports we found that BIID has an onset in early childhood. The main rationale given for their desire for body modification is to feel complete or to feel satisfied inside. Somatic and severe psychiatric co-morbidity is unusual, but depressive symptoms and mood disorders can be present, possibly secondary to the enormous distress BIID puts upon a person. Amputation and paralyzation variant do not differ in any clinical variable. Surgery is found helpful in all subjects who underwent amputation and those subjects score significantly lower on a disability scale than BIID subjects without body modification. CONCLUSIONS: The amputation variant and paralyzation variant of BIID are to be considered as one of the same condition. Amputation of the healthy body part appears to result in remission of BIID and an impressive improvement of quality of life. Knowledge of and respect for the desires of BIID individuals are the first steps in providing care and may decrease the huge burden they experience.

  11. Professionals’ perception on the management of patients with dual disorders

    Science.gov (United States)

    Roncero, Carlos; Szerman, Néstor; Terán, Antonio; Pino, Carlos; Vázquez, José María; Velasco, Elena; García-Dorado, Marta; Casas, Miguel

    2016-01-01

    Background There is a need to evaluate the professionals’ perception about the consequences of the lack of therapeutic adherence in the evolution of patients with co-occurring disorders. Methods An online survey, released on the Socidrogalcohol [Spanish Scientific Society for Research on Alcohol, Alcoholism and other Drug Addictions] and Sociedad Española de Patología Dual [the Spanish Society of Dual Pathology] web pages, was answered by 250 professionals who work in different types of Spanish health centers where dual diagnosis patients are assisted. Results Most professionals perceived the existence of noncompliance among dual diagnosis patients. Almost all of these professionals (99%) perceived that noncompliance leads to a worsening of the progression of the patient’s disorder, in both the exacerbation of mental disorders and the consumption of addictive substances. Most of the professionals (69.2%) considered therapeutic alliance as the main aspect to take into account to improve the prognosis in this population. The primary purpose of treatment must be the improvement of psychotic-phase positive symptoms, followed by the control of behavior disorders, reduction of craving, improvement of social and personal performances, and reduction of psychotic-phase negative symptoms. Conclusion Most professionals perceived low adherence among dual diagnosis patients. This lack of adherence is associated with a worsening of their disease evolution, which is reflected in exacerbations of the psychopathology and relapse in substance use. Therefore, we propose to identify strategies to improve adherence. PMID:27698553

  12. Dual Quaternion Variational Integrator for Rigid Body Dynamic Simulation

    OpenAIRE

    Xu, Jiafeng; Halse, Karl Henning

    2016-01-01

    In rigid body dynamic simulations, often the algorithm is required to deal with general situations where both reference point and inertia matrix are arbitrarily de- fined. We introduce a novel Lie group variational integrator using dual quaternion for simulating rigid body dynamics in all six degrees of freedom. Dual quaternion is used to represent rigid body kinematics and one-step Lie group method is used to derive dynamic equations. The combination of these two becomes the first Lie group ...

  13. Professionals’ perception on the management of patients with dual disorders

    Directory of Open Access Journals (Sweden)

    Roncero C

    2016-09-01

    Full Text Available Carlos Roncero,1,2 Néstor Szerman,3 Antonio Terán,4 Carlos Pino,5 José María Vázquez,6 Elena Velasco,7 Marta García-Dorado,7 Miguel Casas1,2 1Addiction and Dual Diagnosis Unit, CIBERSAM, Hospital Vall Hebron, Barcelona Public Health Agency (ASPB, Barcelona, Spain; 2Department of Psychiatry, Autonomous University of Barcelona, Barcelona, Spain; 3Outpatient Mental Health Clinic El Retiro, Gregorio Marañón University Hospital, Madrid, Spain; 4Outpatient Drug Clinic, Hospital San Juan de Dios, Palencia, Spain; 5Pontevedra City Council Drug Dependence Service, Galician Health Service (Xunta de Galicia, Pontevedra, Spain; 6Outpatient Drug Clinic Sants, Barcelona Public Health Agency (ASPB, Barcelona, Spain; 7Medical Affairs Department, Janssen-Cilag S.A., Madrid, Spain Background: There is a need to evaluate the professionals’ perception about the consequences of the lack of therapeutic adherence in the evolution of patients with co-occurring disorders.Methods: An online survey, released on the Socidrogalcohol [Spanish Scientific Society for Research on Alcohol, Alcoholism and other Drug Addic­tions] and Sociedad Española de Patología Dual [the Spanish Society of Dual Pathology] web pages, was answered by 250 professionals who work in different types of Spanish health centers where dual diagnosis patients are assisted.Results: Most professionals perceived the existence of noncompliance among dual diagnosis patients. Almost all of these professionals (99% perceived that noncompliance leads to a worsening of the progression of the patient’s disorder, in both the exacerbation of mental disorders and the consumption of addictive substances. Most of the professionals (69.2% considered therapeutic alliance as the main aspect to take into account to improve the prognosis in this population. The primary purpose of treatment must be the improvement of psychotic-phase positive symptoms, followed by the control of behavior disorders, reduction of

  14. Integrated neurobiology of bipolar disorder

    Directory of Open Access Journals (Sweden)

    Vladimir eMaletic

    2014-08-01

    Full Text Available From a neurobiological perspective there is no such thing as bipolar disorder. Rather, it is almost certainly the case that many somewhat similar, but subtly different, pathological conditions produce a disease state that we currently diagnose as bipolarity. This heterogeneity—reflected in the lack of synergy between our current diagnostic schema and our rapidly advancing scientific understanding of the condition—limits attempts to articulate an integrated perspective on bipolar disorder. However, despite these challenges, scientific findings in recent years are beginning to offer a provisional unified field theory of the disease. This theory sees bipolar disorder as a suite of related neurodevelopmental conditions with interconnected functional abnormalities that often appear early in life and worsen over time. In addition to accelerated loss of volume in brain areas known to be essential for mood regulation and cognitive function, consistent findings have emerged at a cellular level, providing evidence that bipolar disorder is reliably associated with dysregulation of glial-neuronal interactions. Among these glial elements are microglia—the brain’s primary immune elements, which appear to be overactive in the context of bipolarity. Multiple studies now indicate that inflammation is also increased in the periphery of the body in both the depressive and manic phases of the illness, with at least some return to normality in the euthymic state. These findings are consistent with changes in the HPA axis, which are known to drive inflammatory activation. In summary, the very fact that no single gene, pathway or brain abnormality is likely to ever account for the condition is itself an extremely important first step in better articulating an integrated perspective on both its ontological status and pathogenesis. Whether this perspective will translate into the discovery of innumerable more homogeneous forms of bipolarity is one of the great

  15. New dual conformally invariant off-shell integrals

    International Nuclear Information System (INIS)

    Nguyen, Dung; Spradlin, Marcus; Volovich, Anastasia

    2008-01-01

    Evidence has recently emerged for a hidden symmetry of planar scattering amplitudes in N=4 super-Yang-Mills theory called dual conformal symmetry. At weak coupling the presence of this symmetry has been observed through five loops, while at strong coupling the symmetry has been shown to have a natural interpretation in terms of a T-dualized AdS 5 . In this paper we study dual conformally invariant off-shell four-point Feynman diagrams. We classify all such diagrams through four loops and evaluate 10 new off-shell integrals in terms of Mellin-Barnes representations, also finding explicit expressions for their infrared singularities

  16. Integrated Neurobiology of Bipolar Disorder

    Science.gov (United States)

    Maletic, Vladimir; Raison, Charles

    2014-01-01

    From a neurobiological perspective there is no such thing as bipolar disorder. Rather, it is almost certainly the case that many somewhat similar, but subtly different, pathological conditions produce a disease state that we currently diagnose as bipolarity. This heterogeneity – reflected in the lack of synergy between our current diagnostic schema and our rapidly advancing scientific understanding of the condition – limits attempts to articulate an integrated perspective on bipolar disorder. However, despite these challenges, scientific findings in recent years are beginning to offer a provisional “unified field theory” of the disease. This theory sees bipolar disorder as a suite of related neurodevelopmental conditions with interconnected functional abnormalities that often appear early in life and worsen over time. In addition to accelerated loss of volume in brain areas known to be essential for mood regulation and cognitive function, consistent findings have emerged at a cellular level, providing evidence that bipolar disorder is reliably associated with dysregulation of glial–neuronal interactions. Among these glial elements are microglia – the brain’s primary immune elements, which appear to be overactive in the context of bipolarity. Multiple studies now indicate that inflammation is also increased in the periphery of the body in both the depressive and manic phases of the illness, with at least some return to normality in the euthymic state. These findings are consistent with changes in the hypothalamic–pituitary–adrenal axis, which are known to drive inflammatory activation. In summary, the very fact that no single gene, pathway, or brain abnormality is likely to ever account for the condition is itself an extremely important first step in better articulating an integrated perspective on both its ontological status and pathogenesis. Whether this perspective will translate into the discovery of innumerable more homogeneous forms of

  17. An integrated treatment model for dual diagnosis of psychosis and addiction.

    Science.gov (United States)

    Minkoff, K

    1989-10-01

    A model that integrates the treatment of patients with a dual diagnosis of psychosis and addiction has been developed on a general hospital psychiatric unit. The model emphasizes the parallels between the standard biopsychosocial illness-and-rehabilitation model for treatment of serious psychiatric disorders and the 12-step disease-and-recovery model of Alcoholics Anonymous for treatment of addiction. Dual-diagnosis patients are viewed as having two primary, chronic, biologic mental illnesses, each requiring specific treatment to stabilize acute symptoms and engage the patient in a recovery process. An integrated treatment program is described, as are the steps taken to alleviate psychiatric clinicians' concerns about patient involvement in AA and addiction clinicians' discomfort with patients' use of medication.

  18. Vision and dual IMU integrated attitude measurement system

    Science.gov (United States)

    Guo, Xiaoting; Sun, Changku; Wang, Peng; Lu, Huang

    2018-01-01

    To determination relative attitude between two space objects on a rocking base, an integrated system based on vision and dual IMU (inertial determination unit) is built up. The determination system fuses the attitude information of vision with the angular determinations of dual IMU by extended Kalman filter (EKF) to obtain the relative attitude. One IMU (master) is attached to the measured motion object and the other (slave) to the rocking base. As the determination output of inertial sensor is relative to inertial frame, thus angular rate of the master IMU includes not only motion of the measured object relative to inertial frame but also the rocking base relative to inertial frame, where the latter can be seen as redundant harmful movement information for relative attitude determination between the measured object and the rocking base. The slave IMU here assists to remove the motion information of rocking base relative to inertial frame from the master IMU. The proposed integrated attitude determination system is tested on practical experimental platform. And experiment results with superior precision and reliability show the feasibility and effectiveness of the proposed attitude determination system.

  19. A Notion of Total Dual Integrality for Convex, Semidefinite, and Extended Formulations

    OpenAIRE

    Silva, Marcel K. de Carli; Tunçel, Levent

    2018-01-01

    Total dual integrality is a powerful and unifying concept in polyhedral combinatorics and integer programming that enables the refinement of geometric min-max relations given by linear programming Strong Duality into combinatorial min-max theorems. The definition of total dual integrality (TDI) revolves around the existence of optimal dual solutions that are integral, and thus naturally applies to a host of combinatorial optimization problems that are cast as integer programs whose LP relaxat...

  20. Amputatiewens bij 'body integrity identity disorder'

    NARCIS (Netherlands)

    Blom, Rianne M.; Hennekam, Raoul C. M.

    2014-01-01

    Body integrity identity disorder (BIID) is a rare neuropsychiatric disorder in which patients experience a mismatch between the real and experienced body from childhood. BIID results in a strong desire to amputate or paralyse one or more limbs. We describe two BIID patients. A 40-year-old healthy

  1. Cocaine abuse or dependency and other pyschiatric disorders. Madrid study on dual pathology.

    Science.gov (United States)

    Arias, Francisco; Szerman, Nestor; Vega, Pablo; Mesias, Beatriz; Basurte, Ignacio; Morant, Consuelo; Ochoa, Enriqueta; Poyo, Félix; Babin, Francisco

    2013-01-01

    The main objective of this study was to analyse the cocaine addict subgroup from the Madrid study of prevalence of dual disorders in community mental health and substance misuse services. The sample consisted of 837 outpatients from Madrid, Spain. We compared 488 subjects who had a lifetime diagnosis of cocaine abuse or dependence, and 222 subjects who did not have a cocaine substance use disorder. We used the Mini International Neuropsychiatric Interview to evaluate axis I mental disorders, and the Personality Disorder Questionnaire to evaluate personality disorders. Almost three-quarters (73.4%) of cocaine addicts had a current dual disorder. Most prevalent were mood and anxiety disorders. Almost half (49.6%) had a personality disorder. Most of them (94.9%) had other substance use disorders. Cocaine addicts did not have higher prevalence rates of dual pathology than addicts with no cocaine abuse or dependence. Cocaine addicts were associated to a diagnosis of antisocial personality disorder, agoraphobia, and post-traumatic stress disorder, and they had an early age of onset of alcohol and cannabis use. Dual pathology is no higher in cocaine addicts in treatment than in addicts who do not use cocaine, however cocaine addicts started other drugs earlier, and were associated with specific mental disorders. Copyright © 2012 SEP y SEPB. Published by Elsevier Espana. All rights reserved.

  2. Predicting sugar consumption: Application of an integrated dual-process, dual-phase model.

    Science.gov (United States)

    Hagger, Martin S; Trost, Nadine; Keech, Jacob J; Chan, Derwin K C; Hamilton, Kyra

    2017-09-01

    Excess consumption of added dietary sugars is related to multiple metabolic problems and adverse health conditions. Identifying the modifiable social cognitive and motivational constructs that predict sugar consumption is important to inform behavioral interventions aimed at reducing sugar intake. We tested the efficacy of an integrated dual-process, dual-phase model derived from multiple theories to predict sugar consumption. Using a prospective design, university students (N = 90) completed initial measures of the reflective (autonomous and controlled motivation, intentions, attitudes, subjective norm, perceived behavioral control), impulsive (implicit attitudes), volitional (action and coping planning), and behavioral (past sugar consumption) components of the proposed model. Self-reported sugar consumption was measured two weeks later. A structural equation model revealed that intentions, implicit attitudes, and, indirectly, autonomous motivation to reduce sugar consumption had small, significant effects on sugar consumption. Attitudes, subjective norm, and, indirectly, autonomous motivation to reduce sugar consumption predicted intentions. There were no effects of the planning constructs. Model effects were independent of the effects of past sugar consumption. The model identified the relative contribution of reflective and impulsive components in predicting sugar consumption. Given the prominent role of the impulsive component, interventions that assist individuals in managing cues-to-action and behavioral monitoring are likely to be effective in regulating sugar consumption. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. [The dual process model of addiction. Towards an integrated model?].

    Science.gov (United States)

    Vandermeeren, R; Hebbrecht, M

    2012-01-01

    Neurobiology and cognitive psychology have provided us with a dual process model of addiction. According to this model, behavior is considered to be the dynamic result of a combination of automatic and controlling processes. In cases of addiction the balance between these two processes is severely disturbed. Automated processes will continue to produce impulses that ensure the continuance of addictive behavior. Weak, reflective or controlling processes are both the reason for and the result of the inability to forgo addiction. To identify features that are common to current neurocognitive insights into addiction and psychodynamic views on addiction. The picture that emerges from research is not clear. There is some evidence that attentional bias has a causal effect on addiction. There is no evidence that automatic associations have a causal effect, but there is some evidence that automatic action-tendencies do have a causal effect. Current neurocognitive views on the dual process model of addiction can be integrated with an evidence-based approach to addiction and with psychodynamic views on addiction.

  4. [Dual diagnosis psychosis and substance use disorders: theoretical foundations and treatment].

    Science.gov (United States)

    Gouzoulis-Mayfrank, Euphrosyne

    2008-07-01

    Dual Diagnosis (DD) patients with psychosis and substance use disorders (SUD) represent a large core group among patients with schizophrenia. Cannabis use disorders are most prevalent among DD patients, particularly in adolescent and young adult populations. There are different models to explain the high rates of comorbidity between psychosis and SUD. Currently, evidence is best for the model of cannabis use being a component cause of psychosis in individuals who are highly vulnerable to psychosis. There is also some evidence for the model of common vulnerability factors for psychosis and SUD. DD patients are difficult to treat as they comply poorly, their long-term outcomes are unfavourable and they suffer frequent psychotic relapses and hospitalisations. Successful treatment models integrate traditional psychiatric therapy for psychosis and therapy for addiction in one setting, modifying and adjusting the two components to the special needs of the DD patients. Integrated programmes focus mostly on long-term outpatient treatment and offer pharmacotherapy, motivational enhancement, psychoeducation, cognitive-behavioural therapy and family interventions. Current clinical research demonstrates that integrated treatment programmes can achieve significant improvements with regard to the social adjustment of, as well as decreased substance use by DD patients.

  5. Abuse or dependence on cannabis and other psychiatric disorders. Madrid study on dual pathology prevalence.

    Science.gov (United States)

    Arias, Francisco; Szerman, Nestor; Vega, Pablo; Mesias, Beatriz; Basurte, Ignacio; Morant, Consuelo; Ochoa, Enriqueta; Poyo, Félix; Babin, Francisco

    2013-01-01

    Cannabis use has been associated to a wide variety of mental disorders, the possible causal role of this use in the etiology of severe mental disorders as schizophrenia or bipolar disorder standing out. Moreover, the cannabinoid system is involved in emotional regulation, so cannabis use could disturb this process and provoke anxiety and mood disorders. The main objective of this study was to analyze the cannabis addict subgroup from Madrid study of prevalence of dual disorders in community mental health and substance misuse services. The sample consisted of 837 outpatients under treatment in the mental health network or drug network of the Community of Madrid (Spain). Of these, 353 subjects had a lifetime diagnosis of cannabis abuse or dependence and 357 subjects did not have cannabis substance use disorder. We used the Mini International Neuropsychiatric Interview (MINI) to evaluate axis I mental disorders, and Personality Disorder Questionnaire to evaluate personality disorders. It was considered that 76.5% of the cannabis addicts had a current dual disorder. The most prevalent ones were mood and anxiety disorders. Of those addicted to cannabis, 51% had a personality disorder. Most of them had several substance use disorders. Cannabis abuse or dependence subjects had an earlier onset in consumption of other drugs such as alcohol, cocaine, and tobacco than addicts without cannabis abuse or dependence. The cannabis addicts also differed from the other addicts because of an association to antisocial personality disorder, bipolar disorder, psychosis and agoraphobia. The presence of these mental disorders was significantly associated to a lower age at initiation of cannabis use. Dual pathology is very high in cannabis addicts under treatment. Said consumption of cannabis, probably within a polysubstance use pattern, is associated to severe mental disorders as psychosis and bipolar disorder. An earlier age of onset in cannabis use is associated to a greater risk of

  6. Silicon Integrated Dual-Mode Interferometer with Differential Outputs

    Directory of Open Access Journals (Sweden)

    Niklas Hoppe

    2017-09-01

    Full Text Available The dual-mode interferometer (DMI is an attractive alternative to Mach-Zehnder interferometers for sensor purposes, achieving sensitivities to refractive index changes close to state-of-the-art. Modern designs on silicon-on-insulator (SOI platforms offer thermally stable and compact devices with insertion losses of less than 1 dB and high extinction ratios. Compact arrays of multiple DMIs in parallel are easy to fabricate due to the simple structure of the DMI. In this work, the principle of operation of an integrated DMI with differential outputs is presented which allows the unambiguous phase shift detection with a single wavelength measurement, rather than using a wavelength sweep and evaluating the optical output power spectrum. Fluctuating optical input power or varying attenuation due to different analyte concentrations can be compensated by observing the sum of the optical powers at the differential outputs. DMIs with two differential single-mode outputs are fabricated in a 250 nm SOI platform, and corresponding measurements are shown to explain the principle of operation in detail. A comparison of DMIs with the conventional Mach-Zehnder interferometer using the same technology concludes this work.

  7. Two-dimensional parasitic capacitance extraction for integrated circuit with dual discrete geometric methods

    International Nuclear Information System (INIS)

    Ren Dan; Ren Zhuoxiang; Qu Hui; Xu Xiaoyu

    2015-01-01

    Capacitance extraction is one of the key issues in integrated circuits and also a typical electrostatic problem. The dual discrete geometric method (DGM) is investigated to provide relative solutions in two-dimensional unstructured mesh space. The energy complementary characteristic and quick field energy computation thereof based on it are emphasized. Contrastive analysis between the dual finite element methods and the dual DGMs are presented both from theoretical derivation and through case studies. The DGM, taking the scalar potential as unknown on dual interlocked meshes, with simple form and good accuracy, is expected to be one of the mainstreaming methods in associated areas. (paper)

  8. Integrating Early Intervention for Borderline Personality Disorder and Mood Disorders.

    Science.gov (United States)

    Chanen, Andrew M; Berk, Michael; Thompson, Katherine

    2016-01-01

    Borderline personality disorder (BPD) has been demonstrated to be a reliable and valid construct in young people (adolescents and young adults). Both borderline- and mood-related psychopathology become clinically apparent from puberty through to young adulthood, frequently co-occur, can reinforce one another, and can be difficult to differentiate clinically. This Gordian knot of overlapping clinical features, common risk factors, and precursors to both BPD and mood disorders complicates clinical assessment, prevention, and treatment. Regardless of whether an individual crosses an arbitrary diagnostic threshold, a considerable proportion of young people with borderline- and mood-related psychopathology will develop significant and persistent functional, vocational, and interpersonal impairment and disability during this critical risk and developmental period. There is a clear need for early intervention, but spurious diagnostic certainty risks stigma, misapplication of diagnostic labels, inappropriate treatment, and unfavorable outcomes. This article aims to integrate early intervention for BPD and mood disorders in the clinical context of developmental and phenomenological change and evolution. "Clinical staging," similar to disease staging in general medicine, is presented as a pragmatic, heuristic, and trans-diagnostic framework to guide prevention and intervention. It acknowledges that the early stages of these disorders cannot be disentangled sufficiently to allow for disorder-specific preventive measures and early interventions. Clinical staging defines an individual's location along the continuum of the evolving temporal course of a disorder. Such staging aids differentiation of early or milder clinical phenomena from those that accompany illness progression and chronicity, and suggests the application of appropriate and proportionate intervention strategies.

  9. Protocol for a randomized comparison of integrated versus consecutive dual task practice in Parkinson's disease: the DUALITY trial

    NARCIS (Netherlands)

    Strouwen, C.; Molenaar, E.A.L.M.; Keus, S.H.J.; Munks, L.; Munneke, M.; Vandenberghe, W.; Bloem, B.R.; Nieuwboer, A.

    2014-01-01

    BACKGROUND: Multiple tasking is an integral part of daily mobility. Patients with Parkinson's disease have dual tasking difficulties due to their combined motor and cognitive deficits. Two contrasting physiotherapy interventions have been proposed to alleviate dual tasking difficulties: either to

  10. [Body integrity identity disorder, relief after amputation].

    Science.gov (United States)

    Blom, R M; Braam, A W; de Boer-Kreeft, N; Sonnen, M P A M

    2014-01-01

    Body integrity identity disorder (BIID) is a rare condition in which a person, for no apparent physical reason, is tormented by the experience that a body-part, such as a limb, does not really belong to the body. Patients experience an intense desire for the limb to be amputated (a 'desire' formerly referred to as 'apotemnophilia'). We report on a 58-year-old male patient with BIID who froze one of his legs so that he could amputate it himself. A surgeon ultimately intervened and amputated the leg professionally. The patient was extremely relieved and was still experiencing relief at a follow-up three years later.

  11. [Body schema, multisensory integration and developmental disorders].

    Science.gov (United States)

    Reinersmann, Annika; Lücke, Thomas

    2018-04-01

    Our body is both, the object experiencing the world and the subject of our self- experience. As an object, the body provides sensory information via the bodily surface, which is processed and integrated into a coherent representation of the body, the body schema. This representation is considered to form a crucial structure underlying bodily self-identification. The process of integrating multimodal information into a coherent body representation has received extensive research interest with the aim to further clarify its neuronal correlates and functioning in health and disease. However, little is known about the ontogenetic functioning of body schema or multisensory integration processing and their role in the development of socio-emotional in children. This narrative overview discusses implication of a dysfunctional body schematic functioning for socio-emotional competencies. A general introduction on body schematic processes is followed by a narrative review of current findings on the maturation of the body schema and multisensory integration. We finally outline implications for the self- and socio-emotional development in children and discuss possible implications for a role of disrupted body schema functions in developmental disorders. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Integrated, Dual Orthogonal Antennas for Polarimetric Ground Penetrating Radar

    Science.gov (United States)

    Pauli, Mario; Wiesbeck, Werner

    2015-04-01

    Ground penetrating radar systems are mostly equipped with single polarized antennas, for example with single linear polarization or with circular polarization. The radiated waves are partly reflected at the ground surface and very often the penetrating waves are distorted in their polarization. The distortion depends on the ground homogeneity and the orientation of the antennas relative to the ground structure. The received signals from the reflecting objects may most times only be classified according to their coverage and intensity. This makes the recognition of the objects difficult or impossible. In airborne and spaceborne Remote Sensing the systems are meanwhile mostly equipped with front ends with dual orthogonal polarized antennas for a full polarimetric operation. The received signals, registered in 2x2 scattering matrices according to co- and cross polarization, are processed for the evaluation of all features of the targets. Ground penetrating radars could also profit from the scientific results of Remote Sensing. The classification of detected objects for their structure and orientation requires more information in the reflected signal than can be measured with a single polarization [1, 2]. In this paper dual linear, orthogonal polarized antennas with a common single, frequency independent phase center, are presented [3]. The relative bandwidth of these antennas can be 1:3, up to 1:4. The antenna is designed to work in the frequency range between 3 GHz and 11 GHz, but can be easily adapted to the GPR frequency range by scaling. The size of the antenna scaled for operation in typical GPR frequencies would approximately be 20 by 20 cm2. By the implementation in a dielectric carrier it could be reduced in size if required. The major problem for ultra wide band, dual polarized antennas is the frequency independent feed network, realizing the required phase shifts. For these antennas a network, which is frequency independent over a wide range, has been

  13. Dual CRISPR-Cas9 Cleavage Mediated Gene Excision and Targeted Integration in Yarrowia lipolytica.

    Science.gov (United States)

    Gao, Difeng; Smith, Spencer; Spagnuolo, Michael; Rodriguez, Gabriel; Blenner, Mark

    2018-05-29

    CRISPR-Cas9 technology has been successfully applied in Yarrowia lipolytica for targeted genomic editing including gene disruption and integration; however, disruptions by existing methods typically result from small frameshift mutations caused by indels within the coding region, which usually resulted in unnatural protein. In this study, a dual cleavage strategy directed by paired sgRNAs is developed for gene knockout. This method allows fast and robust gene excision, demonstrated on six genes of interest. The targeted regions for excision vary in length from 0.3 kb up to 3.5 kb and contain both non-coding and coding regions. The majority of the gene excisions are repaired by perfect nonhomologous end-joining without indel. Based on this dual cleavage system, two targeted markerless integration methods are developed by providing repair templates. While both strategies are effective, homology mediated end joining (HMEJ) based method are twice as efficient as homology recombination (HR) based method. In both cases, dual cleavage leads to similar or improved gene integration efficiencies compared to gene excision without integration. This dual cleavage strategy will be useful for not only generating more predictable and robust gene knockout, but also for efficient targeted markerless integration, and simultaneous knockout and integration in Y. lipolytica. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. White matter tract integrity in treatment-resistant gambling disorder

    DEFF Research Database (Denmark)

    Chamberlain, Samuel R.; Derbyshire, Katherine; Daws, Richard E.

    2016-01-01

    Background: Gambling disorder is a relatively common psychiatric disorder recently re-classified within the DSM-5 under the category of ‘substance-related and addictive disorders’. Aims: To compare white matter integrity in patients with gambling disorder with healthy controls; to explore...

  15. Deep white matter hyperintensities, microstructural integrity and dual task walking in older people.

    Science.gov (United States)

    Ghanavati, Tabassom; Smitt, Myriam Sillevis; Lord, Stephen R; Sachdev, Perminder; Wen, Wei; Kochan, Nicole A; Brodaty, Henry; Delbaere, Kim

    2018-01-03

    To examine neural, physiological and cognitive influences on gait speed under single and dual-task conditions. Sixty-two community-dwelling older people (aged 80.0 ± 4.2 years) participated in our study. Gait speed was assessed with a timed 20-meter walk under single and dual-task (reciting alternate letters of the alphabet) conditions. Participants also underwent tests to estimate physiological fall risk based on five measures of sensorimotor function, cognitive function across five domains, brain white matter (WM) hyperintensities and WM microstructural integrity by measuring fractional anisotropy (FA). Univariate linear regression analyses showed that global physiological and cognitive measures were associated with single (β = 0.594 and β=-0.297, respectively) and dual-task gait speed (β = 0.306 and β=-0.362, respectively). Deep WMHs were associated with dual-task gait speed only (β = 0.257). Multivariate mediational analyses showed that global and executive cognition reduced the strength of the association between deep WMHs and dual-task gait speed by 27% (β = 0.188) and 44% (β = 0.145) respectively. There was a significant linear association between single-task gait speed and mean FA values of the genu (β=-0.295) and splenium (β=-0.326) of the corpus callosum, and between dual-task gait speed and mean FA values of Superior Cerebellar Peduncle (β=-0.284), splenium of the Corpus Callosum (β=-0.286) and Cingulum (β=-0.351). Greater deep WMH volumes are associated with slower walking speed under dual-task conditions, and this relationship is mediated in part by global cognition and executive abilities specifically. Furthermore, both cerebellum and cingulum are related to dual-task walking due to their role in motor skill performance and attention, respectively.

  16. Dual joint space arthrography in temporomandibular joint disorders: Comparison with single inferior joint space arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hyung Sik; Chang, Duk Soo; Lee, Kyung Soo; Kim, Woo Sun; Sung, Jung Ho; Jun, Young Hwan [Capital Armed Forces General Hospital, Seoul (Korea, Republic of)

    1989-02-15

    The temporomandibular joint(TMJ) is really a complex of two synovial space separated by fibrocartilaginous disc. Single inferior joint space arthrography is commonly performed for evaluation of TMJ disorders, which is known to be superior in demonstrating joint dynamics. But it reveals only the inferior surface of the disc. Therefore, dual space arthrography is superior to demonstrate the soft tissue anatomic feature of the joint such as disc position and shape. Authors performed 83 TMJ arthrograms in TMJ problems. Initially, the inferior joint space was done and then the superior space was sequentially contrasted. The follow results were noted: 1. In all cases, dual space arthrography revealed accurate disc shape and positions. 2. Concordant findings between the two techniques: 68 cases (82%). Discordance between the two techniques: 15 cases (18%) 3. Possible causes of discordance between inferior and dual space arthrography. a) Normal varians of anterior recess: 3 cases b) Posterior disc displacement: 4 cases c) Influence of the patient's head position change :4 cases d) False perforation: 2 cases e) Reduction change: 2 cases 4. In 5 cases with anterior displacement, dual space arthrography gave additional findings such as adhesion within the superior space, which could not be evaluated by single inferior space.

  17. Vertical integration of dual wavelength index guided lasers

    NARCIS (Netherlands)

    Karouta, F.; Tan, H.H.; Jagadish, C.; Roy, van B.H.

    1999-01-01

    The vertical integration of two GaAs-based lasers operating at different wavelengths has been achieved with the use of re-growth technology. A V-channel substrate inner stripe structure was used for the bottom laser and a ridge waveguide for the top laser. Both lasers shared a common electrode and

  18. Mental Health Service and Drug Treatment Utilization: Adolescents with Substance Use/Mental Disorders and Dual Diagnosis

    Science.gov (United States)

    Cheng, Tyrone C.; Lo, Celia C.

    2010-01-01

    This research is a secondary data analysis of the impact of adolescents' mental/substance-use disorders and dual diagnosis on their utilization of drug treatment and mental health services. By analyzing the same teenagers who participated in the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) study, logistic…

  19. Contingency management for patients with dual disorders in intensive outpatient treatment for addiction.

    Science.gov (United States)

    Kelly, Thomas M; Daley, Dennis C; Douaihy, Antoine B

    2014-01-01

    This quality improvement program evaluation investigated the effectiveness of contingency management for improving retention in treatment and positive outcomes among patients with dual disorders in intensive outpatient treatment for addiction. The effect of contingency management was explored among a group of 160 patients exposed to contingency management (n = 88) and not exposed to contingency management (no contingency management, n = 72) in a six-week partial hospitalization program. Patients referred to the partial hospitalization program for treatment of substance use and comorbid psychiatric disorders received diagnoses from psychiatrists and specialist clinicians according to the Diagnostic and Statistical Manual of the American Psychiatric Association. A unique application of the contingency management "fishbowl" method was used to improve the consistency of attendance at treatment sessions, which patients attended 5 days a week. Days attending treatment and drug-free days were the main outcome variables. Other outcomes of interest were depression, anxiety and psychological stress, coping ability, and intensity of drug cravings. Patients in the contingency management group attended more treatment days compared to patients in the no contingency management group; M = 16.2 days (SD = 10.0) versus M = 9.9 days (SD = 8.5), respectively; t = 4.2, df = 158, p contingency management and self-reported drug-free days. Contingency management is a valuable adjunct for increasing retention in treatment among patients with dual disorders in partial hospitalization treatment. Exposure to contingency management increases retention in treatment, which in turn contributes to increased drug-free days. Interventions for coping with psychological stress and drug cravings should be emphasized in intensive dual diagnosis group therapy.

  20. Parenting Efficacy and Support in Mothers With Dual Disorders in a Substance Abuse Treatment Program.

    Science.gov (United States)

    Brown, Suzanne; Hicks, Laurel M; Tracy, Elizabeth M

    2016-01-01

    Approximately 73% of women entering treatment for substance use disorders are mothers of children younger than 18, and the high rate of mental health disorders among mothers with substance use disorders increases their vulnerability to poor parenting practices. Parenting efficacy and social support for parenting have emerged as significant predictors of positive parenting practices among families at risk for child maltreatment. The purpose of the current study was to examine the impact of parenting support and parenting efficacy on the likelihood of out-of-home placement and custody status among the children of mothers with dual substance use and mental health disorders. This study examined the impact of parenting efficacy and assistance with childcare on the likelihood of child out-of-home placement and custody status among 175 mothers with diagnosed dual substance and mental health disorder and in treatment for substance dependence. Logistic regression was utilized to assess the contributions of parenting efficacy and the number of individuals in mothers' social networks who assist with childcare to the likelihood of out-of-home placement and custody loss of children. Parenting efficacy was also examined as a mediator using bootstrapping in PROCESS for SPSS. Greater parenting efficacy was associated with lower likelihood of having at least one child in out-of-home placement (B = -.064, SE = .029, p = .027) and lower likelihood of loss of child custody (B = -.094, SE = .034, p = .006). Greater number of children in the 6 to 18 age range predicted greater likelihood of having at least one child in the custody of someone else (B = .409, SE = .171, p = .017) and in out-of-home placement (B = .651, SE = .167, p child in out-of-home placement (B = .927, SE = .382, p = .015) or to have lost custody of a child (B = -1.31, SE = .456, p = .004). Finally, parenting efficacy mediated the relationship between parenting support and likelihood of out-of-home placement (effect

  1. Dual Treatments as Starting Point for Integrative Perceptions in Teaching Mathematics

    Science.gov (United States)

    Kërënxhi, Svjetllana; Gjoci, Pranvera

    2015-01-01

    In this paper, we recommend mathematical teaching through dual treatments. The dual treatments notion, classified in dual interpretations, dual analyses, dual solutions, and dual formulations, is explained through concrete examples taken from mathematical textbooks of elementary education. Dual treatments provide opportunities for creating…

  2. Integrative Response Therapy for Binge Eating Disorder

    Science.gov (United States)

    Robinson, Athena

    2013-01-01

    Binge eating disorder (BED), a chronic condition characterized by eating disorder psychopathology and physical and social disability, represents a significant public health problem. Guided self-help (GSH) treatments for BED appear promising and may be more readily disseminable to mental health care providers, accessible to patients, and…

  3. Some New Integrable Equations from the Self-Dual Yang-Mills Equations

    International Nuclear Information System (INIS)

    Ivanova, T.A.; Popov, A.D.

    1994-01-01

    Using the symmetry reductions of the self-dual Yang-Mills (SDYM) equations in (2+2) dimensions, we introduce new integrable equations which are 'deformations' of the chiral model in (2+1) dimensions, generalized nonlinear Schroedinger, Korteweg-de Vries, Toda lattice, Garnier, Euler-Arnold, generalized Calogero-Moser and Euler-Calogero-Moser equations. The Lax pairs for all of these equations are derived by the symmetry reductions of the Lax pair for the SDYM equations. 34 refs

  4. Optical stretching of giant unilamellar vesicles with an integrated dual-beam optical trap.

    Science.gov (United States)

    Solmaz, Mehmet E; Biswas, Roshni; Sankhagowit, Shalene; Thompson, James R; Mejia, Camilo A; Malmstadt, Noah; Povinelli, Michelle L

    2012-10-01

    We have integrated a dual-beam optical trap into a microfluidic platform and used it to study membrane mechanics in giant unilamellar vesicles (GUVs). We demonstrate the trapping and stretching of GUVs and characterize the membrane response to a step stress. We then measure area strain as a function of applied stress to extract the bending modulus of the lipid bilayer in the low-tension regime.

  5. Comparative utilization of pharmacotherapy for alcohol use disorder and other psychiatric disorders among U.S. Veterans Health Administration patients with dual diagnoses.

    Science.gov (United States)

    Rubinsky, Anna D; Chen, Cheng; Batki, Steven L; Williams, Emily C; Harris, Alex H S

    2015-10-01

    Patients with alcohol use disorder (AUD) and another co-occurring psychiatric disorder are a vulnerable population with high symptom severity. Such patients may benefit from a full arsenal of treatment options including pharmacotherapy. Receipt of AUD pharmacotherapy is generally very low despite recommendations that it be made available to every patient with AUD, including those with co-occurring disorders. Little is known about pharmacotherapy rates for AUD compared to other psychiatric disorders among patients with dual diagnoses. This study compared rates of pharmacotherapy for AUD to those for non-substance use psychiatric disorders and tobacco use disorder among patients with dual diagnoses in the U.S. Veterans Affairs (VA) healthcare system. VA data were used to identify patients with AUD and another psychiatric disorder in fiscal year 2012, and to estimate the proportion receiving pharmacotherapy for AUD and for each comorbid condition. Among subsets of patients with AUD and co-occurring schizophrenic, bipolar, posttraumatic stress or major depressive disorder, receipt of medications for AUD ranged from 7% to 11%, whereas receipt of medications for the comorbid disorder ranged from 69% to 82%. Among patients with AUD and co-occurring tobacco use disorder, 6% received medication for their AUD and 34% for their tobacco use disorder. Among patients with dual diagnoses, rates of pharmacotherapy for AUD were far lower than those for the comorbid disorders and contrary to evidence that medications for AUD are effective. Additional system-wide implementation efforts to identify and address patient- and provider-level barriers are needed to increase AUD pharmacotherapy in this high-need population. Published by Elsevier Ltd.

  6. Ten years integrated care for mental disorders in the Netherlands

    Directory of Open Access Journals (Sweden)

    Christina M van der Feltz-Cornelis

    2011-03-01

    Full Text Available Background and problem statement: Integrated care for mental disorders aims to encompass forms of collaboration between different health care settings for the treatment of mental disorders. To this end, it requires integration at several levels, i.e. integration of psychiatry in medicine, of the psychiatric discourse in the medical discourse; of localization of mental health care and general health care facilities; and of reimbursement systems.   Description of policy practice: Steps have been taken in the last decade to meet these requirements, enabling psychiatry to move on towards integrated treatment of mental disorder as such, by development of a collaborative care model that includes structural psychiatric consultation that was found to be applicable and effective in several Dutch health care settings. This collaborative care model is a feasible and effective model for integrated care in several health care settings. The Bio Psycho Social System has been developed as a feasible instrument for assessment in integrated care as well. Discussion: The discipline of Psychiatry has moved from anti-psychiatry in the last century, towards an emancipated medical discipline. This enabled big advances towards integrated care for mental disorder, in collaboration with other medical disciplines, in the last decade. Conclusion: Now is the time to further expand this concept of care towards other mental disorders, and towards integrated care for medical and mental co-morbidity. Integrated care for mental disorder should be readily available to the patient, according to his/her preference, taking somatic co-morbidity into account, and with a focus on rehabilitation of the patient in his or her social roles.

  7. Ten years integrated care for mental disorders in the Netherlands

    Directory of Open Access Journals (Sweden)

    Christina M van der Feltz-Cornelis

    2011-03-01

    Full Text Available Background and problem statement: Integrated care for mental disorders aims to encompass forms of collaboration between different health care settings for the treatment of mental disorders. To this end, it requires integration at several levels, i.e. integration of psychiatry in medicine, of the psychiatric discourse in the medical discourse; of localization of mental health care and general health care facilities; and of reimbursement systems.  Description of policy practice: Steps have been taken in the last decade to meet these requirements, enabling psychiatry to move on towards integrated treatment of mental disorder as such, by development of a collaborative care model that includes structural psychiatric consultation that was found to be applicable and effective in several Dutch health care settings. This collaborative care model is a feasible and effective model for integrated care in several health care settings. The Bio Psycho Social System has been developed as a feasible instrument for assessment in integrated care as well.Discussion: The discipline of Psychiatry has moved from anti-psychiatry in the last century, towards an emancipated medical discipline. This enabled big advances towards integrated care for mental disorder, in collaboration with other medical disciplines, in the last decade.Conclusion: Now is the time to further expand this concept of care towards other mental disorders, and towards integrated care for medical and mental co-morbidity. Integrated care for mental disorder should be readily available to the patient, according to his/her preference, taking somatic co-morbidity into account, and with a focus on rehabilitation of the patient in his or her social roles.

  8. Integration and Mainstreaming of Communicatively Disordered Children.

    Science.gov (United States)

    Moody, Janet B.; Bozeman, Rhoushelle

    The paper presents an overview of the factors involved in providing successful mainstreaming experiences to severely language disordered (SLD) children. Among aspects considered are individualization, behavior management procedures, independent problem solving and decision making, group test taking skills and experiences, social emotional growth,…

  9. An Integrative Dimensional Classification of Personality Disorder

    Science.gov (United States)

    Widiger, Thomas A.; Livesley, W. John; Clark, Lee Anna

    2009-01-01

    Psychological assessment research concerns how to describe psychological dysfunction in ways that are both valid and useful. Recent advances in assessment research hold the promise of facilitating significant improvements in description and diagnosis. One such contribution is in the classification of personality disorder symptomatology. The…

  10. Structural reliability calculation method based on the dual neural network and direct integration method.

    Science.gov (United States)

    Li, Haibin; He, Yun; Nie, Xiaobo

    2018-01-01

    Structural reliability analysis under uncertainty is paid wide attention by engineers and scholars due to reflecting the structural characteristics and the bearing actual situation. The direct integration method, started from the definition of reliability theory, is easy to be understood, but there are still mathematics difficulties in the calculation of multiple integrals. Therefore, a dual neural network method is proposed for calculating multiple integrals in this paper. Dual neural network consists of two neural networks. The neural network A is used to learn the integrand function, and the neural network B is used to simulate the original function. According to the derivative relationships between the network output and the network input, the neural network B is derived from the neural network A. On this basis, the performance function of normalization is employed in the proposed method to overcome the difficulty of multiple integrations and to improve the accuracy for reliability calculations. The comparisons between the proposed method and Monte Carlo simulation method, Hasofer-Lind method, the mean value first-order second moment method have demonstrated that the proposed method is an efficient and accurate reliability method for structural reliability problems.

  11. Integrative data analysis of male reproductive disorders

    DEFF Research Database (Denmark)

    Edsgard, Stefan Daniel

    of such data in conjunction with data from publicly available repositories. This thesis presents an introduction to disease genetics and molecular systems biology, followed by four studies that each provide detailed clues to the etiology of male reproductive disorders. Finally, a fifth study illustrates......-wide association data with respect to copy number variation and show that the aggregated effect of rare variants can influence the risk for testicular cancer. Paper V provides an example of the application of RNA-Seq for expression analysis of a species with an unsequenced genome. We analysed the plant...... of this thesis is the identification of the molecular basis of male reproductive disorders, with a special focus on testicular cancer. To this end, clinical samples were characterized by microarraybased transcription and genomic variation assays and molecular entities were identified by computational analysis...

  12. Dual diagnosis of mental illness and substance use disorder and injury in adults recently released from prison: a prospective cohort study.

    Science.gov (United States)

    Young, Jesse T; Heffernan, Ed; Borschmann, Rohan; Ogloff, James R P; Spittal, Matthew J; Kouyoumdjian, Fiona G; Preen, David B; Butler, Amanda; Brophy, Lisa; Crilly, Julia; Kinner, Stuart A

    2018-05-01

    release from prison compared with the group with no mental health disorders. People released from prison experience high rates of injury compared with the general population. Among people released from prison, dual diagnosis is associated with an increased risk of injury. Contact with the criminal justice system is a key opportunity to prevent subsequent injury morbidity in people with co-occurring mental health disorders. Engagement with integrated psychiatric and addiction treatment delivered without interruption during the transition from prison into the community might prevent the injury-related disparities experienced by this vulnerable group. The development of targeted injury prevention strategies for people with dual diagnosis released from prison is warranted. National Health and Medical Research Council. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

  13. Dual diagnosis of mental illness and substance use disorder and injury in adults recently released from prison: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Jesse T Young, MPH

    2018-05-01

    87, 1·19–2·95; p=0·0071 groups were at increased risk of injury after release from prison compared with the group with no mental health disorders. Interpretation: People released from prison experience high rates of injury compared with the general population. Among people released from prison, dual diagnosis is associated with an increased risk of injury. Contact with the criminal justice system is a key opportunity to prevent subsequent injury morbidity in people with co-occurring mental health disorders. Engagement with integrated psychiatric and addiction treatment delivered without interruption during the transition from prison into the community might prevent the injury-related disparities experienced by this vulnerable group. The development of targeted injury prevention strategies for people with dual diagnosis released from prison is warranted. Funding: National Health and Medical Research Council.

  14. Integrated nanohole array surface plasmon resonance sensing device using a dual-wavelength source

    International Nuclear Information System (INIS)

    Escobedo, C; Vincent, S; Choudhury, A I K; Campbell, J; Gordon, R; Brolo, A G; Sinton, D

    2011-01-01

    In this paper, we demonstrate a compact integrated nanohole array-based surface plasmon resonance sensing device. The unit includes a LED light source, driving circuitry, CCD detector, microfluidic network and computer interface, all assembled from readily available commercial components. A dual-wavelength LED scheme was implemented to increase spectral diversity and isolate intensity variations to be expected in the field. The prototype shows bulk sensitivity of 266 pixel intensity units/RIU and a limit of detection of 6 × 10 −4 RIU. Surface binding tests were performed, demonstrating functionality as a surface-based sensing system. This work is particularly relevant for low-cost point-of-care applications, especially those involving multiple tests and field studies. While nanohole arrays have been applied to many sensing applications, and their suitability to device integration is well established, this is the first demonstration of a fully integrated nanohole array-based sensing device.

  15. SEMICONDUCTOR TECHNOLOGY: TaN wet etch for application in dual-metal-gate integration technology

    Science.gov (United States)

    Yongliang, Li; Qiuxia, Xu

    2009-12-01

    Wet-etch etchants and the TaN film method for dual-metal-gate integration are investigated. Both HF/HN O3/H2O and NH4OH/H2O2 solutions can etch TaN effectively, but poor selectivity to the gate dielectric for the HF/HNO3/H2O solution due to HF being included in HF/HNO3/H2O, and the fact that TaN is difficult to etch in the NH4OH/H2O2 solution at the first stage due to the thin TaOxNy layer on the TaN surface, mean that they are difficult to individually apply to dual-metal-gate integration. A two-step wet etching strategy using the HF/HNO3/H2O solution first and the NH4OH/H2O2 solution later can fully remove thin TaN film with a photo-resist mask and has high selectivity to the HfSiON dielectric film underneath. High-k dielectric film surfaces are smooth after wet etching of the TaN metal gate and MOSCAPs show well-behaved C-V and Jg-Vg characteristics, which all prove that the wet etching of TaN has little impact on electrical performance and can be applied to dual-metal-gate integration technology for removing the first TaN metal gate in the PMOS region.

  16. Brain substrates of social decision-making in dual diagnosis: cocaine dependence and personality disorders.

    Science.gov (United States)

    Verdejo-Garcia, Antonio; Verdejo-Román, Juan; Albein-Urios, Natalia; Martínez-González, José M; Soriano-Mas, Carles

    2017-03-01

    Cocaine dependence frequently co-occurs with personality disorders, leading to increased interpersonal problems and greater burden of disease. Personality disorders are characterised by patterns of thinking and feeling that divert from social expectations. However, the comorbidity between cocaine dependence and personality disorders has not been substantiated by measures of brain activation during social decision-making. We applied functional magnetic resonance imaging to compare brain activations evoked by a social decision-making task-the Ultimatum Game-in 24 cocaine dependents with personality disorders (CDPD), 19 cocaine dependents without comorbidities and 19 healthy controls. In the Ultimatum Game participants had to accept or reject bids made by another player to split monetary stakes. Offers varied in fairness (in fair offers the proposer shares ~50 percent of the money; in unfair offers the proposer shares <30 percent of the money), and participants were told that if they accept both players get the money, and if they reject both players lose it. We contrasted brain activations during unfair versus fair offers and accept versus reject choices. During evaluation of unfair offers CDPD displayed lower activation in the insula and the anterior cingulate cortex and higher activation in the lateral orbitofrontal cortex and superior frontal and temporal gyri. Frontal activations negatively correlated with emotion recognition. During rejection of offers CDPD displayed lower activation in the anterior cingulate cortex, striatum and midbrain. Dual diagnosis is linked to hypo-activation of the insula and anterior cingulate cortex and hyper-activation of frontal-temporal regions during social decision-making, which associates with poorer emotion recognition. © 2015 Society for the Study of Addiction.

  17. Final Technical Report - Integrated Hydrogeophysical and Hydrogeologic Driven Parameter Upscaling for Dual-Domain Transport Modeling

    Energy Technology Data Exchange (ETDEWEB)

    Shafer, John M

    2012-11-05

    The three major components of this research were: 1. Application of minimally invasive, cost effective hydrogeophysical techniques (surface and borehole), to generate fine scale (~1m or less) 3D estimates of subsurface heterogeneity. Heterogeneity is defined as spatial variability in hydraulic conductivity and/or hydrolithologic zones. 2. Integration of the fine scale characterization of hydrogeologic parameters with the hydrogeologic facies to upscale the finer scale assessment of heterogeneity to field scale. 3. Determination of the relationship between dual-domain parameters and practical characterization data.

  18. Ensuring Integrity in AGU Publications and Compliance With Dual Publication Policy

    Science.gov (United States)

    Kumar, Praveen; Calais, Eric

    2011-03-01

    To ensure the highest standards for publication, AGU has begun screening manuscript submissions using CrossCheck (http://www.crossref.org/crosscheck.html) for possible verbatim use of previously published material. Water Resources Research and Geophysical Research Letters have tested this technology since summer 2010. It has proven very useful in ensuring the highest integrity in publication standards and compliance with the AGU dual publication policy (http://www.agu.org/pubs/authors/policies/dualpub_policy.shtml). According to Barbara Major, assistant director of journals, other AGU journals will adopt this screening process in the near future.

  19. Gait disorders in the elderly and dual task gait analysis: a new approach for identifying motor phenotypes.

    Science.gov (United States)

    Auvinet, Bernard; Touzard, Claude; Montestruc, François; Delafond, Arnaud; Goeb, Vincent

    2017-01-31

    Gait disorders and gait analysis under single and dual-task conditions are topics of great interest, but very few studies have looked for the relevance of gait analysis under dual-task conditions in elderly people on the basis of a clinical approach. An observational study including 103 patients (mean age 76.3 ± 7.2, women 56%) suffering from gait disorders or memory impairment was conducted. Gait analysis under dual-task conditions was carried out for all patients. Brain MRI was performed in the absence of contra-indications. Three main gait variables were measured: walking speed, stride frequency, and stride regularity. For each gait variable, the dual task cost was computed and a quartile analysis was obtained. Nonparametric tests were used for all the comparisons (Wilcoxon, Kruskal-Wallis, Fisher or Chi 2 tests). Four clinical subgroups were identified: gait instability (45%), recurrent falls (29%), memory impairment (18%), and cautious gait (8%). The biomechanical severity of these subgroups was ordered according to walking speed and stride regularity under both conditions, from least to most serious as follows: memory impairment, gait instability, recurrent falls, cautious gait (p < 0.01 for walking speed, p = 0.05 for stride regularity). According to the established diagnoses of gait disorders, 5 main pathological subgroups were identified (musculoskeletal diseases (n = 11), vestibular diseases (n = 6), mild cognitive impairment (n = 24), central nervous system pathologies, (n = 51), and without diagnosis (n = 8)). The dual task cost for walking speed, stride frequency and stride regularity were different among these subgroups (p < 0.01). The subgroups mild cognitive impairment and central nervous system pathologies both showed together a higher dual task cost for each variable compared to the other subgroups combined (p = 0.01). The quartile analysis of dual task cost for stride frequency and stride regularity

  20. Integrative Treatment of Personality Disorder. Part I: Psychotherapy.

    Science.gov (United States)

    Jovanovic, Mirjana Divac; Svrakic, Dragan

    2017-03-01

    In this paper, we outline the concept of integrative therapy of borderline personality, also referred to as fragmented personality, which we consider to be the core psychopathology underlying all clinical subtypes of personality disorder. Hence, the terms borderline personality, borderline disorder, fragmented personality, and personality disorder are used interchangeably, as synonyms. Our integrative approach combines pharmacotherapy and psychotherapy, each specifically tailored to accomplish a positive feedback modulation of their respective effects. We argue that pharmacotherapy and psychotherapy of personality disorder complement each other. Pharmacological control of disruptive affects clears the stage, in some cases builds the stage, for the psychotherapeutic process to take place. In turn, psychotherapy promotes integration of personality fragments into more cohesive structures of self and identity, ultimately establishing self-regulation of mood and anxiety. We introduce our original method of psychotherapy, called reconstructive interpersonal therapy (RIT). The RIT integrates humanistic-existential and psychodynamic paradigms, and is thereby designed to accomplish a deep reconstruction of core psychopathology within the setting of high structure. We review and comment the current literature on the strategies, goals, therapy process, priorities, and phases of psychotherapy of borderline disorders, and describe in detail the fundamental principles of RIT.

  1. Body integrity identity disorder and the ethics of mutilation.

    OpenAIRE

    Song, Robert

    2013-01-01

    The rare phenomenon in which a person desires amputation of a healthy limb, now often termed body integrity identity disorder, raises central questions for biomedical ethics. Standard bioethical discussions of surgical intervention in such cases fail to address the meaning of bodily integrity, which is intrinsic to a theological understanding of the goodness of the body. However, moral theological responses are liable to assume that such interventions necessarily represent an implicitly docet...

  2. Modified Dual Second-order Generalized Integrator FLL for Frequency Estimation Under Various Grid Abnormalities

    Directory of Open Access Journals (Sweden)

    Kalpeshkumar Rohitbhai Patil

    2016-10-01

    Full Text Available Proper synchronization of Distributed Generator with grid and its performance in grid-connected mode relies on fast and precise estimation of phase and amplitude of the fundamental component of grid voltage. However, the accuracy with which the frequency is estimated is dependent on the type of grid voltage abnormalities and structure of the phase-locked loop or frequency locked loop control schemes. Among various control schemes, second-order generalized integrator based frequency- locked loop (SOGI-FLL is reported to have the most promising performance. It tracks the frequency of grid voltage accurately even when grid voltage is characterized by sag, swell, harmonics, imbalance, frequency variations etc. However, estimated frequency contains low frequency oscillations in case when sensed grid-voltage has a dc offset. This paper presents a modified dual second-order generalized integrator frequency-locked loop (MDSOGI-FLL for three-phase systems to cope with the non-ideal three-phase grid voltages having all type of abnormalities including the dc offset. The complexity in control scheme is almost the same as the standard dual SOGI-FLL, but the performance is enhanced. Simulation results show that the proposed MDSOGI-FLL is effective under all abnormal grid voltage conditions. The results are validated experimentally to justify the superior performance of MDSOGI-FLL under adverse conditions.

  3. Dual-Source Swept-Source Optical Coherence Tomography Reconstructed on Integrated Spectrum

    Directory of Open Access Journals (Sweden)

    Shoude Chang

    2012-01-01

    Full Text Available Dual-source swept-source optical coherence tomography (DS-SSOCT has two individual sources with different central wavelengths, linewidth, and bandwidths. Because of the difference between the two sources, the individually reconstructed tomograms from each source have different aspect ratio, which makes the comparison and integration difficult. We report a method to merge two sets of DS-SSOCT raw data in a common spectrum, on which both data have the same spectrum density and a correct separation. The reconstructed tomographic image can seamlessly integrate the two bands of OCT data together. The final image has higher axial resolution and richer spectroscopic information than any of the individually reconstructed tomography image.

  4. Psychotherapy integration in the treatment of personality disorders: a commentary.

    Science.gov (United States)

    Nelson, Dana L; Beutler, Larry E; Castonguay, Louis G

    2012-02-01

    Whereas research on the treatment of personality disorders over the past several decades has focused primarily on comparing the efficacy of various treatment packages associated with different theoretical models, there is increasing evidence that the field would benefit from focusing more attention on developing integrative treatments that are both informed by research and capable of scientific verification. The articles assembled for this special section each propose a different approach to integrative treatment for personality disorders. In this commentary, we outline a number of reasons for making such a shift to more integrative treatments, consider some of the potential challenges to integration, and discuss the different approaches to integration illustrated in these articles. We highlight some of the difficult tradeoffs that must be made in developing an integrative approach and discuss similarities and differences in the response to such challenges by the contributors to this special section. Finally, we point to several areas for future research that we believe will contribute to the development of increasingly effective treatments for individuals with personality disorders.

  5. Severe Speech Sound Disorders: An Integrated Multimodal Intervention

    Science.gov (United States)

    King, Amie M.; Hengst, Julie A.; DeThorne, Laura S.

    2013-01-01

    Purpose: This study introduces an integrated multimodal intervention (IMI) and examines its effectiveness for the treatment of persistent and severe speech sound disorders (SSD) in young children. The IMI is an activity-based intervention that focuses simultaneously on increasing the "quantity" of a child's meaningful productions of target words…

  6. Vertically-Integrated Dual-Continuum Models for CO2 Injection in Fractured Aquifers

    Science.gov (United States)

    Tao, Y.; Guo, B.; Bandilla, K.; Celia, M. A.

    2017-12-01

    Injection of CO2 into a saline aquifer leads to a two-phase flow system, with supercritical CO2 and brine being the two fluid phases. Various modeling approaches, including fully three-dimensional (3D) models and vertical-equilibrium (VE) models, have been used to study the system. Almost all of that work has focused on unfractured formations. 3D models solve the governing equations in three dimensions and are applicable to generic geological formations. VE models assume rapid and complete buoyant segregation of the two fluid phases, resulting in vertical pressure equilibrium and allowing integration of the governing equations in the vertical dimension. This reduction in dimensionality makes VE models computationally more efficient, but the associated assumptions restrict the applicability of VE model to formations with moderate to high permeability. In this presentation, we extend the VE and 3D models for CO2 injection in fractured aquifers. This is done in the context of dual-continuum modeling, where the fractured formation is modeled as an overlap of two continuous domains, one representing the fractures and the other representing the rock matrix. Both domains are treated as porous media continua and can be modeled by either a VE or a 3D formulation. The transfer of fluid mass between rock matrix and fractures is represented by a mass transfer function connecting the two domains. We have developed a computational model that combines the VE and 3D models, where we use the VE model in the fractures, which typically have high permeability, and the 3D model in the less permeable rock matrix. A new mass transfer function is derived, which couples the VE and 3D models. The coupled VE-3D model can simulate CO2 injection and migration in fractured aquifers. Results from this model compare well with a full-3D model in which both the fractures and rock matrix are modeled with 3D models, with the hybrid VE-3D model having significantly reduced computational cost. In

  7. Nitrogen fertilization for wheat growing in dual purpose integrated system of agricultural production

    Directory of Open Access Journals (Sweden)

    Éderson Luis Henz

    2016-06-01

    Full Text Available Nowadays, there are numerous arrangements of Integrated Systems of Agricultural Production, due, the particularities of each region and/or rural enterprise. The use of dual-purpose species such as, for example, BRS Tarumã® wheat further intensifies the system, because there is plant-animal production in a short time. Study aimed to evaluate the production and chemical composition of dual purpose wheat pastures managed with different DAN during periods of spikelet terminal (ST and anthesis (AN, aiming crop production (pasture and grain and animal (milk and / or meat. The experimental randomized block design with five treatments (0, 75, 150, 225 e 300 Kg de N ha-1, in the form of ammonium nitrate and four replications. The average biomass values before the first and the second grazing were respectively: 2,164 and 2,127 kg DM per hectare and the waste of about 824 and 1,772 kg of DM per hectare and the daily average accumulation rate between the two grazing DM was 86 kg per hectare at 17 day intervals. The variables, number of spikes per square meter, grain number per square meter, thousand grain weight, hectoliter weight and grain yield did not differ (P>0.05 between treatments. Nitrogen fertilization increases linearly (P=0.0017 the size of the spikes depending on nitrogen rates. For the linear variable layering increased (P=0.0001, indicating the susceptibility of the crop to high levels of nitrogen. The application of nitrogen fertilizer levels in dual purpose grazed wheat before the spikelet terminal stage and anthesis does not influence on grain yield variables. The nitrogen fertilization on wheat double purpose must be fractionated at tillering and after each grazing increasing the remobilization rate of nitrogen by culture.

  8. Silicon photonic integrated circuit swept-source optical coherence tomography receiver with dual polarization, dual balanced, in-phase and quadrature detection.

    Science.gov (United States)

    Wang, Zhao; Lee, Hsiang-Chieh; Vermeulen, Diedrik; Chen, Long; Nielsen, Torben; Park, Seo Yeon; Ghaemi, Allan; Swanson, Eric; Doerr, Chris; Fujimoto, James

    2015-07-01

    Optical coherence tomography (OCT) is a widely used three-dimensional (3D) optical imaging method with many biomedical and non-medical applications. Miniaturization, cost reduction, and increased functionality of OCT systems will be critical for future emerging clinical applications. We present a silicon photonic integrated circuit swept-source OCT (SS-OCT) coherent receiver with dual polarization, dual balanced, in-phase and quadrature (IQ) detection. We demonstrate multiple functional capabilities of IQ polarization resolved detection including: complex-conjugate suppressed full-range OCT, polarization diversity detection, and polarization-sensitive OCT. To our knowledge, this is the first demonstration of a silicon photonic integrated receiver for OCT. The integrated coherent receiver provides a miniaturized, low-cost solution for SS-OCT, and is also a key step towards a fully integrated high speed SS-OCT system with good performance and multi-functional capabilities. With further performance improvement and cost reduction, photonic integrated technology promises to greatly increase penetration of OCT systems in existing applications and enable new applications.

  9. Trends in dual diagnosis of severe mental illness and substance use disorders, 1996-2010, Israel.

    Science.gov (United States)

    Ponizovsky, Alexander M; Rosca, Paola; Haklai, Ziona; Goldberger, Nehama

    2015-03-01

    (1) To examine the trends in the incidence of dual diagnosis (DD) of severe mental illness and substance-related disorders among inpatients in Israel, and (2) the demographic and clinical correlates of DD patients. Using data from the National Psychiatric Case Register, we identified 56,774 inpatients aged 15-64 whose first psychiatric hospitalization occurred between 1996 and 2010. We compared the characteristics of inpatients having DD with drugs, alcohol or drug/alcohol abuse with those with mental disorder only. Over the period, DD with drugs decreased from 8.2% in 1996 to 6% in 2010; DD with alcohol increased from 3% to 4% and DD with drugs/alcohol from 2% to 4%. DD with drugs was highest, whereas DD with alcohol was lowest for the youngest age- group in 1996 but increased to the same as other age-groups in 2006-2010. Male gender, a previous suicide attempt, compulsory hospitalizations and marital status were positive predictors for all DD. Immigrant status was a positive predictor of DD with alcohol, but the opposite for DD with drugs; being Jewish and psychotic diagnosis was a positive predictor of DD with drugs, but negative for DD with alcohol. Over the study period, DD with drugs has decreased among young patients, although it is still higher than among older groups. However, DD with alcohol or drugs/alcohol has increased in the younger group. The clinical-demographic profile of DD patients was similar to that from the relevant literature, except for immigrant status that was negatively associated with DD with drugs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Post-traumatic stress disorder and head injury as a dual diagnosis: "islands" of memory as a mechanism.

    Science.gov (United States)

    King, N S

    1997-01-01

    This case study describes post-traumatic stress disorder (PTSD) and head injury after a road traffic accident involving a pedestrian. Previous studies have proposed two mechanisms by which this dual diagnosis may occur: (1) when post-traumatic amnesia and retrograde amnesia are small or non-existent and (2) when non-declarative memory systems for the traumatic event are in operation. This case study demonstrates a third mechanism--"islands" of memory within post-traumatic amnesia.

  11. Full-Scale Field Test of a Blade-Integrated Dual-Telescope Wind Lidar

    DEFF Research Database (Denmark)

    Pedersen, Anders Tegtmeier; Sjöholm, Mikael; Angelou, Nikolas

    . Simultaneously, data regarding wind speed, rotational speed, and pitch angle recorded by the turbine was logged as well as data from a nearby met mast. The encouraging results of this first campaign include wind speed measurements at 20 Hz data rate along the rotor plane, acquired during the co...... in the top and bottom of the rotor plane. Conclusion We present here what we believe is the first successful wind speed measurements from a dual-telescope lidar installed on the blade of an operating wind turbine. The full-scale field test performed in the summer of 2012 has clearly demonstrated...... the possibility of integrating lidar telescopes into turbine blades as well as the capability of the lidar to measure the required wind speeds and to operate in the challenging environment of a rotating spinner and vibrating blade. The use of two separate telescopes allows a direct measurement of the blade’s AOA...

  12. Dual Pressure versus Hybrid Recuperation in an Integrated Solid Oxide Fuel Cell Cycle – Steam Cycle

    DEFF Research Database (Denmark)

    Rokni, Masoud

    2014-01-01

    A SOFC (solid oxide fuel cell) cycle running on natural gas was integrated with a ST (steam turbine) cycle. The fuel is desulfurized and pre-reformed before entering the SOFC. A burner was used to combust the remaining fuel after the SOFC stacks. The off-gases from the burner were used to produce...... pressure configuration steam cycle combined with SOFC cycle (SOFC-ST) was new and has not been studied previously. In each of the configuration, a hybrid recuperator was used to recovery the remaining energy of the off-gases after the HRSG. Thus, four different plants system setups were compared to each...... other to reveal the most superior concept with respect to plant efficiency and power. It was found that in order to increase the plant efficiency considerably, it was enough to use a single pressure with a hybrid recuperator instead of a dual pressure Rankine cycle....

  13. An integrated model of clinical reasoning: dual-process theory of cognition and metacognition.

    Science.gov (United States)

    Marcum, James A

    2012-10-01

    Clinical reasoning is an important component for providing quality medical care. The aim of the present paper is to develop a model of clinical reasoning that integrates both the non-analytic and analytic processes of cognition, along with metacognition. The dual-process theory of cognition (system 1 non-analytic and system 2 analytic processes) and the metacognition theory are used to develop an integrated model of clinical reasoning. In the proposed model, clinical reasoning begins with system 1 processes in which the clinician assesses a patient's presenting symptoms, as well as other clinical evidence, to arrive at a differential diagnosis. Additional clinical evidence, if necessary, is acquired and analysed utilizing system 2 processes to assess the differential diagnosis, until a clinical decision is made diagnosing the patient's illness and then how best to proceed therapeutically. Importantly, the outcome of these processes feeds back, in terms of metacognition's monitoring function, either to reinforce or to alter cognitive processes, which, in turn, enhances synergistically the clinician's ability to reason quickly and accurately in future consultations. The proposed integrated model has distinct advantages over other models proposed in the literature for explicating clinical reasoning. Moreover, it has important implications for addressing the paradoxical relationship between experience and expertise, as well as for designing a curriculum to teach clinical reasoning skills. © 2012 Blackwell Publishing Ltd.

  14. Dynamic response characteristics of dual flow-path integrally bladed rotors

    Science.gov (United States)

    Beck, Joseph A.; Brown, Jeffrey M.; Scott-Emuakpor, Onome E.; Cross, Charles J.; Slater, Joseph C.

    2015-02-01

    New turbine engine designs requiring secondary flow compression often look to dual flow-path integrally bladed rotors (DFIBRs) since these stages have the ability to perform work on the secondary, or bypassed, flow-field. While analogous to traditional integrally bladed rotor stages, DFIBR designs have many differences that result in unique dynamic response characteristics that must be understood to avoid fatigue. This work investigates these characteristics using reduced-order models (ROMs) that incorporate mistuning through perturbations to blade frequencies. This work provides an alternative to computationally intensive geometric-mistuning approaches for DFIBRs by utilizing tuned blade mode reductions and substructure coupling in cyclic coordinates. Free and forced response results are compared to full finite element model (FEM) solutions to determine if any errors are related to the reduced-order model formulation reduction methods. It is shown that DFIBRs have many more frequency veering regions than their single flow-path integrally blade rotor (IBR) counterparts. Modal families are shown to transition between system, inner-blade, and outer-blade motion. Furthermore, findings illustrate that while mode localization of traditional IBRs is limited to a single or small subset of blades, DFIBRs can have modal energy localized to either an inner- or outer-blade set resulting in many blades responding above tuned levels. Lastly, ROM forced response predictions compare well to full FEM predictions for the two test cases shown.

  15. Apotemnophilia or body integrity identity disorder: a case report review.

    Science.gov (United States)

    Bou Khalil, Rami; Richa, Sami

    2012-12-01

    Apotemnophilia or body integrity identity disorder (BIID) denotes a syndrome in which a person is preoccupied with the desire to amputate a healthy limb. In this report, we review the available case reports in the literature in order to enhance psychiatrists' and physicians' comprehension of this disorder. A search for the case reports available via MEDLINE was done since the first case report published by Money et al in 1977 till May 2011, using the following terms: apotemnophilia, self-demand amputation, body integrity identity disorder, and BIID. In all, 14 case reports were found relevant to our search. The desire to amputate one's healthy limb seems to be related to a major disturbance in the person's perception of one's own identity, where limb amputation can relieve temporarily the patient's feeling of distress without necessarily and uniformly adjusting the patient's own identity misperception. More investigations are needed in this domain in order to develop noninvasive treatment strategies that approach this aspect of the patient's distress within a globalist perspective. In addition, the health professionals' awareness regarding this disorder is required to ensure professional management of patients' suffering.

  16. Interval Timing Deficits Assessed by Time Reproduction Dual Tasks as Cognitive Endophenotypes for Attention-Deficit/Hyperactivity Disorder

    Science.gov (United States)

    Hwang-Gu, Shoou-Lian; Gau, Susan Shur-Fen

    2015-01-01

    The literature has suggested timing processing as a potential endophenotype for attention deficit/hyperactivity disorder (ADHD); however, whether the subjective internal clock speed presented by verbal estimation and limited attention capacity presented by time reproduction could be endophenotypes for ADHD is still unknown. We assessed 223 youths with DSM-IV ADHD (age range: 10-17 years), 105 unaffected siblings, and 84 typically developing (TD) youths using psychiatric interviews, intelligence tests, verbal estimation and time reproduction tasks (single task and simple and difficult dual tasks) at 5-second, 12-second, and 17-second intervals. We found that youths with ADHD tended to overestimate time in verbal estimation more than their unaffected siblings and TD youths, implying that fast subjective internal clock speed might be a characteristic of ADHD, rather than an endophenotype for ADHD. Youths with ADHD and their unaffected siblings were less precise in time reproduction dual tasks than TD youths. The magnitude of estimated errors in time reproduction was greater in youths with ADHD and their unaffected siblings than in TD youths, with an increased time interval at the 17-second interval and with increased task demands on both simple and difficult dual tasks versus the single task. Increased impaired time reproduction in dual tasks with increased intervals and task demands were shown in youths with ADHD and their unaffected siblings, suggesting that time reproduction deficits explained by limited attention capacity might be a useful endophenotype of ADHD. PMID:25992899

  17. A novel dual-functional MEMS sensor integrating both pressure and temperature units

    Energy Technology Data Exchange (ETDEWEB)

    Chen Tao; Zhang Zhaohua; Ren Tianling; Miao Gujin; Zhou Changjian; Lin Huiwang; Liu Litian, E-mail: RenTL@tsinghua.edu.c [National Laboratory for Information Science and Technology, Institute of Microelectronics, Tsinghua University, Beijing 100084 (China)

    2010-07-15

    This paper proposes a novel miniature dual-functional sensor integrating both pressure and temperature sensitive units on a single chip. The device wafer of SOI is used as a pizeoresistive diaphragm which features excellent consistency in thickness. The conventional anisotropic wet etching has been abandoned, while ICP etching has been employed to etch out the reference cave to minimize the area of individual device in the way that the 57.4{sup 0} slope has been eliminated. As a result, the average cost of the single chip is reduced. Two PN junctions with constant ratio of the areas of depletion regions have also been integrated on the same chip to serve as a temperature sensor, and each PN junction shows high linearity over -40 to 100 {sup 0}C and low power consumption. The iron implanting process for PN junction is exactly compatible with the piezoresistor, with no additional expenditure. The pressure sensitivity is 86 mV/MPa, while temperature sensitivity is 1.43 mV/{sup 0}C, both complying with the design objective.

  18. A novel dual-functional MEMS sensor integrating both pressure and temperature units

    International Nuclear Information System (INIS)

    Chen Tao; Zhang Zhaohua; Ren Tianling; Miao Gujin; Zhou Changjian; Lin Huiwang; Liu Litian

    2010-01-01

    This paper proposes a novel miniature dual-functional sensor integrating both pressure and temperature sensitive units on a single chip. The device wafer of SOI is used as a pizeoresistive diaphragm which features excellent consistency in thickness. The conventional anisotropic wet etching has been abandoned, while ICP etching has been employed to etch out the reference cave to minimize the area of individual device in the way that the 57.4 0 slope has been eliminated. As a result, the average cost of the single chip is reduced. Two PN junctions with constant ratio of the areas of depletion regions have also been integrated on the same chip to serve as a temperature sensor, and each PN junction shows high linearity over -40 to 100 0 C and low power consumption. The iron implanting process for PN junction is exactly compatible with the piezoresistor, with no additional expenditure. The pressure sensitivity is 86 mV/MPa, while temperature sensitivity is 1.43 mV/ 0 C, both complying with the design objective.

  19. A longitudinal investigation of older adults' physical activity: Testing an integrated dual-process model.

    Science.gov (United States)

    Arnautovska, Urska; Fleig, Lena; O'Callaghan, Frances; Hamilton, Kyra

    2017-02-01

    To assess the effects of conscious and non-conscious processes for prediction of older adults' physical activity (PA), we tested a dual-process model that integrated motivational (behavioural intention) and volitional (action planning and coping planning) processes with non-conscious, automatic processes (habit). Participants (N = 215) comprised community-dwelling older adults (M = 73.8 years). A longitudinal design was adopted to investigate direct and indirect effects of intentions, habit strength (Time 1), and action planning and coping planning (Time 2) on PA behaviour (Time 3). Structural equation modelling was used to evaluate the model. The model provided a good fit to the data, accounting for 44% of the variance in PA behaviour at Time 3. PA was predicted by intentions, action planning, and habit strength, with action planning mediating the intention-behaviour relationship. An effect of sex was also found where males used fewer planning strategies and engaged in more PA than females. By investigating an integration of conscious and non-conscious processes, this study provides a novel understanding of older adults' PA. Interventions aiming to promote PA behaviour of older adults should target the combination of psychological processes.

  20. Deficit in visual temporal integration in autism spectrum disorders.

    Science.gov (United States)

    Nakano, Tamami; Ota, Haruhisa; Kato, Nobumasa; Kitazawa, Shigeru

    2010-04-07

    Individuals with autism spectrum disorders (ASD) are superior in processing local features. Frith and Happe conceptualize this cognitive bias as 'weak central coherence', implying that a local enhancement derives from a weakness in integrating local elements into a coherent whole. The suggested deficit has been challenged, however, because individuals with ASD were not found to be inferior to normal controls in holistic perception. In these opposing studies, however, subjects were encouraged to ignore local features and attend to the whole. Therefore, no one has directly tested whether individuals with ASD are able to integrate local elements over time into a whole image. Here, we report a weakness of individuals with ASD in naming familiar objects moved behind a narrow slit, which was worsened by the absence of local salient features. The results indicate that individuals with ASD have a clear deficit in integrating local visual information over time into a global whole, providing direct evidence for the weak central coherence hypothesis.

  1. Closing service system gaps for homeless clients with a dual diagnosis: integrated teams and interagency cooperation.

    Science.gov (United States)

    Rosenheck, Robert A; Resnick, Sandra G; Morrissey, Joseph P

    2003-06-01

    There is great concern about fragmentation of mental health service delivery, especially for dually diagnosed homeless people, and apprehension that such fragmentation adversely affects service access and outcomes. This study first seeks to articulate two alternative approaches to the integration of psychiatric and substance abuse services, one involving an integrated team model and the other a collaborative relationship between agencies. It then applies this conceptualization to a sample of dually diagnosed homeless people who participated in the ACCESS demonstration. Longitudinal outcome data were obtained through interviews at baseline, 3 months, and 12 months with homeless clients with a dual diagnosis (N = 1074) who received ACT-like case management services through the ACCESS demonstration. A survey of ACCESS case managers was conducted to obtain information on: (i) the proportion of clients who received substance abuse services directly from ACCESS case management teams, and the proportion who received services from other agencies; and (ii) the perceived quality of the relationship (i.e. communication, cooperation and trust) between providers--both within the same teams and between agencies. Hierarchical linear modeling was then used to examine the relationship of these two factors to service use and outcome with mixed-model regression analysis. Significant (pintegrated team care is more effective than interagency collaborations. This study broadens the conceptual framework for addressing service system fragmentation by considering both single team integration and interagency coordination, and by considering both program structure and the quality of relationships between providers. Data from a multi-site outcome study demonstrated suggestive associations between perceptions of communication, cooperation and measures of clinical service use. However, the proportion of clients treated entirely within a single team was associated with poorer housing and

  2. A Study on the Structural Integrity Issues of a Dual-Cooled Fuel Rod

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyung-Kyu; Lee, Kang-Hee; Lee, Young-Ho; Yoon, Kyung-Ho; Kim, Jae-Yong; Song, Kun-Woo [Korea Atomic Energy Research Institute, 1045 Daedeokdaero Yuseong Daejeon 305-353 (Korea, Republic of)

    2009-06-15

    A dual-cooled fuel rod has an internal coolant flow passage in addition to the external one. A remarkable power up-rate can be achieved due to the increased surface area, which may draw great interests from the fuel researchers, designers and vendors. However, it requires effective resolution to the difficult technical issues when a fuel assembly is to be realized. It becomes much more difficult if a tough boundary condition needs to be satisfied such as a compatibility with the existing reactor internal structures. This kind of challenge is tackled through a national R and D project in Korea: to develop the structural components of a dual-cooled fuel that should be compatible with the current OPR 1000 (Korea Standard Nuclear Power Plant) internal structures. Fuel rod supporting structures, top and bottom end pieces and guide tubes are the components. Besides, the fuel rod components have to be developed as well since the fuel rod's geometry becomes much different from the conventional rod's one. The dimension change may well affect the above mentioned structural components. As a part of the work, structural integrity of the components of a dual-cooled fuel rod is studied in this paper. The investigated topics are: i) the thickness determination of a cladding tube (especially outer tube of a large diameter), ii) vibration issue of an inner cladding tube, iii) design concern of plenum spring and spacer. The cladding thickness issue arises due to the increased outside diameter of a fuel rod, which is caused by an internal flow passage formation. Among the criteria for the thickness determination, an elastic buckling criteria was focused on. Theoretical background for the well-known formula (such as a stability problem) was revisited. Verification tests were carried out independently with using a cladding tube of PHWR fuel rod. Results showed that the formula was not conservative to apply for the cladding thickness determination. Minimum thickness for the

  3. Body integrity identity disorder beyond amputation: consent and liberty.

    Science.gov (United States)

    White, Amy

    2014-09-01

    In this article, I argue that persons suffering from Body Integrity Identity Disorder (BIID) can give informed consent to surgical measures designed to treat this disorder. This is true even if the surgery seems radical or irrational to most people. The decision to have surgery made by a BIID patient is not necessarily coerced, incompetent or uninformed. If surgery for BIID is offered, there should certainly be a screening process in place to insure informed consent. It is beyond the scope of this work, however, to define all the conditions that should be placed on the availability of surgery. However, I argue, given the similarities between BIID and gender dysphoria and the success of such gatekeeping measures for the surgical treatment of gender dysphoria, it is reasonable that similar conditions be in place for BIID. Once other treatment options are tried and gatekeeping measures satisfied, A BIID patient can give informed consent to radical surgery.

  4. [Desire for amputation in body integrity identity disorder].

    Science.gov (United States)

    Blom, Rianne M; Hennekam, Raoul C M

    2014-01-01

    Body integrity identity disorder (BIID) is a rare neuropsychiatric disorder in which patients experience a mismatch between the real and experienced body from childhood. BIID results in a strong desire to amputate or paralyse one or more limbs. We describe two BIID patients. A 40-year-old healthy male suffered daily from his desire for amputation, and therefore made a request for amputation at our academic medical centre. A 61-year-old male proceeded to self-amputation to create the body he had wished for, thereby curing himself from BIID. To date, no treatment has been found for BIID. Therefore patients often proceed to self-amputation, which could lead to serious and even dangerous complications. These case histories suggest that elective amputation may be a treatment for BIID. Many doctors, however, will question the admissibility of amputation of a healthy limb.

  5. The Power of Integrators, Financiers, and Insurers to Reduce Proliferation Risks: Nuclear Dual-Use Goods

    Energy Technology Data Exchange (ETDEWEB)

    Weise, Rachel A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hund, Gretchen [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-05-01

    Globalization of manufacturing supply chains has changed the nature of nuclear proliferation. Before 1991, nonproliferation efforts focused almost exclusively on limiting the spread of materials and equipment specifically designed for nuclear use -- reactors, centrifuges, and fissile material. Dual-use items, those items with both nuclear and non-nuclear applications, were not closely scrutinized or controlled. However, in 1991 the international community discovered that Iraq had developed a fairly sophisticated nuclear weapons program by importing dual-use items; this discovery spurred the international community to increase controls on dual-use technologies. Despite these international efforts, dual-use items are still a challenge for those seeking to limit proliferation.

  6. The Power of Integrators, Financiers, and Insurers to Reduce Proliferation Risks: Nuclear Dual-Use Goods

    International Nuclear Information System (INIS)

    Weise, Rachel A.; Hund, Gretchen

    2015-01-01

    Globalization of manufacturing supply chains has changed the nature of nuclear proliferation. Before 1991, nonproliferation efforts focused almost exclusively on limiting the spread of materials and equipment specifically designed for nuclear use -- reactors, centrifuges, and fissile material. Dual-use items, those items with both nuclear and non-nuclear applications, were not closely scrutinized or controlled. However, in 1991 the international community discovered that Iraq had developed a fairly sophisticated nuclear weapons program by importing dual-use items; this discovery spurred the international community to increase controls on dual-use technologies. Despite these international efforts, dual-use items are still a challenge for those seeking to limit proliferation.

  7. Integrated approach to yoga therapy and autism spectrum disorders

    Directory of Open Access Journals (Sweden)

    Shantha Radhakrishna

    2010-01-01

    Full Text Available A specially designed Integrated Approach to Yoga Therapy module was applied to Autism Spectrum Disorders over a period of two academic years. Despite low numbers (six in each arm, consistency and magnitude of effects make the findings significant. Parental participation, allowing firm guidance to be given to each child, resulted in significant improvements in imitation and other skills, and in behavior at home and family relationships. We hypothesize that guided imitation of therapist body positions stimulated mirror neuron activation, resulting in improved sense of self.

  8. Short-time dynamics of random-bond Potts ferromagnet with continuous self-dual quenched disorders

    OpenAIRE

    Pan, Z. Q.; Ying, H. P.; Gu, D. W.

    2001-01-01

    We present Monte Carlo simulation results of random-bond Potts ferromagnet with the Olson-Young self-dual distribution of quenched disorders in two-dimensions. By exploring the short-time scaling dynamics, we find universal power-law critical behavior of the magnetization and Binder cumulant at the critical point, and thus obtain estimates of the dynamic exponent $z$ and magnetic exponent $\\eta$, as well as the exponent $\\theta$. Our special attention is paid to the dynamic process for the $q...

  9. Thermodynamic Analyses of Biomass Gasification Integrated Externally Fired, Post-Firing and Dual-Fuel Combined Cycles

    Directory of Open Access Journals (Sweden)

    Saeed Soltani

    2015-01-01

    Full Text Available In the present work, the results are reported of the energy and exergy analyses of three biomass-related processes for electricity generation: the biomass gasification integrated externally fired combined cycle, the biomass gasification integrated dual-fuel combined cycle, and the biomass gasification integrated post-firing combined cycle. The energy efficiency for the biomass gasification integrated post-firing combined cycle is 3% to 6% points higher than for the other cycles. Although the efficiency of the externally fired biomass combined cycle is the lowest, it has an advantage in that it only uses biomass. The energy and exergy efficiencies are maximized for the three configurations at particular values of compressor pressure ratios, and increase with gas turbine inlet temperature. As pressure ratio increases, the mass of air per mass of steam decreases for the biomass gasification integrated post-firing combined cycle, but the pressure ratio has little influence on the ratio of mass of air per mass of steam for the other cycles. The gas turbine exergy efficiency is the highest for the three configurations. The combustion chamber for the dual-fuel cycle exhibits the highest exergy efficiency and that for the post-firing cycle the lowest. Another benefit of the biomass gasification integrated externally fired combined cycle is that it exhibits the highest air preheater and heat recovery steam generator exergy efficiencies.

  10. Integrated cognitive behavioral therapy for patients with substance use disorder and comorbid ADHD: two case presentations

    NARCIS (Netherlands)

    van Emmerik-van Oortmerssen, Katelijne; Vedel, Ellen; van den Brink, Wim; Schoevers, Robert A.

    2015-01-01

    Two cases of integrated cognitive behavioral therapy (ICBT) for substance use disorder (SUD) and Attention Deficit Hyperactivity Disorder (ADHD) are presented illustrating that ICBT is a promising new treatment option

  11. Integrated cognitive behavioral therapy for patients with Substance Use Disorder and Comorbid ADHD : Two case presentations

    NARCIS (Netherlands)

    van Emmerik-van Oortmerssen, Katelijne; Vedel, Ellen; van den Brink, Wir; Schoevers, Robert A.

    Two cases of integrated cognitive behavioral therapy (ICBT) for substance use disorder (SUD) and Attention Deficit Hyperactivity Disorder (ADHD) are presented illustrating that ICBT is a promising new treatment option. (C) 2015 Elsevier Ltd. All rights reserved.

  12. [Integrative approach in the psychotherapy of borderline personality disorder].

    Science.gov (United States)

    Kuritárné Szabó, Ildikó

    2012-01-01

    In the last 20 years six psychotherapy methods have been developed specifically for borderline personality disorder. Solid RCT evidences suggests the efficacy of all the methods. Roughly equivalent improvement was obtained from the different types of psychotherapies. Today we have reached a new phase of the borderline "psychotherapy boom", the integrative approach. According to the integrative treatment advocates we should not choose among these effective treatments but we can incorporate in the therapy all the components that work. The integrative approach uses general factors common to all effective therapies, combined with specific treatment techniques taken from different therapies in order to treat the given patient's psychopathology. These common factors are: coherent framework; attention to strategies for building strong positive alliance and maintaining patient motivation; creating a safe and structured therapeutic environment; clear treatment frame; transparency of the goals and roles; focus upon presenting problems; higher level therapeutic activity; here-and-now focus; and facilitating self-reflection. Treatment focuses on change while maintaining a validating and supportive stance. General strategies can be supplemented by more specific techniques such as cognitive-behavioral interventions for reducing maladaptive behavior, training for developing emotion regulation skills and interpersonal skills coming from dialectical behavior therapy. Methods drawn from psychodynamic approaches can be used for the modification of underlying interpersonal cognitive-emotional schemas.

  13. Novel method of dual fiber Bragg gratings integrated in fiber ring laser for biochemical sensors

    Science.gov (United States)

    Bui, H.; Pham, T. B.; Nguyen, V. A.; Pham, V. D.; Do, T. C.; Nguyen, T. V.; Hoang, T. H. C.; Le, H. T.; Pham, V. H.

    2018-05-01

    Optical sensors have been shown to be very effective for measuring the toxic content in liquid and air environments. Optical sensors, which operate based on the wavelength shift of the optical signals, require an expensive spectrometer. In this paper, we propose a new configuration of the optical sensor device for measuring wavelength shift without using a spectrometer. This configuration has a large potential for application in biochemical sensing techniques, and comes with a low cost. This configuration uses dual fiber Bragg gratings (FBGs) integrated in a fiber ring laser structure of erbium-doped fiber, in which one FBG is used as a reference to sweep over the applicable spectrum of the etched-Bragg grating. The etched-FBG as a sensing probe is suitable for bio- and/or chemical sensors. The sensitivity and accuracy of the sensor system can be improved by the narrow linewidth of emission spectra from the laser, the best limit of detection of this sensor is 1.5  ×  10‑4 RIU (RIU: refractive index unit), as achieved by the optical sensor using a high resolution spectrometer. This sensor system has been experimentally investigated to detect different types of organic compounds, gasoline, mixing ratios of organic solvents in gasoline, and nitrate concentration in water samples. The experimental results show that this sensing method could determine different mixing ratios of organic solvents with good repeatability, high accuracy, and rapid response: e.g. for ethanol and/or methanol in gasoline RON 92 (RON: research octane number) of 0%–14% v/v, and nitrate in water samples at a low concentration range of 0–50 ppm. These results suggest that the proposed configuration can construct low-cost and accurate biochemical sensors.

  14. Structural hierarchy of autism spectrum disorder symptoms: an integrative framework.

    Science.gov (United States)

    Kim, Hyunsik; Keifer, Cara M; Rodriguez-Seijas, Craig; Eaton, Nicholas R; Lerner, Matthew D; Gadow, Kenneth D

    2018-01-01

    In an attempt to resolve questions regarding the symptom classification of autism spectrum disorder (ASD), previous research generally aimed to demonstrate superiority of one model over another. Rather than adjudicating which model may be optimal, we propose an alternative approach that integrates competing models using Goldberg's bass-ackwards method, providing a comprehensive understanding of the underlying symptom structure of ASD. The study sample comprised 3,825 individuals, consecutive referrals to a university hospital developmental disabilities specialty clinic or a child psychiatry outpatient clinic. This study analyzed DSM-IV-referenced ASD symptom statements from parent and teacher versions of the Child and Adolescent Symptom Inventory-4R. A series of exploratory structural equation models was conducted in order to produce interpretable latent factors that account for multivariate covariance. Results indicated that ASD symptoms were structured into an interpretable hierarchy across multiple informants. This hierarchy includes five levels; key features of ASD bifurcate into different constructs with increasing specificity. This is the first study to examine an underlying structural hierarchy of ASD symptomatology using the bass-ackwards method. This hierarchy demonstrates how core features of ASD relate at differing levels of resolution, providing a model for conceptualizing ASD heterogeneity and a structure for integrating divergent theories of cognitive processes and behavioral features that define the disorder. These findings suggest that a more coherent and complete understanding of the structure of ASD symptoms may be reflected in a metastructure rather than at one level of resolution. © 2017 Association for Child and Adolescent Mental Health.

  15. Identification and Management of Eating Disorders in Integrated Primary Care: Recommendations for Psychologists in Integrated Care Settings.

    Science.gov (United States)

    Buchholz, Laura J; King, Paul R; Wray, Laura O

    2017-06-01

    Eating disorders are associated with deleterious health consequences, increased risk of mortality, and psychosocial impairment. Although individuals with eating disorders are likely to seek treatment in general medical settings such as primary care (PC), these conditions are often under-detected by PC providers. However, psychologists in integrated PC settings are likely to see patients with eating disorders because of the mental health comorbidities associated with these conditions. Further, due to their training in identifying risk factors associated with eating disorders (i.e., comorbid mental health and medical disorders) and opportunities for collaboration with PC providers, psychologists are well-positioned to improve the detection and management of eating disorders in PC. This paper provides a brief overview of eating disorders and practical guidance for psychologists working in integrated PC settings to facilitate the identification and management of these conditions.

  16. Speech Enhancement of Mobile Devices Based on the Integration of a Dual Microphone Array and a Background Noise Elimination Algorithm.

    Science.gov (United States)

    Chen, Yung-Yue

    2018-05-08

    Mobile devices are often used in our daily lives for the purposes of speech and communication. The speech quality of mobile devices is always degraded due to the environmental noises surrounding mobile device users. Regretfully, an effective background noise reduction solution cannot easily be developed for this speech enhancement problem. Due to these depicted reasons, a methodology is systematically proposed to eliminate the effects of background noises for the speech communication of mobile devices. This methodology integrates a dual microphone array with a background noise elimination algorithm. The proposed background noise elimination algorithm includes a whitening process, a speech modelling method and an H ₂ estimator. Due to the adoption of the dual microphone array, a low-cost design can be obtained for the speech enhancement of mobile devices. Practical tests have proven that this proposed method is immune to random background noises, and noiseless speech can be obtained after executing this denoise process.

  17. Speech Enhancement of Mobile Devices Based on the Integration of a Dual Microphone Array and a Background Noise Elimination Algorithm

    Directory of Open Access Journals (Sweden)

    Yung-Yue Chen

    2018-05-01

    Full Text Available Mobile devices are often used in our daily lives for the purposes of speech and communication. The speech quality of mobile devices is always degraded due to the environmental noises surrounding mobile device users. Regretfully, an effective background noise reduction solution cannot easily be developed for this speech enhancement problem. Due to these depicted reasons, a methodology is systematically proposed to eliminate the effects of background noises for the speech communication of mobile devices. This methodology integrates a dual microphone array with a background noise elimination algorithm. The proposed background noise elimination algorithm includes a whitening process, a speech modelling method and an H2 estimator. Due to the adoption of the dual microphone array, a low-cost design can be obtained for the speech enhancement of mobile devices. Practical tests have proven that this proposed method is immune to random background noises, and noiseless speech can be obtained after executing this denoise process.

  18. Psychosocial approaches to dual diagnosis.

    Science.gov (United States)

    Drake, R E; Mueser, K T

    2000-01-01

    Recent research elucidates many aspects of the problem of co-occurring substance use disorder (SUD) in patients with severe mental illness, which is often termed dual diagnosis. This paper provides a brief overview of current research on the epidemiology, adverse consequences, and phenomenology of dual diagnosis, followed by a more extensive review of current approaches to services, assessment, and treatment. Accumulating evidence shows that comorbid SUD is quite common among individuals with severe mental illness and that these individuals suffer serious adverse consequences of SUD. The research further suggests that traditional, separate services for individuals with dual disorders are ineffective, and that integrated treatment programs, which combine mental health and substance abuse interventions, offer more promise. In addition to a comprehensive integration of services, successful programs include assessment, assertive case management, motivational interventions for patients who do not recognize the need for substance abuse treatment, behavioral interventions for those who are trying to attain or maintain abstinence, family interventions, housing, rehabilitation, and psychopharmacology. Further research is needed on the organization and financing of dual-diagnosis services and on specific components of the integrated treatment model, such as group treatments, family interventions, and housing approaches.

  19. IAEA'S International Working Group on Integrated Transport and Storage Safety case for Dual Purpose Casks

    International Nuclear Information System (INIS)

    Kumano, Yumiko; Varley, Kasturi; ); Droste, Bernhard; Wolff, Dietmar; Hirose, Makoto; Harvey, John; Reiche, Ingo; McConnell, Paul

    2014-01-01

    Spent nuclear fuel is generated from the operation of nuclear reactors and it is imperative that it is safely managed following its removal from reactor cores. Reactor pools are usually designed based on the assumption that the fuel will be removed after a short period of time either for reprocessing, disposal, or further storage. As a result of storing higher burn-up fuel, significantly increased time-frame till disposal solutions are prepared, and delays in decisions on strategies for spent fuel management, the volume of spent fuel discharged from reactors which needs to be managed and stored is on the increase. Consequently, additional storage capacity is needed following the initial storage in reactor pools. Options for additional storage include wet storage or dry storage in a dedicated facility or in storage casks. One of these options is the use of a Dual Purpose Cask (DPC), which is a specially designed cask for both storage and transport. The management of spent fuel using a DPC generally involves on-site and off-site transportation before and after storage. Most countries require package design approval for the DPC to be transported. In addition, it is required in many countries to have a licence for storage of the spent fuel in the DPC or a licence for a storage facility that contains DPCs. Therefore, demonstration of compliance of the DPC with national and international transport regulations as well as with the storage requirements is necessary. In order to address this increasing need among Member States, the IAEA established an international working group in 2010 to develop a guidance for integrating safety cases for both storage and transport in a holistic manner. The working group consists of experts from regulatory bodies, Technical Support Organizations, operators for both transportation and storage, and research institutes. This activity is planned to be completed by 2013. Currently, a technical report has been drafted and is expected to be

  20. Animal Modeling and Neurocircuitry of Dual Diagnosis

    Science.gov (United States)

    Chambers, R. Andrew

    2010-01-01

    Dual diagnosis is a problem of tremendous depth and scope, spanning many classes of mental disorders and addictive drugs. Animal models of psychiatric disorders studied in addiction paradigms suggest a unitary nature of mental illness and addiction vulnerability both on the neurocircuit and clinical-behavioral levels. These models provide platforms for exploring the interactive roles of biological, environmental and developmental factors on neurocircuits commonly involved in psychiatric and addiction diseases. While suggestive of the artifice of segregated research, training, and clinical cultures between psychiatric and addiction fields, this research may lead to more parsimonious, integrative and preventative treatments for dual diagnosis. PMID:20585464

  1. Integrated or dual vocational training focused on the operations of a nuclear power plant

    International Nuclear Information System (INIS)

    Roca, F.

    2014-01-01

    Dual vocational training is understood to be all the mixed employment and training actions and initiatives, the purpose of which in the vocational qualification of workers in a system alternating a job in a company with the training activity received in the framework of the vocational training system for employment of the educational system. The dual vocational training that results from this mixed strategy is provided via the following modality: Shared training between the training center and the company, which consists of coparticipation to varying degrees in the teaching and learning processes in the company and the training center. (Author)

  2. Deficits in Interval Timing Measured by the Dual-Task Paradigm among Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

    Science.gov (United States)

    Hwang, Shoou-Lian; Gau, Susan Shur-Fen; Hsu, Wen-Yau; Wu, Yu-Yu

    2010-01-01

    Background: The underlying mechanism of time perception deficit in long time intervals in attention-deficit/hyperactivity disorder (ADHD) is still unclear. This study used the time reproduction dual task to explore the role of the attentional resource in time perception deficits among children and adolescents with ADHD. Methods: Participants…

  3. An Integrated Model of Chronic Whiplash-Associated Disorder.

    Science.gov (United States)

    Walton, David M; Elliott, James M

    2017-07-01

    Synopsis The development of persistent symptoms following whiplash injury from a motor vehicle collision is common and contributes substantially to societal and personal costs. The popular Quebec Task Force classification system of whiplash-associated disorders (WADs) was meant to function as a prognostic and intervention decision aid, but its usefulness has been questioned. Emerging evidence highlights the heterogeneity of WAD by demonstrating physical and psychological impairments that are unique to those who develop persistent symptoms. These impairments are not recognized in the Quebec Task Force classification system. The purpose of this clinical commentary is to describe an integrated model that focuses on how psychological and neurobiological factors interact with, and are influenced by, existing personal and environmental factors to contribute to the development of chronic WAD. The model has been developed through more than 20 years of work in the field, consultation with experts, in-depth synthesis of existing evidence, and new evidence from the authors' own research programs. A subtheme is that a point of convergence currently exists between the psychological, physiological, and social determinants of health literature that can further explain the complex presentation of WAD. The new model is proposed to orient future research toward more interdisciplinary efforts across nontraditional fields, including data scientists and consumers, to clarify the WAD condition. J Orthop Sports Phys Ther 2017;47(7):462-471. Epub 16 Jun 2017. doi:10.2519/jospt.2017.7455.

  4. Enhancement of the static extinction ratio by using a dual-section distributed feedback laser integrated with an electro-absorption modulator

    Science.gov (United States)

    Cho, Chun-Hyung; Kim, Jongseong; Sung, Hyuk-Kee

    2016-09-01

    We report on the enhancement of the static extinction ratio by using a dual-section distributed feedback laser diode integrated with an electro-absorption modulator. A directly- modulated dual-section laser can provide improved modulation performance under a low bias level ( i.e., below the threshold level) compared with a standard directly-modulated laser. By combining the extinction ratio from a dual-section laser with that from an electro-absorption modulator section, a total extinction ratio of 49.6. dB are successfully achieved.

  5. Do communication and social interaction skills differ across youth diagnosed with autism spectrum disorder, attention-deficit/hyperactivity disorder, or dual diagnosis?

    Science.gov (United States)

    Salley, Brenda; Gabrielli, Joy; Smith, Catherine M; Braun, Matthew

    2015-12-01

    Given the well-documented symptom overlap between Autism Spectrum Disorder (ASD) and Attention Deficit/Hyperactivity Disorder (ADHD), careful evaluation of potential differentiation and overlap is critical for accurate diagnostic decisions. Although research has considered the use of symptom checklists and parent/teacher report questionnaires for symptom differentiation, standardized observational methods, typically utilized in the context of ASD evaluation, have received less attention. The present study examined the continuum of communication and social interaction impairment for youth diagnosed with ASD and ADHD, as indexed by the Autism Diagnostic Observation Schedule (ADOS). Participants were 209 youth ages 3 to 18 years with ASD, ADHD, Dual Diagnosis (ASD+ADHD) or No Diagnosis. Differences across diagnostic groups were observed for mean communication and social interaction total scores on the ADOS, with the highest scores (i.e., greater impairment) observed for the ASD group and lowest scores for the ADHD and No Diagnosis groups. Results provide the first evidence for use of the ADOS for distinguishing youth who have ADHD alone versus ASD alone or co-occurring ASD+ADHD. Findings are discussed in light of implications for clinical practice and future research.

  6. Replication and extension of the dual pathway model of disordered eating: The role of fear of negative evaluation, suggestibility, rumination, and self-compassion.

    Science.gov (United States)

    Maraldo, Toni M; Zhou, Wanni; Dowling, Jessica; Vander Wal, Jillon S

    2016-12-01

    The dual pathway model, a theoretical model of eating disorder development, suggests that thin ideal internalization leads to body dissatisfaction which leads to disordered eating via the dual pathways of negative affect and dietary restraint. While the dual pathway model has been a valuable guide for eating disorder prevention, greater knowledge of characteristics that predict thin ideal internalization is needed. The present study replicated and extended the dual pathway model by considering the addition of fear of negative evaluation, suggestibility, rumination, and self-compassion in a sample of community women and female university students. Results showed that fear of negative evaluation and suggestibility predicted thin ideal internalization whereas rumination and self-compassion (inversely) predicted body dissatisfaction. Negative affect was predicted by fear of negative evaluation, rumination, and self-compassion (inversely). The extended model fit the data well in both samples. Analogue and longitudinal study of these constructs is warranted in future research. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. The effects of stimulus modality and task integrality: Predicting dual-task performance and workload from single-task levels

    Science.gov (United States)

    Hart, S. G.; Shively, R. J.; Vidulich, M. A.; Miller, R. C.

    1986-01-01

    The influence of stimulus modality and task difficulty on workload and performance was investigated. The goal was to quantify the cost (in terms of response time and experienced workload) incurred when essentially serial task components shared common elements (e.g., the response to one initiated the other) which could be accomplished in parallel. The experimental tasks were based on the Fittsberg paradigm; the solution to a SternBERG-type memory task determines which of two identical FITTS targets are acquired. Previous research suggested that such functionally integrated dual tasks are performed with substantially less workload and faster response times than would be predicted by suming single-task components when both are presented in the same stimulus modality (visual). The physical integration of task elements was varied (although their functional relationship remained the same) to determine whether dual-task facilitation would persist if task components were presented in different sensory modalities. Again, it was found that the cost of performing the two-stage task was considerably less than the sum of component single-task levels when both were presented visually. Less facilitation was found when task elements were presented in different sensory modalities. These results suggest the importance of distinguishing between concurrent tasks that complete for limited resources from those that beneficially share common resources when selecting the stimulus modalities for information displays.

  8. Dual-function photonic integrated circuit for frequency octo-tupling or single-side-band modulation.

    Science.gov (United States)

    Hasan, Mehedi; Maldonado-Basilio, Ramón; Hall, Trevor J

    2015-06-01

    A dual-function photonic integrated circuit for microwave photonic applications is proposed. The circuit consists of four linear electro-optic phase modulators connected optically in parallel within a generalized Mach-Zehnder interferometer architecture. The photonic circuit is arranged to have two separate output ports. A first port provides frequency up-conversion of a microwave signal from the electrical to the optical domain; equivalently single-side-band modulation. A second port provides tunable millimeter wave carriers by frequency octo-tupling of an appropriate amplitude RF carrier. The circuit exploits the intrinsic relative phases between the ports of multi-mode interference couplers to provide substantially all the static optical phases needed. The operation of the proposed dual-function photonic integrated circuit is verified by computer simulations. The performance of the frequency octo-tupling and up-conversion functions is analyzed in terms of the electrical signal to harmonic distortion ratio and the optical single side band to unwanted harmonics ratio, respectively.

  9. A Three-Phase Dual-Input Matrix Converter for Grid Integration of Two AC Type Energy Resources

    DEFF Research Database (Denmark)

    Liu, Xiong; Wang, Peng; Chiang Loh, Poh

    2013-01-01

    This paper proposes a novel dual-input matrix converter (DIMC) to integrate two three-phase ac type energy resources to a power grid. The proposed matrix converter is developed based on the traditional indirect matrix converter under reverse power flow operation mode, but with its six......-to-output voltage boost capability since power flows from the converter’s voltage source side to its current source side. Commanded currents can be extracted from the two input sources to the grid. The proposed control and modulation schemes guarantee sinusoidal input and output waveforms as well as unity input......-switch voltage source converter replaced by a nine-switch configuration. With the additional three switches, the proposed DIMC can provide six in put terminals, which make it possible to integrate two independent ac sources into a single grid-tied power electronics interface. The proposed converter has input...

  10. Dual drug-loaded nanoparticles on self-integrated scaffold for controlled delivery

    Directory of Open Access Journals (Sweden)

    Bennet D

    2012-07-01

    Full Text Available Devasier Bennet,1 Mohana Marimuthu,1 Sanghyo Kim,1 Jeongho An21Department of Bionanotechnology, Gachon University, Gyeonggi, Republic of Korea; 2Department of Polymer Science and Engineering, SunKyunKwan University, Gyeonggi, Republic of KoreaAbstract: Antioxidant (quercetin and hypoglycemic (voglibose drug-loaded poly-D,L-lactide-co-glycolide nanoparticles were successfully synthesized using the solvent evaporation method. The dual drug-loaded nanoparticles were incorporated into a scaffold film using a solvent casting method, creating a controlled transdermal drug-delivery system. Key features of the film formulation were achieved utilizing several ratios of excipients, including polyvinyl alcohol, polyethylene glycol, hyaluronic acid, xylitol, and alginate. The scaffold film showed superior encapsulation capability and swelling properties, with various potential applications, eg, the treatment of diabetes-associated complications. Structural and light scattering characterization confirmed a spherical shape and a mean particle size distribution of 41.3 nm for nanoparticles in the scaffold film. Spectroscopy revealed a stable polymer structure before and after encapsulation. The thermoresponsive swelling properties of the film were evaluated according to temperature and pH. Scaffold films incorporating dual drug-loaded nanoparticles showed remarkably high thermoresponsivity, cell compatibility, and ex vivo drug-release behavior. In addition, the hybrid film formulation showed enhanced cell adhesion and proliferation. These dual drug-loaded nanoparticles incorporated into a scaffold film may be promising for development into a transdermal drug-delivery system.Keywords: quercetin, voglibose, biocompatible materials, encapsulation, transdermal

  11. The Dual Role of Disorder on the Dissociation of Interfacial Charge Transfer Excitons

    Science.gov (United States)

    Shi, Liang; Lee, Chee-Kong; Willard, Adam

    In organic-based photovoltaics (OPV), dissociation of neutral photo-excitations (i.e., Frenkel excitons) into free charge carriers requires the excitons to overcome binding energy that can significantly exceed thermal energies. The inability of bound charges to overcome this large binding energy has been implicated as a primary source of efficiency loss in OPVs. Despite the potential impact on the performance of organic solar cells much remains to be understood about the microscopic mechanism of exciton dissociation in OPV materials. Here we explore the role of static molecular disorder in mediating this charge dissociation process. Using a simple lattice model of exciton dynamics we demonstrate that random spatial variations in the energetic landscape can mitigate the effects of the exciton binding energy by lowering the free energy barrier. By considering the competition between this thermodynamic effect and the disorder-induced slowing of dissociation kinetics we demonstrate that exciton dissociation yields are expected to depend non-monotonically on the degree of static disorder. We conclude that a certain amount of molecular-scale disorder is desirable in order to optimize the performance of organic photovoltaic materials.

  12. Premorbid Personality Disorders in Male Schizophrenic Patients with or without Comorbid Substance Use Disorder: Is Dual Diagnosis Mediated by Personality Disorder?

    Science.gov (United States)

    Altunsoy, Neslihan; Şahiner, Şafak Yalçın; Cingi Külük, Merve; Okay, Tuncer; Ulusoy Kaymak, Semra; Aydemir, Çiğdem; Göka, Erol

    2015-09-01

    Although substance abuse is an important clinical problem in schizophrenic patients, very little evidence explains why these patients use drugs and alcohol. This study therefore aimed to examine whether premorbid personality disorders affect substance abuse. The sample included 40 male schizophrenic patients with and 40 male schizophrenic patients without substance use disorder comorbidity who had applied to Ankara Numune Research and Training Hospital. Each participant and a family member were interviewed in a structured clinical interview that addressed premorbid personality disorders. Altogether, 32 patients (80%) in the group with comorbidity and 28 (70%) in the group without comorbidity had a premorbid personality disorder. Antisocial (35% vs. 0%; ppersonality disorders were more often detected in the group with comorbidity, while avoidant (10% vs. 35%; p=.014) and obsessive-compulsive (0% vs. 15%; p=.026) personality disorders were less frequently found in this group. Comparing the group with comorbidity with premorbid personality types, schizophrenic patients with premorbid antisocial personality disorder were more frequently unemployed and hospitalized as well as had an earlier onset age of schizophrenia (p=.034, p=.038 and p=.035, respectively). Schizophrenic patients with premorbid borderline personality disorder had a significantly earlier onset age of substance use (19±5; p=.028). Schizophrenic patients with substance use comorbidity variously differ from those without comorbidity and some of these differences may be associated with premorbid personality disorders.

  13. Advanced Stirling Convertor Dual Convertor Controller Testing at NASA Glenn Research Center in the Radioisotope Power Systems System Integration Laboratory

    Science.gov (United States)

    Dugala, Gina M.; Taylor, Linda M.; Bell, Mark E.; Dolce, James L.; Fraeman, Martin; Frankford, David P.

    2015-01-01

    NASA Glenn Research Center developed a nonnuclear representation of a Radioisotope Power System (RPS) consisting of a pair of Advanced Stirling Convertors (ASCs), Dual Convertor Controller (DCC) EMs (engineering models) 2 and 3, and associated support equipment, which were tested in the Radioisotope Power Systems System Integration Laboratory (RSIL). The DCC was designed by the Johns Hopkins University Applied Physics Laboratory (JHU/APL) to actively control a pair of ASCs. The first phase of testing included a Dual Advanced Stirling Convertor Simulator (DASCS), which was developed by JHU/APL and simulates the operation and electrical behavior of a pair of ASCs in real time via a combination of hardware and software. RSIL provides insight into the electrical interactions between a representative radioisotope power generator, its associated control schemes, and realistic electric system loads. The first phase of integration testing included the following spacecraft bus configurations: capacitive, battery, and super-capacitor. A load profile, created based on data from several missions, tested the RPS's and RSIL's ability to maintain operation during load demands above and below the power provided by the RPS. The integration testing also confirmed the DCC's ability to disconnect from the spacecraft when the bus voltage dipped below 22 volts or exceeded 36 volts. Once operation was verified with the DASCS, the tests were repeated with actual operating ASCs. The goal of this integration testing was to verify operation of the DCC when connected to a spacecraft and to verify the functionality of the newly designed RSIL. The results of these tests are presented in this paper.

  14. Conducting to non-conducting transition in dual transmission lines using a ternary model with long-range correlated disorder

    International Nuclear Information System (INIS)

    Lazo, E.; Diez, E.

    2010-01-01

    In this work we study the behavior of the allowed and forbidden frequencies in disordered classical dual transmission lines when the values of capacitances {C j } are distributed according to a ternary model with long-range correlated disorder. We introduce the disorder from a random sequence with a power spectrum S(k)∝k -(2α-1) , where α≥0.5 is the correlation exponent. From this sequence we generate an asymmetric ternary map using two map parameters b 1 and b 2 , which adjust the occupancy probability of each possible value of the capacitances C j ={C A, C B, C C, }. If the sequence of capacitance values is totally at random α=0.5 (white noise), the electrical transmission line is in the non-conducting state for every frequency ω. When we introduce long-range correlations in the distribution of capacitances, the electrical transmission lines can change their conducting properties and we can find a transition from the non-conducting to conducting state for a fixed system size. This implies the existence of critical values of the map parameters for each correlation exponent α. By performing finite-size scaling we obtain the asymptotic value of the map parameters in the thermodynamic limit for any α. With these data we obtain a phase diagram for the symmetric ternary model, which separates the non-conducting state from the conducting one. This is the fundamental result of this Letter. In addition, introducing one or more impurities in random places of the long-range correlated distribution of capacitances, we observe a dramatic change in the conducting properties of the electrical transmission lines, in such a way that the system jumps from conducting to non-conducting states. We think that this behavior can be considered as a possible mechanism to secure communication.

  15. Perceived empowerment in people with a dual diagnosis of schizophrenia spectrum disorder and substance misuse.

    Science.gov (United States)

    Berry, Katherine; Allott, Rory; Emsley, Richard; Ennion, Sarah; Barrowclough, Christine

    2014-03-01

    The aims of the present study were to validate a measure of empowerment in a British population of people with a dual diagnosis of schizophrenia and substance misuse and assess relationships between empowerment and other key outcomes. Patients participating in a large randomised control trial for Motivational Interviewing for Drug and Alcohol misuse in Schizophrenia or psychosis (MIDAS trial) completed measures of empowerment, symptoms, global functioning and substance use at baseline, 12- and 24-month follow-ups. A three factor model of empowerment: self-efficacy and control; power and anger; and activism provided the best fit of the data across all three time points. There was some evidence of associations between empowerment and both symptoms and global functioning, although these associations were not consistent across subscales. Changes in empowerment predicted changes in symptoms and functioning at follow-up. Empowerment is a broadly defined construct and its meaning may differ across different populations of people with severe and enduring mental health problems. Empowerment is a key component of recovery and should be assessed in treatments in addition to more traditional outcome measures of symptoms and functioning.

  16. Dual orexin receptor antagonists - promising agents in the treatment of sleep disorders.

    Science.gov (United States)

    Pałasz, Artur; Lapray, Damien; Peyron, Christelle; Rojczyk-Gołębiewska, Ewa; Skowronek, Rafał; Markowski, Grzegorz; Czajkowska, Beata; Krzystanek, Marek; Wiaderkiewicz, Ryszard

    2014-01-01

    Insomnia is a serious medical and social problem, its prevalence in the general population ranges from 9 to 35% depending on the country and assessment method. Often, patients are subject to inappropriate and therefore dangerous pharmacotherapies that include prolonged administration of hypnotic drugs, benzodiazepines and other GABAA receptor modulators. This usually does not lead to a satisfactory improvement in patients' clinical states and may cause lifelong drug dependence. Brain state transitions require the coordinated activity of numerous neuronal pathways and brain structures. It is thought that orexin-expressing neurons play a crucial role in this process. Due to their interaction with the sleep-wake-regulating neuronal population, they can activate vigilance-promoting regions and prevent unwanted sleep intrusions. Understanding the multiple orexin modulatory effects is crucial in the context of pathogenesis of insomnia and should lead to the development of novel treatments. An important step in this process was the synthesis of dual antagonists of orexin receptors. Crucially, these drugs, as opposed to benzodiazepines, do not change the sleep architecture and have limited side-effects. This new pharmacological approach might be the most appropriate to treat insomnia.

  17. A dual-mode proximity sensor with integrated capacitive and temperature sensing units

    International Nuclear Information System (INIS)

    Qiu, Shihua; Huang, Ying; He, Xiaoyue; Sun, Zhiguang; Liu, Ping; Liu, Caixia

    2015-01-01

    The proximity sensor is one of the most important devices in the field of robot application. It can accurately provide the proximity information to assistant robots to interact with human beings and the external environment safely. In this paper, we have proposed and demonstrated a dual-mode proximity sensor composed of capacitive and resistive sensing units. We defined the capacitive type proximity sensor perceiving the proximity information as C-mode and the resistive type proximity sensor detecting as R-mode. Graphene nanoplatelets (GNPs) were chosen as the R-mode sensing material because of its high performance. The dual-mode proximity sensor presents the following features: (1) the sensing distance of the dual-mode proximity sensor has been enlarged compared with the single capacitive proximity sensor in the same geometrical pattern; (2) experiments have verified that the proposed sensor can sense the proximity information of different materials; (3) the proximity sensing capability of the sensor has been improved by two modes perceive collaboratively, for a plastic block at a temperature of 60 °C: the R-mode will perceive the proximity information when the distance d between the sensor and object is 6.0–17.0 mm and the C-mode will do that when their interval is 0–2.0 mm; additionally two modes will work together when the distance is 2.0–6.0 mm. These features indicate our transducer is very valuable in skin-like sensing applications. (paper)

  18. The effect of methylphenidate on postural stability under single and dual task conditions in children with attention deficit hyperactivity disorder - a double blind randomized control trial.

    Science.gov (United States)

    Jacobi-Polishook, Talia; Shorer, Zamir; Melzer, Itshak

    2009-05-15

    To investigate the effects of Methylphenidate (MPH) on postural stability in attention deficit hyperactivity disorder (ADHD) children in single and dual task conditions. A randomized controlled double-blind study analyzing postural stability in 24 ADHD children before and after MPH vs. placebo treatments, in three task conditions: (1) Single task, standing still; (2) dual task, standing still performing a memory-attention demanding task; (3) standing still listening to music. MPH resulted in a significant improvement in postural stability during the dual task condition and while listening to music, with no equivalent improvement in placebo controls. MPH improves postural stability in ADHD, especially when an additional task is performed. This is probably due to enhanced attention abilities, thus contributing to improved balance control during performance of tasks that require attention. MPH remains to be studied as a potential drug treatment to improve balance control and physical functioning in other clinical populations.

  19. INTEGRATED DIAGNOSTICS AND CORRECTION OF SLEEP DISORDERS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    S. A. Nemkova

    2015-01-01

    Full Text Available The article is devoted to the actual problem of modern pediatrics and neurology ― a comprehensive diagnosis and correction of sleep disorders in children. Detail the features of the clinical manifestations of sleep disorders in childhood (insomnia and parasomnia, great attention is paid to sleep apnea syndrome as a risk factor for somatic and psychopathological disorders in children. Highlight the current capabilities of complex instrumental diagnosis of sleep disorders with the use of highly effective methods of polysomnography and pulse oximetry. The actual dimensions as non-drug and drug treatment of sleep disorders in children, taking into account the pathogenetic features of their occurrence. From the standpoint of evidence-based medicine demonstrate efficient methods of herbal medicine, developed on the basis of traditional Chinese recipes, as well as modern nootropics and magnesium preparations. It is shown that sleep disorders in children not only lead to a deterioration of emotional mood, cognitive function, health and school performance, but also are associated with increasing risk of somatic disorders, which determines the need for timely diagnosis and comprehensive differentiated medical and psychological data correction of pathological conditions, taking into account the neurophysiological and biochemical mechanisms of their development, as well as polymorphism of clinical manifestations, in order to increase the effectiveness of treatment and quality of life of patients.  

  20. Bioinformatic Analysis Reveals Conservation of Intrinsic Disorder in the Linker Sequences of Prokaryotic Dual-family Immunophilin Chaperones.

    Science.gov (United States)

    Barik, Sailen

    2018-01-01

    The two classical immunophilin families, found essentially in all living cells, are: cyclophilin (CYN) and FK506-binding protein (FKBP). We previously reported a novel class of immunophilins that are natural chimera of these two, which we named dual-family immunophilin (DFI). The DFIs were found in either of two conformations: CYN-linker-FKBP (CFBP) or FKBP-3TPR-CYN (FCBP). While the 3TPR domain can serve as a flexible linker between the FKBP and CYN modules in the FCBP-type DFI, the linker sequences in the CFBP-type DFIs are relatively short, diverse in sequence, and contain no discernible motif or signature. Here, I present several lines of computational evidence that, regardless of their primary structure, these CFBP linkers are intrinsically disordered. This report provides the first molecular foundation for the model that the CFBP linker acts as an unstructured, flexible loop, allowing the two flanking chaperone modules function independently while linked in cis , likely to assist in the folding of multisubunit client complexes.

  1. Integration of Correlative Raman microscopy in a dual beam FIB-SEM J. of Raman Spectroscopy

    NARCIS (Netherlands)

    Timmermans, Frank Jan; Liszka, B.; Lenferink, Aufrid T.M.; van Wolferen, Hendricus A.G.M.; Otto, Cornelis

    2016-01-01

    We present an integrated confocal Raman microscope in a focused ion beam scanning electron microscope (FIB SEM). The integrated system enables correlative Raman and electron microscopic analysis combined with focused ion beam sample modification on the same sample location. This provides new

  2. Integrating play therapy in the treatment of children with obsessive-compulsive disorder.

    Science.gov (United States)

    Gold-Steinberg, S; Logan, D

    1999-10-01

    While behavioral and psychopharmacological approaches are the most effective interventions for treating obsessive-compulsive disorder (OCD), psychodynamically oriented play therapy can enhance the treatment of children with this disorder. Play therapy techniques are useful in addressing treatment resistance, feelings of shame around OCD symptoms, negative self-concept, and issues of psychosocial adjustment. A case study illustrates this integrated approach to treatment.

  3. Body integrity identity disorder crosses culture: case reports in the Japanese and Chinese literature

    NARCIS (Netherlands)

    Blom, Rianne M.; Vulink, Nienke C.; van der Wal, Sija J.; Nakamae, Takashi; Tan, Zhonglin; Derks, Eske M.; Denys, Damiaan

    2016-01-01

    Body integrity identity disorder (BIID) is a condition in which people do not perceive a part of their body as their own, which results in a strong desire for amputation or paralyzation. The disorder is likely to be congenital due to its very early onset. The English literature describes only

  4. PRACTICING SPEECH THERAPY INTERVENTION FOR SOCIAL INTEGRATION OF CHILDREN WITH SPEECH DISORDERS

    Directory of Open Access Journals (Sweden)

    Martin Ofelia POPESCU

    2016-11-01

    Full Text Available The article presents a concise speech correction intervention program in of dyslalia in conjunction with capacity development of intra, interpersonal and social integration of children with speech disorders. The program main objectives represent: the potential increasing of individual social integration by correcting speech disorders in conjunction with intra- and interpersonal capacity, the potential growth of children and community groups for social integration by optimizing the socio-relational context of children with speech disorder. In the program were included 60 children / students with dyslalia speech disorders (monomorphic and polymorphic dyslalia, from 11 educational institutions - 6 kindergartens and 5 schools / secondary schools, joined with inter-school logopedic centre (CLI from Targu Jiu city and areas of Gorj district. The program was implemented under the assumption that therapeutic-formative intervention to correct speech disorders and facilitate the social integration will lead, in combination with correct pronunciation disorders, to social integration optimization of children with speech disorders. The results conirm the hypothesis and gives facts about the intervention program eficiency.

  5. Integrating a dual-silicon photoelectrochemical cell into a redox flow battery for unassisted photocharging

    DEFF Research Database (Denmark)

    Liao, Shichao; Zong, Xu; Seger, Brian

    2016-01-01

    Solar rechargeable flow cells (SRFCs) provide an attractive approach for in situ capture and storage of intermittent solar energy via photoelectrochemical regeneration of discharged redox species for electricity generation. However, overall SFRC performance is restricted by inefficient photoelect......Solar rechargeable flow cells (SRFCs) provide an attractive approach for in situ capture and storage of intermittent solar energy via photoelectrochemical regeneration of discharged redox species for electricity generation. However, overall SFRC performance is restricted by inefficient...... photoelectrochemical reactions. Here we report an efficient SRFC based on a dual-silicon photoelectrochemical cell and a quinone/bromine redox flow battery for in situ solar energy conversion and storage. Using narrow bandgap silicon for efficient photon collection and fast redox couples for rapid interface charge...

  6. Integrating a dual-silicon photoelectrochemical cell into a redox flow battery for unassisted photocharging.

    Science.gov (United States)

    Liao, Shichao; Zong, Xu; Seger, Brian; Pedersen, Thomas; Yao, Tingting; Ding, Chunmei; Shi, Jingying; Chen, Jian; Li, Can

    2016-05-04

    Solar rechargeable flow cells (SRFCs) provide an attractive approach for in situ capture and storage of intermittent solar energy via photoelectrochemical regeneration of discharged redox species for electricity generation. However, overall SFRC performance is restricted by inefficient photoelectrochemical reactions. Here we report an efficient SRFC based on a dual-silicon photoelectrochemical cell and a quinone/bromine redox flow battery for in situ solar energy conversion and storage. Using narrow bandgap silicon for efficient photon collection and fast redox couples for rapid interface charge injection, our device shows an optimal solar-to-chemical conversion efficiency of ∼5.9% and an overall photon-chemical-electricity energy conversion efficiency of ∼3.2%, which, to our knowledge, outperforms previously reported SRFCs. The proposed SRFC can be self-photocharged to 0.8 V and delivers a discharge capacity of 730 mAh l(-1). Our work may guide future designs for highly efficient solar rechargeable devices.

  7. Sleep disorders in children with cerebral palsy: An integrative review.

    Science.gov (United States)

    Lélis, Ana Luíza P A; Cardoso, Maria Vera L M; Hall, Wendy A

    2016-12-01

    Sleep disorders are more prevalent in children with cerebral palsy. The review aimed to identify and synthesize information about the nature of sleep disorders and their related factors in children with cerebral palsy. We performed an electronic search by using the search terms sleep/child*, and sleep/cerebral palsy in the following databases: Latin American literature on health sciences, SCOPUS, medical publications, cumulative index to nursing and allied health literature, psycinfo, worldcat, web of science, and the Cochrane library. The selection criteria were studies: available in Portuguese, English or Spanish and published between 2004 and 2014, with results addressing sleep disorders in children (ages 0-18 y) with a diagnosis of cerebral palsy. 36,361 abstracts were identified. Of those, 37 papers were selected, and 25 excluded. Twelve papers were incorporated in the study sample: eight quantitative studies, three reviews, and one case study. Eleven types of sleep disorders were identified, such as difficult morning awakening, insomnia, nightmares, difficulties in initiating and maintaining nighttime sleep (night waking), and sleep anxiety. Twenty-one factors were linked to sleep disorders, which we classified as intrinsic factors associated with common comorbidities accompanying cerebral palsy, and extrinsic aspects, specifically environmental and socio-familial variables, and clinical-surgical and pharmacological interventions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Convergent integration of animal model and human studies of bipolar disorder (manic-depressive illness).

    Science.gov (United States)

    Le-Niculescu, Helen; Patel, Sagar D; Niculescu, Alexander B

    2010-10-01

    Animal models and human studies of bipolar disorder and other psychiatric disorders are becoming increasingly integrated, prompted by recent successes. Particularly for genomics, the convergence and integration of data across species, experimental modalities and technical platforms is providing a fit-to-disease way of extracting reproducible and biologically important signal, in sharp contrast to the fit-to-cohort effect, disappointing findings to date, and limited reproducibility of human genetic analyses alone. Such work in psychiatry can provide an example of how to address other genetically complex disorders, and in turn will benefit by incorporating concepts from other areas, such as cancer biology and diabetes. Copyright © 2010. Published by Elsevier Ltd.

  9. Developing Distinct Mathematical and Scientific Pedagogical Content Knowledge in an Early Childhood Dual-Content Methods Course: An Alternative to Integration

    Science.gov (United States)

    Kalchman, Mindy; Kozoll, Richard H.

    2017-01-01

    Methods for teaching early childhood mathematics and science are often addressed in a single, dual-content course. Approaches to teaching this type of course include integrating the content and the pedagogy of both subjects, or keeping the subject areas distinct. In this article, the authors discuss and illustrate their approach to such a combined…

  10. A new integrated dual time-point amyloid PET/MRI data analysis method

    Energy Technology Data Exchange (ETDEWEB)

    Cecchin, Diego; Zucchetta, Pietro; Turco, Paolo; Bui, Franco [University Hospital of Padua, Nuclear Medicine Unit, Department of Medicine - DIMED, Padua (Italy); Barthel, Henryk; Tiepolt, Solveig; Sabri, Osama [Leipzig University, Department of Nuclear Medicine, Leipzig (Germany); Poggiali, Davide; Cagnin, Annachiara; Gallo, Paolo [University Hospital of Padua, Neurology, Department of Neurosciences (DNS), Padua (Italy); Frigo, Anna Chiara [University Hospital of Padua, Biostatistics, Epidemiology and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padua (Italy)

    2017-11-15

    In the initial evaluation of patients with suspected dementia and Alzheimer's disease, there is no consensus on how to perform semiquantification of amyloid in such a way that it: (1) facilitates visual qualitative interpretation, (2) takes the kinetic behaviour of the tracer into consideration particularly with regard to at least partially correcting for blood flow dependence, (3) analyses the amyloid load based on accurate parcellation of cortical and subcortical areas, (4) includes partial volume effect correction (PVEC), (5) includes MRI-derived topographical indexes, (6) enables application to PET/MRI images and PET/CT images with separately acquired MR images, and (7) allows automation. A method with all of these characteristics was retrospectively tested in 86 subjects who underwent amyloid ({sup 18}F-florbetaben) PET/MRI in a clinical setting (using images acquired 90-110 min after injection, 53 were classified visually as amyloid-negative and 33 as amyloid-positive). Early images after tracer administration were acquired between 0 and 10 min after injection, and later images were acquired between 90 and 110 min after injection. PVEC of the PET data was carried out using the geometric transfer matrix method. Parametric images and some regional output parameters, including two innovative ''dual time-point'' indexes, were obtained. Subjects classified visually as amyloid-positive showed a sparse tracer uptake in the primary sensory, motor and visual areas in accordance with the isocortical stage of the topographic distribution of the amyloid plaque (Braak stages V/VI). In patients classified visually as amyloid-negative, the method revealed detectable levels of tracer uptake in the basal portions of the frontal and temporal lobes, areas that are known to be sites of early deposition of amyloid plaques that probably represented early accumulation (Braak stage A) that is typical of normal ageing. There was a strong correlation between

  11. A new integrated dual time-point amyloid PET/MRI data analysis method

    International Nuclear Information System (INIS)

    Cecchin, Diego; Zucchetta, Pietro; Turco, Paolo; Bui, Franco; Barthel, Henryk; Tiepolt, Solveig; Sabri, Osama; Poggiali, Davide; Cagnin, Annachiara; Gallo, Paolo; Frigo, Anna Chiara

    2017-01-01

    In the initial evaluation of patients with suspected dementia and Alzheimer's disease, there is no consensus on how to perform semiquantification of amyloid in such a way that it: (1) facilitates visual qualitative interpretation, (2) takes the kinetic behaviour of the tracer into consideration particularly with regard to at least partially correcting for blood flow dependence, (3) analyses the amyloid load based on accurate parcellation of cortical and subcortical areas, (4) includes partial volume effect correction (PVEC), (5) includes MRI-derived topographical indexes, (6) enables application to PET/MRI images and PET/CT images with separately acquired MR images, and (7) allows automation. A method with all of these characteristics was retrospectively tested in 86 subjects who underwent amyloid ( 18 F-florbetaben) PET/MRI in a clinical setting (using images acquired 90-110 min after injection, 53 were classified visually as amyloid-negative and 33 as amyloid-positive). Early images after tracer administration were acquired between 0 and 10 min after injection, and later images were acquired between 90 and 110 min after injection. PVEC of the PET data was carried out using the geometric transfer matrix method. Parametric images and some regional output parameters, including two innovative ''dual time-point'' indexes, were obtained. Subjects classified visually as amyloid-positive showed a sparse tracer uptake in the primary sensory, motor and visual areas in accordance with the isocortical stage of the topographic distribution of the amyloid plaque (Braak stages V/VI). In patients classified visually as amyloid-negative, the method revealed detectable levels of tracer uptake in the basal portions of the frontal and temporal lobes, areas that are known to be sites of early deposition of amyloid plaques that probably represented early accumulation (Braak stage A) that is typical of normal ageing. There was a strong correlation between age

  12. [AIT (Adolescent Identity Treatment) - an Integrative Treatment Model for the Treatment of Personality Disorders].

    Science.gov (United States)

    Schlüter-Müller, Susanne

    2017-07-01

    AIT (Adolescent Identity Treatment) - an Integrative Treatment Model for the Treatment of Personality Disorders Personality disorders are patterns of maladaptive personality traits that have an impact on the individual throughout the life span. Borderline Personality Disorder (BPD) is a very severe, but treatable mental disorder. Identity disturbance is seen as the central construct for detecting severe personality pathology - and, most notably, borderline personality disorder - in adults and adolescents. Crises in the development of identity usually resolve into a normal and consolidated identity with flexible and adaptive functioning whereas identity diffusion is viewed as a lack of integration of the concept of the self and significant others. It is seen as the basis for subsequent personality pathology, including that of borderline personality disorder. Although BPD has its onset in adolescence and emerging adulthood the diagnosis is often delayed. In most cases, specific treatment is only offered late in the course of the disorder and to relatively few individuals. Adolescent Identity Treatment (AIT) is a treatment model that focuses on identity pathology as the core characteristic of personality disorders. This model integrates specific techniques for the treatment of adolescent personality pathology on the background of object-relation theories and modified elements of Transference-Focused Psychotherapy. Moreover, psychoeducation, a behavior-oriented homeplan and intensive family work is part of AIT.

  13. Dual Binding Site and Selective Acetylcholinesterase Inhibitors Derived from Integrated Pharmacophore Models and Sequential Virtual Screening

    Directory of Open Access Journals (Sweden)

    Shikhar Gupta

    2014-01-01

    Full Text Available In this study, we have employed in silico methodology combining double pharmacophore based screening, molecular docking, and ADME/T filtering to identify dual binding site acetylcholinesterase inhibitors that can preferentially inhibit acetylcholinesterase and simultaneously inhibit the butyrylcholinesterase also but in the lesser extent than acetylcholinesterase. 3D-pharmacophore models of AChE and BuChE enzyme inhibitors have been developed from xanthostigmine derivatives through HypoGen and validated using test set, Fischer’s randomization technique. The best acetylcholinesterase and butyrylcholinesterase inhibitors pharmacophore hypotheses Hypo1_A and Hypo1_B, with high correlation coefficient of 0.96 and 0.94, respectively, were used as 3D query for screening the Zinc database. The screened hits were then subjected to the ADME/T and molecular docking study to prioritise the compounds. Finally, 18 compounds were identified as potential leads against AChE enzyme, showing good predicted activities and promising ADME/T properties.

  14. Dual Converter Fed Open-End Transformer Topology with Parallel Converters and Integrated Magnetics

    DEFF Research Database (Denmark)

    Gohil, Ghanshyamsinh Vijaysinh; Bede, Lorand; Teodorescu, Remus

    2016-01-01

    that flows between the parallel interleaved VSCs. An integrated inductor is proposed which suppresses the circulating current in both the converter groups. In addition, the functionality of the line filter inductor is also integrated. Flux in various parts of the integrated inductor is analyzed and a design......A converter system for high power applications, connected to a medium-voltage network using a stepup transformer, is presented in this paper. The converterside winding of the transformer is configured as an openend and both the ends of the windings are fed from two different converter groups. Each...... procedure is also described. The volume and the losses of the proposed solution are compared with that of the state-of-art solution. The control of the proposed converter system is also discussed. The analysis has been verified by the simulation and experimental results....

  15. Four Quadrants Integrated Transformers for Dual-input Isolated DC-DC Converters

    DEFF Research Database (Denmark)

    Ouyang, Ziwei; Zhang, Zhe; Andersen, Michael A. E.

    2012-01-01

    A common limitation of power coupling effect in some known multiple-input dc-dc converters has been addressed in many literatures. In order to overcome this limitation, a new concept for decoupling the primary windings in the integrated multiple-winding transformers based on 3-dimensional (3D...... perpendicular primary windings, a name of “four quadrants integrated transformers” (FQIT) is therefore given to the proposed construction. Since the two primary windings are uncoupled, the FQIT allows the two input power stages to transfer the energy into the output load simultaneously or at any...

  16. Graduates' Perceptions of Learning Affordances in Longitudinal Integrated Clerkships: A Dual-Institution, Mixed-Methods Study.

    Science.gov (United States)

    Latessa, Robyn A; Swendiman, Robert A; Parlier, Anna Beth; Galvin, Shelley L; Hirsh, David A

    2017-09-01

    The authors explored affordances that contribute to participants' successful learning in longitudinal integrated clerkships (LICs). This dual-institutional, mixed-methods study included electronic surveys and semistructured interviews of LIC graduates who completed their core clinical (third) year of medical school. These LIC graduates took part in LICs at Harvard Medical School from 2004 to 2013 and the University of North Carolina School of Medicine-Asheville campus from 2009 to 2013. The survey questions asked LIC graduates to rate components of LICs that they perceived as contributing to successful learning. A research assistant interviewed a subset of study participants about their learning experiences. The authors analyzed aggregate data quantitatively and performed a qualitative content analysis on interview data. The graduates reported multiple affordances that they perceive contributed to successful learning in their LIC. The most reported components included continuity and relationships with preceptors, patients, place, and peers, along with integration of and flexibility within the curriculum. As LIC models grow in size and number, and their structures and processes evolve, learners' perceptions of affordances may guide curriculum planning. Further research is needed to investigate to what degree and by what means these affordances support learning in LICs and other models of clinical education.

  17. Microcontroller Based Proportional Derivative Plus Conditional Integral Controller for Electro-Mechanical Dual Acting Pulley Continuously Variable Transmission Ratio Control

    International Nuclear Information System (INIS)

    Budianto, A; Tawi, K B; Hussein, M; Supriyo, B; Kob, M S Che; Zulkifli, Mohd Ezlamy; Khairuldean A K; Daraoh, Aishah; Ariyono, S

    2012-01-01

    Electro-Mechanical Dual Acting Pulley (EMDAP) Continuously Variable Transmission (CVT) is a transmission utilized by electro-mechanical actuated system. It has a potential to reduce energy consumption because it only needs power during changing CVT ratio and no power is needed to maintain CVT ratio due to self lock mechanism design. This paper proposed simple proportional derivative plus conditional integral (PDCI) controller to control EMDAP CVT ratio which can be simply implemented on a microcontroller. This proposed controller used Astrom-Hagglund method and Ziegler-Nichols formula to tune PDCI gain. The Proportional Derivative controller is directly activated from the start but Integral controller is only activated when the error value reaches error value setting point. Simulation using Matlab/Simulink software was conducted to evaluate PDCI system performance. The simulation results showed PDCI controller has ability to perform maximum overshoot 0.1%, 0.001 steady state error and 0.5s settling time. For clamping condition, settling time is about 11.46s during changing ratio from 2.0 to 0.7, while for release condition, settling time is about 8.33s during changing ratio from 0.7 to 2.0.

  18. Dual uses of microalgal biomass: An integrative approach for biohydrogen and biodiesel production

    International Nuclear Information System (INIS)

    Dasgupta, Chitralekha Nag; Suseela, M.R.; Mandotra, S.K.; Kumar, Pankaj; Pandey, Manish K.; Toppo, Kiran; Lone, J.A.

    2015-01-01

    Highlights: • Chlorella sp. NBRI029 and Scenedesmus sp. NBRI012 shows high biomass productivity. • Scenedesmus sp. NBRI012 shows maximum H 2 evolution in 6th day of fermentation. • Residual biomass after H 2 production contains high lipid content. • Lipid extracted from the residual biomass fulfills various biodiesel properties. - Abstract: Dual application of biomass for biohydrogen and biodiesel production could be considered a feasible option for economic and sustainable energy production from microalgae. In this study, after a large screening of fresh water microalgal isolates, Scenedesmus sp. NBRI012 and Chlorella sp. NBRI029 have exhibited high biomass (1.31 ± 0.11 and 2.62 ± 0.13 g/L respectively) and lipid (244.44 ± 12.3 and 587.38 ± 20.2 mg/L respectively) yield with an organic carbon (acetate) source. Scenedesmus sp. NBRI012 has shown the highest H 2 (maximum evolution of 17.72% v/v H 2 of total gases) production; it produced H 2 continuously for seven days in sulfur-deprived TAP media. Sulfur deprivation during the H 2 production was found to increase the lipid content (410.03 ± 18.5 mg/L) of the residual biomass. Fatty acid profile of the lipid extracted from the residual biomass of Scenedesmus sp. NBRI012 has showed abundance of fatty acids with a carbon chain length of C16 and C18. Cetane number, iodine value, and saponification value of biodiesel were found suitable according to the range given by the Indian standard (IS 15607), Brazilian National Petroleum Agency (ANP255) and the European biodiesel standard EN14214

  19. Posture-Motor and Posture-Ideomotor Dual-Tasking: A Putative Marker of Psychomotor Retardation and Depressive Rumination in Patients With Major Depressive Disorder.

    Science.gov (United States)

    Aftanas, Lyubomir I; Bazanova, Olga M; Novozhilova, Nataliya V

    2018-01-01

    Background: Recent studies have demonstrated that the assessment of postural performance may be a potentially reliable and objective marker of the psychomotor retardation (PMR) in the major depressive disorder (MDD). One of the important facets of MDD-related PMR is reflected in disrupted central mechanisms of psychomotor control, heavily influenced by compelling maladaptive depressive rumination. In view of this we designed a research paradigm that included sequential execution of simple single-posture task followed by more challenging divided attention posture tasks, involving concurring motor and ideomotor workloads. Another difficulty dimension assumed executing of all the tasks with eyes open (EO) (easy) and closed (EC) (difficult) conditions. We aimed at investigating the interplay between the severity of MDD, depressive rumination, and efficiency of postural performance. Methods: Compared with 24 age- and body mass index-matched healthy controls (HCs), 26 patients with MDD sequentially executed three experimental tasks: (1) single-posture task of maintaining a quiet stance (ST), (2) actual posture-motor dual task (AMT); and (3) mental/imaginary posture-motor dual task (MMT). All the tasks were performed in the EO and the EC conditions. The primary dependent variable was the amount of kinetic energy ( E ) expended for the center of pressure deviations (CoPDs), whereas the absolute divided attention cost index showed energy cost to the dual-tasking vs. the single-posture task according to the formula: Δ E = ( E Dual-task - E Single-task ). Results: The signs of PMR in the MDD group were objectively indexed by deficient posture control in the EC condition along with overall slowness of fine motor and ideomotor activity. Another important and probably more challenging feature of the findings was that the posture deficit manifested in the ST condition was substantially and significantly attenuated in the MMT and AMT performance dual-tasking activity. A multiple

  20. Sensorimotor integration and psychopathology: motor control abnormalities related to psychiatric disorders.

    Science.gov (United States)

    Velasques, Bruna; Machado, Sergio; Paes, Flávia; Cunha, Marlo; Sanfim, Antonio; Budde, Henning; Cagy, Mauricio; Anghinah, Renato; Basile, Luis F; Piedade, Roberto; Ribeiro, Pedro

    2011-12-01

    Recent evidence is reviewed to examine relationships among sensorimotor and cognitive aspects in some important psychiatry disorders. This study reviews the theoretical models in the context of sensorimotor integration and the abnormalities reported in the most common psychiatric disorders, such as Alzheimer's disease, autism spectrum disorder and squizophrenia. The bibliographical search used Pubmed/Medline, ISI Web of Knowledge, Cochrane data base and Scielo databases. The terms chosen for the search were: Alzheimer's disease, AD, autism spectrum disorder, and Squizophrenia in combination with sensorimotor integration. Fifty articles published in English and were selected conducted from 1989 up to 2010. We found that the sensorimotor integration process plays a relevant role in elementary mechanisms involved in occurrence of abnormalities in most common psychiatric disorders, participating in the acquisition of abilities that have as critical factor the coupling of different sensory data which will constitute the basis of elaboration of consciously goal-directed motor outputs. Whether these disorders are associated with an abnormal peripheral sensory input or defective central processing is still unclear, but some studies support a central mechanism. Sensorimotor integration seems to play a significant role in the disturbances of motor control, like deficits in the feedforward mechanism, typically seen in AD, autistic and squizophrenic patients.

  1. Single integrated device for optical CDMA code processing in dual-code environment.

    Science.gov (United States)

    Huang, Yue-Kai; Glesk, Ivan; Greiner, Christoph M; Iazkov, Dmitri; Mossberg, Thomas W; Wang, Ting; Prucnal, Paul R

    2007-06-11

    We report on the design, fabrication and performance of a matching integrated optical CDMA encoder-decoder pair based on holographic Bragg reflector technology. Simultaneous encoding/decoding operation of two multiple wavelength-hopping time-spreading codes was successfully demonstrated and shown to support two error-free OCDMA links at OC-24. A double-pass scheme was employed in the devices to enable the use of longer code length.

  2. Conventional dual-cure versus self-adhesive resin cements in dentin bond integrity

    Directory of Open Access Journals (Sweden)

    Renata Andreza Talaveira da Silva

    2011-08-01

    Full Text Available During post preparation, the root canal is exposed to the oral cavity, and endodontic treatment may fail because of coronal leakage, bacterial infection and sealing inability of the luting cement. OBJECTIVE: this study quantified the interfacial continuity produced with conventional dual-cure and self-adhesive resin cements in the cervical (C, medium (M and apical (A thirds of the root. MATERIAL AND METHODS: Forty single-rooted human teeth were restored using Reforpost # 01 conical glass-fiber posts and different materials (N=10 per group: group AC=Adper™ ScotchBond™ Multi-purpose Plus + AllCem; group ARC=Adper™ ScotchBond™ Multi-purpose Plus + RelyX ARC; group U100=RelyX U100; and group MXC=Maxcem Elite. After being kept in 100% humidity at 37°C for 72 hours, the samples were sectioned parallel to their longitudinal axis and positive epoxy resin replicas were made. The scanning electron micrographs of each third section of the teeth were combined using Image Analyst software and measured with AutoCAD-2002. We obtained percentage values of the interfacial continuity. RESULTS: Interfacial continuity was similar in the apical, medium and cervical thirds of the roots within the groups (Friedman test, p>0.05. Comparison of the different cements in a same root third showed that interfacial continuity was lower in MXC (C=45.5%; M=48.5%; A=47.3% than in AC (C=85.9%, M=81.8% and A=76.0%, ARC (C=83.8%, M=82.4% and A=75.0% and U100 (C=84.1%, M=82.4% and A=77.3% (Kruskal-Wallis test, p<0.05. CONCLUSIONS: Allcem, Rely X ARC and U100 provide the best cementation; cementation was similar among root portions; in practical terms, U100 is the best resin because it combines good cementation and easy application and none of the cements provides complete interfacial continuity.

  3. Conventional dual-cure versus self-adhesive resin cements in dentin bond integrity

    Science.gov (United States)

    da SILVA, Renata Andreza Talaveira; COUTINHO, Margareth; CARDOZO, Pedro Igor; da SILVA, Larissa Alves; ZORZATTO, José Roberto

    2011-01-01

    During post preparation, the root canal is exposed to the oral cavity, and endodontic treatment may fail because of coronal leakage, bacterial infection and sealing inability of the luting cement. Objective this study quantified the interfacial continuity produced with conventional dual-cure and self-adhesive resin cements in the cervical (C), medium (M) and apical (A) thirds of the root. Material and methods Forty single-rooted human teeth were restored using Reforpost # 01 conical glass-fiber posts and different materials (N=10 per group): group AC=Adper™ ScotchBond™ Multi-purpose Plus + AllCem; group ARC=Adper™ ScotchBond™ Multi-purpose Plus + RelyX ARC; group U100=RelyX U100; and group MXC=Maxcem Elite. After being kept in 100% humidity at 37ºC for 72 hours, the samples were sectioned parallel to their longitudinal axis and positive epoxy resin replicas were made. The scanning electron micrographs of each third section of the teeth were combined using Image Analyst software and measured with AutoCAD-2002. We obtained percentage values of the interfacial continuity. Results Interfacial continuity was similar in the apical, medium and cervical thirds of the roots within the groups (Friedman test, p>0.05). Comparison of the different cements in a same root third showed that interfacial continuity was lower in MXC (C=45.5%; M=48.5%; A=47.3%) than in AC (C=85.9%, M=81.8% and A=76.0%), ARC (C=83.8%, M=82.4% and A=75.0%) and U100 (C=84.1%, M=82.4% and A=77.3%) (Kruskal-Wallis test, p<0.05). Conclusions Allcem, Rely X ARC and U100 provide the best cementation; cementation was similar among root portions; in practical terms, U100 is the best resin because it combines good cementation and easy application and none of the cements provides complete interfacial continuity. PMID:21710099

  4. [Integrated treatment of cooccurring mental and substance use disorders in urban populations : the situation in Montréal].

    Science.gov (United States)

    Dubreucq, Simon; Chanut, Florence; Jutras-Aswad, Didier

    2012-01-01

    The prevalence of patients diagnosed with both a psychiatric and an addiction disorder is considerable. Like many other large urban centers, Montreal harbors many of these socially marginalized individuals. In spite of a wide range of resources for the treatment of each condition taken singly, there has been until recently an alarming dearth of programs aimed at providing integrated treatment models. In recent years, the CHUM has endeavored to implement such a program in order to address the multiple needs of a population often rendered vulnerable in many respects. In this article, the authors address the magnitude of this "dual diagnosis" problem, existing intervention models and the obstacles faced by this population in terms of access to health care ; they describe the steps leading to the establishment of an Addiction Psychiatric Unit at the CHUM and the challenges arising from the creation of a multidisciplinary integrated treatment model in an urban setting.

  5. Why clinicians do not implement integrated treatment for comorbid substance use disorder and posttraumatic stress disorder: a qualitative study

    Directory of Open Access Journals (Sweden)

    Nele Gielen

    2014-02-01

    Full Text Available Background: Healthcare providers working in addiction facilities do not often implement integrated treatment of comorbid substance use disorder (SUD and posttraumatic stress disorder (PTSD while there is empirical evidence to do so. Objective: This study aims to get insight into the views of clinicians with regard to the diagnosis and treatment of PTSD in SUD patients. Method: A qualitative research method was chosen. Fourteen treatment staff members of different wards of an addiction care facility were interviewed by an independent interviewer. Results: Despite acknowledging adverse consequences of trauma exposure on SUD, severe underdiagnosis of PTSD was mentioned and treatment of PTSD during SUD treatment was not supported. Obstacles related to the underestimation of PTSD among SUD patients and to the perceptions of SUD clinicians concerning the treatment of comorbid SUD/PTSD were reported. Conclusions: It is concluded that SUD facilities should train their clinicians to enable them to provide for integrated treatment of SUD/PTSD.

  6. Generalized Anxiety Disorder Across the Lifespan: An Integrative ...

    African Journals Online (AJOL)

    underlying philosophy of this work, which is, therefore, a truly integrative effort to present ... a good balance achieved between the two. The second aspect of ... devoted to the links between GAD and depression, in view of the ongoing debates ...

  7. Intermittent explosive disorder: development of integrated research criteria for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

    Science.gov (United States)

    Coccaro, Emil F

    2011-01-01

    This study was designed to develop a revised diagnostic criteria set for intermittent explosive disorder (IED) for consideration for inclusion in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). This revised criteria set was developed by integrating previous research criteria with elements from the current DSM-IV set of diagnostic criteria. Evidence supporting the reliability and validity of IED-IR ("IED Integrated Criteria") in a new and well-characterized group of subjects with personality disorder is presented. Clinical, phenomenologic, and diagnostic data from 201 individuals with personality disorder were reviewed. All IED diagnoses were assigned using a best-estimate process (eg, kappa for IED-IR >0.85). In addition, subjects meeting IED-IR criteria had higher scores on dimensional measures of aggression and had lower global functioning scores than non-IED-IR subjects, even when related variables were controlled. The IED-IR criteria were more sensitive than the DSM-IV criteria only in identifying subjects with significant impulsive-aggressive behavior by a factor of 16. We conclude that the IED-IR criteria can be reliably applied and have sufficient validity to warrant consideration as DSM-V criteria for IED. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. Body integrity identity disorder: from a psychological to a neurological syndrome.

    Science.gov (United States)

    Sedda, Anna

    2011-12-01

    Body Integrity Identity Disorder (BIID) is a condition in which individuals experience an intense desire for amputation of an healthy limb. Recently, McGeoch and colleagues provided the first direct evidence that this syndrome may be neurological rather than psychological in its origin. However, before including BIID in body ownership disorders, several concerns should be clarified, exploring other components of body representation and not only somatosensory perception.

  9. Abelson Helper Integration Site-1 Gene Variants on Major Depressive Disorder and Bipolar Disorder

    Science.gov (United States)

    Porcelli, Stefano; Han, Changsu; Lee, Soo-Jung; Patkar, Ashwin A.; Masand, Prakash S.; Balzarro, Beatrice; Alberti, Siegfried; De Ronchi, Diana; Serretti, Alessandro

    2014-01-01

    Objective The present study aimed to explore whether 4 single nucleotide polymorphisms (SNPs) within the AHI1 gene could be associated with major depressive disorder (MD) and bipolar disorder (BD), and whether they could predict clinical outcomes in mood disorders. Methods One hundred and eighty-four (184) patients with MD, 170 patients with BD and 170 healthy controls were genotyped for 4 AHI1 SNPs (rs11154801, rs7750586, rs9647635 and rs9321501). Baseline and final clinical measures for MD patients were assessed through the Hamilton Rating Scale for Depression (HAM-D). Allelic and genotypic frequencies in MD and BD subjects were compared with those of each disorder and healthy group using the χ2 statistics. Repeated measures ANOVA was used to test possible influences of SNPs on treatment efficacy. Results The rs9647635 A/A was more represented in subjects with BD as compared with MD and healthy subjects together. The rs9647635 A/A was also more presented in patients with MD than in healthy subjects. With regard to the allelic analysis, rs9647635 A allele was more represented in subjects with BD compared with healthy subjects, while it was not observed between patients with MD and healthy subjects. Conclusion Our findings provide potential evidence of an association between some variants of AHI1 and mood disorders susceptibility but not with clinical outcomes. However, we will need to do more adequately-powered and advanced association studies to draw any conclusion due to clear limitations. PMID:25395981

  10. A Sol-gel Integrated Dual-readout Microarray Platform for Quantification and Identification of Prostate-specific Antigen.

    Science.gov (United States)

    Lee, SangWook; Lee, Jong Hyun; Kwon, Hyuck Gi; Laurell, Thomas; Jeong, Ok Chan; Kim, Soyoun

    2018-01-01

    Here, we report a sol-gel integrated affinity microarray for on-chip matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) that enables capture and identification of prostate?specific antigen (PSA) in samples. An anti-PSA antibody (H117) was mixed with a sol?gel, and the mixture was spotted onto a porous silicon (pSi) surface without additional surface modifications. The antibody easily penetrates the sol-gel macropore fluidic network structure, making possible high affinities. To assess the capture affinity of the platform, we performed a direct assay using fluorescein isothiocyanate-labeled PSA. Pure PSA was subjected to on-chip MALDI-TOF-MS analysis, yielding three clear mass peptide peaks (m/z = 1272, 1407, and 1872). The sol-gel microarray platform enables dual readout of PSA both fluorometric and MALDI-TOF MS analysis in biological samples. Here we report a useful method for a means for discovery of biomarkers in complex body fluids.

  11. How do leader-member exchange quality and differentiation affect performance in teams? An integrated multilevel dual process model.

    Science.gov (United States)

    Li, Alex Ning; Liao, Hui

    2014-09-01

    Integrating leader-member exchange (LMX) research with role engagement theory (Kahn, 1990) and role system theory (Katz & Kahn, 1978), we propose a multilevel, dual process model to understand the mechanisms through which LMX quality at the individual level and LMX differentiation at the team level simultaneously affect individual and team performance. With regard to LMX differentiation, we introduce a new configural approach focusing on the pattern of LMX differentiation to complement the traditional approach focusing on the degree of LMX differentiation. Results based on multiphase, multisource data from 375 employees of 82 teams revealed that, at the individual level, LMX quality positively contributed to customer-rated employee performance through enhancing employee role engagement. At the team level, LMX differentiation exerted negative influence on teams' financial performance through disrupting team coordination. In particular, teams with the bimodal form of LMX configuration (i.e., teams that split into 2 LMX-based subgroups with comparable size) suffered most in team performance because they experienced greatest difficulty in coordinating members' activities. Furthermore, LMX differentiation strengthened the relationship between LMX quality and role engagement, and team coordination strengthened the relationship between role engagement and employee performance. Theoretical and practical implications of the findings are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  12. Integrated dual-tomography for refractive index analysis of free-floating single living cell with isotropic superresolution.

    Science.gov (United States)

    B, Vinoth; Lai, Xin-Ji; Lin, Yu-Chih; Tu, Han-Yen; Cheng, Chau-Jern

    2018-04-13

    Digital holographic microtomography is a promising technique for three-dimensional (3D) measurement of the refractive index (RI) profiles of biological specimens. Measurement of the RI distribution of a free-floating single living cell with an isotropic superresolution had not previously been accomplished. To the best of our knowledge, this is the first study focusing on the development of an integrated dual-tomographic (IDT) imaging system for RI measurement of an unlabelled free-floating single living cell with an isotropic superresolution by combining the spatial frequencies of full-angle specimen rotation with those of beam rotation. A novel 'UFO' (unidentified flying object) like shaped coherent transfer function is obtained. The IDT imaging system does not require any complex image-processing algorithm for 3D reconstruction. The working principle was successfully demonstrated and a 3D RI profile of a single living cell, Candida rugosa, was obtained with an isotropic superresolution. This technology is expected to set a benchmark for free-floating single live sample measurements without labeling or any special sample preparations for the experiments.

  13. Effectiveness of dual focus mutual aid for co-occurring substance use and mental health disorders: a review and synthesis of the "Double Trouble" in Recovery evaluation.

    Science.gov (United States)

    Magura, Stephen

    2008-01-01

    Over 5 million adults in the United States have a co-occurring substance use disorder and serious psychological distress. Mutual aid (self-help) can usefully complement treatment, but people with co-occurring substance use and psychiatric disorders often encounter a lack of empathy and acceptance in traditional mutual aid groups. Double Trouble in Recovery (DTR) is a dual focus fellowship whose mission is to bring the benefits of mutual aid to persons recovering from co-occurring disorders. An evaluation of DTR was conducted by interviewing 310 persons attending 24 DTR meetings in New York City (NYC) in 1998 and following them up for 2 years, in 1999 and 2000. The evaluation produced 13 articles in 12 peer-reviewed journals, the main results of which are summarized here. The sample's characteristics were as follows: mean age, 40 years; women, 28%; black, 59%; white, 25%; Hispanic, 14%; never married, 63%; live in supported community residence, 53%; high school graduate or GED, 60%; arrested as adult, 63%; diagnoses of: schizophrenia, 39%; major depression, 21%; or bipolar disorder, 20%; currently prescribed psychiatric medication, 92%; primary substance used, current or past: cocaine/crack, 42%; alcohol 34%; or heroin, 11%. Overall, the findings indicate that DTR participation has both direct and indirect effects on several important components of recovery: drug/alcohol abstinence, psychiatric medication adherence, self-efficacy for recovery, and quality of life. The study also identified several "common" therapeutic factors (e.g., internal motivation and social support) and unique mutual aid processes (helper-therapy and reciprocal learning) that mediate the influence of DTR participation on recovery. For clinicians, these results underline the importance of fostering stable affiliation with specialized dual focus 12-step groups for their patients with co-occurring disorders, as part of a comprehensive recovery-oriented treatment approach.

  14. Video modeling for children with dual diagnosis of deafness or hard of hearing and autism spectrum disorder to promote peer interaction.

    Science.gov (United States)

    Thrasher, Amy

    2014-11-01

    This article describes an intervention program offered at the University of Colorado Boulder that supports peer interaction among young children with autism spectrum disorders and their typical peers using a multicomponent approach, including video modeling. Characteristics of autism that may interfere with the development of peer interaction in young children will be discussed. Components of the approach will be described and the evidence base for the application of these components examined in regards to children with autism and for the potential application to children with the dual diagnosis of autism and deafness or hard of hearing. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  15. An integrative model of risk for high school disordered eating.

    Science.gov (United States)

    Davis, Heather A; Smith, Gregory T

    2018-06-21

    Binge eating and purging behaviors are associated with significant harm and distress among adolescents. The process by which these behaviors develop (often in the high school years) is not fully understood. We tested the Acquired Preparedness (AP) model of risk involving transactions among biological, personality, and psychosocial factors to predict binge eating and purging behavior in a sample of 1,906 children assessed in the spring of 5th grade (the last year of elementary school), the fall of 6th grade (the first year of middle school), spring of 6th grade, and spring of 10th grade (second year of high school). Pubertal onset in spring of 5th grade predicted increases in negative urgency, but not negative affect, in the fall of 6th grade. Negative urgency in the fall of 6th grade predicted increases in expectancies for reinforcement from eating in the spring of 6th grade, which in turn predicted increases in binge eating behavior in the spring of 10th grade. Negative affect in the fall of 6th grade predicted increases in thinness expectancies in the spring of 6th grade, which in turn predicted increases in purging in the spring of 10th grade. Results demonstrate similarities and differences in the development of these two different bulimic behaviors. Intervention efforts targeting the risk factors evident in this model may prove fruitful in the treatment of eating disorders characterized by binge eating and purging. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  16. Dual-task study of cognitive and postural interference: a preliminary investigation of the automatization deficit hypothesis of developmental co-ordination disorder.

    Science.gov (United States)

    Tsai, C-L; Pan, C-Y; Cherng, R-J; Wu, S-K

    2009-07-01

    The purpose of this study was to investigate whether children with developmental co-ordination disorder and balance problem (DCD-BP) had greater problems than controls in performing a primary balance task while concurrently completing different cognitive tasks varying in oral or listening cognitive complexity, as well as to investigate the automatization deficit hypothesis of DCD-BP. Children with DCD-BP (n= 39), along with age-matched control counterparts (n= 39), were placed on automatic processing situation under dual-task conditions. All children were required to perform a primary task, five dual-task paradigms (oral counting task, auditory-verbal reaction task, auditory-choice reaction task, auditory-memory task and articulation alone) and an eyes-closed balancing task. In the primary task condition, the differences were not statistically significant (P= 0.393) between children with and without DCD-BP. However, children with DCD-BP were significantly more impaired on three of five dual-task conditions (oral counting task: P= 0.003; auditory-verbal reaction task: P= 0.011; auditory-memory task: P= 0.041) compared with the single-task situation, with the exception of the auditory-choice reaction task (P= 0.471) and articulation alone (P= 0.067). These results suggest that children with DCD-BP were more cognitively dependant and may have an automatization deficit.

  17. Interhemispheric functional disconnection because of abnormal corpus callosum integrity in bipolar disorder type II.

    Science.gov (United States)

    Yasuno, Fumihiko; Kudo, Takashi; Matsuoka, Kiwamu; Yamamoto, Akihide; Takahashi, Masato; Nakagawara, Jyoji; Nagatsuka, Kazuyuki; Iida, Hidehiro; Kishimoto, Toshifumi

    2016-11-01

    A significantly lower fractional anisotropy (FA) value has been shown in anterior parts of the corpus callosum in patients with bipolar disorder. We investigated the association between abnormal corpus callosum integrity and interhemispheric functional connectivity (IFC) in patients with bipolar disorder. We examined the association between FA values in the corpus callosum (CC-FA) and the IFC between homotopic regions in the anterior cortical structures of bipolar disorder ( n =16) and major depressive disorder ( n =22) patients with depressed or euthymic states. We found a positive correlation between the CC-FA and IFC values between homotopic regions of the ventral prefrontal cortex and insula cortex, and significantly lower IFC between these regions in bipolar disorder patients. The abnormal corpus callosum integrity in bipolar disorder patients is relevant to the IFC between homotopic regions, possibly disturbing the exchange of emotional information between the cerebral hemispheres resulting in emotional dysregulation. None. © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

  18. Violence Survivors with Posttraumatic Stress Disorder: Treatment by Integrating Existential and Narrative Therapies

    Science.gov (United States)

    Day, Kristen W.

    2009-01-01

    In this article, the author proposes an integration of existential and narrative therapies with current evidence-supported approaches to treating the aforementioned population. First, she briefly defines interpersonal violence, then provides a history and review of the diagnostic criteria for Posttraumatic Stress Disorder (PTSD), which frequently…

  19. Path integral methods for the dynamics of stochastic and disordered systems

    DEFF Research Database (Denmark)

    Hertz, John A.; Roudi, Yasser; Sollich, Peter

    2017-01-01

    We review some of the techniques used to study the dynamics of disordered systems subject to both quenched and fast (thermal) noise. Starting from the Martin–Siggia–Rose/Janssen–De Dominicis–Peliti path integral formalism for a single variable stochastic dynamics, we provide a pedagogical survey...

  20. Neural basis of limb ownership in individuals with body integrity identity disorder

    NARCIS (Netherlands)

    van Dijk, Milenna T.; van Wingen, Guido A.; van Lammeren, Anouk; Blom, Rianne M.; de Kwaasteniet, Bart P.; Scholte, H. Steven; Denys, Damiaan

    2013-01-01

    Our body feels like it is ours. However, individuals with body integrity identity disorder (BIID) lack this feeling of ownership for distinct limbs and desire amputation of perfectly healthy body parts. This extremely rare condition provides us with an opportunity to study the neural basis

  1. Self-amputation of a healthy hand: a case of body integrity identity disorder.

    Science.gov (United States)

    Sorene, E D; Heras-Palou, C; Burke, F D

    2006-12-01

    A case report is presented of self-amputation of a healthy hand. We have reviewed the literature and seek to broaden the scope of understanding of Body Integrity Identity Disorder. This rare condition can constitute a pitfall for the unsuspecting hand surgeon.

  2. Integrative psychotherapy model for treatment of Depressive Recurrent disorder without psychotic symptoms effectiveness.

    Directory of Open Access Journals (Sweden)

    Joaquín F. Márquez Pérez

    2010-10-01

    Full Text Available The investigation shows the results of the application of an integrative psychotherapy model in the treatment of Depressive Recurrent disorder without psychotic symptoms. The use of a design of a qualitative Investigation - Action was necessary for finding the psychological mechanism that explain different levels of effectiveness.

  3. Advancing early detection of autism spectrum disorder by applying an integrated two-stage screening approach

    NARCIS (Netherlands)

    Oosterling, Iris J.; Wensing, Michel; Swinkels, Sophie H.; van der Gaag, Rutger Jan; Visser, Janne C.; Woudenberg, Tim; Minderaa, Ruud; Steenhuis, Mark-Peter; Buitelaar, Jan K.

    Background: Few field trials exist on the impact of implementing guidelines for the early detection of autism spectrum disorders (ASD). The aims of the present study were to develop and evaluate a clinically relevant integrated early detection programme based on the two-stage screening approach of

  4. Preschool language interventions for latino dual language learners with language disorders: what, in what language, and how.

    Science.gov (United States)

    Simon-Cereijido, Gabriela

    2015-05-01

    About a quarter of young children in the United States are dual language learners. The large majority are Latino children who are exposed to Spanish in their homes. The language needs of Latino dual language preschoolers are different from the needs of monolingual English-speaking children. As a group, they are likely to live in environments that put them at risk of delays in language development. This situation is direr for dual language preschoolers with language impairment. Recent findings from studies on interventions for Spanish-English preschoolers with language impairment suggest that a bilingual approach does not delay English vocabulary and oral language learning and promotes Spanish maintenance. Targets and strategies for different language domains are described. The effects of pullout versus push-in interventions for this population are preliminarily explored. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  5. Evaluation of plasma cytokines in patients with cocaine use disorders in abstinence identifies transforming growth factor alpha (TGFα as a potential biomarker of consumption and dual diagnosis

    Directory of Open Access Journals (Sweden)

    Rosa Maza-Quiroga

    2017-10-01

    Full Text Available Background Cocaine use disorder (CUD is a complex health condition, especially when it is accompanied by comorbid psychiatric disorders (dual diagnosis. Dual diagnosis is associated with difficulties in the stratification and treatment of patients. One of the major challenges in clinical practice of addiction psychiatry is the lack of objective biological markers that indicate the degree of consumption, severity of addiction, level of toxicity and response to treatment in patients with CUD. These potential biomarkers would be fundamental players in the diagnosis, stratification, prognosis and therapeutic orientation in addiction. Due to growing evidence of the involvement of the immune system in addiction and psychiatric disorders, we tested the hypothesis that patients with CUD in abstinence might have altered circulating levels of signaling proteins related to systemic inflammation. Methods The study was designed as a cross-sectional study of CUD treatment-seeking patients. These patients were recruited from outpatient programs in the province of Malaga (Spain. The study was performed with a total of 160 white Caucasian subjects, who were divided into the following groups: patients diagnosed with CUD in abstinence (N = 79, cocaine group and matched control subjects (N = 81, control group. Participants were clinically evaluated with the diagnostic interview PRISM according to the DSM-IV-TR, and blood samples were collected for the determination of chemokine C-C motif ligand 11 (CCL11, eotaxin-1, interferon gamma (IFNγ, interleukin-4 (IL-4, interleukin-8 (IL-8, interleukin-17α (IL-17α, macrophage inflammatory protein 1α (MIP-1α and transforming growth factor α (TGFα levels in the plasma. Clinical and biochemical data were analyzed in order to find relationships between variables. Results While 57% of patients with CUD were diagnosed with dual diagnosis, approximately 73% of patients had other substance use disorders. Cocaine patients

  6. Difficulties of familes in caring for children and adolescents with mental disorders: an integrative review

    Directory of Open Access Journals (Sweden)

    Lany Leide de Castro Rocha Campelo

    2014-08-01

    Full Text Available Objective To identify the difficulties of families with children and/or adolescents with mental disorder. Method This is an integrative review. In December 2013, an electronic search was performed on Latin American Caribbean Literature on Health Sciences databases (LILACS and on Electronic Medicus Index of the National Library of Medicine (MEDLINE indexed in the Health Virtual Library (BVS using a combination of descriptors and boolean operators as follows: mental disorders and child or adolescent and caregivers and/not health staff. Results 557 studies were identified, of which 15 were selected for this study. The findings indicated difficulties related to the care for or to interaction with children/adolescents with mental disorder. Conclusion The studies revealed difficulties related to everyday practices of care and feelings expressed during care practices, as well as in relationships with children or adolescents with mental disorder.

  7. Limb amputations in fixed dystonia: a form of body integrity identity disorder?

    Science.gov (United States)

    Edwards, Mark J; Alonso-Canovas, Araceli; Schrag, Arnette; Bloem, Bastiaan R; Thompson, Philip D; Bhatia, Kailash

    2011-07-01

    Fixed dystonia is a disabling disorder mainly affecting young women who develop fixed abnormal limb postures and pain after apparently minor peripheral injury. There is continued debate regarding its pathophysiology and management. We report 5 cases of fixed dystonia in patients who sought amputation of the affected limb. We place these cases in the context of previous reports of patients with healthy limbs and patients with chronic regional pain syndrome who have sought amputation. Our cases, combined with recent data regarding disorders of mental rotation in patients with fixed dystonia, as well as previous data regarding body integrity identity disorder and amputations sought by patients with chronic regional pain syndrome, raise the possibility that patients with fixed dystonia might have a deficit in body schema that predisposes them to developing fixed dystonia and drives some to seek amputation. The outcome of amputation in fixed dystonia is invariably unfavorable. Copyright © 2011 Movement Disorder Society.

  8. Gabor-domain optical coherence microscopy with integrated dual-axis MEMS scanner for fast 3D imaging and metrology

    Science.gov (United States)

    Canavesi, Cristina; Cogliati, Andrea; Hayes, Adam; Santhanam, Anand P.; Tankam, Patrice; Rolland, Jannick P.

    2015-10-01

    Fast, robust, nondestructive 3D imaging is needed for characterization of microscopic structures in industrial and clinical applications. A custom micro-electromechanical system (MEMS)-based 2D scanner system was developed to achieve 55 kHz A-scan acquisition in a Gabor-domain optical coherence microscopy (GD-OCM) instrument with a novel multilevel GPU architecture for high-speed imaging. GD-OCM yields high-definition volumetric imaging with dynamic depth of focusing through a bio-inspired liquid lens-based microscope design, which has no moving parts and is suitable for use in a manufacturing setting or in a medical environment. A dual-axis MEMS mirror was chosen to replace two single-axis galvanometer mirrors; as a result, the astigmatism caused by the mismatch between the optical pupil and the scanning location was eliminated and a 12x reduction in volume of the scanning system was achieved. Imaging at an invariant resolution of 2 μm was demonstrated throughout a volume of 1 × 1 × 0.6 mm3, acquired in less than 2 minutes. The MEMS-based scanner resulted in improved image quality, increased robustness and lighter weight of the system - all factors that are critical for on-field deployment. A custom integrated feedback system consisting of a laser diode and a position-sensing detector was developed to investigate the impact of the resonant frequency of the MEMS and the driving signal of the scanner on the movement of the mirror. Results on the metrology of manufactured materials and characterization of tissue samples with GD-OCM are presented.

  9. Dual Income Taxes

    DEFF Research Database (Denmark)

    Sørensen, Peter Birch

    This paper discusses the principles and practices of dual income taxation in the Nordic countries. The first part of the paper explains the rationale and the historical background for the introduction of the dual income tax and describes the current Nordic tax practices. The second part...... of the paper focuses on the problems of taxing income from small businesses and the issue of corporate-personal tax integration under the dual income tax, considering alternative ways of dealing with these challenges. In the third and final part of the paper, I briefly discuss whether introducing a dual income...

  10. Integrating care for neurodevelopmental disorders by unpacking control: A grounded theory study

    Directory of Open Access Journals (Sweden)

    Gustaf Waxegård

    2016-09-01

    Full Text Available Background: To establish integrated healthcare pathways for patients with neurodevelopmental disorders (ND such as autism spectrum disorder and attention-deficit hyperactivity disorder is challenging. This study sets out to investigate the main concerns for healthcare professionals when integrating ND care pathways and how they resolve these concerns. Methods: Using classic grounded theory (Glaser, we analysed efforts to improve and integrate an ND care pathway for children and youth in a Swedish region over a period of 6 years. Data from 42 individual interviews with a range of ND professionals, nine group interviews with healthcare teams, participant observation, a 2-day dialogue conference, focus group meetings, regional media coverage, and reports from other Swedish regional ND projects were analysed. Results: The main concern for participants was to deal with overwhelming ND complexity by unpacking control, which is control over strategies to define patients’ status and needs. Unpacking control is key to the professionals’ strivings to expand constructive life space for patients, to squeeze health care to reach available care goals, to promote professional ideologies, and to uphold workplace integrity. Control-seeking behaviour in relation to ND unpacking is ubiquitous and complicates integration of ND care pathways. Conclusions: The Unpacking control theory expands central aspects of professions theory and may help to improve ND care development.

  11. Integrating care for neurodevelopmental disorders by unpacking control: A grounded theory study

    Science.gov (United States)

    Waxegård, Gustaf; Thulesius, Hans

    2016-01-01

    Background To establish integrated healthcare pathways for patients with neurodevelopmental disorders (ND) such as autism spectrum disorder and attention-deficit hyperactivity disorder is challenging. This study sets out to investigate the main concerns for healthcare professionals when integrating ND care pathways and how they resolve these concerns. Methods Using classic grounded theory (Glaser), we analysed efforts to improve and integrate an ND care pathway for children and youth in a Swedish region over a period of 6 years. Data from 42 individual interviews with a range of ND professionals, nine group interviews with healthcare teams, participant observation, a 2-day dialogue conference, focus group meetings, regional media coverage, and reports from other Swedish regional ND projects were analysed. Results The main concern for participants was to deal with overwhelming ND complexity by unpacking control, which is control over strategies to define patients’ status and needs. Unpacking control is key to the professionals’ strivings to expand constructive life space for patients, to squeeze health care to reach available care goals, to promote professional ideologies, and to uphold workplace integrity. Control-seeking behaviour in relation to ND unpacking is ubiquitous and complicates integration of ND care pathways. Conclusions The Unpacking control theory expands central aspects of professions theory and may help to improve ND care development. PMID:27609793

  12. Development of an integrated model of personality, personality disorders and severe axis I disorders, with special reference to major affective disorders.

    Science.gov (United States)

    von Zerssen, Detlev

    2002-04-01

    A unidimensional model of the relationships between normal temperament, psychopathic variants of it and the two main forms of so-called endogenous psychoses (major affective disorders and schizophrenia) was derived from Kretschmer's constitutional typology. It was, however, not confirmed by means of a biometric approach nor was Kretschmer's broad concept of cyclothymia as a correlate of physical stoutness on the one hand and major affective disorders on the other supported by empirical data. Yet the concept of the 'melancholic type' of personality of patients with severe unipolar major depression (melancholia) which resembles descriptions by psychoanalysts could be corroborated. This was also true for the 'manic type' of personality as a (premorbid) correlate of predominantly manic forms of a bipolar I disorder. As predicted from a spectrum concept of major affective disorders, the ratio of traits of either type co-varied with the ratio of the depressive and the manic components in the long-term course of such a disorder. The two types of premorbid personality and a rare variant of the 'manic type', named 'relaxed, easy-going type', were conceived as 'affective types' dominating in major affective disorders. They are opposed to three 'neurotoid types' prevailing in so-called neurotic disorders as well as in schizophrenic psychoses. The similarity among the types can be visualized as spatial relationships in a circular, i.e. a two-dimensional, model (circumplex). Personality disorders as maladapted extreme variants of personality are, by definition, located outside the circle, mainly along its 'neurotoid' side. However, due to their transitional nature, axis I disorders cannot be represented adequately within the plane which represents (adapted as well as maladapted) forms of habitual behaviour (personality types and disorders, respectively). To integrate them into the spatial model of similarity interrelations, a dimension of actual psychopathology has to be added

  13. [Effectiveness of an integrated treatment for severe personality disorders. A 36-month pragmatic follow-up].

    Science.gov (United States)

    Lana, Fernando; Sánchez-Gil, Carmen; Ferrer, Laia; López-Patón, Nuria; Litvan, Lia; Marcos, Susana; Sierra, Ana C; Soldevilla, Joan M; Feixas, Guillem; Pérez, Víctor

    2015-01-01

    Over the past 25 years, several studies have shown the efficacy of a number of psychological interventions for severe personality disorders. However, the generalizability of these positive results from long traditional research settings to more ordinary ones has been questioned, requiring a need for replication in pragmatic studies. This pragmatic study compares hospitalizations and Emergency Room visits before and during a 6-month therapeutic program for severe personality disorders, and at 36 months after starting it. The therapeutic program, which integrates several specific interventions within a coherent framework, was carried out in an ordinary clinical setting. Fifty-one patients, evaluated according DSM-IV criteria by using the Spanish version of the Structured Clinical Interview for Personality Disorders (SCID-II), were included. The clinical characteristics showed a group of severely disturbed patients, of which 78.4% met criteria for borderline personality disorder. The percentage of patients hospitalized and visiting the Emergency Room, as well as the number of days of hospitalization and Emergency Room visits was significantly reduced during the treatment, and this improvement was maintained throughout. An integrated treatment for severe personality disorders could be effective in preventing reliance on readmissions, or prolonged hospital stays, when it is implemented by clinicians in ordinary clinical settings. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.

  14. Contraceptive Choice and Use of Dual Protection Among Women Living with HIV in Canada: Priorities for Integrated Care.

    Science.gov (United States)

    Kaida, Angela; Patterson, Sophie; Carter, Allison; Loutfy, Mona; Ding, Erin; Sereda, Paul; Webster, Kath; Pick, Neora; Kestler, Mary; de Pokomandy, Alexandra

    2017-12-01

    Preventing unintended pregnancy and HIV transmission is important for women with HIV, but little is known about their contraceptive use, particularly under current antiretroviral therapy (ART) recommendations for treatment and prevention. The prevalence of contraceptive use and of dual protection was examined among 453 sexually active women with HIV aged 16-49 and enrolled in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study in 2013-2015; multivariable logistic regression was used to identify correlates of use. Two definitions of dual protection were assessed: the World Health Organization (WHO) definition (consistent condom use alongside another effective method) and an expanded definition (consistent condom use or a suppressed HIV viral load alongside an effective method). Overall, 73% of women used effective contraceptives, primarily male condoms (45%) or tubal ligation (19%). Eighteen percent practiced WHO-defined dual protection, and 40% practiced dual protection according to the expanded definition. Characteristics positively associated with contraceptive use were younger age, having been pregnant, being heterosexual, being unaware of ART's HIV prevention benefits and having had partners of unknown HIV status (odds ratios, 1.1-6.7). Younger age and perceived inability to become pregnant were positively associated with both definitions of dual protection (1.04-3.3); additionally, WHO-defined dual protection was associated with perceiving HIV care to be women-centered and having had partners of unknown HIV status (2.0-4.1), and dual protection under the expanded definition was related to having been pregnant (2.7). Future research should explore how sustained ART and broader contraceptive options can support women's sexual and reproductive health care needs. Copyright © 2017 by the Guttmacher Institute.

  15. Integrating cut-and-solve and semi-Lagrangean based dual ascent for the single-source capacitated facility location problem

    DEFF Research Database (Denmark)

    Gadegaard, Sune Lauth

    polytope with generalized upper bounds. From our computational study, we show that the semi-Lagrangean relaxation approach has its merits when the instances are tightly constrained with regards to the capacity of the system, but that it is very hard to compete with a standalone implementation of the cut......This paper describes how the cut-and-solve framework and semi-Lagrangean based dual ascent algorithms can be integrated in two natural ways in order to solve the single source capacitated facility location problem. The first uses the cut-and-solve framework both as a heuristic and as an exact...... solver for the semi-Lagrangean subproblems. The other uses a semi-Lagrangean based dual ascent algorithm to solve the sparse problems arising in the cut-and-solve algorithm. Furthermore, we developed a simple way to separate a special type of cutting planes from what we denote the effective capacity...

  16. Prescription drug monitoring program data tracking of opioid addiction treatment outcomes in integrated dual diagnosis care involving injectable naltrexone.

    Science.gov (United States)

    Sajid, Ayesha; Whiteman, Aaron; Bell, Richard L; Greene, Marion S; Engleman, Eric A; Chambers, R Andrew

    2016-10-01

    Fourfold increases in opioid prescribing and dispensations over 2 decades in the U.S. has paralleled increases in opioid addictions and overdoses, requiring new preventative, diagnostic, and treatment strategies. This study examines Prescription Drug Monitoring Program (PDMP) tracking as a novel measure of opioid addiction treatment outcomes in a university-affiliated integrated mental health-addiction treatment clinic. Repeated measure parametrics examined PDMP and urine drug screening (UDS) data before and after first injection for all patients (N = 68) who received at least one long-acting naltrexone injection (380 mg/IM) according to diagnostic groupings of having either (i) alcohol (control); (ii) opioid; or (iii) combined alcohol and opioid use disorders. There were no group differences post-injection in treatment days, injections delivered, or treatment service encounters. UDS and PDMP measures of opioid exposures were greater in opioid compared to alcohol-only patients. Post-first injection, UDS's positive for opioids declined (p opioid prescriptions (p Opioid patients without alcohol disorders showed the best outcomes with 50% to 80% reductions in PDMP-measures of opioids, down to levels of alcohol-only patients. This study shows PDMP utility for measuring opioid addiction treatment outcomes, supporting the routine use of PDMPs in clinical and research settings. These findings demonstrate that opioid addiction in patients with complex addictions and mental illnesses comorbidities can show effective treatment responses as measured by PDMP tracking of decreases in opioid prescriptions to those patients. (Am J Addict 2016;25:557-564). © 2016 The Authors. The American Journal on Addictions Published by Wiley Periodicals, Inc. on behalf of The American Academy of Addiction Psychiatry (AAAP).

  17. Amputees by choice: body integrity identity disorder and the ethics of amputation.

    Science.gov (United States)

    Bayne, Tim; Levy, Neil

    2005-01-01

    Should surgeons be permitted to amputate healthy limbs if patients request such operations? We argue that if such patients are experiencing significant distress as a consequence of the rare psychological disorder named Body Integrity Identity Disorder (BIID), such operations might be permissible. We examine rival accounts of the origins of the desire for healthy limb amputations and argue that none are as plausible as the BIID hypothesis. We then turn to the moral arguments against such operations, and argue that on the evidence available, none is compelling. BIID sufferers meet reasonable standards for rationality and autonomy: so as long as no other effective treatment for their disorder is available, surgeons ought to be allowed to accede to their requests.

  18. Path integral methods for the dynamics of stochastic and disordered systems

    International Nuclear Information System (INIS)

    Hertz, John A; Roudi, Yasser; Sollich, Peter

    2017-01-01

    We review some of the techniques used to study the dynamics of disordered systems subject to both quenched and fast (thermal) noise. Starting from the Martin–Siggia–Rose/Janssen–De Dominicis–Peliti path integral formalism for a single variable stochastic dynamics, we provide a pedagogical survey of the perturbative, i.e. diagrammatic, approach to dynamics and how this formalism can be used for studying soft spin models. We review the supersymmetric formulation of the Langevin dynamics of these models and discuss the physical implications of the supersymmetry. We also describe the key steps involved in studying the disorder-averaged dynamics. Finally, we discuss the path integral approach for the case of hard Ising spins and review some recent developments in the dynamics of such kinetic Ising models. (topical review)

  19. An Integrative Approach to Treatment-Resistant Obsessive-Compulsive Disorder.

    Science.gov (United States)

    Woon, Luke Sy-Cherng; Kanapathy, Anita; Zakaria, Hazli; Alfonso, César A

    2017-01-01

    Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder that often runs a chronic unremitting course. Treatment outcomes can be unsatisfactory despite the availability of various somatic and psychological therapies. Psychodynamic psychotherapy in combination with cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) could help patients with treatment-resistant OCD achieve better outcomes. An integrative approach can help patients gain insight, strengthen the therapeutic alliance, improve treatment adherence, and provide symptomatic relief when other treatments seem insufficient or have failed. We describe the treatment process of a person with treatment-resistant OCD who received pharmacotherapy, concurrent CBT/ERP, and a brief course of psychodynamic psychotherapy. Case formulations from cognitive behavioral and psychodynamic perspectives are presented. The authors discuss the advantages of doing a psychodynamic assessment and formulation in treatment refractory cases and the wisdom of integrating psychotherapy interventions for OCD, as well as the unique clinical features of cases that warrant a multimodal treatment approach.

  20. Integrating the participants' perspective in the study of language and communcation disorders

    DEFF Research Database (Denmark)

    Klemmensen, Charlotte Marie Bisgaard

    This book presents a new analytical approach that will advance the establishment of a new discourse within the study of language and communication disorders. Instances of recurring aphasia and acquired brain injury are discussed in an empirical observation study through a theoretical lens that co...... that combines Integrational linguistics, Ethnomethodology and Conversation analysis and Practice theory. In doing so, this interdisciplinary analysis adds a person-centered perspective to existing ethnographic approaches. It addresses a significant gap in our understanding of the social...

  1. Neural Basis of Limb Ownership in Individuals with Body Integrity Identity Disorder

    OpenAIRE

    van Dijk, Milenna T.; van Wingen, Guido A.; van Lammeren, Anouk; Blom, Rianne M.; de Kwaasteniet, Bart P.; Scholte, H. Steven; Denys, Damiaan

    2013-01-01

    Our body feels like it is ours. However, individuals with body integrity identity disorder (BIID) lack this feeling of ownership for distinct limbs and desire amputation of perfectly healthy body parts. This extremely rare condition provides us with an opportunity to study the neural basis underlying the feeling of limb ownership, since these individuals have a feeling of disownership for a limb in the absence of apparent brain damage. Here we directly compared brain activation between limbs ...

  2. [Body integrity identity disorder--first success in long-term psychotherapy].

    Science.gov (United States)

    Thiel, Aylin; Ehni, Franziska J F; Oddo, Silvia; Stirn, Aglaja

    2011-07-01

    The Body Integrity Identity Disorder (BIID) is a fairly unknown and unexplored psychic illness. Very little cases underwent a psychotherapeutic treatment. We report on the two-and-a-half year psychotherapy with a 37 years old man, who wants an amputation of his two legs. Origin and meaning of the amputation desire were uncovered in psychotherapy. The psychodynamic oriented therapy with cognitive-behavioral elements can be used to develop further treatment approaches. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Social support networks and eating disorders: an integrative review of the literature

    OpenAIRE

    Leonidas, Carolina; dos Santos, Manoel Antônio

    2014-01-01

    Carolina Leonidas, Manoel Antônio dos Santos Department of Psychology, Faculty of Philosophy, Sciences and Letters of Ribeirão Preto, University of São Paulo, Brazil Aims: This study aimed to analyze the scientific literature about social networks and social support in eating disorders (ED). Methods: By combining keywords, an integrative review was performed. It included publications from 2006–2013, retrieved from the MEDLINE, LILACS, PsycINFO, an...

  4. Integrating genetic and toxicogenomic information for determining underlying susceptibility to developmental disorders.

    Science.gov (United States)

    Robinson, Joshua F; Port, Jesse A; Yu, Xiaozhong; Faustman, Elaine M

    2010-10-01

    To understand the complex etiology of developmental disorders, an understanding of both genetic and environmental risk factors is needed. Human and rodent genetic studies have identified a multitude of gene candidates for specific developmental disorders such as neural tube defects (NTDs). With the emergence of toxicogenomic-based assessments, scientists now also have the ability to compare and understand the expression of thousands of genes simultaneously across strain, time, and exposure in developmental models. Using a systems-based approach in which we are able to evaluate information from various parts and levels of the developing organism, we propose a framework for integrating genetic information with toxicogenomic-based studies to better understand gene-environmental interactions critical for developmental disorders. This approach has allowed us to characterize candidate genes in the context of variables critical for determining susceptibility such as strain, time, and exposure. Using a combination of toxicogenomic studies and complementary bioinformatic tools, we characterize NTD candidate genes during normal development by function (gene ontology), linked phenotype (disease outcome), location, and expression (temporally and strain-dependent). In addition, we show how environmental exposures (cadmium, methylmercury) can influence expression of these genes in a strain-dependent manner. Using NTDs as an example of developmental disorder, we show how simple integration of genetic information from previous studies into the standard microarray design can enhance analysis of gene-environment interactions to better define environmental exposure-disease pathways in sensitive and resistant mouse strains. © Wiley-Liss, Inc.

  5. Aspects of Piaget's cognitive developmental psychology and neurobiology of psychotic disorders - an integrative model.

    Science.gov (United States)

    Gebhardt, Stefan; Grant, Phillip; von Georgi, Richard; Huber, Martin T

    2008-09-01

    Psychological, neurobiological and neurodevelopmental approaches have frequently been used to provide pathogenic concepts on psychotic disorders. However, aspects of cognitive developmental psychology have hardly been considered in current models. Using a hypothesis-generating approach an integration of these concepts was conducted. According to Piaget (1896-1980), assimilation and accommodation as forms of maintenance and modification of cognitive schemata represent fundamental processes of the brain. In general, based on the perceived input stimuli, cognitive schemata are developed resulting in a conception of the world, the realistic validity and the actuality of which is still being controlled and modified by cognitive adjustment processes. In psychotic disorders, however, a disproportion of environmental demands and the ability to activate required neuronal adaptation processes occurs. We therefore hypothesize a failure of the adjustment of real and requested output patterns. As a consequence autonomous cognitive schemata are generated, which fail to adjust with reality resulting in psychotic symptomatology. Neurobiological, especially neuromodulatory and neuroplastic processes play a central role in these perceptive and cognitive processes. In conclusion, integration of cognitive developmental psychology into the existing pathogenic concepts of psychotic disorders leads to interesting insights into basic disease mechanisms and also guides future research in the cognitive neuroscience of such disorders.

  6. Self-wise, Other-wise, Streetwise (SOS) training: a novel intervention to reduce victimization in dual diagnosis psychiatric patients with substance use disorders: protocol for a randomized controlled trial

    NARCIS (Netherlands)

    de Waal, M.M.; Kikkert, M.J.; Blankers, M.; Dekker, J.J.M.; Goudriaan, A.E.

    2015-01-01

    Background: Psychiatric patients are more likely to be victims of crime than others in the community. Dual diagnosis patients with comorbid psychiatric and substance use disorders are especially prone to victimization. Victimization is associated with substance abuse, more severe symptomatology and

  7. Body integrity identity disorder crosses culture: case reports in the Japanese and Chinese literature.

    Science.gov (United States)

    Blom, Rianne M; Vulink, Nienke C; van der Wal, Sija J; Nakamae, Takashi; Tan, Zhonglin; Derks, Eske M; Denys, Damiaan

    2016-01-01

    Body integrity identity disorder (BIID) is a condition in which people do not perceive a part of their body as their own, which results in a strong desire for amputation or paralyzation. The disorder is likely to be congenital due to its very early onset. The English literature describes only Western patients with BIID, suggesting that the disorder might be merely prevalent in the West. To scrutinize this assumption, and to extend our knowledge of the etiology of BIID, it is important to trace cases with BIID in non-Western populations. Our objective was to review Chinese and Japanese literature on BIID to learn about its presence in populations with a different genetic background. A systematic literature search was performed in databases containing Japanese and Chinese research, published in the respective languages. Five Japanese articles of BIID were identified which described two cases of BIID, whereas in the Chinese databases only BIID-related conditions were found. This article reports some preliminary evidence that BIID is also present in non-Western countries. However, making general statements about the biological background of the disorder is hampered by the extremely low number of cases found. This low number possibly resulted from the extreme secrecy associated with the disorder, perhaps even more so in Asian countries.

  8. Management of "dual diagnosis" patients : consensus, controversies and considerations.

    Science.gov (United States)

    Basu, D; Gupta, N

    2000-01-01

    The term 'dual diagnosis' denotes the coexistence of substance use disorder(s) and other, non-substance-use, psychiatric disorder(s). The last two decades, and especially the 1990s, have witnessed tremendous research and clinical interest in this previously neglected area. India, however, lags behind, inspite of indications that the problem exists here too. The current approach to managing such patients is the 'integrated treatment model' in which the same clinician (or team of clinicians) provides treatment for both the disorders at the same time, treating both with equal understanding and importance. Both pharmacotherapy as well as psychosocial therapies are specifically designed keeping in mind the 'integrated' philosophy of treatment. The specific principles and components are described Areas of difficulty, uncertainty, and future considerations are highlighted, with a note on the Indian setting.

  9. Simultaneous detection of multiple DNA targets by integrating dual-color graphene quantum dot nanoprobes and carbon nanotubes.

    Science.gov (United States)

    Qian, Zhaosheng; Shan, Xiaoyue; Chai, Lujing; Chen, Jianrong; Feng, Hui

    2014-12-01

    Simultaneous detection of multiple DNA targets was achieved based on a biocompatible graphene quantum dots (GQDs) and carbon nanotubes (CNTs) platform through spontaneous assembly between dual-color GQD-based probes and CNTs and subsequently self-recognition between DNA probes and targets. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  10. Fetzima (levomilnacipran), a drug for major depressive disorder as a dual inhibitor for human serotonin transporters and beta-site amyloid precursor protein cleaving enzyme-1.

    Science.gov (United States)

    Rizvi, Syed Mohd Danish; Shaikh, Sibhghatulla; Khan, Mahiuddin; Biswas, Deboshree; Hameed, Nida; Shakil, Shazi

    2014-01-01

    Pharmacological management of Major Depressive Disorder includes the use of serotonin reuptake inhibitors which targets serotonin transporters (SERT) to increase the synaptic concentrations of serotonin. Beta-site amyloid precursor protein cleaving enzyme-1 (BACE-1) is responsible for amyloid β plaque formation. Hence it is an interesting target for Alzheimer's disease (AD) therapy. This study describes molecular interactions of a new Food and Drug Administration approved antidepressant drug named 'Fetzima' with BACE-1 and SERT. Fetzima is chemically known as levomilnacipran. The study has explored a possible link between the treatment of Depression and AD. 'Autodock 4.2' was used for docking study. The free energy of binding (ΔG) values for 'levomilnacipran-SERT' interaction and 'levomilnacipran-BACE1' interaction were found to be -7.47 and -8.25 kcal/mol, respectively. Levomilnacipran was found to interact with S438, known to be the most important amino acid residue of serotonin binding site of SERT during 'levomilnacipran-SERT' interaction. In the case of 'levomilnacipran-BACE1' interaction, levomilnacipran interacted with two very crucial aspartic acid residues of BACE-1, namely, D32 and D228. These residues are accountable for the cleavage of amyloid precursor protein and the subsequent formation of amyloid β plaques in AD brain. Hence, Fetzima (levomilnacipran) might act as a potent dual inhibitor of SERT and BACE-1 and expected to form the basis of a future dual therapy against depression and AD. It is an established fact that development of AD is associated with Major Depressive Disorder. Therefore, the design of new BACE-1 inhibitors based on antidepressant drug scaffolds would be particularly beneficial.

  11. Development of an integrated cognitive behavioral therapy for anxiety and opioid use disorder: Study protocol and methods.

    Science.gov (United States)

    McHugh, R Kathryn; Votaw, Victoria R; Barlow, David H; Fitzmaurice, Garrett M; Greenfield, Shelly F; Weiss, Roger D

    2017-09-01

    Opioid use disorder is a highly disabling psychiatric disorder, and is associated with both significant functional disruption and risk for negative health outcomes such as infectious disease and fatal overdose. Even among those who receive evidence-based pharmacotherapy for opioid use disorder, many drop out of treatment or relapse, highlighting the importance of novel treatment strategies for this population. Over 60% of those with opioid use disorder also meet diagnostic criteria for an anxiety disorder; however, efficacious treatments for this common co-occurrence have not be established. This manuscript describes the rationale and methods for a behavioral treatment development study designed to develop and test an integrated cognitive-behavioral therapy for those with co-occurring opioid use disorder and anxiety disorders. The aims of the study are (1) to develop and pilot test a new manualized cognitive behavioral therapy for co-occurring opioid use disorder and anxiety disorders, (2) to test the efficacy of this treatment relative to an active comparison treatment that targets opioid use disorder alone, and (3) to investigate the role of stress reactivity in both prognosis and recovery from opioid use disorder and anxiety disorders. Our overarching aim is to investigate whether this new treatment improves both anxiety and opioid use disorder outcomes relative to standard treatment. Identifying optimal treatment strategies for this population are needed to improve outcomes among those with this highly disabling and life-threatening disorder. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Reducing perceived stigma: Work integration of people with severe mental disorders in Italian social enterprise.

    Science.gov (United States)

    Villotti, Patrizia; Zaniboni, Sara; Corbière, Marc; Guay, Stéphane; Fraccaroli, Franco

    2018-06-01

    People with mental illnesses face stigma that hinders their full integration into society. Work is a major determinant of social inclusion, however, people with mental disorders have fewer opportunities to work. Emerging evidence suggests that social enterprises help disadvantaged people with their work integration process. The purpose of this study is to enhance our understanding about how perceptions of stigma can be decreased for people with mental disorders throughout their work experience in a social enterprise. Using a longitudinal study design, 310 individuals with mental disorders employed in Italian social enterprises completed a battery of questionnaires on individual (e.g., severity of symptoms; occupational self-efficacy) and environmental (e.g., social support; organizational constraints) variables. Of the 223 individuals potentially eligible at the 12-month follow up, 139 completed a battery of questionnaires on social and working skills, perceived work productivity and perceived stigma. Path analyses were used to test a model delineating how people with mental disorders working in social enterprises improve social and work outcomes (i.e., motivation, skills and productivity), and reduce the perception of being stigmatized. Working in a social enterprise enhances working social skills, which leads to a perception of higher productivity and, consequently, the perception of being discriminated against and stigmatized is reduced. Social enterprise provides a context in which people with mental disorders reach a sense of work-related and social competence. This sense of competence helps them to reduce perceived stigma, which is a crucial step toward social inclusion. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  13. Mental disorders and work integration: a retrospective study in a northern italian town.

    Science.gov (United States)

    Buizza, Chiara; Pioli, Rosaria; Lecchi, Sara; Bonetto, Chiara; Bartoli, Anna; Taglietti, Renzo; Ghilardi, Alberto; Riva, Eugenio

    2013-01-01

    THE PRESENT STUDY WAS CONDUCTED IN A VOCATIONAL INTEGRATION SERVICE OF A NORTHERN ITALIAN TOWN WITH TWO MAJOR AIMS: to assess vocational integration programs undertaken from 1(st) January 2004 to 1(st) January 2007; and to identify job tenure-associated predictors. This is a retrospective study; we collected data such as gender, age, duration, type and outcome of the vocational integration program, and number of interventions performed by the vocational integration service. Self-report questionnaires were also used to assess the satisfaction of users, caregivers, practitioners, and of the company contacts involved in the study. The service has enrolled 84 users during the observation period. Out of these users, 64.3% of them still had their jobs after three years. Users, caregivers and company contacts expressed high levels of satisfaction for the support received by the vocational integration service. The company expressed less satisfaction for the collaboration received by the Departments of Mental Health (DMHs) that coached the users. The only variable associated to the outcome was the number of interventions that the users received before their placement on the job. Despite all the limits of this study, its results show that the chance of taking advantage of a supported job placement service has likely proven itself effective in helping people with mental disorders to obtain and maintain a competitive employment. Our results, however, also point to the necessity of implementing newer strategies meant to develop a greater integration among all services dealing with mentally ill people.

  14. Body integrity identity disorder (BIID)--is the amputation of healthy limbs ethically justified?

    Science.gov (United States)

    Müller, Sabine

    2009-01-01

    The term body integrity identity disorder (BIID) describes the extremely rare phenomenon of persons who desire the amputation of one or more healthy limbs or who desire a paralysis. Some of these persons mutilate themselves; others ask surgeons for an amputation or for the transection of their spinal cord. Psychologists and physicians explain this phenomenon in quite different ways; but a successful psychotherapeutic or pharmaceutical therapy is not known. Lobbies of persons suffering from BIID explain the desire for amputation in analogy to the desire of transsexuals for surgical sex reassignment. Medical ethicists discuss the controversy about elective amputations of healthy limbs: on the one hand the principle of autonomy is used to deduce the right for body modifications; on the other hand the autonomy of BIID patients is doubted. Neurological results suggest that BIID is a brain disorder producing a disruption of the body image, for which parallels for stroke patients are known. If BIID were a neuropsychological disturbance, which includes missing insight into the illness and a specific lack of autonomy, then amputations would be contraindicated and must be evaluated as bodily injuries of mentally disordered patients. Instead of only curing the symptom, a causal therapy should be developed to integrate the alien limb into the body image.

  15. Deficits in Visuo-Motor Temporal Integration Impacts Manual Dexterity in Probable Developmental Coordination Disorder.

    Science.gov (United States)

    Nobusako, Satoshi; Sakai, Ayami; Tsujimoto, Taeko; Shuto, Takashi; Nishi, Yuki; Asano, Daiki; Furukawa, Emi; Zama, Takuro; Osumi, Michihiro; Shimada, Sotaro; Morioka, Shu; Nakai, Akio

    2018-01-01

    The neurological basis of developmental coordination disorder (DCD) is thought to be deficits in the internal model and mirror-neuron system (MNS) in the parietal lobe and cerebellum. However, it is not clear if the visuo-motor temporal integration in the internal model and automatic-imitation function in the MNS differs between children with DCD and those with typical development (TD). The current study aimed to investigate these differences. Using the manual dexterity test of the Movement Assessment Battery for Children (second edition), the participants were either assigned to the probable DCD (pDCD) group or TD group. The former was comprised of 29 children with clumsy manual dexterity, while the latter consisted of 42 children with normal manual dexterity. Visuo-motor temporal integration ability and automatic-imitation function were measured using the delayed visual feedback detection task and motor interference task, respectively. Further, the current study investigated whether autism-spectrum disorder (ASD) traits, attention-deficit hyperactivity disorder (ADHD) traits, and depressive symptoms differed among the two groups, since these symptoms are frequent comorbidities of DCD. In addition, correlation and multiple regression analyses were performed to extract factors affecting clumsy manual dexterity. In the results, the delay-detection threshold (DDT) and steepness of the delay-detection probability curve, which indicated visuo-motor temporal integration ability, were significantly prolonged and decreased, respectively, in children with pDCD. The interference effect, which indicated automatic-imitation function, was also significantly reduced in this group. These results highlighted that children with clumsy manual dexterity have deficits in visuo-motor temporal integration and automatic-imitation function. There was a significant correlation between manual dexterity, and measures of visuo-motor temporal integration, and ASD traits and ADHD traits and

  16. An Integrative, Cognitive-Behavioral, Systemic Approach to Working with Students Diagnosed with Attention Deficit Hyperactive Disorder

    Science.gov (United States)

    Shillingford, Margaret Ann; Lambie, Glenn W.; Walter, Sara Meghan

    2007-01-01

    Attention deficit hyperactive disorder (ADHD) is a prevalent diagnostic disorder for many students, which correlates with negative academic, social, and personal consequences. This article presents an integrative, cognitive-behavioral, systemic approach that offers behaviorally based interventions for professional school counselors to support…

  17. Sensory integration dysfunction affects efficacy of speech therapy on children with functional articulation disorders

    Directory of Open Access Journals (Sweden)

    Tung LC

    2013-01-01

    Full Text Available Li-Chen Tung,1,# Chin-Kai Lin,2,# Ching-Lin Hsieh,3,4 Ching-Chi Chen,1 Chin-Tsan Huang,1 Chun-Hou Wang5,6 1Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Tainan, 2Program of Early Intervention, Department of Early Childhood Education, National Taichung University of Education, Taichung, 3School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, 4Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, 5School of Physical Therapy, College of Medical Science and Technology, Chung Shan Medical University, Taichung, 6Physical Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan#These authors contributed equally Background: Articulation disorders in young children are due to defects occurring at a certain stage in sensory and motor development. Some children with functional articulation disorders may also have sensory integration dysfunction (SID. We hypothesized that speech therapy would be less efficacious in children with SID than in those without SID. Hence, the purpose of this study was to compare the efficacy of speech therapy in two groups of children with functional articulation disorders: those without and those with SID.Method: A total of 30 young children with functional articulation disorders were divided into two groups, the no-SID group (15 children and the SID group (15 children. The number of pronunciation mistakes was evaluated before and after speech therapy.Results: There were no statistically significant differences in age, sex, sibling order, education of parents, and pretest number of mistakes in pronunciation between the two groups (P > 0.05. The mean and standard deviation in the pre- and posttest number of mistakes in pronunciation were 10.5 ± 3.2 and 3.3 ± 3.3 in the no-SID group, and 10.1 ± 2.9 and 6.9 ± 3.5 in the SID group, respectively. Results showed great changes after speech therapy treatment (F

  18. Numerical Evaluation of the "Dual-Kernel Counter-flow" Matric Convolution Integral that Arises in Discrete/Continuous (D/C) Control Theory

    Science.gov (United States)

    Nixon, Douglas D.

    2009-01-01

    Discrete/Continuous (D/C) control theory is a new generalized theory of discrete-time control that expands the concept of conventional (exact) discrete-time control to create a framework for design and implementation of discretetime control systems that include a continuous-time command function generator so that actuator commands need not be constant between control decisions, but can be more generally defined and implemented as functions that vary with time across sample period. Because the plant/control system construct contains two linear subsystems arranged in tandem, a novel dual-kernel counter-flow convolution integral appears in the formulation. As part of the D/C system design and implementation process, numerical evaluation of that integral over the sample period is required. Three fundamentally different evaluation methods and associated algorithms are derived for the constant-coefficient case. Numerical results are matched against three available examples that have closed-form solutions.

  19. Hierarchical Fabrication of Engineered Vascularized Bone Biphasic Constructs via Dual 3D Bioprinting: Integrating Regional Bioactive Factors into Architectural Design.

    Science.gov (United States)

    Cui, Haitao; Zhu, Wei; Nowicki, Margaret; Zhou, Xuan; Khademhosseini, Ali; Zhang, Lijie Grace

    2016-09-01

    A biphasic artificial vascularized bone construct with regional bioactive factors is presented using dual 3D bioprinting platform technique, thereby forming a large functional bone grafts with organized vascular networks. Biocompatible mussel-inspired chemistry and "thiol-ene" click reaction are used to regionally immobilize bioactive factors during construct fabrication for modulating or improving cellular events. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. What’s left feels right : Studies in obsessive-compulsive disorder (OCD) and body integrity identity disorder (BIID)

    NARCIS (Netherlands)

    Blom, R.M.

    2017-01-01

    Over the last decade the nosology status of obsessive-compulsive and related disorders has been topic of debate. Whereas in DSM-IV (Diagnostic and Statistical Manual of Mental Disorders IV) obsessive-compulsive disorder (OCD) was classified as an anxiety disorder, in DSM-V it is classified as a

  1. Perceptual Integration Deficits in Autism Spectrum Disorders Are Associated with Reduced Interhemispheric Gamma-Band Coherence.

    Science.gov (United States)

    Peiker, Ina; David, Nicole; Schneider, Till R; Nolte, Guido; Schöttle, Daniel; Engel, Andreas K

    2015-12-16

    The integration of visual details into a holistic percept is essential for object recognition. This integration has been reported as a key deficit in patients with autism spectrum disorders (ASDs). The weak central coherence account posits an altered disposition to integrate features into a coherent whole in ASD. Here, we test the hypothesis that such weak perceptual coherence may be reflected in weak neural coherence across different cortical sites. We recorded magnetoencephalography from 20 adult human participants with ASD and 20 matched controls, who performed a slit-viewing paradigm, in which objects gradually passed behind a vertical or horizontal slit so that only fragments of the object were visible at any given moment. Object recognition thus required perceptual integration over time and, in case of the horizontal slit, also across visual hemifields. ASD participants were selectively impaired in the horizontal slit condition, indicating specific difficulties in long-range synchronization between the hemispheres. Specifically, the ASD group failed to show condition-related enhancement of imaginary coherence between the posterior superior temporal sulci in both hemispheres during horizontal slit-viewing in contrast to controls. Moreover, local synchronization reflected in occipitocerebellar beta-band power was selectively reduced for horizontal compared with vertical slit-viewing in ASD. Furthermore, we found disturbed connectivity between right posterior superior temporal sulcus and left cerebellum. Together, our results suggest that perceptual integration deficits co-occur with specific patterns of abnormal global and local synchronization in ASD. The weak central coherence account proposes a tendency of individuals with autism spectrum disorders (ASDs) to focus on details at the cost of an integrated coherent whole. Here, we provide evidence, at the behavioral and the neural level, that visual integration in object recognition is impaired in ASD, when

  2. Novel spirotetracyclic zwitterionic dual H(1)/5-HT(2A) receptor antagonists for the treatment of sleep disorders.

    Science.gov (United States)

    Gianotti, Massimo; Botta, Maurizio; Brough, Stephen; Carletti, Renzo; Castiglioni, Emiliano; Corti, Corrado; Dal-Cin, Michele; Delle Fratte, Sonia; Korajac, Denana; Lovric, Marija; Merlo, Giancarlo; Mesic, Milan; Pavone, Francesca; Piccoli, Laura; Rast, Slavko; Roscic, Maja; Sava, Anna; Smehil, Mario; Stasi, Luigi; Togninelli, Andrea; Wigglesworth, Mark J

    2010-11-11

    Histamine H(1) and serotonin 5-HT(2A) receptors mediate two different mechanisms involved in sleep regulation: H(1) antagonists are sleep inducers, while 5-HT(2A) antagonists are sleep maintainers. Starting from 9'a, a novel spirotetracyclic compound endowed with good H(1)/5-HT(2A) potency but poor selectivity, very high Cli, and a poor P450 profile, a specific optimization strategy was set up. In particular, we investigated the possibility of introducing appropriate amino acid moieties to optimize the developability profile of the series. Following this zwitterionic approach, we were able to identify several advanced leads (51, 65, and 73) with potent dual H(1)/5-HT(2A) activity and appropriate developability profiles. These compounds exhibited efficacy as hypnotic agents in a rat telemetric sleep model with minimal effective doses in the range 3-10 mg/kg po.

  3. Autism spectrum disorders: Integration of the genome, transcriptome and the environment.

    Science.gov (United States)

    Vijayakumar, N Thushara; Judy, M V

    2016-05-15

    Autism spectrum disorders denote a series of lifelong neurodevelopmental conditions characterized by an impaired social communication profile and often repetitive, stereotyped behavior. Recent years have seen the complex genetic architecture of the disease being progressively unraveled with advancements in gene finding technology and next generation sequencing methods. However, a complete elucidation of the molecular mechanisms behind autism is necessary for potential diagnostic and therapeutic applications. A multidisciplinary approach should be adopted where the focus is not only on the 'genetics' of autism but also on the combinational roles of epigenetics, transcriptomics, immune system disruption and environmental factors that could all influence the etiopathogenesis of the disease. ASD is a clinically heterogeneous disorder with great genetic complexity; only through an integrated multidimensional effort can modern autism research progress further. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Thought disorder in schizophrenia: impairment in contextual processing via integrative failures in cognition.

    Science.gov (United States)

    Patniyot, Nicholas S

    2011-10-01

    Formal thought disorder is a critical dysfunction in schizophrenia whose cause remains uncertain, but whose explanation may greatly further our understanding of the disease. Thought disorder in patients with schizophrenia has been hypothesized to involve a disturbance in the internal representation of context. Positive symptoms of schizophrenia attributable to thought disorder display a lack of organization that may be accounted for by an absence of normal contextual processing occurring within the operations of the executive system. But the precise nature and pervasiveness of the deficient cognitive operation remain undistinguished. It is proposed here that the assimilatory functions of the brain appear to lack the ability to perform a particular type of integrative operation when presented with heterogeneous information. This deficit involves committing cognitive misattributions through a confusion of mental terms via a process in thought analogous to a linguistic failure to correctly interpret deictic referents. Both proposed deficits in mental deixis and analogous "metarepresentational" deficits in schizophrenia potentially involve a failure to draw information for a conclusion from a separate framework of relations in integrative fashion. These deficits appear to involve a failure to take an interpreted piece of information as an output from a particular mental task and incorporate it into a new operational scheme, and a central attribute to the deficit is that there is a loss of an effective or adequate integration of separate strata of information. Potential neurobiological correlates to such a system based on current knowledge about schizophrenia neurocircuitry, as well as implications for testing, are also discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Some dual relations in twistor theory

    International Nuclear Information System (INIS)

    Tarski, J.

    1983-08-01

    The option of employing twistors or dual twistors in integral representations, etc., is considered. In particular, dual-space analyses are presented which relate to the problem of background electromagnetic fields, and to the inverse transformation. (author)

  6. Real-time functional integral approach to the quantum disordered spin systems

    International Nuclear Information System (INIS)

    Kopec, T.K.

    1989-01-01

    In this paper the effect of randomness and frustration in the quantum Ising spin glass in a transverse field is studied by using the thermofield dynamics (TFD), the real time, finite temperature quantum field theory. It is shown that the method can be conveniently used for the averaging of the free energy of the system by completely avoiding the use of the n-replica trick. The effective dynamic Lagrangian for the disorder averaged causal, correlations and response Green functions is derived by functional integral approach. Furthermore, the properties of this Lagrangian are analyzed by the saddle point method which leads to the self-consistent equation for the spin glass order parameter

  7. Many-body-localization: strong disorder perturbative approach for the local integrals of motion

    Science.gov (United States)

    Monthus, Cécile

    2018-05-01

    For random quantum spin models, the strong disorder perturbative expansion of the local integrals of motion around the real-spin operators is revisited. The emphasis is on the links with other properties of the many-body-localized phase, in particular the memory in the dynamics of the local magnetizations and the statistics of matrix elements of local operators in the eigenstate basis. Finally, this approach is applied to analyze the many-body-localization transition in a toy model studied previously from the point of view of the entanglement entropy.

  8. Integrating Art into Group Treatment for Adults with Post-Traumatic Stress Disorder from Childhood Sexual Abuse: A Pilot Study

    Science.gov (United States)

    Becker, Carol-Lynne J.

    2015-01-01

    Current research supports the use of exposure-based treatments for posttraumatic stress disorder (PTSD) and integrated treatments show potential for enhanced symptom reduction. This pilot study developed a manualized group treatment integrating art interventions with exposure, grounding, and narrative therapy for five adults with PTSD who were…

  9. A Comparison of the Development of Audiovisual Integration in Children with Autism Spectrum Disorders and Typically Developing Children

    Science.gov (United States)

    Taylor, Natalie; Isaac, Claire; Milne, Elizabeth

    2010-01-01

    This study aimed to investigate the development of audiovisual integration in children with Autism Spectrum Disorder (ASD). Audiovisual integration was measured using the McGurk effect in children with ASD aged 7-16 years and typically developing children (control group) matched approximately for age, sex, nonverbal ability and verbal ability.…

  10. Integrative Analyses of De Novo Mutations Provide Deeper Biological Insights into Autism Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Atsushi Takata

    2018-01-01

    Full Text Available Recent studies have established important roles of de novo mutations (DNMs in autism spectrum disorders (ASDs. Here, we analyze DNMs in 262 ASD probands of Japanese origin and confirm the “de novo paradigm” of ASDs across ethnicities. Based on this consistency, we combine the lists of damaging DNMs in our and published ASD cohorts (total number of trios, 4,244 and perform integrative bioinformatics analyses. Besides replicating the findings of previous studies, our analyses highlight ATP-binding genes and fetal cerebellar/striatal circuits. Analysis of individual genes identified 61 genes enriched for damaging DNMs, including ten genes for which our dataset now contributes to statistical significance. Screening of compounds altering the expression of genes hit by damaging DNMs reveals a global downregulating effect of valproic acid, a known risk factor for ASDs, whereas cardiac glycosides upregulate these genes. Collectively, our integrative approach provides deeper biological and potential medical insights into ASDs.

  11. A view from Riggs: treatment resistance and patient authority-IX. Integrative psychodynamic treatment of psychotic disorders.

    Science.gov (United States)

    Tillman, Jane G

    2008-01-01

    Psychotic spectrum disorders present treatment challenges for patients, families, and clinicians. This article addresses the history of the dualism in the field between biological and psychological approaches to mental disorders, and surveys the contemporary literature about the etiology and treatment of psychotic spectrum disorders. An integrative approach to treatment derived from work at Austen Riggs with previously treatment refractory patients with psychotic spectrum disorders is described that combines individual psycho- dynamic psychotherapy, psychopharmacology, family systems approaches, and intensive psychosocial engagement. Helping patients develop their own authority to join the treatment, use relationships for learning, and understand the meaning of their symptoms is central to the treatment at Austen Riggs. An extended case vignette of a patient diagnosed with a schizoaffective disorder is presented illustrating this integrative psychodynamic treatment approach.

  12. A Planar, Chip-Based, Dual-Beam Refractometer Using an Integrated Organic Light Emitting Diode (OLED) Light Source and Organic Photovoltaic (OPV) Detectors

    Science.gov (United States)

    Ratcliff, Erin L.; Veneman, P. Alex; Simmonds, Adam; Zacher, Brian; Huebner, Daniel

    2010-01-01

    We present a simple chip-based refractometer with a central organic light emitting diode (OLED) light source and two opposed organic photovoltaic (OPV) detectors on an internal reflection element (IRE) substrate, creating a true dual-beam sensor platform. For first-generation platforms, we demonstrate the use of a single heterojunction OLED based on electroluminescence emission from an Alq3/TPD heterojunction (tris-(8-hydroxyquinoline)aluminum/N,N′-Bis(3-methylphenyl)-N,N′-diphenylbenzidine) and light detection with planar heterojunction pentacene/C60 OPVs. The sensor utilizes the considerable fraction of emitted light from conventional thin film OLEDs that is coupled into guided modes in the IRE instead of into the forward (display) direction. A ray-optics description is used to describe light throughput and efficiency-limiting factors for light coupling from the OLED into the substrate modes, light traversing through the IRE substrate, and light coupling into the OPV detectors. The arrangement of the OLED at the center of the chip provides for two sensing regions, a “sample” and “reference” channel, with detection of light by independent OPV detectors. This configuration allows for normalization of the sensor response against fluctuations in OLED light output, stability, and local fluctuations (temperature) which might influence sensor response. The dual beam configuration permits significantly enhanced sensitivity to refractive index changes relative to single-beam protocols, and is easily integrated into a field-portable instrumentation package. Changes in refractive index (ΔR.I.) between 10−2 and 10−3 R.I. units could be detected for single channel operation, with sensitivity increased to ΔR.I. ≈ 10−4 units when the dual beam configuration is employed. PMID:20218580

  13. What's left feels right: Studies in obsessive-compulsive disorder (OCD) and body integrity identity disorder (BIID).

    OpenAIRE

    Blom, R.M.

    2017-01-01

    Over the last decade the nosology status of obsessive-compulsive and related disorders has been topic of debate. Whereas in DSM-IV (Diagnostic and Statistical Manual of Mental Disorders IV) obsessive-compulsive disorder (OCD) was classified as an anxiety disorder, in DSM-V it is classified as a separate entity with compulsivity as the main symptom. The first part of this thesis consists of studies that contributed to this debate, investigating the prevalence of obsessions in the general popul...

  14. Mapping White Matter Integrity and Neurobehavioral Correlates in Children with Fetal Alcohol Spectrum Disorders

    Science.gov (United States)

    Sowell, Elizabeth R.; Johnson, Arianne; Kan, Eric; Lu, Lisa H.; Van Horn, John Darrell; Toga, Arthur W.; O’Connor, Mary J.; Bookheimer, Susan Y.

    2013-01-01

    Brain structural abnormalities and neurocognitive dysfunction have been observed in individuals with fetal alcohol spectrum disorders (FASDs). Little is known about how white matter integrity is related to these functional and morphological deficits. We used a combination of diffusion tensor and T1-weighted magnetic resonance imaging to evaluate white matter integrity in individuals with FASDs and related these findings to neurocognitive deficits. Seventeen children and adolescents with FASDs were compared with 19 typically developing age-and gender-matched controls. Lower fractional anisotropy (FA) was observed in individuals with FASDs relative to controls in the right lateral temporal lobe and bilaterally in the lateral aspects of the splenium of the corpus callosum. White matter density was also lower in some, but not all regions in which FA was lower. FA abnormalities were confirmed to be in areas of white matter in post hoc region of interest analyses, further supporting that less myelin or disorganized fiber tracts are associated with heavy prenatal alcohol exposure. Significant correlations between performance on a test of visuomotor integration and FA in bilateral splenium, but not temporal regions were observed within the FASD group. Correlations between the visuomotor task and FA within the splenium were not significant with in the control group, and were not significant for measures of reading ability. This suggests that this region of white matter is particularly susceptible to damage from prenatal alcohol exposure and that disruption of splenial fibers in this group is associated with poorer visuomotor integration. PMID:18256251

  15. Towards an integration of positive and sickness paradigms in the prevention of eating disorders in adolescents

    Directory of Open Access Journals (Sweden)

    Vanesa C. Góngora

    2015-09-01

    Full Text Available Eating disorders problems are highly relevant in adolescence and require intervention through the implementation of prevention and promotion health programs. A Few primary prevention programmers to fight eating disorders have reached satisfactory results. The most successful results have been obtained with approaches that promote media literacy, the use of cognitive dissonance and the enhancement of self-esteem. Since many of the programs based on the disease model have failed to prevent such difficulties, the prevention of eating disorders may be improved by taking the contributions of positive psychology. Studies have shown that interventions based on this paradigm are effective to increase the feeling of happiness and subjective well-being. Unlike the traditional approach that works with the identification of risk and protective factors, positive psychology emphasizes the identification and promotion of healthy factors. Positive interventions assume that strengthening the positive, the dysfunctional or negative will be diminished. The integration of both contributions will enrich the approach to promote healthy behavior in adolescents.

  16. Merleau-Ponty's sexual schema and the sexual component of body integrity identity disorder.

    Science.gov (United States)

    De Preester, Helena

    2013-05-01

    Body integrity identity disorder (BIID), formerly also known as apotemnophilia, is characterized by a desire for amputation of a healthy limb and is claimed to straddle or to even blur the boundary between psychiatry and neurology. The neurological line of approach, however, is a recent one, and is accompanied or preceded by psychodynamical, behavioural, philosophical, and psychiatric approaches and hypotheses. Next to its confusing history in which the disorder itself has no fixed identity and could not be classified under a specific discipline, its sexual component has been an issue of unclarity and controversy, and its assessment a criterion for distinguishing BIID from apotemnophilia, a paraphilia. Scholars referring to the lived body-a phenomenon primarily discussed in the phenomenological tradition in philosophy-seem willing to exclude the sexual component as inessential, whereas other authors notice important similarities with gender identity disorder or transsexualism, and thus precisely focus attention on the sexual component. This contribution outlines the history of BIID highlighting the vicissitudes of its sexual component, and questions the justification for distinguishing BIID from apotemnophilia and thus for omitting the sexual component as essential. Second, we explain a hardly discussed concept from Maurice Merleau-Ponty's Phenomenology of Perception (1945a), the sexual schema, and investigate how the sexual schema could function in interaction with the body image in an interpretation of BIID which starts from the lived body while giving the sexual component its due.

  17. [Integrative parent-infant psychotherapy for early regulatory and relationship disorders].

    Science.gov (United States)

    Papousek, Mechthild; de Chuquisengo, Ruth Wollwerth

    2006-01-01

    The author introduces both the concept and practice of Integrative Parent-Infant Psychotherapy (IPI-P), a treatment specifically designed for the most frequent developmental problems and psychological needs of infants and their parents. Based on growing knowledge from interdisciplinary infancy research, both basic and clinical, IPI-P has been developed and practised in the "Munich Interdisciplinary Research and Intervention Program" for early regulatory and relationship disorders since the early nineties. Preverbal parent-infant communication represents both the port of entry into the system and the main focus of diagnostics, developmental counselling, interaction guidance, or psychodynamic psychotherapy of distorted communication and distressed/disordered relationships. The method of videomicroanalysis during video-feedback with the parent has proven particularly efficient--while observing, reliving and working through brief episodes of recorded parent-infant interaction. The author illustrates the diagnostic and therapeutic procedures with excerpts from psychotherapy of a toddler with an age-specific regulatory disorder in the context of severely distressed primary relationships.

  18. [Body Integrity Identity Disorder (BIID): interrogation of patients and theories for explanation].

    Science.gov (United States)

    Kasten, E

    2009-01-01

    Apotemnophilia, Amputee Identity Disorder or Body Integrity Identity Disorder (BIID) is the intensive feeling that the body will be "more complete" after amputation of a limb. The article disputes the question of matching personality characteristics of these subjects and asks for motives. Based on reports of nine individuals, triggering experiences are referred. In contrast to other children, often these subjects were fascinated by the sight of a handicapped person. In the article is investigated, whether the concerned limb showed more affections. Described is typical pretending behavior. Parallels to body dysmorphic disorder (BDD), fetishism, or delusions are investigated. These were minor, in most cases the wish was fixated on a specific limb, the subjects were aware of the abnormity of their desire and quarreled with the pros and cons. Sexual motives were found in one third. Some of the interviewed persons were in medical or psychological therapy; this did not let the desire disappear. In several BIID sufferers the wish for amputation changed, e. g. from the left to the right leg. This finding is not in accordance with the brain-dysfunction-theory. These people rather have an ideal of a "perfect" body minus one arm or leg. Most admire the beauty of a stump, and see amputees as "heroes" who still master their life in spite of their handicap. BIID is not a homogenous disturbance, one should separate three axes: 1. Strength of neuronal dysfunction, 2. Psychic components (e. g. secondary morbid gain) and 3. Intensity of sexual interests.

  19. Social psychological theories of disordered eating in college women: review and integration.

    Science.gov (United States)

    Fitzsimmons-Craft, Ellen E

    2011-11-01

    Because peer interaction, weight/shape, and self-concept formation are particularly salient to college women, the implications of social psychological theories may be especially far-reaching during the college years. College women may be particularly vulnerable to the effects of social comparison, objectification, and uses and gratifications theories, which describe social-cognitive mechanisms that provide an individual with information regarding her own view of her body and how she perceives that others perceive her body. The current paper will review and integrate findings related to these three theories of disordered eating in college women in an effort to present a more comprehensive understanding of the social psychological mechanisms that play a role in the development and maintenance of such pathology for this group of young women. Limitations of and future directions for research on these theories will be discussed, as will their potential integration with other factors that contribute to disordered eating and implications for treatment and prevention. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Morphology and Structure Engineering in Nanofiber Reactor: Tubular Hierarchical Integrated Networks Composed of Dual Phase Octahedral CoMn2 O4 /Carbon Nanofibers for Water Oxidation.

    Science.gov (United States)

    Zhu, Han; Yu, Danni; Zhang, Songge; Chen, Jiawei; Wu, Wenbo; Wan, Meng; Wang, Lina; Zhang, Ming; Du, Mingliang

    2017-07-01

    1D hollow nanostructures combine the advantages of enhanced surface-to-volume ratio, short transport lengths, and efficient 1D electron transport, which can provide more design ideas for the preparation of highly active oxygen evolution (OER) electrocatalysts. A unique architecture of dual-phase octahedral CoMn 2 O 4 /carbon hollow nanofibers has been prepared via a two-step heat-treatment process including preoxidation treatment and Ostwald ripening process. The hollow and porous structures provide interior void spaces, large exposed surfaces, and high contact areas between the nanofibers and electrolyte and the morphology can be engineered by adjusting the heating conditions. Due to the intimate electrical and chemical coupling between the oxide nanocrystals and integrated carbon, the dual-phase octahedral CoMn 2 O 4 /carbon hollow nanofibers exhibit excellent OER activity with overpotentials of 337 mV at current density of 10 mA cm -2 and Tafel slope of 82 mV dec -1 . This approach will lead to the new perception of design issue for the nanoarchitecture with fine morphology, structures, and excellent electrocatalytic activity. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Cognitive structure, flexibility, and plasticity in human multitasking-An integrative review of dual-task and task-switching research.

    Science.gov (United States)

    Koch, Iring; Poljac, Edita; Müller, Hermann; Kiesel, Andrea

    2018-06-01

    Numerous studies showed decreased performance in situations that require multiple tasks or actions relative to appropriate control conditions. Because humans often engage in such multitasking activities, it is important to understand how multitasking affects performance. In the present article, we argue that research on dual-task interference and sequential task switching has proceeded largely separately using different experimental paradigms and methodology. In our article we aim at organizing this complex set of research in terms of three complementary research perspectives on human multitasking. One perspective refers to structural accounts in terms of cognitive bottlenecks (i.e., critical processing stages). A second perspective refers to cognitive flexibility in terms of the underlying cognitive control processes. A third perspective emphasizes cognitive plasticity in terms of the influence of practice on human multitasking abilities. With our review article we aimed at highlighting the value of an integrative position that goes beyond isolated consideration of a single theoretical research perspective and that broadens the focus from single experimental paradigms (dual task and task switching) to favor instead a view that emphasizes the fundamental similarity of the underlying cognitive mechanisms across multitasking paradigms. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  2. Optimization of the integration time of pulse shape analysis for dual-layer GSO detector with different amount of Ce

    International Nuclear Information System (INIS)

    Yamamoto, Seiichi

    2008-01-01

    For a multi-layer depth-of-interaction (DOI) detector using different decay times, pulse shape analysis based on two different integration times is often used to distinguish scintillators in DOI direction. This method measures a partial integration and a full integration, and calculates the ratio of these two to obtain the pulse shape distribution. The full integration time is usually set to integrate full width of the scintillation pulse. However, the optimum partial integration time is not obvious for obtaining the best separation of the pulse shape distribution. To make it clear, a theoretical analysis and experiments were conducted for pulse shape analysis by changing the partial integration time using a scintillation detector of GSOs with different amount of Ce. A scintillation detector with 1-in. round photomultiplier tube (PMT) optically coupled GSO of 1.5 mol% (decay time: 35 ns) and that of 0.5 mol% (decay time: 60 ns) was used for the experiments. The signal from PMT was digitally integrated with partial (50-150 ns) and full (160 ns) integration times and ratio of these two was calculated to obtain the pulse shape distribution. In the theoretical analysis, partial integration time of 50 ns showed largest distance between two peaks of the pulse shape distribution. In the experiments, it showed maximum at 70-80 ns of partial integration time. The peak to valley ratio showed the maximum at 120-130 ns. Because the separation of two peaks is determined by the peak to valley ratio, we conclude the optimum partial integration time for these combinations of GSOs is around 120-130 ns, relatively longer than the expected value

  3. Animacroxam, a Novel Dual-Mode Compound Targeting Histone Deacetylases and Cytoskeletal Integrity of Testicular Germ Cell Cancer Cells.

    Science.gov (United States)

    Steinemann, Gustav; Dittmer, Alexandra; Kuzyniak, Weronika; Hoffmann, Björn; Schrader, Mark; Schobert, Rainer; Biersack, Bernhard; Nitzsche, Bianca; Höpfner, Michael

    2017-11-01

    Novel approaches for the medical treatment of advanced solid tumors, including testicular germ cell tumors (TGCT), are desperately needed. Especially, TGCT patients not responding to cisplatin-based therapy need therapeutic alternatives, as there is no effective medical treatment available for this particular subgroup. Here, we studied the suitability of the novel dual-mode compound animacroxam for TGCT treatment. Animacroxam consists of an HDAC-inhibitory hydroxamate moiety coupled to a 4,5-diarylimidazole with inherent cytoskeleton disrupting potency. Animacroxam revealed pronounced antiproliferative, cell-cycle arresting, and apoptosis-inducing effects in TGCT cell lines with different cisplatin sensitivities. The IC 50 values of animacroxam ranged from 0.22 to 0.42 μmol/L and were not correlated to the cisplatin sensitivity of the tumor cells. No unspecific cytotoxicity of animacroxam was observed in either cisplatin-sensitive or resistant TGCT cells, even at doses as high as 10 μmol/L. Furthermore, animacroxam induced the formation of actin stress fibers in cancer cells, thereby confirming the cytoskeleton-disrupting and antimigratory properties of its imidazole moiety. When compared with the clinically established HDAC inhibitor vorinostat, the novel dual-mode compound animacroxam exhibited superior antitumoral efficacy in vitro Animacroxam also reduced the tumor size of TGCT tumors in vivo , as evidenced by performing xenograft experiments on tumor bearing chorioallantoic membranes of fertilizes chicken eggs (CAM assay). The in vivo experiments also revealed a very good tolerability of the compound, and hence, animacroxam may be a promising candidate for innovative treatment of TGCT in general and the more so for platinum-insensitive or refractory TGCT. Mol Cancer Ther; 16(11); 2364-74. ©2017 AACR . ©2017 American Association for Cancer Research.

  4. Impact of model complexity and multi-scale data integration on the estimation of hydrogeological parameters in a dual-porosity aquifer

    Science.gov (United States)

    Tamayo-Mas, Elena; Bianchi, Marco; Mansour, Majdi

    2018-03-01

    This study investigates the impact of model complexity and multi-scale prior hydrogeological data on the interpretation of pumping test data in a dual-porosity aquifer (the Chalk aquifer in England, UK). In order to characterize the hydrogeological properties, different approaches ranging from a traditional analytical solution (Theis approach) to more sophisticated numerical models with automatically calibrated input parameters are applied. Comparisons of results from the different approaches show that neither traditional analytical solutions nor a numerical model assuming a homogenous and isotropic aquifer can adequately explain the observed drawdowns. A better reproduction of the observed drawdowns in all seven monitoring locations is instead achieved when medium and local-scale prior information about the vertical hydraulic conductivity (K) distribution is used to constrain the model calibration process. In particular, the integration of medium-scale vertical K variations based on flowmeter measurements lead to an improvement in the goodness-of-fit of the simulated drawdowns of about 30%. Further improvements (up to 70%) were observed when a simple upscaling approach was used to integrate small-scale K data to constrain the automatic calibration process of the numerical model. Although the analysis focuses on a specific case study, these results provide insights about the representativeness of the estimates of hydrogeological properties based on different interpretations of pumping test data, and promote the integration of multi-scale data for the characterization of heterogeneous aquifers in complex hydrogeological settings.

  5. Image quality and radiation dose of lower extremity CT angiography at 70 kVp on an integrated circuit detector dual-source computed tomography.

    Science.gov (United States)

    Qi, Li; Zhao, Yan'E; Zhou, Chang Sheng; Spearman, James V; Renker, Matthias; Schoepf, U Joseph; Zhang, Long Jiang; Lu, Guang Ming

    2015-06-01

    Despite the well-established requirement for radiation dose reduction there are few studies examining the potential for lower extremity CT angiography (CTA) at 70 kVp. To compare the image quality and radiation dose of lower extremity CTA at 70 kVp using a dual-source CT system with an integrated circuit detector to similar studies at 120 kVp. A total of 62 patients underwent lower extremity CTA. Thirty-one patients were examined at 70 kVp using a second generation dual-source CT with an integrated circuit detector (70 kVp group) and 31 patients were evaluated at 120 kVp using a first generation dual-source CT (120 kVp group). The attenuation and image noise were measured and signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Two radiologists assessed image quality. Radiation dose was compared. The mean attenuation of the 70 kVp group was higher than the 120 kVp group (575 ± 149 Hounsfield units [HU] vs. 258 ± 38 HU, respectively, P < 0.001) as was SNR (44.0 ± 22.0 vs 32.7 ± 13.3, respectively, P = 0.017), CNR (39.7 ± 20.6 vs 26.6 ± 11.7, respectively, P = 0.003) and the mean image quality score (3.7 ± 0.1 vs. 3.2 ± 0.3, respectively, P < 0.001). The inter-observer agreement was good for the 70 kVp group and moderate for the 120 kVp group. The dose-length product was lower in the 70 kVp group (264.5 ± 63.1 mGy × cm vs. 412.4 ± 81.5 mGy × cm, P < 0.001). Lower extremity CTA at 70 kVp allows for lower radiation dose with higher SNR, CNR, and image quality when compared with standard 120 kVp. © The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  6. Dual-core Itanium Processor

    CERN Multimedia

    2006-01-01

    Intel’s first dual-core Itanium processor, code-named "Montecito" is a major release of Intel's Itanium 2 Processor Family, which implements the Intel Itanium architecture on a dual-core processor with two cores per die (integrated circuit). Itanium 2 is much more powerful than its predecessor. It has lower power consumption and thermal dissipation.

  7. Perceived Factors Influencing High School Student Participation in an Integrated Statewide Dual Credit Program: An Examination of Program Success and Student Higher Education Selection Decisions

    Science.gov (United States)

    Touchstone, Allison J. L.

    2010-01-01

    Dual credit programs have become increasingly popular with 71% U.S. public high schools offering dual credit courses in 2002-2003. As this popularity has grown, so have concerns regarding academic rigor, course quality, parity with college courses, and effects on higher education. Determining actual dual credit course equivalent in higher…

  8. Body integrity identity disorder crosses culture: case reports in the Japanese and Chinese literature

    Directory of Open Access Journals (Sweden)

    Blom RM

    2016-06-01

    Full Text Available Rianne M Blom,1 Nienke C Vulink,1 Sija J van der Wal,1 Takashi Nakamae,1–3 Zhonglin Tan,1,4 Eske M Derks,1 Damiaan Denys1,5 1Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; 2Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 3Department of Neural Computation for Decision-Making, ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan; 4Department of Psychiatry, Hangzhou Mental Health Center, Hangzhou, People’s Republic of China; 5Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands Abstract: Body integrity identity disorder (BIID is a condition in which people do not perceive a part of their body as their own, which results in a strong desire for amputation or paralyzation. The disorder is likely to be congenital due to its very early onset. The English literature describes only Western patients with BIID, suggesting that the disorder might be merely prevalent in the West. To scrutinize this assumption, and to extend our knowledge of the etiology of BIID, it is important to trace cases with BIID in non-Western populations. Our objective was to review Chinese and Japanese literature on BIID to learn about its presence in populations with a different genetic background. A systematic literature search was performed in databases containing Japanese and Chinese research, published in the respective languages. Five Japanese articles of BIID were identified which described two cases of BIID, whereas in the Chinese databases only BIID-related conditions were found. This article reports some preliminary evidence that BIID is also present in non-Western countries. However, making general statements about the biological background of the disorder is hampered by the extremely low number of cases found. This low number possibly resulted from the extreme secrecy

  9. Dimensions of personality structure among patients with substance use disorders and co-occurring personality disorders: a comparison with psychiatric outpatients and healthy controls.

    Science.gov (United States)

    Di Pierro, Rossella; Preti, Emanuele; Vurro, Nicoletta; Madeddu, Fabio

    2014-08-01

    Although dual diagnosis has been a topic of great scientific interest for a long time, few studies have investigated the personality traits that characterize patients suffering from substance use disorders and co-occurring personality disorders through a dimensional approach. The present study aimed to evaluate structural personality profiles among dual-diagnosis inpatients to identify specific personality impairments associated with dual diagnosis. The present study involved 97 participants divided into three groups: 37 dual-diagnosis inpatients, 30 psychiatric outpatients and 30 nonclinical controls. Dimensions of personality functioning were assessed and differences between groups were tested using Kernberg's dimensional model of personality. Results showed that dual diagnosis was associated with the presence of difficulties in three main dimensions of personality functioning. Dual-diagnosis inpatients reported a poorly integrated identity with difficulties in the capacity to invest, poorly integrated moral values, and high levels of self-direct and other-direct aggression. The present study highlighted that a dimensional approach to the study of dual diagnosis may clarify the personality functioning of patients suffering from this pathological condition. The use of the dimensional approach could help to advance research on dual diagnosis, and it could have important implications on clinical treatment programs for dual-diagnosis inpatients. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. The place of psychodynamic psychotherapy in the integrated treatment of posttraumatic stress disorder and trauma recovery.

    Science.gov (United States)

    Moss, Eric

    2009-06-01

    Psychodynamic psychotherapists treating posttraumatic stress disorder (PTSD) sufferers can draw on an accumulated body of trauma studies from their own field to guide their work. However, these reports, often based on case studies or conceptual reviews, do not have the same empirical conclusiveness as more recent evidence-based research demonstrating the efficacy of cognitive-behavioral and body-oriented therapies. In this article, a psychodynamic psychotherapist reflects on his treatment of an Israeli man who developed PTSD after enduring 4 terrorist attacks. The author shows how assimilative integration offered him a theory- and research-based model that helped him comfortably combine separate treatment interventions. He also shows how this model helped him locate with some precision the specific contribution of psychodynamic psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  11. Integrating Fundamental Concepts of Obesity and Eating Disorders: Implications for the Obesity Epidemic

    Science.gov (United States)

    2015-01-01

    Physiological mechanisms promote weight gain after famine. Because eating disorders, obesity, and dieting limit food intake, they are famine-like experiences. The development of the concept of meeting an ideal weight was the beginning of increasing obesity. Weight stigma, the perception of being fat, lack of understanding of normal growth and development, and increased concern about obesity on the part of health providers, parents, and caregivers have reinforced each other to promote dieting. Because weight suppression and disinhibition provoke long-term weight increase, dieting is a major factor producing the obesity epidemic. The integrated eating disorder–obesity theory included in this article emphasizes that, contrary to dieters, lifetime weight maintainers depend on physiological processes to control weight and experience minimal weight change. PMID:25713933

  12. Feminist psychodynamic psychotherapy of eating disorders. Theoretic integration informing clinical practice.

    Science.gov (United States)

    Zerbe, K J

    1996-12-01

    Ideas derived from feminism and psychoanalytic theory can be combined for the integrated treatment of eating disorder patients. For a large subgroup of patients who continue to have a poor quality of life or inadequate symptom control (despite customary psychopharmacologic and cognitive behavioral interventions), feminist psychodynamic psychotherapy may prove lifesaving. This article explores how the patient may come to grasp more deeply the multiple roles her symptom has played in her psychological survival. Practical suggestions to enrich the psychotherapy as the patient traverses the natural struggles of adult life are emphasized. The importance of understanding and working with transference and countertransference issues while helping the patient accept life's paradoxes, ambiguities, and potential avenues for growth are underscored. The author reviews eight specific areas that warrant attention in psychotherapeutic exploration from a feminist psychoanalytic perspective (Culture as Bedrock Issue; Gender as Organizer of Behavior, Ownership of Body; Moral Development; Development of Personal Voice; Emphasis on Adult Development; Sexual Concerns; and Aggressive Conflicts).

  13. Social support networks and eating disorders: an integrative review of the literature

    Directory of Open Access Journals (Sweden)

    Leonidas C

    2014-05-01

    Full Text Available Carolina Leonidas, Manoel Antônio dos Santos Department of Psychology, Faculty of Philosophy, Sciences and Letters of Ribeirão Preto, University of São Paulo, Brazil Aims: This study aimed to analyze the scientific literature about social networks and social support in eating disorders (ED. Methods: By combining keywords, an integrative review was performed. It included publications from 2006–2013, retrieved from the MEDLINE, LILACS, PsycINFO, and CINAHL databases. The selection of articles was based on preestablished inclusion and exclusion criteria. Results: A total of 24 articles were selected for data extraction. There was a predominance of studies that used nonexperimental and descriptive designs, and which were published in international journals. This review provided evidence of the fact that fully consolidated literature regarding social support and social networks in patients with ED is not available, given the small number of studies dedicated to the subject. We identified evidence that the family social network of patients with ED has been widely explored by the literature, although there is a lack of studies about other networks and sources of social support outside the family. Conclusion: The evidence presented in this study shows the need to include other social networks in health care. This expansion beyond family networks would include significant others – such as friends, colleagues, neighbors, people from religious groups, among others – who could help the individual coping with the disorder. The study also highlights the need for future research on this topic, as well as a need for greater investment in publications on the various dimensions of social support and social networks. Keywords: eating disorders, social networks, social support, family relations, peer relations

  14. Social support networks and eating disorders: an integrative review of the literature.

    Science.gov (United States)

    Leonidas, Carolina; Dos Santos, Manoel Antônio

    2014-01-01

    This study aimed to analyze the scientific literature about social networks and social support in eating disorders (ED). By combining keywords, an integrative review was performed. It included publications from 2006-2013, retrieved from the MEDLINE, LILACS, PsycINFO, and CINAHL databases. The selection of articles was based on preestablished inclusion and exclusion criteria. A total of 24 articles were selected for data extraction. There was a predominance of studies that used nonexperimental and descriptive designs, and which were published in international journals. This review provided evidence of the fact that fully consolidated literature regarding social support and social networks in patients with ED is not available, given the small number of studies dedicated to the subject. We identified evidence that the family social network of patients with ED has been widely explored by the literature, although there is a lack of studies about other networks and sources of social support outside the family. The evidence presented in this study shows the need to include other social networks in health care. This expansion beyond family networks would include significant others - such as friends, colleagues, neighbors, people from religious groups, among others - who could help the individual coping with the disorder. The study also highlights the need for future research on this topic, as well as a need for greater investment in publications on the various dimensions of social support and social networks.

  15. Paralyzed by desire: a new type of body integrity identity disorder.

    Science.gov (United States)

    Giummarra, Melita J; Bradshaw, John L; Hilti, Leonie M; Nicholls, Michael E R; Brugger, Peter

    2012-03-01

    Body incongruity in body integrity identity disorder (BIID) manifests in the desire to have a healthy limb amputated. We describe a variant of the disorder: the desire to become paralyzed (paralysis-BIID). Sixteen otherwise healthy participants, recruited through Internet-based forums, websites, or word of mouth, completed questionnaires about details of their desire and accompanying symptoms. Onset of the desire for paralysis typically preceded puberty. All participants indicated a specific level for desired spinal cord injury. All participants simulated paralysis through mental imagery or physical pretending, and 9 (56%) reported erotic interest in paraplegia and/or disability. Our key new finding was that 37.5% of paralysis-BIID participants were women, compared with 4.4% women in a sample of 68 individuals with amputation-BIID. BIID reflects a disunity between self and body, usually with a prominent sexual component. Sex-related differences are emerging: unlike men, a higher proportion of women desire paralysis than desire amputation, and, while men typically seek unilateral amputation, women typically seek bilateral amputation. We propose that these sex-related differences in BIID manifestation may relate to sex differences in cerebral lateralization, or to disruption of representation and/or processing of body-related information in right-hemisphere frontoparietal networks.

  16. Integrated motivational interviewing and cognitive-behavioural therapy for bipolar disorder with comorbid substance use.

    Science.gov (United States)

    Jones, Steven H; Barrowclough, Christine; Allott, Rory; Day, Christine; Earnshaw, Paul; Wilson, Ian

    2011-01-01

    Although comorbid substance use is a common problem in bipolar disorder, there has been little research into options for psychological therapy. Studies to date have concentrated on purely cognitive-behavioural approaches, which are not equipped to deal with the ambivalence to change exhibited by many towards therapy designed to change substance use. This paper provides the first report of an integrated psychological treatment approach for bipolar disorder with comorbid substance use. The intervention reported combines motivational interviewing and cognitive-behavioural therapy to address ambivalence and equips individuals with strategies to address substance use. Across five individual case studies, preliminary evidence is reported to support the acceptability and the feasibility of this approach. Despite most participants not highlighting their substance use as a primary therapy target, all but one exhibited reduced use of drugs or alcohol at the end of therapy, sustained at 6 months' follow-up. There was some evidence for improvements in mood symptoms and impulsiveness, but this was less clear-cut. The impact of social and relationship issues on therapy process and outcome is discussed. The implications of the current findings for future intervention research in this area are considered. Copyright © 2011 John Wiley & Sons, Ltd.

  17. Integration of Nanobots Into Neural Circuits As a Future Therapy for Treating Neurodegenerative Disorders.

    Science.gov (United States)

    Saniotis, Arthur; Henneberg, Maciej; Sawalma, Abdul-Rahman

    2018-01-01

    Recent neuroscientific research demonstrates that the human brain is becoming altered by technological devices. Improvements in biotechnologies and computer based technologies are now increasing the likelihood for the development of brain augmentation devices in the next 20 years. We have developed the idea of an "Endomyccorhizae like interface" (ELI) nanocognitive device as a new kind of future neuroprosthetic which aims to facilitate neuronal network properties in individuals with neurodegenerative disorders. The design of our ELI may overcome the problems of invasive neuroprosthetics, post-operative inflammation, and infection and neuroprosthetic degradation. The method in which our ELI is connected and integrated to neuronal networks is based on a mechanism similar to endomyccorhizae which is the oldest and most widespread form of plant symbiosis. We propose that the principle of Endomyccorhizae could be relevant for developing a crossing point between the ELI and neuronal networks. Similar to endomyccorhizae the ELI will be designed to form webs, each of which connects multiple neurons together. The ELI will function to sense action potentials and deliver it to the neurons it connects to. This is expected to compensate for neuronal loss in some neurodegenerative disorders, such as Alzheimer's disease and Parkinson's disease.

  18. Integration of Nanobots Into Neural Circuits As a Future Therapy for Treating Neurodegenerative Disorders

    Directory of Open Access Journals (Sweden)

    Arthur Saniotis

    2018-03-01

    Full Text Available Recent neuroscientific research demonstrates that the human brain is becoming altered by technological devices. Improvements in biotechnologies and computer based technologies are now increasing the likelihood for the development of brain augmentation devices in the next 20 years. We have developed the idea of an “Endomyccorhizae like interface” (ELI nanocognitive device as a new kind of future neuroprosthetic which aims to facilitate neuronal network properties in individuals with neurodegenerative disorders. The design of our ELI may overcome the problems of invasive neuroprosthetics, post-operative inflammation, and infection and neuroprosthetic degradation. The method in which our ELI is connected and integrated to neuronal networks is based on a mechanism similar to endomyccorhizae which is the oldest and most widespread form of plant symbiosis. We propose that the principle of Endomyccorhizae could be relevant for developing a crossing point between the ELI and neuronal networks. Similar to endomyccorhizae the ELI will be designed to form webs, each of which connects multiple neurons together. The ELI will function to sense action potentials and deliver it to the neurons it connects to. This is expected to compensate for neuronal loss in some neurodegenerative disorders, such as Alzheimer's disease and Parkinson's disease.

  19. The effects of market integration on childhood growth and nutritional status: the dual burden of under- and over-nutrition in the Northern Ecuadorian Amazon.

    Science.gov (United States)

    Houck, Kelly; Sorensen, Mark V; Lu, Flora; Alban, Dayuma; Alvarez, Kati; Hidobro, David; Doljanin, Citlali; Ona, Ana Isabel

    2013-01-01

    Market integration is an important source of cultural change exposing indigenous populations to epidemiologic and nutrition transitions. As children and adolescents are biologically sensitive to the health effects of market integration, we examine community variation of anthropometric indicators of nutritional status and growth among a cross-cultural sample of Kichwa, Shuar, Huaorani, and Cofán indigenous groups in the northern Ecuadorian Amazon. We measured height, weight, body mass index (BMI), upper arm circumference, and triceps skinfolds of 186 children and adolescents aged 2 to 18 years from seven communities. Anthropometric z-scores were calculated based on the National Health and Nutritional Examination Survey. Comparisons were made with this US reference group, along with between community differences to contextually explore the impacts of varying degrees of market integration. We found a high prevalence of stunting in both boys (40%) and girls (34%). Adiposity increased with age and 40% of girls between 15 and 18 years old were overweight. There were large sex differences in body composition with higher BMI, arm circumference, and triceps skinfolds in adolescent girls. The Kichwa demonstrated the poorest growth outcomes and nutritional stress followed by the Huaorani and Shuar; yet distinctions in under- and over-nutrition were evident within groups. Market integration is a major factor influencing the developmental and lifestyle mismatch associated with the epidemiologic and nutrition transition in general, and the dual burden pattern of high rates of stunting yet adequate to above average short-term nutritional status indicators found among indigenous Amazonian populations. Copyright © 2013 Wiley Periodicals, Inc.

  20. Behavioral interventions for dual-diagnosis patients.

    Science.gov (United States)

    Goldsmith, R Jeffrey; Garlapati, Vamsi

    2004-12-01

    Dual diagnosis patients come to treatment with a variety of deficits,talents, and motivations. A biopsychosocial treatment plan involves multiple interventions, including medications, medical treatment, psychotherapy, family therapy, housing, and vocational rehabilitation. Treatment must be individualized and integrated, and this requires collaboration among a variety of health caregivers. There is empirical evidence that dual-diagnosis patients can be helped to stabilize, to remain in the community,and even to enter the workforce. Behavioral interventions are key ingredients to integrated and comprehensive treatment planning. There is no single model for dual disorders that explains why substance use and psychiatric illness co-occur so frequently. Mueser et al described four theoretical models accounting for the increased rates of comorbidity between psychiatric disorders and substance use disorders. They suggested that there could be a common factor that accounts for both, primary psychiatric disorder causing secondary substance abuse, primary substance abuse causing secondary psychiatric disorder, or a bidirectional problem, where each contributes to the other. There is evidence for each, although some are more compelling than others, and none is so compelling that it stands alone. Although family studies and genetic research could explain the common factor, no common gene has appeared. Antisocial personality disorder has been associated with very high rates of substance use disorders and mental illness; however, its prevalence is too low to explain most of the co-occurring phenomena. Common neurobiology, specifically the dopamine-releasing neurons in the mesolimbic system, also may be involved in mental illness, but this is not compelling at the moment. The Self-medication model is very appealing to mental health professionals, as an explanation for the secondary substance abuse model. Mueser et al suggest that three lines of evidence would be present to

  1. Tracking Architecture Based on Dual-Filter with State Feedback and Its Application in Ultra-Tight GPS/INS Integration.

    Science.gov (United States)

    Zhang, Xi; Miao, Lingjuan; Shao, Haijun

    2016-05-02

    If a Kalman Filter (KF) is applied to Global Positioning System (GPS) baseband signal preprocessing, the estimates of signal phase and frequency can have low variance, even in highly dynamic situations. This paper presents a novel preprocessing scheme based on a dual-filter structure. Compared with the traditional model utilizing a single KF, this structure avoids carrier tracking being subjected to code tracking errors. Meanwhile, as the loop filters are completely removed, state feedback values are adopted to generate local carrier and code. Although local carrier frequency has a wide fluctuation, the accuracy of Doppler shift estimation is improved. In the ultra-tight GPS/Inertial Navigation System (INS) integration, the carrier frequency derived from the external navigation information is not viewed as the local carrier frequency directly. That facilitates retaining the design principle of state feedback. However, under harsh conditions, the GPS outputs may still bear large errors which can destroy the estimation of INS errors. Thus, an innovative integrated navigation filter is constructed by modeling the non-negligible errors in the estimated Doppler shifts, to ensure INS is properly calibrated. Finally, field test and semi-physical simulation based on telemetered missile trajectory validate the effectiveness of methods proposed in this paper.

  2. Dual Regression

    OpenAIRE

    Spady, Richard; Stouli, Sami

    2012-01-01

    We propose dual regression as an alternative to the quantile regression process for the global estimation of conditional distribution functions under minimal assumptions. Dual regression provides all the interpretational power of the quantile regression process while avoiding the need for repairing the intersecting conditional quantile surfaces that quantile regression often produces in practice. Our approach introduces a mathematical programming characterization of conditional distribution f...

  3. An analysis of integrated health care for Internet Use Disorders in adolescents and adults.

    Science.gov (United States)

    Lindenberg, Katajun; Szász-Janocha, Carolin; Schoenmaekers, Sophie; Wehrmann, Ulrich; Vonderlin, Eva

    2017-12-01

    Background and aims Although first treatment approaches for Internet Use Disorders (IUDs) have proven to be effective, health care utilization remained low. New service models focus on integrated health care systems, which facilitate access and reduce burdens of health care utilization, and stepped-care interventions, which efficiently provide individualized therapy. Methods An integrated health care approach for IUD intended to (a) be easily accessible and comprehensive, (b) cover a variety of comorbid syndromes, and (c) take heterogeneous levels of impairment into account was investigated in a one-armed prospective intervention study on n = 81 patients, who were treated from 2012 to 2016. Results First, patients showed significant improvement in Compulsive Internet Use over time, as measured by hierarchical linear modeling. Effect sizes of outcome change from baseline to 6-month follow-up ranged from d = 0.48 to d = 1.46. Second, differential effects were found depending on patients' compliance, demonstrating that high compliance resulted in significantly higher rates of change. Third, patients referred to minimal interventions did not differ significantly in amount of change from patients referred to intensive psychotherapy. Discussion Tailored interventions result in higher efficiency through optimized resource allocation and equal amounts of symptom change in all treatment conditions. Moreover, comprehensive, low-threshold interventions seem to increase health service utilization.

  4. Biological and psychological rhythms: an integrative approach to rhythm disturbances in autistic disorder.

    Science.gov (United States)

    Botbol, Michel; Cabon, Philippe; Kermarrec, Solenn; Tordjman, Sylvie

    2013-09-01

    Biological rhythms are crucial phenomena that are perfect examples of the adaptation of organisms to their environment. A considerable amount of work has described different types of biological rhythms (from circadian to ultradian), individual differences in their patterns and the complexity of their regulation. In particular, the regulation and maturation of the sleep-wake cycle have been thoroughly studied. Its desynchronization, both endogenous and exogenous, is now well understood, as are its consequences for cognitive impairments and health problems. From a completely different perspective, psychoanalysts have shown a growing interest in the rhythms of psychic life. This interest extends beyond the original focus of psychoanalysis on dreams and the sleep-wake cycle, incorporating central theoretical and practical psychoanalytic issues related to the core functioning of the psychic life: the rhythmic structures of drive dynamics, intersubjective developmental processes and psychic containment functions. Psychopathological and biological approaches to the study of infantile autism reveal the importance of specific biological and psychological rhythmic disturbances in this disorder. Considering data and hypotheses from both perspectives, this paper proposes an integrative approach to the study of these rhythmic disturbances and offers an etiopathogenic hypothesis based on this integrative approach. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Major depressive disorder and measures of cellular aging: an integrative review.

    Science.gov (United States)

    Kinser, Patricia Anne; Lyon, Debra E

    2013-01-01

    Major depressive disorder (MDD) affects millions of individuals and causes significant suffering worldwide. It has been speculated that MDD is associated with accelerated aging-related biological and functional decline. To examine the accelerated aging hypothesis, one of the biomarkers under study is leukocyte telomeres, and specifically the measure of telomere length and telomerase activity. This review integrates findings from eleven human studies which evaluated telomere length and telomerase activity, in order to synthesize the state of the current science and to inform the development of new knowledge and enhance nursing research of depression using appropriate biobehavioral measures. Although preliminary, the findings from this integrated review suggest that there is evidence to support a conceptualization of depression as a stress-related condition in which telomeres shorten over time in relation to cumulative exposure to the chronic stress of depression. For the purposes of testing in future nursing research, visual representations of the theoretical connection between stress vulnerabilities, depression, and health outcomes and key moderators and mediators involved in this conceptualization are provided. The findings from this review and the conceptual framework provided may be a useful step towards advancing therapeutic nursing interventions for this debilitating chronic condition.

  6. The Development and Course of Bipolar Spectrum Disorders: An Integrated Reward and Circadian Rhythm Dysregulation Model

    Science.gov (United States)

    Alloy, Lauren B.; Nusslock, Robin; Boland, Elaine M.

    2014-01-01

    In this article, we present and review the evidence for two major biopsychosocial theories of the onset and course of bipolar spectrum disorders (BSDs) that integrate behavioral, environmental, and neurobiological mechanisms: the reward hypersensitivity and the social and circadian rhythm disruption models. We describe the clinical features, spectrum, age of onset, and course of BSDs. We then discuss research designs relevant to demonstrating whether a hypothesized mechanism represents a correlate, vulnerability, or predictor of the course of BSDs, as well as important methodological issues. We next present the reward hypersensitivity model of BSD, followed by the social/circadian rhythm disruption model of BSD. For each model, we review evidence regarding whether the proposed underlying mechanism is associated with BSDs, provides vulnerability to the onset of BSDs, and predicts the course of BSDs. We then present a new integrated reward/circadian rhythm (RCR) dysregulation model of BSD and discuss how the RCR model explains the symptoms, onset, and course of BSDs. We end with recommendations for future research directions. PMID:25581235

  7. Neural basis of limb ownership in individuals with body integrity identity disorder.

    Directory of Open Access Journals (Sweden)

    Milenna T van Dijk

    Full Text Available Our body feels like it is ours. However, individuals with body integrity identity disorder (BIID lack this feeling of ownership for distinct limbs and desire amputation of perfectly healthy body parts. This extremely rare condition provides us with an opportunity to study the neural basis underlying the feeling of limb ownership, since these individuals have a feeling of disownership for a limb in the absence of apparent brain damage. Here we directly compared brain activation between limbs that do and do not feel as part of the body using functional MRI during separate tactile stimulation and motor execution experiments. In comparison to matched controls, individuals with BIID showed heightened responsivity of a large somatosensory network including the parietal cortex and right insula during tactile stimulation, regardless of whether the stimulated leg felt owned or alienated. Importantly, activity in the ventral premotor cortex depended on the feeling of ownership and was reduced during stimulation of the alienated compared to the owned leg. In contrast, no significant differences between groups were observed during the performance of motor actions. These results suggest that altered somatosensory processing in the premotor cortex is associated with the feeling of disownership in BIID, which may be related to altered integration of somatosensory and proprioceptive information.

  8. Neural basis of limb ownership in individuals with body integrity identity disorder.

    Science.gov (United States)

    van Dijk, Milenna T; van Wingen, Guido A; van Lammeren, Anouk; Blom, Rianne M; de Kwaasteniet, Bart P; Scholte, H Steven; Denys, Damiaan

    2013-01-01

    Our body feels like it is ours. However, individuals with body integrity identity disorder (BIID) lack this feeling of ownership for distinct limbs and desire amputation of perfectly healthy body parts. This extremely rare condition provides us with an opportunity to study the neural basis underlying the feeling of limb ownership, since these individuals have a feeling of disownership for a limb in the absence of apparent brain damage. Here we directly compared brain activation between limbs that do and do not feel as part of the body using functional MRI during separate tactile stimulation and motor execution experiments. In comparison to matched controls, individuals with BIID showed heightened responsivity of a large somatosensory network including the parietal cortex and right insula during tactile stimulation, regardless of whether the stimulated leg felt owned or alienated. Importantly, activity in the ventral premotor cortex depended on the feeling of ownership and was reduced during stimulation of the alienated compared to the owned leg. In contrast, no significant differences between groups were observed during the performance of motor actions. These results suggest that altered somatosensory processing in the premotor cortex is associated with the feeling of disownership in BIID, which may be related to altered integration of somatosensory and proprioceptive information.

  9. Integrated employee assistance program/managed behavioral health plan utilization by persons with substance use disorders.

    Science.gov (United States)

    Merrick, Elizabeth S Levy; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M; Greenfield, Shelly F; McCann, Bernard

    2011-04-01

    New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral health care (MBHC) organization's integrated EAP/MBHC product (N = 1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan, and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of the clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Integrated EAP/Managed Behavioral Health Plan Utilization by Persons with Substance Use Disorders

    Science.gov (United States)

    Levy Merrick, Elizabeth S.; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M.; Greenfield, Shelly F.; McCann, Bernard

    2011-01-01

    New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral healthcare organization's integrated EAP/managed behavioral health care product (N=1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes. PMID:21185684

  11. Obesity and eating disorders in integrative prevention programmes for adolescents: protocol for a systematic review and meta-analysis.

    Science.gov (United States)

    Leme, Ana Carolina Barco; Thompson, Debbe; Lenz Dunker, Karin Louise; Nicklas, Theresa; Tucunduva Philippi, Sonia; Lopez, Tabbetha; Vézina-Im, Lydi-Anne; Baranowski, Tom

    2018-04-19

    Obesity and eating disorders are public health problems that have lifelong financial and personal costs and common risk factors, for example, body dissatisfaction, weight teasing and disordered eating. Obesity prevention interventions might lead to the development of an eating disorder since focusing on weight may contribute to excessive concern with diet and weight. Therefore, the proposed research will assess whether integrating obesity and eating disorder prevention procedures ('integrated approach') do better than single approach interventions in preventing obesity among adolescents, and if integrated approaches influence weight-related outcomes. Integrated obesity and eating disorder prevention interventions will be identified. Randomised controlled trials and quasi-experimental trials reporting data on adolescents ranging from 10 to 19 years of age from both sexes will be included. Outcomes of interest include body composition, unhealthy weight control behaviours and body satisfaction measurements. MEDLINE/PubMed, PsycINFO, Web of Science and SciELO will be searched. Data will be extracted independently by two reviewers using a standardised data extraction form. Trial quality will be assessed using the Cochrane Collaboration criteria. The effects of integrated versus single approach intervention studies will be compared using systematic review procedures. If an adequate number of studies report data on integrated interventions among similar populations (k>5), a meta-analysis with random effects will be conducted. Sensitivity analyses and meta-regression will be performed only if between-study heterogeneity is high (I 2 ≥75%). Ethics approval will not be required as this is a systematic review of published studies. The findings will be disseminated through conference presentations and peer-reviewed journals. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted

  12. Use of dual energy X-ray absorptiometry, the trabecular bone score and quantitative computed tomography in the evaluation of chronic kidney disease-mineral and bone disorders.

    Science.gov (United States)

    Pocock, Nicholas

    2017-03-01

    In subjects with chronic kidney disease (CKD) who suffer a minimal trauma fracture, the problem is to differentiate between osteoporosis and the various forms of renal bone disease associated with CKD-mineral and bone disorder. This problem is exacerbated by the fact that renal osteodystrophy may coexist with osteoporosis. The World Health Organization's bone mineral density (BMD) criteria for osteopenia ( -2.5 < T-score < -1.0) and osteoporosis (a T-score ≤ -2.5) may be used in patients with CKD stages 1-3. In CKD stages 4-5, BMD by dual-energy X-ray absorptiometry (DXA) is less predictive and may underestimate fracture risk. The development of absolute fracture risk (AFR) algorithms, such as FRAX® and the Garvan absolute fracture risk calculator, to predict risk of fracture over a given time (usually 10 years) aims to incorporate non-BMD risk factors into the clinical assessment. FRAX® has been shown to be useful to assess fracture risk in CKD but may underestimate fracture risk in advanced CKD. The trabecular bone score is a measure of grey scale homogeneity obtained from spine DXA, which correlates to trabecular microarchitecture and is an independent risk factor for fracture. Recent data demonstrate the potential utility of the trabecular bone score adjustment of AFR through the FRAX® algorithm in subjects with CKD. Parameters of bone microarchitecture using peripheral quantitative computed tomography (pQCT) or high-resolution pQCT are also able to discriminate fracture status in subjects with CKD. However, there are at present no convincing data that the addition of pQCT or high-resolution pQCT parameters to DXA BMD improves fracture discrimination. More advanced estimates of bone strength derived from measurements of micro-architecture, by QCT-derived finite element analysis may be incorporated into AFR algorithms in the future. © 2017 Asian Pacific Society of Nephrology.

  13. The Challenge of Integrating Care in Dual Diagnosis; Anti-NMDA-Receptor Encephalitis; Presentation And Outcome In 3 Cases Referred For Complex Specialist Rehabilitation Services

    LENUS (Irish Health Repository)

    Carroll, A

    2018-03-01

    The successful implementation of an integrated care pathway (ICP) for any given condition is a challenge. Even more challenging is successful ICP implementation for individuals who have multiple co-morbidities. This is further compounded when there are dual mental health and physical disabilities that require integrated working across multiple disciplines, specialties, institutions and organisations. Anti-NMDA-Receptor encephalitis (aNMDARe) is a relatively new diagnostic entity with patients typically presenting with significant psychiatric symptoms followed by progressive neurological deterioration. In this case series, we describe 3 cases of females with aNMDARe who were referred for complex specialist rehabilitation (CSR) to The National Rehabilitation Hospital. CSR is the total active care of patients with a disabling condition, and their families, by a multi-professional team who have undergone recognised specialist training in rehabilitation, led \\/supported by a consultant trained and accredited in rehabilitation medicine (RM). These services provide for patients with highly complex rehabilitation needs that are beyond the scope of local services. In these cases, referral to CSR resulted in the construction of a bespoke integrated care pathway (ICP) that transcended the barriers between primary, secondary and tertiary care and across the boundaries of physical and mental health. A care pathway is a complex intervention for the mutual decision-making and organisation of care processes Rehabilitation services acted as the coordinator of services in these cases to ensure implementation of the care plan and to ensure successful transitions of care and supported local specialist and general teams in the management of these complex cases.

  14. Treatment Integrity of Literacy Interventions for Students with Emotional and/or Behavioral Disorders: A Review of Literature

    Science.gov (United States)

    Griffith, Annette K.; Hurley, Kristin Duppong; Hagaman, Jessica L.

    2009-01-01

    This review examines the treatment integrity data of literacy interventions for students with emotional and/or behavioral disorders (EBD). Forty-four studies published between 1977 and 2005 were examined. Findings indicate that studies focusing on literacy interventions for students with EBD included clear operational definitions and data on…

  15. A Qualitative Study of the Integration of Arab Muslim Israelis Suffering from Mental Disorders into the Normative Community.

    Science.gov (United States)

    Gesser-Edelsburg, Anat; Shbat, Shbat

    2017-06-01

    This study focuses on the process of the integration of Arab Muslim Israelis suffering from mental disorders into the normative community, addressing perspectives of both people with mental disorders and the community. This qualitative-constructivist study seeks to understand the dynamics of face-to-face meetings by highlighting the participants' points of view. The main themes of the findings included stereotypes and prejudices, gender discrimination, and the effect of face-to-face meetings on integration of people with mental disorders (PMD) into the community. The findings support former studies about the integration of PMD into the normative community, but add a unique finding that females suffer from double discrimination: both as women in a conservative society and as PMD. The study findings indicate a perception of lack of self-efficacy of PMD as a key barrier preventing integration into the community, which also prevents community members and counselors from accepting them or treating them as equals. We recommend on a social marketing campaign to be undertaken with the Arab Muslim community to refute stigmas and prejudices, particulary with double gender discrimination suffered by women with mental disorders in the Muslim community and training of community center counselors who have contact with the PMD population.

  16. Integrating Dialectical Behavior Therapy and Prolonged Exposure to Treat Co-Occurring Borderline Personality Disorder and PTSD: Two Case Studies

    Science.gov (United States)

    Harned, Melanie S.; Linehan, Marsha M.

    2008-01-01

    Despite the high rate of trauma and PTSD among individuals with borderline personality disorder (BPD), no studies have specifically evaluated the treatment of PTSD in a BPD population. These case studies illustrate the use of a protocol based on prolonged exposure therapy that can be integrated into standard dialectical behavior therapy to treat…

  17. The Desire for Amputation or Paralyzation : Evidence for Structural Brain Anomalies in Body Integrity Identity Disorder (BIID)

    NARCIS (Netherlands)

    Blom, Rianne M; van Wingen, Guido A; van der Wal, Sija J; Luigjes, Judy; van Dijk, Milenna T; Scholte, H Steven; Denys, D.

    2016-01-01

    BACKGROUND: Body Integrity Identity Disorder (BIID) is a condition in which individuals perceive a mismatch between their internal body scheme and physical body shape, resulting in an absolute desire to be either amputated or paralyzed. The condition is hypothesized to be of congenital nature, but

  18. The Desire for Amputation or Paralyzation: Evidence for Structural Brain Anomalies in Body Integrity Identity Disorder (BIID)

    NARCIS (Netherlands)

    Blom, Rianne M.; van Wingen, Guido A.; van der Wal, Sija J.; Luigjes, Judy; van Dijk, Milenna T.; Scholte, H. Steven; Denys, Damiaan

    2016-01-01

    Body Integrity Identity Disorder (BIID) is a condition in which individuals perceive a mismatch between their internal body scheme and physical body shape, resulting in an absolute desire to be either amputated or paralyzed. The condition is hypothesized to be of congenital nature, but evidence for

  19. Role of Sexuality in Body Integrity Identity Disorder (BIID) : A Cross-Sectional Internet-Based Survey Study

    NARCIS (Netherlands)

    Blom, Rianne M; van der Wal, Sija J; Vulink, Nienke C; Denys, D.

    2017-01-01

    BACKGROUND: Body integrity identity disorder (BIID)-a strong desire for amputation or paralysis-is often accompanied by feelings and cognitions of sexual arousal, although this sexual component has been largely neglected in the recent literature. AIM: To examine the presence of BIID-related sexual

  20. Role of Sexuality in Body Integrity Identity Disorder (BIID): A Cross-Sectional Internet-Based Survey Study

    NARCIS (Netherlands)

    Blom, Rianne M.; van der Wal, Sija J.; Vulink, Nienke C.; Denys, Damiaan

    2017-01-01

    Body integrity identity disorder (BIID)-a strong desire for amputation or paralysis-is often accompanied by feelings and cognitions of sexual arousal, although this sexual component has been largely neglected in the recent literature. To examine the presence of BIID-related sexual arousal in

  1. Validation of an integrated software for the detection of rapid eye movement sleep behavior disorder.

    Science.gov (United States)

    Frauscher, Birgit; Gabelia, David; Biermayr, Marlene; Stefani, Ambra; Hackner, Heinz; Mitterling, Thomas; Poewe, Werner; Högl, Birgit

    2014-10-01

    Rapid eye movement sleep without atonia (RWA) is the polysomnographic hallmark of REM sleep behavior disorder (RBD). To partially overcome the disadvantages of manual RWA scoring, which is time consuming but essential for the accurate diagnosis of RBD, we aimed to validate software specifically developed and integrated with polysomnography for RWA detection against the gold standard of manual RWA quantification. Academic referral center sleep laboratory. Polysomnographic recordings of 20 patients with RBD and 60 healthy volunteers were analyzed. N/A. Motor activity during REM sleep was quantified manually and computer assisted (with and without artifact detection) according to Sleep Innsbruck Barcelona (SINBAR) criteria for the mentalis ("any," phasic, tonic electromyographic [EMG] activity) and the flexor digitorum superficialis (FDS) muscle (phasic EMG activity). Computer-derived indices (with and without artifact correction) for "any," phasic, tonic mentalis EMG activity, phasic FDS EMG activity, and the SINBAR index ("any" mentalis + phasic FDS) correlated well with the manually derived indices (all Spearman rhos 0.66-0.98). In contrast with computerized scoring alone, computerized scoring plus manual artifact correction (median duration 5.4 min) led to a significant reduction of false positives for "any" mentalis (40%), phasic mentalis (40.6%), and the SINBAR index (41.2%). Quantification of tonic mentalis and phasic FDS EMG activity was not influenced by artifact correction. The computer algorithm used here appears to be a promising tool for REM sleep behavior disorder detection in both research and clinical routine. A short check for plausibility of automatic detection should be a basic prerequisite for this and all other available computer algorithms. © 2014 Associated Professional Sleep Societies, LLC.

  2. Integrated analysis of whole-exome sequencing and transcriptome profiling in males with autism spectrum disorders.

    Science.gov (United States)

    Codina-Solà, Marta; Rodríguez-Santiago, Benjamín; Homs, Aïda; Santoyo, Javier; Rigau, Maria; Aznar-Laín, Gemma; Del Campo, Miguel; Gener, Blanca; Gabau, Elisabeth; Botella, María Pilar; Gutiérrez-Arumí, Armand; Antiñolo, Guillermo; Pérez-Jurado, Luis Alberto; Cuscó, Ivon

    2015-01-01

    Autism spectrum disorders (ASD) are a group of neurodevelopmental disorders with high heritability. Recent findings support a highly heterogeneous and complex genetic etiology including rare de novo and inherited mutations or chromosomal rearrangements as well as double or multiple hits. We performed whole-exome sequencing (WES) and blood cell transcriptome by RNAseq in a subset of male patients with idiopathic ASD (n = 36) in order to identify causative genes, transcriptomic alterations, and susceptibility variants. We detected likely monogenic causes in seven cases: five de novo (SCN2A, MED13L, KCNV1, CUL3, and PTEN) and two inherited X-linked variants (MAOA and CDKL5). Transcriptomic analyses allowed the identification of intronic causative mutations missed by the usual filtering of WES and revealed functional consequences of some rare mutations. These included aberrant transcripts (PTEN, POLR3C), deregulated expression in 1.7% of mutated genes (that is, SEMA6B, MECP2, ANK3, CREBBP), allele-specific expression (FUS, MTOR, TAF1C), and non-sense-mediated decay (RIT1, ALG9). The analysis of rare inherited variants showed enrichment in relevant pathways such as the PI3K-Akt signaling and the axon guidance. Integrative analysis of WES and blood RNAseq data has proven to be an efficient strategy to identify likely monogenic forms of ASD (19% in our cohort), as well as additional rare inherited mutations that can contribute to ASD risk in a multifactorial manner. Blood transcriptomic data, besides validating 88% of expressed variants, allowed the identification of missed intronic mutations and revealed functional correlations of genetic variants, including changes in splicing, expression levels, and allelic expression.

  3. The role of dual diagnosis in health-related quality of life among treatment-seeking patients in Spain.

    Science.gov (United States)

    Daigre, Constanza; Grau-López, Lara; Rodríguez-Cintas, Laia; Ros-Cucurull, Elena; Sorribes-Puertas, Marta; Esculies, Oriol; Bones-Rocha, Katia; Roncero, Carlos

    2017-12-01

    The comorbidity of any substance use disorder and another mental disorder is defined as dual diagnosis. Dual diagnosis is very common and clinical and therapeutic consequences have been described. This cross-sectional study aimed to analyse health-related quality of life (HRQoL) according to clinical characteristics and psychiatric comorbidities in patients with substance dependence. A total of 1276 substance-dependent patients seeking treatment were recruited. HRQoL was evaluated by the Short-Form 36 (SF-36) questionnaire. The SCID-I, SCID-II and Conners' adult ADHD diagnostic interview were used to evaluate dual diagnosis. A visual analogue scale was used to measure craving. Bivariate and multivariate analyses were performed, and correction for multiple tests was conducted. Substance-dependent patients had impaired quality of life, especially in the mental component. SF-36 physical and mental component scores were 47.7 ± 10.9 and 36.1 ± 14.1, respectively. Furthermore, 65% of the patients had dual diagnosis, 51% had an Axis I DSM-IV-TR mental disorder and 35% had some personality disorder. Impaired physical quality of life was independently associated with medical condition, age, being female, depressive disorder and anxiety disorder. Depression disorder, any personality disorder, active consumption last month, Attention deficit hyperactivity disorder, anxiety disorder, suicide attempt were independently associated with worse mental quality of life. These findings emphasize the significance of dual diagnosis in the impairment of HRQoL in substance-dependent patients, particularly with regard to mental component. In addicted patients with low scores on SF-36, psychiatric comorbidity should be evaluated and treated in an integrated approach.

  4. Using dual classifications in the development of avian wetland indices of biological integrity for wetlands in West Virginia, USA.

    Science.gov (United States)

    Veselka, Walter; Anderson, James T; Kordek, Walter S

    2010-05-01

    Considerable resources are being used to develop and implement bioassessment methods for wetlands to ensure that "biological integrity" is maintained under the United States Clean Water Act. Previous research has demonstrated that avian composition is susceptible to human impairments at multiple spatial scales. Using a site-specific disturbance gradient, we built avian wetland indices of biological integrity (AW-IBI) specific to two wetland classification schemes, one based on vegetative structure and the other based on the wetland's position in the landscape and sources of water. The resulting class-specific AW-IBI was comprised of one to four metrics that varied in their sensitivity to the disturbance gradient. Some of these metrics were specific to only one of the classification schemes, whereas others could discriminate varying levels of disturbance regardless of classification scheme. Overall, all of the derived biological indices specific to the vegetative structure-based classes of wetlands had a significant relation with the disturbance gradient; however, the biological index derived for floodplain wetlands exhibited a more consistent response to a local disturbance gradient. We suspect that the consistency of this response is due to the inherent nature of the connectivity of available habitat in floodplain wetlands.

  5. Implementation of integrated therapies for comorbid post-traumatic stress disorder and substance use disorders in community substance abuse treatment programs.

    Science.gov (United States)

    Killeen, Therese K; Back, Sudie E; Brady, Kathleen T

    2015-05-01

    The high prevalence of trauma and post-traumatic stress disorder (PTSD) in individuals with substance use disorders (SUDs) presents a number of treatment challenges for community treatment providers and programs in the USA. Although several evidence-based, integrated therapies for the treatment of comorbid PTSD/SUD have been developed, rates of utilisation of such practices remain low in community treatment programs. The goal of this article was to review the extant literature on common barriers that prevent adoption and implementation of integrated treatments for PTSD/SUD among substance abuse community treatment programs. Organisational, provider-level and patient-level factors that drive practice decisions were discussed, including organisational philosophy of care policies, funding and resources, as well as provider and patient knowledge and attitudes related to implementation of new integrated treatments for comorbid PTSD and SUD. Understanding and addressing these community treatment challenges may facilitate use of evidence-based integrated treatments for comorbid PTSD and SUD. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  6. Retrospective, nonrandomized controlled study on autoadjusting, dual-pressure positive airway pressure therapy for a consecutive series of complex insomnia disorder patients

    Directory of Open Access Journals (Sweden)

    Krakow B

    2017-03-01

    Full Text Available Barry Krakow,1–3 Natalia D McIver,1,2 Victor A Ulibarri,1,2 Michael R Nadorff4,5 1Sleep & Human Health Institute, 2Maimonides Sleep Arts & Sciences, Ltd, Albuquerque, 3Los Alamos Medical Center, Los Alamos, NM, 4Department of Psychology, Mississippi State University, Mississippi, MS, 5Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA Purpose: Emerging evidence shows that positive airway pressure (PAP treatment of obstructive sleep apnea (OSA and upper airway resistance syndrome (UARS in chronic insomnia patients (proposed “complex insomnia” disorder leads to substantial decreases in insomnia severity. Although continuous PAP (CPAP is the pressure mode most widely researched, intolerance to fixed pressurized air is rarely investigated or described in comorbidity patients. This retrospective study examined dual pressure, autoadjusting PAP modes in chronic, complex insomnia disorder patients.Patients and methods: Chronic insomnia disorder patients (mean [SD] insomnia severity index [ISI] =19.11 [3.34] objectively diagnosed with OSA or UARS and using either autobilevel PAP device or adaptive servoventilation (ASV device after failing CPAP therapy (frequently due to intolerance to pressurized air, poor outcomes, or emergence of CSA were divided into PAP users (≥20 h/wk and partial users (<20 h/wk for comparison. Subjective and objective baseline and follow-up measures were analyzed.Results: Of the 302 complex insomnia patients, PAP users (n=246 averaged 6.10 (1.78 nightly hours and 42.71 (12.48 weekly hours and partial users (n=56 averaged 1.67 (0.76 nightly hours and 11.70 (5.31 weekly hours. For mean (SD decreases in total ISI scores, a significant (group × time interaction was observed (F[1,300]=13.566; P<0.0001 with PAP users (–7.59 [5.92]; d=1.63 showing superior results to partial users (-4.34 [6.13]; d=0.81. Anecdotally, patients reported better tolerability with advanced PAP

  7. An Integrated Neuroscience Perspective on Formulation and Treatment Planning for Posttraumatic Stress Disorder: An Educational Review.

    Science.gov (United States)

    Ross, David A; Arbuckle, Melissa R; Travis, Michael J; Dwyer, Jennifer B; van Schalkwyk, Gerrit I; Ressler, Kerry J

    2017-04-01

    Posttraumatic stress disorder (PTSD) is a common psychiatric illness, increasingly in the public spotlight in the United States due its prevalence in the soldiers returning from combat in Iraq and Afghanistan. This educational review presents a contemporary approach for how to incorporate a modern neuroscience perspective into an integrative case formulation. The article is organized around key neuroscience "themes" most relevant for PTSD. Within each theme, the article highlights how seemingly diverse biological, psychological, and social perspectives all intersect with our current understanding of neuroscience. Any contemporary neuroscience formulation of PTSD should include an understanding of fear conditioning, dysregulated circuits, memory reconsolidation, epigenetics, and genetic factors. Fear conditioning and other elements of basic learning theory offer a framework for understanding how traumatic events can lead to a range of behaviors associated with PTSD. A circuit dysregulation framework focuses more broadly on aberrant network connectivity, including between the prefrontal cortex and limbic structures. In the process of memory reconsolidation, it is now clear that every time a memory is reactivated it becomes momentarily labile-with implications for the genesis, maintenance, and treatment of PTSD. Epigenetic changes secondary to various experiences, especially early in life, can have long-term effects, including on the regulation of the hypothalamic-pituitary-adrenal axis, thereby affecting an individual's ability to regulate the stress response. Genetic factors are surprisingly relevant: PTSD has been shown to be highly heritable despite being definitionally linked to specific experiences. The relevance of each of these themes to current clinical practice and its potential to transform future care are discussed. Together, these perspectives contribute to an integrative, neuroscience-informed approach to case formulation and treatment planning. This may

  8. Decoupled Power Solution for Dual-input Isolated DC-DC Converters Using Four Quadrants Integrated Transformers (FQIT)

    DEFF Research Database (Denmark)

    Ouyang, Ziwei; Andersen, Michael A. E.; Thomsen, Ole Cornelius

    2012-01-01

    ) space orthogonal flux is proposed in this paper. And thus a new geometry core and relative winding arrangements are proposed in accordance with the rthogonal flux decoupling technology. Due to the four secondary windings are arranged in a quadratic pattern at the base core plate with the two...... perpendicular primary windings, a name of “four quadrants integrated transformers” (FQIT) is therefore given to the proposed construction. Since the two primary windings are uncoupled, the FQIT allows the two input power stages to transfer the energy into the output load simultaneously or at any...... timemultiplexing scheme, which can optimize the utilization of diversified power energy sources, simplify the system structure, improve the flexibility and reduce the overall cost, so they are attractive for the hybrid renewable power system. Section IV initiates a discussion for the advantages of the FQIT...

  9. A Fully Integrated Dual-Channel On-Coil CMOS Receiver for Array Coils in 1.5-10.5 T MRI.

    Science.gov (United States)

    Sporrer, Benjamin; Wu, Lianbo; Bettini, Luca; Vogt, Christian; Reber, Jonas; Marjanovic, Josip; Burger, Thomas; Brunner, David O; Pruessmann, Klaas P; Troster, Gerhard; Huang, Qiuting

    2017-12-01

    Magnetic resonance imaging (MRI) is among the most important medical imaging modalities. Coil arrays and receivers with high channel counts (16 and more) have to be deployed to obtain the image quality and acquisition speed required by modern clinical protocols. In this paper, we report the theoretical analysis, the system-level design, and the circuit implementation of the first receiver IC (RXIC) for clinical MRI fully integrated in a modern CMOS technology. The dual-channel RXIC sits directly on the sensor coil, thus eliminating any RF cable otherwise required to transport the information out of the magnetic field. The first stage LNA was implemented using a noise-canceling architecture providing a highly reflective input used to decouple the individual channels of the array. Digitization is performed directly on-chip at base-band by means of a delta-sigma modulator, allowing the subsequent optical transmission of data. The presented receiver, implemented in a CMOS technology, is compatible with MRI scanners up to . It reaches sub- noise figure for MRI units and features a dynamic range up to at a power consumption below per channel, with an area occupation of . Mounted on a small-sized printed circuit board (PCB), the receiver IC has been employed in a commercial MRI scanner to acquire in-vivo images matching the quality of traditional systems, demonstrating the first step toward multichannel wearable MRI array coils.

  10. Cross-tissue integration of genetic and epigenetic data offers insight into autism spectrum disorder.

    Science.gov (United States)

    Andrews, Shan V; Ellis, Shannon E; Bakulski, Kelly M; Sheppard, Brooke; Croen, Lisa A; Hertz-Picciotto, Irva; Newschaffer, Craig J; Feinberg, Andrew P; Arking, Dan E; Ladd-Acosta, Christine; Fallin, M Daniele

    2017-10-24

    Integration of emerging epigenetic information with autism spectrum disorder (ASD) genetic results may elucidate functional insights not possible via either type of information in isolation. Here we use the genotype and DNA methylation (DNAm) data from cord blood and peripheral blood to identify SNPs associated with DNA methylation (meQTL lists). Additionally, we use publicly available fetal brain and lung meQTL lists to assess enrichment of ASD GWAS results for tissue-specific meQTLs. ASD-associated SNPs are enriched for fetal brain (OR = 3.55; P < 0.001) and peripheral blood meQTLs (OR = 1.58; P < 0.001). The CpG targets of ASD meQTLs across cord, blood, and brain tissues are enriched for immune-related pathways, consistent with other expression and DNAm results in ASD, and reveal pathways not implicated by genetic findings. This joint analysis of genotype and DNAm demonstrates the potential of both brain and blood-based DNAm for insights into ASD and psychiatric phenotypes more broadly.

  11. Sensory Integration Training Tool Design for Children with Autism Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Jiang Lijun

    2017-01-01

    Full Text Available This study aims to design a training tool for therapy of children with autism spectrum disorder (ASDs. Typically, ASDs pass through obstacle track several times with sandbags, which should be picked up from starting point and threw into a box at the end during sensory integration therapy. Counting the sandbags can help ASDs to have concept about the progress of mission. We redesign the counting box named “Skybox” which can help counting by playing sound after detect something throw in it. Aims to probe into the sound preference of two main subjects, an experiment with four kinds of sounds is conducted in this paper by using the method of paired comparisons. The result shows they like animals most, followed by human voice and nature sounds, and music instrument is the last. The material preference experiment shows two subjects like acrylic most, wood and paper are secondary while furry is the last. Skybox shortens their training time for 23.53%, 29.87% and 37.37% in three different projects. We consider that Skybox attracts ASDs therefore reduces their distraction and improves their performance in the usability test.

  12. Body integrity identity disorder: the persistent desire to acquire a physical disability.

    Science.gov (United States)

    First, Michael B; Fisher, Carl E

    2012-01-01

    Body integrity identity disorder (BIID) is a rare and unusual psychiatric condition characterized by a persistent desire to acquire a physical disability (e.g., amputation, paraplegia) since childhood that to date has not been formally described in the psychiatric nosology. Most BIID sufferers experience a chronic and dysphoric sense of inappropriateness regarding their being able-bodied, and many have been driven to actualize their desired disability through surreptitious surgical or other more dangerous methods. This review aims to characterize the history and phenomenology of this condition, to present its differential diagnosis, and to consider possible etiologies, treatment options, and ethical considerations. Review of the psychiatric and neurological literature. A growing body of data suggests the existence of a discrete entity with onset by early adolescence and a negative impact on functioning. Parallel neurological conditions and preliminary experimental investigations suggest a possible neurobiological component in at least a portion of cases. While attempts at treatment have been described, no systematic evidence for efficacy has emerged. BIID is a unique nosological entity with significant consequences for its sufferers and as such may warrant inclusion in some form in the forthcoming DSM-5 and ICD-11. Copyright © 2011 S. Karger AG, Basel.

  13. Institutional profile: integrated center for research and treatment of vertigo, balance and ocular motor disorders.

    Science.gov (United States)

    Brandt, Thomas; Zwergal, Andreas; Jahn, Klaus; Strupp, Michael

    2010-01-01

    In 2009 the German BMBF (German Ministry of Education and Research) established an Integrated Center for Research and Treatment (IFB(LMU)) of Vertigo, Balance and Ocular Motor Disorders in Munich. After the 10-year period of funding by the BMBF, it is envisioned that the (IFB(LMU)) will continue over the long term with the joint support of the University Hospital, the Medical Faculty, and the Bavarian State. Vertigo is one of the most common complaints in medicine. Despite its high prevalence, patients with vertigo generally receive either inappropriate or inadequate treatment. This deplorable situation is internationally well known and its causes are multiple: insufficient interdisciplinary cooperation, no standardized diagnostics and therapy, the failure to translate findings of basic science into clinical applications, and the scarcity of clinical multicenter studies. The (IFB(LMU)) will constitute a suitable tool with which these structural, clinical, and scientific deficits can be overcome. It will also make possible the establishment of an international interdisciplinary referral center. Munich has become the site of a unique concentration of leading experts on vertigo, balance and ocular motor disorders, both in the clinical and basic sciences. Academic structures have paved the way for the creation of an interdisciplinary horizontal network that also allows structured, vertical academic career paths via the Bachelor's and Master's degree programs in Neuroscience, a Graduate School of Systemic Neurosciences, and the Munich Center for Neurosciences - Brain and Mind. The (IFB(LMU)) has the following objectives as regards structure and content: to create an independent patient-oriented clinical research center under the auspices of the Medical Faculty but with autonomous administration and budget; to overcome existing clinical and academic barriers separating the traditional specializations; to establish a standardized interdisciplinary longitudinal and

  14. Integrating the behavioral and neural dynamics of response selection in a dual-task paradigm: a dynamic neural field model of Dux et al. (2009).

    Science.gov (United States)

    Buss, Aaron T; Wifall, Tim; Hazeltine, Eliot; Spencer, John P

    2014-02-01

    People are typically slower when executing two tasks than when only performing a single task. These dual-task costs are initially robust but are reduced with practice. Dux et al. (2009) explored the neural basis of dual-task costs and learning using fMRI. Inferior frontal junction (IFJ) showed a larger hemodynamic response on dual-task trials compared with single-task trial early in learning. As dual-task costs were eliminated, dual-task hemodynamics in IFJ reduced to single-task levels. Dux and colleagues concluded that the reduction of dual-task costs is accomplished through increased efficiency of information processing in IFJ. We present a dynamic field theory of response selection that addresses two questions regarding these results. First, what mechanism leads to the reduction of dual-task costs and associated changes in hemodynamics? We show that a simple Hebbian learning mechanism is able to capture the quantitative details of learning at both the behavioral and neural levels. Second, is efficiency isolated to cognitive control areas such as IFJ, or is it also evident in sensory motor areas? To investigate this, we restrict Hebbian learning to different parts of the neural model. None of the restricted learning models showed the same reductions in dual-task costs as the unrestricted learning model, suggesting that efficiency is distributed across cognitive control and sensory motor processing systems.

  15. Ensemble averaged coherent state path integral for disordered bosons with a repulsive interaction (Derivation of mean field equations)

    International Nuclear Information System (INIS)

    Mieck, B.

    2007-01-01

    We consider bosonic atoms with a repulsive contact interaction in a trap potential for a Bose-Einstein condensation (BEC) and additionally include a random potential. The ensemble averages for two models of static (I) and dynamic (II) disorder are performed and investigated in parallel. The bosonic many body systems of the two disorder models are represented by coherent state path integrals on the Keldysh time contour which allow exact ensemble averages for zero and finite temperatures. These ensemble averages of coherent state path integrals therefore present alternatives to replica field theories or super-symmetric averaging techniques. Hubbard-Stratonovich transformations (HST) lead to two corresponding self-energies for the hermitian repulsive interaction and for the non-hermitian disorder-interaction. The self-energy of the repulsive interaction is absorbed by a shift into the disorder-self-energy which comprises as an element of a larger symplectic Lie algebra sp(4M) the self-energy of the repulsive interaction as a subalgebra (which is equivalent to the direct product of M x sp(2); 'M' is the number of discrete time intervals of the disorder-self-energy in the generating function). After removal of the remaining Gaussian integral for the self-energy of the repulsive interaction, the first order variations of the coherent state path integrals result in the exact mean field or saddle point equations, solely depending on the disorder-self-energy matrix. These equations can be solved by continued fractions and are reminiscent to the 'Nambu-Gorkov' Green function formalism in superconductivity because anomalous terms or pair condensates of the bosonic atoms are also included into the selfenergies. The derived mean field equations of the models with static (I) and dynamic (II) disorder are particularly applicable for BEC in d=3 spatial dimensions because of the singularity of the density of states at vanishing wavevector. However, one usually starts out from

  16. A compactly integrated cooling system of a combination dual 1.5-MW HTS motors for electric propulsion

    Energy Technology Data Exchange (ETDEWEB)

    Le, T. D.; Kim, J. H.; Hyeon, C. J.; Kim, H. M.; Kim, D. K. [Jeju National University, Jeju (Korea, Republic of); Kim, Y. S. [Shin Ansan University, Ansan (Korea, Republic of); Lee, J.; Park, Y. G.; Jeon, H. [Yonsei University, Seoul (Korea, Republic of); Quach, H. L. [Electronic and Telecommunication Engineering, Can Tho University of Technology, Can Tho (Viet Nam)

    2016-12-15

    The high temperature superconducting (HTS) contra-rotating propulsion (CRP) systems comprise two coaxial propellers sited on behind the other and rotate in opposite directions. They have the hydrodynamic advantage of recovering the slipstream rotational energy which would otherwise be lost to a conventional single-screw system. However, the cooling systems used for HTS CRP system need a high cooling power enough to maintain a low temperature of 2G HTS material operating at liquid neon (LNe) temperature (24.5 - 27 K). In this paper, a single thermo-syphon cooling approach using a Gifford-McMahon (G-M) cryo-cooler is presented. First, an optimal thermal design of a 1.5 MW HTS motor was conducted varying to different types of commercial 2G HTS tapes. Then, a mono-cryogenic cooling system for an integration of two 1.5 MW HTS motors will be designed and analyzed. Finally, the 3D finite element analysis (FEA) simulation of thermal characteristics was also performed.

  17. Direct Surface and Droplet Microsampling for Electrospray Ionization Mass Spectrometry Analysis with an Integrated Dual-Probe Microfluidic Chip

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Cong-Min [Institute of Microanalytical; Zhu, Ying [Institute of Microanalytical; Jin, Di-Qiong [Institute of Microanalytical; Kelly, Ryan T. [Environmental; Fang, Qun [Institute of Microanalytical

    2017-08-15

    Ambient mass spectrometry (MS) has revolutionized the way of MS analysis and broadened its application in various fields. This paper describes the use of microfluidic techniques to simplify the setup and improve the functions of ambient MS by integrating the sampling probe, electrospray emitter probe, and online mixer on a single glass microchip. Two types of sampling probes, including a parallel-channel probe and a U-shaped channel probe, were designed for dryspot and liquid-phase droplet samples, respectively. We demonstrated that the microfabrication techniques not only enhanced the capability of ambient MS methods in analysis of dry-spot samples on various surfaces, but also enabled new applications in the analysis of nanoliter-scale chemical reactions in an array of droplets. The versatility of the microchip-based ambient MS method was demonstrated in multiple different applications including evaluation of residual pesticide on fruit surfaces, sensitive analysis of low-ionizable analytes using postsampling derivatization, and high-throughput screening of Ugi-type multicomponent reactions.

  18. SU-E-E-15: Design of a Water Calorimeter for Dual Use in An Integrated MRI-Linac and Gamma-Knife

    Energy Technology Data Exchange (ETDEWEB)

    Entezari, N [Ryerson University, Toronto, Ontario (Canada); Renaud, J [McGill University, Montreal, Quebec (Canada); Ly, D [Waterloo University, Waterloo, Ontario (Canada); Sarfehnia, A [Sunnybrook Hospital, Toronto, ON (Canada)

    2015-06-15

    Purpose: To design a water calorimeter for dual use in an integrated MRI-linac and Gamma-Knife. In calorimetry, dose to water is measured based on the assumption that energy absorbed in a sensitive volume is completely converted to temperature rise {sub (}ΔΤ{sub )} according to the specific heat capacity of the medium c: D=c*ΔT*k, where k is heat transfer correction factor and compensates for heat gain or loss at point of measurement due to conductive effects. Methods: A commercial finite element method software package was used to model four different water calorimeter designs. The long term (48 h) thermal stability of each design was accurately modeled, and the optimization of the final design was based on evaluation of the standard deviation of k for ten consecutive irradiation runs (lower standard deviation translates to greater thermal stability). Several insulator materials of varying thicknesses were investigated, and a sensitivity study of thermal stability to variations in ambient temperature fluctuations was undertaken. Specifically, we evaluated the effect of possible variations in coolant temperature circulating around the calorimeter tank in several scenarios (constant, slowly increasing, or fluctuating). Results: Due to MRI-compatibility requirements, the calorimeter is to be built entirely out of plastic. Among all insulation materials tested, solid state aerogel-based insulation resulted in least heat loss and thermal stability. The final design is cylindrical on top (to be used upright in MRI-linac) and semi-spherical at bottom (for use in GammaKnife). The range of k was found to be 1.002 ± 0.013 (k = 1), comparable with a k of 1.002 ± 0.014 for typical water calorimeters used in high energy beams. A long term stability of 0.36 µK/hr was evaluated. Conclusion: Optimization of a water calorimeter design for dual use in MRI-linac and Gamma-Knife has been completed and the device is currently in production. Supported by NSERC RGPIN 435608.

  19. SU-E-E-15: Design of a Water Calorimeter for Dual Use in An Integrated MRI-Linac and Gamma-Knife

    International Nuclear Information System (INIS)

    Entezari, N; Renaud, J; Ly, D; Sarfehnia, A

    2015-01-01

    Purpose: To design a water calorimeter for dual use in an integrated MRI-linac and Gamma-Knife. In calorimetry, dose to water is measured based on the assumption that energy absorbed in a sensitive volume is completely converted to temperature rise ( ΔΤ ) according to the specific heat capacity of the medium c: D=c*ΔT*k, where k is heat transfer correction factor and compensates for heat gain or loss at point of measurement due to conductive effects. Methods: A commercial finite element method software package was used to model four different water calorimeter designs. The long term (48 h) thermal stability of each design was accurately modeled, and the optimization of the final design was based on evaluation of the standard deviation of k for ten consecutive irradiation runs (lower standard deviation translates to greater thermal stability). Several insulator materials of varying thicknesses were investigated, and a sensitivity study of thermal stability to variations in ambient temperature fluctuations was undertaken. Specifically, we evaluated the effect of possible variations in coolant temperature circulating around the calorimeter tank in several scenarios (constant, slowly increasing, or fluctuating). Results: Due to MRI-compatibility requirements, the calorimeter is to be built entirely out of plastic. Among all insulation materials tested, solid state aerogel-based insulation resulted in least heat loss and thermal stability. The final design is cylindrical on top (to be used upright in MRI-linac) and semi-spherical at bottom (for use in GammaKnife). The range of k was found to be 1.002 ± 0.013 (k = 1), comparable with a k of 1.002 ± 0.014 for typical water calorimeters used in high energy beams. A long term stability of 0.36 µK/hr was evaluated. Conclusion: Optimization of a water calorimeter design for dual use in MRI-linac and Gamma-Knife has been completed and the device is currently in production. Supported by NSERC RGPIN 435608

  20. Effectiveness of Dual Focus Mutual Aid for Co-occurring Substance Use and Mental Health Disorders: A Review and Synthesis of the “Double Trouble” in Recovery Evaluation

    Science.gov (United States)

    Magura, Stephen

    2010-01-01

    Over five million adults in the U.S. have a co-occurring substance use disorder and serious psychological distress. Mutual aid (“self-help”) can usefully complement treatment, but people with co-occurring substance use and psychiatric disorders often encounter a lack of empathy and acceptance in traditional mutual aid groups. Double Trouble in Recovery (DTR) is a dual focus fellowship whose mission is to bring the benefits of mutual aid to persons recovering from co-occurring disorders. An evaluation of DTR was conducted by interviewing 310 persons attending 24 DTR meetings in New York City in 1998 and following them up for two years, in 1999 and 2000. The evaluation produced 13 articles in 12 peer reviewed journals, the main results of which are summarized here. The sample’s characteristics were: mean age, 40 years; women, 28%; black, 59%; white, 25%; Hispanic, 14%; never married, 63%; live in supported community residence, 53%; high school graduate or GED, 60%; arrested as adult, 63%; diagnoses of: schizophrenia, 39%; major depression, 21%; or bipolar disorder; 20%; currently prescribed psychiatric medication, 92%; primary substance used, current or past: cocaine/crack, 42%; alcohol 34%; or heroin, 11%. Overall, the findings indicate that DTR participation has both direct and indirect effects on several important components of recovery: drug/alcohol abstinence, psychiatric medication adherence, self-efficacy for recovery, and quality of life. The study also identified several “common” therapeutic factors (e.g., internal motivation, social support) and unique mutual aid processes (helper-therapy, reciprocal learning) that mediate the influence of DTR participation on recovery. For clinicians, these results underline the importance of fostering stable affiliation with specialized dual focus 12-step groups for their patients with co-occurring disorders, as part of a comprehensive recovery-oriented treatment approach. PMID:19016171

  1. Integrated or dual vocational training focused on the operations of a nuclear power plant; La formacion profesional integrada y/o dual enfocada a la operativa de una central nuclear

    Energy Technology Data Exchange (ETDEWEB)

    Roca, F.

    2014-10-01

    Dual vocational training is understood to be all the mixed employment and training actions and initiatives, the purpose of which in the vocational qualification of workers in a system alternating a job in a company with the training activity received in the framework of the vocational training system for employment of the educational system. The dual vocational training that results from this mixed strategy is provided via the following modality: Shared training between the training center and the company, which consists of coparticipation to varying degrees in the teaching and learning processes in the company and the training center. (Author)

  2. Executive functioning in dual-diagnosis

    NARCIS (Netherlands)

    Duijkers, J.C.L.M.; Vissers, C.T.W.M.; Egger, J.I.M.

    2016-01-01

    Objectives: In mental health, the term dual-diagnosis (DD) is used for the co-occurrence of Substance Use Disorder (SUD: alcohol/drugs) with another mental disorder. These co-occurring disorders can have a shared cause, and can cause/intensify each other's expression. Forming a threat to health and

  3. Evaluation of an integrated treatment for active duty service members with comorbid posttraumatic stress disorder and major depressive disorder: Study protocol for a randomized controlled trial.

    Science.gov (United States)

    Walter, Kristen H; Glassman, Lisa H; Michael Hunt, W; Otis, Nicholas P; Thomsen, Cynthia J

    2018-01-01

    Posttraumatic stress disorder (PTSD) commonly co-occurs with major depressive disorder (MDD) in both civilian and military/veteran populations. Existing, evidence-based PTSD treatments, such as cognitive processing therapy (CPT), often reduce symptoms of both PTSD and depression; however, findings related to the influence of comorbid MDD on PTSD treatment outcomes are mixed, and few studies use samples of individuals with both conditions. Behavioral activation (BA), an approach that relies on behavioral principles, is an effective treatment for depression. We have integrated BA into CPT (BA+CPT), a more cognitive approach, to address depressive symptoms among active duty service members with both PTSD and comorbid MDD. We describe an ongoing randomized controlled trial investigating the efficacy of our innovative, integrated BA+CPT intervention, compared with standard CPT, for active duty service members with PTSD and comorbid MDD. We detail the development of this integrated treatment, as well as the design and implementation of the randomized controlled trial, to evaluate its effect on symptoms. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. The Explicit Determinations Of Dual Plane Curves And Dual Helices In Terms Of Its Dual Curvature And Dual Torsion

    OpenAIRE

    Lee Jae Won; Choi Jin Ho; Jin Dae Ho

    2014-01-01

    In this paper, we give the explicit determinations of dual plane curves, general dual helices and dual slant helices in terms of its dual curvature and dual torsion as a fundamental theory of dual curves in a dual 3-space

  5. Dual Criteria Decisions

    DEFF Research Database (Denmark)

    Andersen, Steffen; Harrison, Glenn W.; Lau, Morten Igel

    2014-01-01

    The most popular models of decision making use a single criterion to evaluate projects or lotteries. However, decision makers may actually consider multiple criteria when evaluating projects. We consider a dual criteria model from psychology. This model integrates the familiar tradeoffs between...... to the clear role that income thresholds play in such decision making, but does not rule out a role for tradeoffs between risk and utility or probability weighting....

  6. The science of well-being: an integrated approach to mental health and its disorders.

    Science.gov (United States)

    Cloninger, C Robert

    2006-06-01

    Psychiatry has failed to improve the average levels of happiness and well-being in the general population, despite vast expenditures on psychotropic drugs and psychotherapy manuals. The practical failure of psychiatry to improve well-being is the result of an excessive focus on stigmatizing aspects of mental disorders and the neglect of methods to enhance positive emotions, character development, life satisfaction, and spirituality. In this paper, a simple and practical approach to well-being is described by integrating biological, psychological, social, and spiritual methods for enhancing mental health. Evidence is presented showing that people can be helped to develop their character and happiness by a catalytic sequence of practical clinical methods. People can learn to flourish and to be more selfdirected by becoming more calm, accepting their limitations, and letting go of their fears and conflicts. People can learn to be more cooperative by increasing in mindfulness and working in the service of others. In addition, people can learn to be more self-transcendent by growing in self-awareness of the perspectives that lead to beliefs and assumptions about life which produce negative emotions and limit the experience of positive emotions. The personality traits of self-directedness, cooperativeness, and self-transcendence are each essential for well-being. They can be reliably measured using the Temperament and Character Inventory. A psychoeducational program for wellbeing has been developed, called "The happy life: voyages to well-being". It is a multi-stage universal-style intervention by which anyone who wants to be happier and healthier can do so through self-help and/or professional therapy.

  7. Integration of ultra-high field MRI and histology for connectome based research of brain disorders

    Directory of Open Access Journals (Sweden)

    Shan eYang

    2013-09-01

    Full Text Available Ultra-high field magnetic resonance imaging (MRI became increasingly relevant for in vivo neuroscientific research because of improved spatial resolutions. However, this is still the unchallenged domain of histological studies, which long played an important role in the investigation of neuropsychiatric disorders. While the field of biological psychiatry strongly advanced on macroscopic levels, current developments are rediscovering the richness of immunohistological information when attempting a multi-level systematic approach to brain function and dysfunction. For most studies, histology sections lost information on three-dimensional reconstructions. Translating histological sections to 3D-volumes would thus not only allow for multi-stain and multi-subject alignment in post mortem data, but also provide a crucial step in big data initiatives involving the network analyses currently performed with in vivo MRI. We therefore investigated potential pitfalls during integration of MR and histological information where no additional blockface information is available. We demonstrated that strengths and requirements from both methods seem to be ideally merged at a spatial resolution of 200 μm. However, the success of this approach is heavily dependent on choices of hardware, sequence and reconstruction. We provide a fully automated pipeline that optimizes histological 3D reconstructions, providing a potentially powerful solution not only for primary human post mortem research institutions in neuropsychiatric research, but also to help alleviate the massive workloads in neuroanatomical atlas initiatives. We further demonstrate (for the first time the feasibility and quality of ultra-high spatial resolution (150 µm isotopic imaging of the entire human brain MRI at 7T, offering new opportunities for analyses on MR-derived information.

  8. The Desire for Amputation or Paralyzation: Evidence for Structural Brain Anomalies in Body Integrity Identity Disorder (BIID)

    OpenAIRE

    Blom, Rianne M; van Wingen, Guido A; van der Wal, Sija J; Luigjes, Judy; van Dijk, Milenna T; Scholte, H Steven; Denys, D.

    2016-01-01

    BACKGROUND: Body Integrity Identity Disorder (BIID) is a condition in which individuals perceive a mismatch between their internal body scheme and physical body shape, resulting in an absolute desire to be either amputated or paralyzed. The condition is hypothesized to be of congenital nature, but evidence for a neuro-anatomical basis is sparse. METHODS: We collected T1-weighted structural magnetic resonance imaging scans on a 3T scanner in eight individuals with BIID and 24 matched healthy c...

  9. White matter integrity and its association with affective and interpersonal symptoms in borderline personality disorder

    OpenAIRE

    Whalley, Heather C; Nickson, Thomas; Pope, Merrick; Nicol, Katie; Romaniuk, Liana; Bastin, Mark E; Semple, Scott I; McIntosh, Andrew M; Hall, Jeremy

    2015-01-01

    BACKGROUND: \\ud \\ud Borderline personality disorder (BPD) is a severe psychiatric disorder involving a range of symptoms including marked affective instability and disturbances in interpersonal interactions. Neuroimaging studies are beginning to provide evidence of altered processing in fronto-limbic network deficits in the disorder, however, few studies directly examine structural connections within this circuitry together with their relation to proposed causative processes and clinical feat...

  10. Dual Diagnosis

    Science.gov (United States)

    ... tend to occur with Depression Anxiety disorders Schizophrenia Personality disorders Sometimes the mental problem occurs first. This can ... Treatments may include behavioral therapy, medicines, and support groups. NIH: National Institute on Drug Abuse

  11. Determination of actual crop evapotranspiration (ETc) and dual crop coefficients (Kc) for cotton, wheat and maize in Fergana Valley: integration of the FAO-56 approach and BUDGET

    Science.gov (United States)

    Kenjabaev, Shavkat; Dernedde, Yvonne; Frede, Hans-Georg; Stulina, Galina

    2014-05-01

    Determination of the actual crop evapotranspiration (ETc) during the growing period is important for accurate irrigation scheduling in arid and semi-arid regions. Development of a crop coefficient (Kc) can enhance ETc estimations in relation to specific crop phenological development. This research was conducted to determine daily and growth-stage-specific Kc and ETc values for cotton (Gossypium hirsutum L.), winter wheat (Triticum aestivum L.) and maize (Zea mays L.) for silage at fields in Fergana Valley (Uzbekistan). The soil water balance model - Budget with integration of the dual crop procedure of the FAO-56 was used to estimate the ETc and separate it into evaporation (Ec) and transpiration (Tc) components. An empirical equation was developed to determine the daily Kc values based on the estimated Ec and Tc. The ETc, Kc determination and comparison to existing FAO Kc values were performed based on 10, 5 and 6 study cases for cotton, wheat and maize, respectively. Mean seasonal amounts of crop water consumption in terms of ETc were 560±50, 509±27 and 243±39 mm for cotton, wheat and maize, respectively. The growth-stage-specific Kc for cotton, wheat and maize was 0.15, 0.27 and 0.11 at initial; 1.15, 1.03 and 0.56 at mid; and 0.45, 0.89 and 0.53 at late season stages. These values correspond to those reported by the FAO-56. Development of site specific Kc helps tremendously in irrigation management and furthermore provides precise water applications in the region. The developed simple approach to estimate daily Kc for the three main crops grown in the Fergana region was a first attempt to meet this issue. Keywords: Actual crop evapotranspiration, evaporation and transpiration, crop coefficient, model BUDGET, Fergana Valley.

  12. Beyond Neural Cubism: Promoting a Multidimensional View of Brain Disorders by Enhancing the Integration of Neurology and Psychiatry in Education

    Science.gov (United States)

    Taylor, Joseph J.; Williams, Nolan R.; George, Mark S.

    2014-01-01

    Cubism was an influential early 20th century art movement characterized by angular, disjointed imagery. The two-dimensional appearance of Cubist figures and objects is created through juxtaposition of angles. The authors posit that the constrained perspectives found in Cubism may also be found in the clinical classification of brain disorders. Neurological disorders are often separated from psychiatric disorders as if they stem from different organ systems. Maintaining two isolated clinical disciplines fractionalizes the brain in the same way that Pablo Picasso fractionalized figures and objects in his Cubist art. This Neural Cubism perpetuates a clinical divide that does not reflect the scope and depth of neuroscience. All brain disorders are complex and multidimensional, with aberrant circuitry and resultant psychopharmacology manifesting as altered behavior, affect, mood or cognition. Trainees should receive a multidimensional education based on modern neuroscience, not a partial education based on clinical precedent. The authors briefly outline the rationale for increasing the integration of neurology and psychiatry and discuss a nested model with which clinical neuroscientists (neurologists and psychiatrists) can approach and treat brain disorders. PMID:25340364

  13. Integrated circuits and molecular components for stress and feeding: implications for eating disorders.

    Science.gov (United States)

    Hardaway, J A; Crowley, N A; Bulik, C M; Kash, T L

    2015-01-01

    Eating disorders are complex brain disorders that afflict millions of individuals worldwide. The etiology of these diseases is not fully understood, but a growing body of literature suggests that stress and anxiety may play a critical role in their development. As our understanding of the genetic and environmental factors that contribute to disease in clinical populations like anorexia nervosa, bulimia nervosa and binge eating disorder continue to grow, neuroscientists are using animal models to understand the neurobiology of stress and feeding. We hypothesize that eating disorder clinical phenotypes may result from stress-induced maladaptive alterations in neural circuits that regulate feeding, and that these circuits can be neurochemically isolated using animal model of eating disorders. © 2014 John Wiley & Sons Ltd and International Behavioural and Neural Genetics Society.

  14. QCD Dual

    DEFF Research Database (Denmark)

    Sannino, Francesco

    2009-01-01

    We uncover a novel solution of the 't Hooft anomaly matching conditions for QCD. Interestingly in the perturbative regime the new gauge theory, if interpreted as a possible QCD dual, predicts the critical number of flavors above which QCD in the nonperturbative regime, develops an infrared stable...

  15. Early detection and integrated care for adolescents and young adults with severe psychotic disorders: rationales and design of the Integrated Care in Early Psychosis Study (ACCESS III).

    Science.gov (United States)

    Lambert, Martin; Schöttle, Daniel; Sengutta, Mary; Ruppelt, Friederike; Rohenkohl, Anja; Luedecke, Daniel; Nawara, Luise Antonia; Galling, Britta; Falk, Anne-Lena; Wittmann, Linus; Niehaus, Vivien; Sarikaya, Gizem; Handwerk, Ute; Rothländer, Wiebke; Rietschel, Liz; Gagern, Charlotte; Lange, Benjamin; Meigel-Schleiff, Christina; Naber, Dieter; Schulte-Markwort, Michael; Krüger, Helmut; Unger, Hans-Peter; Sippel, Sven; Ott, Sabine; Romer, Georg; Daubmann, Anne; Wegscheider, Karl; Correll, Christoph U; Schimmelmann, Benno G; Bock, Thomas; Gallinat, Jürgen; Karow, Anne

    2018-02-01

    The Integrated Care in Early Psychosis (ACCESS III) Study examined the efficacy and cost-effectiveness of a combined intervention consisting of strategies to improve early detection and quality of care (integrated care including therapeutic assertive community treatment) in adolescents and young adults in the early phase of a severe psychotic disorder from 2011 to 2014. This is a prospective, single-centre, 1-year cohort study comparing an intervention condition (early detection plus integrated care, n = 120) to the historical control condition (standard care, SC, n = 105) for adolescents and young adults aged 12-29 years suffering from a severe, early-phase psychotic disorder (i.e. within 2 years of treatment). Primary outcome is the rate of combined symptomatic (i.e. Positive and Negative Syndrome Scale (PANSS) criteria) and functional (i.e. Global Assessment of Functioning scale (GAF) ≥ 60 points criterion) remission over at least 6 months at study endpoint. Secondary outcome comprises the comparison of the reduction in the duration of untreated psychosis within the 4-year study duration between integrated care and SC, course of psychopathology, functioning, quality of life, satisfaction with care, cost and quality-adjusted life years (QALYs) in comparison to a historical control group. To the authors' knowledge, this is the first study assessing the efficacy and cost-effectiveness of a combined intervention consisting of early detection strategies and strategies to improve quality of care in both adolescents and young adults with early-phase psychosis. The results will be published in 2016. © 2016 John Wiley & Sons Australia, Ltd.

  16. Measuring fragmentation in dissociative identity disorder: the integration measure and relationship to switching and time in therapy.

    Science.gov (United States)

    Barlow, M Rose; Chu, James A

    2014-01-01

    Some people with dissociative identity disorder (DID) have very little communication or awareness among the parts of their identity, while others experience a great deal of cooperation among alternate identities. Previous research on this topic has been sparse. Currently, there is no empirical measure of integration versus fragmentation in a person with DID. In this study, we report the development of such a measure. The goal of this study was to pilot the integration measure (IM) and to address its psychometric properties and relationships to other measures. The IM is the first standardized measure of integration in DID. Eleven women with DID participated in an experiment that included a variety of tasks. They filled out questionnaires about trauma and dissociation as well as the IM. They also provided verbal results about switching among alternate identities during the study sessions. Participants switched among identities an average of 5.8 times during the first session, and switching was highly correlated with trauma. Integration was related to switching, though this relationship may be non-linear. Integration was not related to time in psychotherapy. The IM provides a useful beginning to quantify and study integration and fragmentation in DID. Directions for future research are also discussed, including expanding the IM from this pilot. The IM may be useful in treatment settings to assess progress or change over time.

  17. Measuring fragmentation in dissociative identity disorder: the integration measure and relationship to switching and time in therapy

    Directory of Open Access Journals (Sweden)

    Margaret Rose Barlow

    2014-01-01

    Full Text Available Background: Some people with dissociative identity disorder (DID have very little communication or awareness among the parts of their identity, while others experience a great deal of cooperation among alternate identities. Previous research on this topic has been sparse. Currently, there is no empirical measure of integration versus fragmentation in a person with DID. In this study, we report the development of such a measure. Objective: The goal of this study was to pilot the integration measure (IM and to address its psychometric properties and relationships to other measures. The IM is the first standardized measure of integration in DID. Method: Eleven women with DID participated in an experiment that included a variety of tasks. They filled out questionnaires about trauma and dissociation as well as the IM. They also provided verbal results about switching among alternate identities during the study sessions. Results: Participants switched among identities an average of 5.8 times during the first session, and switching was highly correlated with trauma. Integration was related to switching, though this relationship may be non-linear. Integration was not related to time in psychotherapy. Conclusions: The IM provides a useful beginning to quantify and study integration and fragmentation in DID. Directions for future research are also discussed, including expanding the IM from this pilot. The IM may be useful in treatment settings to assess progress or change over time.

  18. Dual diagnosis in Depression: treatment recommendations.

    Science.gov (United States)

    Tirado Muñoz, Judit; Farré, Adriana; Mestre-Pintó, Joan; Szerman, Nestor; Torrens, Marta

    2018-01-01

    Comorbidity between substance use disorders (SUD) and major depression (MD) is the most common dual pathology in the field of addiction to substances and has prevalence rates ranging between 12% and 80%, which complicates the response to treatment and worsens the prognosis of patients. Differentiating between diagnoses of induced depressive episodes and primary depressive episodes concurrent to substance use is especially relevant for therapeutic management. This article presents the state of the art of the currently available pharmacologic treatments of comorbid depression in patients with SUD, taking into account the safety and risk of abuse of antidepressant drugs. Due to the fact that comorbidity of MD and SUD is frequent and presents greater psychopathological and medical severity, as well as worse social functioning, it is crucial to treat MD and SUD simultaneously using the integrated treatment model and not to treat both conditions separately.

  19. Motor-auditory-visual integration: The role of the human mirror neuron system in communication and communication disorders.

    Science.gov (United States)

    Le Bel, Ronald M; Pineda, Jaime A; Sharma, Anu

    2009-01-01

    The mirror neuron system (MNS) is a trimodal system composed of neuronal populations that respond to motor, visual, and auditory stimulation, such as when an action is performed, observed, heard or read about. In humans, the MNS has been identified using neuroimaging techniques (such as fMRI and mu suppression in the EEG). It reflects an integration of motor-auditory-visual information processing related to aspects of language learning including action understanding and recognition. Such integration may also form the basis for language-related constructs such as theory of mind. In this article, we review the MNS system as it relates to the cognitive development of language in typically developing children and in children at-risk for communication disorders, such as children with autism spectrum disorder (ASD) or hearing impairment. Studying MNS development in these children may help illuminate an important role of the MNS in children with communication disorders. Studies with deaf children are especially important because they offer potential insights into how the MNS is reorganized when one modality, such as audition, is deprived during early cognitive development, and this may have long-term consequences on language maturation and theory of mind abilities. Readers will be able to (1) understand the concept of mirror neurons, (2) identify cortical areas associated with the MNS in animal and human studies, (3) discuss the use of mu suppression in the EEG for measuring the MNS in humans, and (4) discuss MNS dysfunction in children with (ASD).

  20. Body integrity identity disorder: deranged body processing, right fronto-parietal dysfunction, and phenomenological experience of body incongruity.

    Science.gov (United States)

    Giummarra, Melita J; Bradshaw, John L; Nicholls, Michael E R; Hilti, Leonie M; Brugger, Peter

    2011-12-01

    Body integrity identity disorder (BIID) is characterised by profound experience of incongruity between the biological and desired body structure. The condition manifests in "non-belonging" of body parts, and the subsequent desire to amputate, paralyse or disable a limb. Little is known about BIID; however, a neuropsychological model implicating right fronto-parietal and insular networks is emerging, with potential disruption to body representation. We argue that, as there is scant systematic research on BIID published to date and much of the research is methodologically weak, it is premature to assume that the only process underlying bodily experience that is compromised is body representation. The present review systematically investigates which aspects of neurological processing of the body, and sense of self, may be compromised in BIID. We argue that the disorder most likely reflects dysregulation in multiple levels of body processing. That is, the disunity between self and the body could arguably come about through congenital and/or developmental disruption of body representations, which, together with altered multisensory integration, may preclude the experience of self-attribution and embodiment of affected body parts. Ulimately, there is a need for official diagnostic criteria to facilitate epidemiological characterisation of BIID, and for further research to systematically investigate which aspects of body representation and processing are truly compromised in the disorder.

  1. Integral intervention in a child with epilepsy and attention-deficit/hyperactivity disorder symptoms

    Directory of Open Access Journals (Sweden)

    Agustín Ernesto Martínez González

    2014-12-01

    Full Text Available For several years, studies have investigated the appearance and prevalence of symptoms typical of Attention-Deficit/ Hyperactivity Disorder in children with epilepsy. Traditional intervention methods to treat Attention-Deficit/ Hyperactivity Disorder symptoms include pharmacology and psychological therapy in children and parents. The present study assessed cognitive processes in a child with epilepsy and Attention-Deficit/ Hyperactivity Disorder symptoms after one year of neuropsychological rehabilitation and cognitive-behavioural family therapy. The results show an improvement in cognitive processes such as attention, short-term and long-term verbal and non-verbal memory, and executive function. There was also a slight improvement among parents in their perception of hyperactivity and impulsivity symptoms. This study suggests that comprehensive intervention is a promising approach in children with epilepsy and Attention-Deficit/ Hyperactivity Disorder symptoms. Future studies should include a larger sample of patients with cognitive impairment and similar brain lesions.

  2. Dual Entwining Structures and Dual Entwined Modules

    OpenAIRE

    Abuhlail, Jawad Y.

    2003-01-01

    In this note we introduce and investigate the concepts of dual entwining structures and dual entwined modules. This generalizes the concepts of dual Doi-Koppinen structures and dual Doi-Koppinen modules introduced (in the infinite case over rings) by the author is his dissertation.

  3. Dual diagnosis resource needs in Spain: a national survey of professionals.

    Science.gov (United States)

    Szerman, Nestor; Vega, Pablo; Grau-López, Lara; Barral, Carmen; Basurte-Villamor, Ignacio; Mesías, Beatriz; Rodríguez-Cintas, Laia; Martínez-Raga, José; Casas, Miguel; Roncero, Carlos

    2014-01-01

    Since provision of integrated services for patients with dual pathology or dual disorders (coexistence of an addictive disorder and another mental health disorder) is an important challenge in mental health, this study assessed health care professionals' perceptions and knowledge of the current state of specific resources for patients with dual pathology in Spain. We conducted a national survey of health care professionals seeing patients with dual pathology in treatment facilities throughout Spain. Participants completed a specific online questionnaire about the needs of and available resources for patients with dual pathology. A total of 659 professionals, mostly psychologists (n = 286, 43.4%) or psychiatrists (n = 217, 32.9%), participated in the study. Nearly all participants who responded to these items reported that specific resources for dual pathology were needed (n = 592/635, 93.2%); 76.7% (n = 487) identified intermediate resources, 68.8% (n = 437) acute detoxification units, and 64.6% (n = 410) medium-stay rehabilitation units as particularly necessary. In the opinion of 54.0% of respondents (n = 343), integrated mental health and addiction treatment services were available. Of the participants who answered these items, only a small proportion (n = 162/605, 26.8%) reported that there were appropriate outpatient programs for dual pathology, 30.4% (n = 184/605) specific hospitalization units, 16.9% (n = 99/587) subacute inpatient units, 34.2% (n = 201/587) outpatient intermediate resources, 15.5% (n = 91/587) day hospitals, and 21.5% (n = 126/587) day centers. Conversely, 62.5% (n = 378/587) of participants reported a greater presence of specific detoxification/withdrawal units, 47.3% (n = 286/587) psychiatric acute admission units, and 41.9% (n = 246/587) therapeutic communities. In the professionals' opinion, the presence of specialty programs was low; 11.6% of respondents (n = 68/587) reported that vocational programs and 16.7% (n = 98/587) reported

  4. [Dual pathology].

    Science.gov (United States)

    Rougier, A

    2008-05-01

    Dual pathology is defined as the association of two potentially epileptogenic lesions, hippocampal (sclerosis, neuronal loss) and extrahippocampal (temporal or extratemporal). Epileptic activity may be generated by either lesion and the relative importance of every lesion's epileptogenicity conditions the surgical strategy adopted. Most frequently associated with hippocampal sclerosis are cortical dysplasias. The common physiopathology of the two lesions is not clearly established. Extrahippocampal lesions may be undetectable on MRI (microdysgenesis, for example) and ictal discharge patterns may vary among dual pathology patients. The surgical strategy depends on the location of the extrahippocampal lesion and its relative role in seizure generation; however, reported surgical results suggest that simultaneous resection of mesial temporal structures along with the extrahippocampal lesion should be performed.

  5. Performance Enhancements Under Dual-task Conditions

    Science.gov (United States)

    Kramer, A. F.; Wickens, C. D.; Donchin, E.

    1984-01-01

    Research on dual-task performance has been concerned with delineating the antecedent conditions which lead to dual-task decrements. Capacity models of attention, which propose that a hypothetical resource structure underlies performance, have been employed as predictive devices. These models predict that tasks which require different processing resources can be more successfully time shared than tasks which require common resources. The conditions under which such dual-task integrality can be fostered were assessed in a study in which three factors likely to influence the integrality between tasks were manipulated: inter-task redundancy, the physical proximity of tasks and the task relevant objects. Twelve subjects participated in three experimental sessions in which they performed both single and dual-tasks. The primary task was a pursuit step tracking task. The secondary tasks required the discrimination between different intensities or different spatial positions of a stimulus. The results are discussed in terms of a model of dual-task integrality.

  6. Integral Characterization of Defective BDNF/TrkB Signalling in Neurological and Psychiatric Disorders Leads the Way to New Therapies

    Science.gov (United States)

    Tejeda, Gonzalo S.; Díaz-Guerra, Margarita

    2017-01-01

    Enhancement of brain-derived neurotrophic factor (BDNF) signalling has great potential in therapy for neurological and psychiatric disorders. This neurotrophin not only attenuates cell death but also promotes neuronal plasticity and function. However, an important challenge to this approach is the persistence of aberrant neurotrophic signalling due to a defective function of the BDNF high-affinity receptor, tropomyosin-related kinase B (TrkB), or downstream effectors. Such changes have been already described in several disorders, but their importance as pathological mechanisms has been frequently underestimated. This review highlights the relevance of an integrative characterization of aberrant BDNF/TrkB pathways for the rational design of therapies that by combining BDNF and TrkB targets could efficiently promote neurotrophic signalling. PMID:28134845

  7. Corpus callosum integrity is affected by mood disorders and also by the suicide attempt history: A diffusion tensor imaging study.

    Science.gov (United States)

    Cyprien, Fabienne; de Champfleur, Nicolas Menjot; Deverdun, Jérémy; Olié, Emilie; Le Bars, Emmanuelle; Bonafé, Alain; Mura, Thibault; Jollant, Fabrice; Courtet, Philippe; Artero, Sylvaine

    2016-12-01

    Some MRI studies have noted alterations in the corpus callosum (CC) white matter integrity of individuals with mood disorders and also in patients with suicidal behavior. We investigated the specific impact of suicidal behavior on CC integrity in mood disorders. CC structural changes were assessed by diffusion tensor imaging (DTI) in 121 women 18-50-year-old): 41 with bipolar disorder (BD), 50 with major depressive disorder (MDD) and 30 healthy controls (HC). Fractional anisotropy (FA) and DTI metrics were calculated for the genu, body and splenium of CC and compared in the three groups by MANCOVA. Then, they were re-analyzed relative to the suicide attempt history within the MDD and BD groups and to the suicide number/severity. FA values for the CC genu and body were lower in non-suicide attempters with BD than with MDD and in HC. Conversely, FA values for all CC regions were significantly lower in suicide attempters with BD than in HC. Finally, higher number of suicide attempts (>2) and elevated Suicidal Intent Scale score were associated with significant splenium alterations. Limitations include the cross-sectional design (non-causal study), the potential influence of medications and concerns about the generalizability to men. Genu and body are altered in non-suicide attempters with BD, while splenium is specifically altered in suicide attempters, independently from their psychiatric status. History of suicide attempts may be a source of heterogeneity in the association between CC alterations and BD and may partially explain the variable results of previous studies. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Parametric Ward-Takahashi identity in disordered systems and the integral identity associated with the Calogero-Sutherland model

    International Nuclear Information System (INIS)

    Taniguchi, N.

    1997-01-01

    By utilizing the symmetric property known as the Ward-Takahashi identity in disordered systems, we explore the novel symmetry relations which hold in one-dimensional systems with inverse square interaction (the Calogero-Sutherland model). The identities emerge totally from the algebraic structure of the model. They show that the dynamical correlators are connected with one another, involving the higher-order integrals of motion. We obtain the result for the coupling strengths λ=1/2, 1, and 2, and conjecture that a similar relation may hold for arbitrary rational λ. copyright 1997 The American Physical Society

  9. An Overwhelming Desire to Be Blind: Similarities and Differences between Body Integrity Identity Disorder and the Wish for Blindness

    OpenAIRE

    Katja Gutschke; Aglaja Stirn; Erich Kasten

    2017-01-01

    Background: The urge to be permanently blind is an extremely rare mental health disturbance. The underlying cause of this desire has not been determined yet, and it is uncertain whether the wish for blindness is a condition that can be included in the context of body integrity identity disorder, a condition where people feel an overwhelming need to be disabled, in many cases by amputation of a limb or through paralysis. Objective: The aim of this study is to test the hypothesis that people wi...

  10. Social Outcomes in Childhood Brain Disorder: A Heuristic Integration of Social Neuroscience and Developmental Psychology

    Science.gov (United States)

    Yeates, Keith Owen; Bigler, Erin D.; Dennis, Maureen; Gerhardt, Cynthia A.; Rubin, Kenneth H.; Stancin, Terry; Taylor, H. Gerry; Vannatta, Kathryn

    2010-01-01

    The authors propose a heuristic model of the social outcomes of childhood brain disorder that draws on models and methods from both the emerging field of social cognitive neuroscience and the study of social competence in developmental psychology/psychopathology. The heuristic model characterizes the relationships between social adjustment, peer interactions and relationships, social problem solving and communication, social-affective and cognitive-executive processes, and their neural substrates. The model is illustrated by research on a specific form of childhood brain disorder, traumatic brain injury. The heuristic model may promote research regarding the neural and cognitive-affective substrates of children’s social development. It also may engender more precise methods of measuring impairments and disabilities in children with brain disorder and suggest ways to promote their social adaptation. PMID:17469991

  11. Integral cryptanalysis

    DEFF Research Database (Denmark)

    Knudsen, Lars Ramkilde; Wagner, David

    2002-01-01

    This paper considers a cryptanalytic approach called integral cryptanalysis. It can be seen as a dual to differential cryptanalysis and applies to ciphers not vulnerable to differential attacks. The method is particularly applicable to block ciphers which use bijective components only.......This paper considers a cryptanalytic approach called integral cryptanalysis. It can be seen as a dual to differential cryptanalysis and applies to ciphers not vulnerable to differential attacks. The method is particularly applicable to block ciphers which use bijective components only....

  12. Utility of the Community Integration Questionnaire in a sample of adults with neurological and neuropsychiatric disorders receiving prevocational training.

    Science.gov (United States)

    Tomaszewski, Robert; Mitrushina, Maura

    2015-08-03

    To investigate utility of the Community Integration Questionnaire (CIQ) in a mixed sample of adults with neurological and neuropsychiatric disorders. Cross-sectional, interview-based study. Participants were community-dwelling adults with disabilities resulting from neurological and neuropsychiatric disorders (N = 54), who participated in a pre-vocational readiness and social skills training program. Psychometric properties of the Community Integration Questionnaire (CIQ) were assessed and validated against Mayo-Portland Adaptability Inventory (MPAI) and The Problem Checklist from the New York University Head Injury Family Interview (PCL). Based on the revised scoring procedures, psychometric properties of the CIQ Home Competency scale were excellent, followed by the Total score and Social Integration scale. Productive Activity scale had low content validity and a weak association with the total score. Convergent and discriminant validity of the CIQ were demonstrated by correlation patterns with MPAI scales in the expected direction. Significant relationship was found with PCL Physical/Dependency scale. Significant associations were found with sex, living status, and record of subsequent employment. The results provide support for the use of the CIQ as a measure of participation in individuals with neurological and neuropsychiatric diagnoses and resulting disabilities. Implications for Rehabilitation An important goal of rehabilitation and training programs for individuals with dysfunction of the central nervous system is to promote their participation in social, vocational, and domestic activities. The Community Integration Questionnaire (CIQ) is a brief and efficient instrument for measuring these participation domains. This study demonstrated good psychometric properties and high utility of the CIQ in a sample of 54 individuals participating in a prevocational training program.

  13. Toward a Psychotherapy Integration Approach for Complex Post Traumatic Stress Disorder: A Critical Literature Review

    Science.gov (United States)

    Confer, Jacob Russell

    2013-01-01

    The symptoms, assessment, and treatments of Post Traumatic Stress Disorder (PTSD) have been empirically investigated to the extent that there is a breadth of valid and reliable instruments investigating this psychopathological syndrome. There, too, exists a substantial evidence base for various treatment models demonstrating effectiveness in…

  14. Treatment of Sexual Disorders in the 1990s: An Integrated Approach.

    Science.gov (United States)

    Rosen, Raymond C.; Leiblum, Sandra R.

    1995-01-01

    Reviews existing data regarding the etiology and treatment of male and female sexual dysfunctions. Discusses the use of multidimensional assessment models, especially in the evaluation of erectile dysfunction and sexual pain disorders. Despite the conceptual and technological sophistication of current approaches, treatment outcomes are…

  15. Integrating Recovery and the Narrative Attachment Systems Perspective to Working through Borderline Personality Disorder

    Science.gov (United States)

    Bernardon, Stephanie; Pernice-Duca, Francesca

    2012-01-01

    Borderline personality disorder (BPD) presents a number of symptoms and adjustment issues for individuals, but it is also associated with a myriad of risks for the larger family system. A systemic perspective is crucial to comprehending the development of BPD. Promoting healthy relationships with one or more supportive adult enables the child to…

  16. Modeling alcohol use disorder severity: an integrative structural equation modeling approach

    Directory of Open Access Journals (Sweden)

    Nathasha R Moallem

    2013-07-01

    Full Text Available Background: Alcohol dependence is a complex psychological disorder whose phenomenology changes as the disorder progresses. Neuroscience has provided a variety of theories and evidence for the development, maintenance, and severity of addiction; however, clinically, it has been difficult to evaluate alcohol use disorder (AUD severity. Objective: This study seeks to evaluate and validate a data-driven approach to capturing alcohol severity in a community sample. Method: Participants were non-treatment seeking problem drinkers (n = 283. A structural equation modeling (SEM approach was used to (a verify the latent factor structure of the indices of AUD severity; and (b test the relationship between the AUD severity factor and measures of alcohol use, affective symptoms, and motivation to change drinking. Results: The model was found to fit well, with all chosen indices of AUD severity loading significantly and positively onto the severity factor. In addition, the paths from the alcohol use, motivation, and affective factors accounted for 68% of the variance in AUD severity. Greater AUD severity was associated with greater alcohol use, increased affective symptoms, and higher motivation to change.Conclusions: Unlike the categorical diagnostic criteria, the AUD severity factor is comprised of multiple quantitative dimensions of impairment observed across the progression of the disorder. The AUD severity factor was validated by testing it in relation to other outcomes such as alcohol use, affective symptoms, and motivation for change. Clinically, this approach to AUD severity can be used to inform treatment planning and ultimately to improve outcomes.

  17. Limb amputations in fixed dystonia: A form of body integrity identity disorder?

    NARCIS (Netherlands)

    Edwards, M.J.; Alonso-Canovas, A.; Schrag, A.; Bloem, B.R.; Thompson, P.D.; Bhatia, K.

    2011-01-01

    Fixed dystonia is a disabling disorder mainly affecting young women who develop fixed abnormal limb postures and pain after apparently minor peripheral injury. There is continued debate regarding its pathophysiology and management. We report 5 cases of fixed dystonia in patients who sought

  18. Testing an integrated model of eating disorders in paediatric type 1 diabetes mellitus.

    Science.gov (United States)

    Wilson, Charlotte E; Smith, Emma L; Coker, Sian E; Hobbis, Imogen Ca; Acerini, Carlo L

    2015-11-01

    Eating disorders in young people with type 1 diabetes mellitus confer additional health risks beyond those conferred by the disease itself. Risk factors for developing eating disorders are poorly understood. The current study aimed to examine risk factors for eating disturbance in young people with type 1 diabetes mellitus. Both diabetes specific risk factors, such as body mass index (BMI), glycaemic control and diabetes-related conflict, and also more general risk factors such as dysfunctional perfectionism and low self-esteem were assessed. Fifty young people aged 14-16 and their primary caregiver were asked to complete interviews and questionnaires about their eating attitudes and behaviours, dysfunctional perfectionism, self-esteem, family conflict, and general mental health symptoms. Recent weight and height and glycaemic control were extracted from the medical file. Different factors distinguished those young people who displayed eating disorder attitudes from those who did not (higher BMI-z, poorer glycaemic control, and lower self-esteem) and those young people who displayed eating disorder behaviour from those who did not (lower self-esteem and higher diabetes-related family conflict). The results of the current study suggest that there might be different factors associated with eating disorders (ED) attitudes and ED behaviours, but that food/eating-related factors, family factors, and intra-personal factors are all important. Furthermore there are some gender differences in the presence of ED attitudes and behaviours and preliminary evidence that higher body mass indexes (BMIs) impact on girls more than they do on boys. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Understanding the feasibility of integrating the eating disorders and obesity fields: the beyond obesity and disordered eating in youth (BODY) Study.

    Science.gov (United States)

    Ferrari, Manuela

    2015-06-01

    Attention has been devoted to exploring ways to integrate the eating disorders (ED) and obesity (OB) prevention fields. Although research has revealed considerable overlap between the risk factors for ED and those for OB, collaboration between the two fields remains strained. Existing position papers focus mainly on discussions about the lack of collaboration and whether or not the two fields should merge their prevention efforts. However, no empirical study has yet addressed these questions. The beyond obesity and disordered eating in youth (BODY) Study is a qualitative study that sheds light on the relationship between the ED and OB fields. Using part of the BODY Study data and findings, this paper aims to further explore the costs and benefits of ED and OB collaboration/integration. Four models, or scenarios, proposed by Neumark-Sztainer to describe the interaction between the ED and OB prevention fields are used as a framework to guide the BODY Study findings' discussion. Based on grounded theory methodology, the BODY Study used in-depth interviews and focus groups as data collection methods. A total of 61 participants took part in the study: 35 researchers/practitioners who work in either ED or OB; and 26 youths (aged 16-26 who attended six focus groups and 12 in-depth interviews). Selected BODY Study themes, relevant to better understanding the four scenarios proposed by Neumark-Sztainer, presented in this paper are: (a) Two camps: understanding the relationship between the ED and OB fields; (b) Consequences for professionals and youths of the existence of two camps; (c) Root causes of the perceived tension: ideology and philosophy, power and knowledge, and gender. Findings from this study mirror existing theoretical papers that look at the relationship between the two fields-including Neumark-Sztainer's scenarios. At the same time, this empirical work further discusses the costs of a possible integration that, even if desirable, does not take into account

  20. Comparing cognitive behavioural therapy for eating disorders integrated with behavioural weight loss therapy to cognitive behavioural therapy-enhanced alone in overweight or obese people with bulimia nervosa or binge eating disorder: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Palavras, Marly Amorim; Hay, Phillipa; Touyz, Stephen; Sainsbury, Amanda; da Luz, Felipe; Swinbourne, Jessica; Estella, Nara Mendes; Claudino, Angélica

    2015-12-18

    Around 40 % of individuals with eating disorders of recurrent binge eating, namely bulimia nervosa and binge eating disorder, are obese. In contrast to binge eating disorder, currently there is no evidence base for weight management or weight loss psychological therapies in the treatment of bulimia nervosa despite their efficacy in binge eating disorder. Thus, a manualised therapy called HAPIFED (Healthy APproach to weIght management and Food in Eating Disorders) has been developed. HAPIFED integrates the leading evidence-based psychological therapies, cognitive behavioural therapy-enhanced (CBT-E) and behavioural weight loss treatment (BWLT) for binge eating disorder and obesity respectively. The aim of the present study is to detail the protocol for a randomised controlled trial (RCT) of HAPIFED versus CBT-E for people with bulimia nervosa and binge eating disorder who are overweight/obese. A single-blind superiority RCT is proposed. One hundred Brazilian participants aged ≥ 18 years, with a diagnosis of bulimia nervosa or binge eating disorder, BMI > 27 to bulimia nervosa as well as with binge eating disorder. It will have the potential to improve health outcomes for the rapidly increasing number of adults with co-morbid obesity and binge eating disorder or bulimia nervosa. US National Institutes of Health clinical trial registration number NCT02464345 , date of registration 1 June 2015.

  1. Dual Diagnosis - Multiple Languages

    Science.gov (United States)

    ... National Library of Medicine Comorbidity or dual diagnosis - Opioid addiction, part 9 - English PDF Comorbidity or dual diagnosis - Opioid addiction, part 9 - español (Spanish) PDF Comorbidity or dual ...

  2. Adolescents and Dual Diagnosis in a Psychiatric Emergency Service.

    Science.gov (United States)

    Matali, José Luis; Andión, Oscar; Pardo, Marta; Iniesta, Raquel; Serrano, Eduard; San, Luis

    2016-03-02

    In recent years, both the prevalence of drug use and related child and adolescent psychiatric emergencies have risen sharply. There are few studies about the impact on child and adolescent emergency services. This study has a twofold aim. The first is to describe the prevalence of substance use disorders, mental disorders and dual diagnosis (substance use problems plus mental disorder) in adolescents in psychiatric emergency service. The second is to analyze clinical and healthcare differences between patients with dual diagnosis and patients with a mental disorder without substance use disorder.We retrospectively reviewed 4012 discharge forms for emergencies treated at the psychiatric emergency department during the period 2007-2009. We obtained a sample of 1795 visits. This sample was divided into two groups: the dual diagnosis group (n = 477) and the psychiatric disorder group (n = 1318).The dual diagnosis group accounted for 26.5% of psychiatric emergencies analyzed. Compared to the psychiatric disorder group,the dual diagnosis group had significantly more conduct disorders, social problems, involuntariness in the visit, less hospital admissions and less connection with the healthcare network.Adolescents with a dual diagnosis account for a high percentage of visits at child and adolescent psychiatric emergency services. This patient group requires specialized care both at emergency services and in specific units. Accordingly, these units should play a triple role when handling dual diagnosis: detection, brief treatment and referral to a specialised unit.

  3. Toward an Interdisciplinary Understanding of Sensory Dysfunction in Autism Spectrum Disorder: An Integration of the Neural and Symptom Literatures.

    Science.gov (United States)

    Schauder, Kimberly B; Bennetto, Loisa

    2016-01-01

    Sensory processing differences have long been associated with autism spectrum disorder (ASD), and they have recently been added to the diagnostic criteria for the disorder. The focus on sensory processing in ASD research has increased substantially in the last decade. This research has been approached from two different perspectives: the first focuses on characterizing the symptoms that manifest in response to real world sensory stimulation, and the second focuses on the neural pathways and mechanisms underlying sensory processing. The purpose of this paper is to integrate the empirical literature on sensory processing in ASD from the last decade, including both studies characterizing sensory symptoms and those that investigate neural response to sensory stimuli. We begin with a discussion of definitions to clarify some of the inconsistencies in terminology that currently exist in the field. Next, the sensory symptoms literature is reviewed with a particular focus on developmental considerations and the relationship of sensory symptoms to other core features of the disorder. Then, the neuroscience literature is reviewed with a focus on methodological approaches and specific sensory modalities. Currently, these sensory symptoms and neuroscience perspectives are largely developing independently from each other leading to multiple, but separate, theories and methods, thus creating a multidisciplinary approach to sensory processing in ASD. In order to progress our understanding of sensory processing in ASD, it is now critical to integrate these two research perspectives and move toward an interdisciplinary approach. This will inevitably aid in a better understanding of the underlying biological basis of these symptoms and help realize the translational value through its application to early identification and treatment. The review ends with specific recommendations for future research to help bridge these two research perspectives in order to advance our understanding

  4. Integration

    DEFF Research Database (Denmark)

    Emerek, Ruth

    2004-01-01

    Bidraget diskuterer de forskellige intergrationsopfattelse i Danmark - og hvad der kan forstås ved vellykket integration......Bidraget diskuterer de forskellige intergrationsopfattelse i Danmark - og hvad der kan forstås ved vellykket integration...

  5. Unraveling Executive Functioning in Dual Diagnosis.

    Science.gov (United States)

    Duijkers, Judith C L M; Vissers, Constance Th W M; Egger, Jos I M

    2016-01-01

    In mental health, the term dual-diagnosis is used for the co-occurrence of Substance Use Disorder (SUD) with another mental disorder. These co-occurring disorders can have a shared cause, and can cause/intensify each other's expression. Forming a threat to health and society, dual-diagnosis is associated with relapses in addiction-related behavior and a destructive lifestyle. This is due to a persistent failure to control impulses and the maintaining of inadequate self-regulatory behavior in daily life. Thus, several aspects of executive functioning like inhibitory, shifting and updating processes seem impaired in dual-diagnosis. Executive (dys-)function is currently even seen as a shared underlying key component of most mental disorders. However, the number of studies on diverse aspects of executive functioning in dual-diagnosis is limited. In the present review, a systematic overview of various aspects of executive functioning in dual-diagnosis is presented, striving for a prototypical profile of patients with dual-diagnosis. Looking at empirical results, inhibitory and shifting processes appear to be impaired for SUD combined with schizophrenia, bipolar disorder or cluster B personality disorders. Studies involving updating process tasks for dual-diagnosis were limited. More research that zooms in to the full diversity of these executive functions is needed in order to strengthen these findings. Detailed insight in the profile of strengths and weaknesses that underlies one's behavior and is related to diagnostic classifications, can lead to tailor-made assessment and indications for treatment, pointing out which aspects need attention and/or training in one's self-regulative abilities.

  6. Limb Amputations in Fixed Dystonia: A Form of Body Integrity Identity Disorder?

    OpenAIRE

    Edwards, Mark J; Alonso-Canovas, Araceli; Schrag, Arnette; Bloem, Bastiaan R; Thompson, Philip D; Bhatia, Kailash

    2011-01-01

    Fixed dystonia is a disabling disorder mainly affecting young women who develop fixed abnormal limb postures and pain after apparently minor peripheral injury. There is continued debate regarding its pathophysiology and management. We report 5 cases of fixed dystonia in patients who sought amputation of the affected limb. We place these cases in the context of previous reports of patients with healthy limbs and patients with chronic regional pain syndrome who have sought amputation. Our cases...

  7. An integrative review of attention biases and their contribution to treatment for anxiety disorders

    Directory of Open Access Journals (Sweden)

    Tom Joseph Barry

    2015-07-01

    Full Text Available Models of exposure therapy, one of the key components of cognitive behavioural therapy for anxiety disorders, suggest that attention may play an important role in the extinction of fear and anxiety. Evidence from cognitive research suggests that individual differences may play a causal role in the onset and maintenance of anxiety disorders and so it is also likely to influence treatment. We review the evidence concerning attention and treatment outcomes in anxiety disorders. The evidence reviewed here suggests that that attention biases assessed at pre-treatment might actually predict improved response to treatment, and in particular that prolonged engagement with threat as measured in tasks such as the dot probe is associated with greater reductions in anxious symptoms following treatment. We examine this research within a fear learning framework, considering the possible role of individual differences in attention in the extinction of fear during exposure. Theoretical, experimental and clinical implications are discussed, particularly with reference to the potential for attention bias modification programs in augmenting treatment, and also with reference to how existing research in this area might inform best practice for clinicians.

  8. Narcissistic personality disorder: an integrative review of recent empirical data and current definitions.

    Science.gov (United States)

    Roepke, Stefan; Vater, Aline

    2014-05-01

    Although concepts of pathological narcissism are as old as psychology and psychiatry itself, only a small number of clinical studies are based on the criteria for narcissistic personality disorder (NPD), as defined in the Diagnostic and Statistical Manuals of Mental Disorders (DSM). As a result, NPD appears to be one of the most controversially discussed nosological entities in psychiatry. Whereas the majority of empirical studies used self or other ratings of NPD criteria to address issues of reliability and validity of the diagnostic category (i.e., internal consistency, factor structure, discriminant validity), only recent research has applied experimental designs to investigate specific features of NPD (e.g., self-esteem, empathy, shame). The aim of this review is to summarize available empirical data on NPD and relate these findings to current definitions of NPD (according to the DSM-5, [1]). In order to do so, this review follows the five steps to establishing diagnostic validity proposed by Robins and Guze [2], i.e., (1) clinical description, (2) laboratory studies, (3) delimitation from other disorders, (4) family studies, and (5) follow up studies. Finally, this review suggests pathways for future research that may assist further nosological evaluation of NPD and contribute to the overall goal, the improvement of treatment for patients.

  9. Genetics of borderline personality disorder: systematic review and proposal of an integrative model.

    Science.gov (United States)

    Amad, Ali; Ramoz, Nicolas; Thomas, Pierre; Jardri, Renaud; Gorwood, Philip

    2014-03-01

    Borderline personality disorder (BPD) is one of the most common mental disorders and is characterized by a pervasive pattern of emotional lability, impulsivity, interpersonal difficulties, identity disturbances, and disturbed cognition. Here, we performed a systematic review of the literature concerning the genetics of BPD, including familial and twin studies, association studies, and gene-environment interaction studies. Moreover, meta-analyses were performed when at least two case-control studies testing the same polymorphism were available. For each gene variant, a pooled odds ratio (OR) was calculated using fixed or random effects models. Familial and twin studies largely support the potential role of a genetic vulnerability at the root of BPD, with an estimated heritability of approximately 40%. Moreover, there is evidence for both gene-environment interactions and correlations. However, association studies for BPD are sparse, making it difficult to draw clear conclusions. According to our meta-analysis, no significant associations were found for the serotonin transporter gene, the tryptophan hydroxylase 1 gene, or the serotonin 1B receptor gene. We hypothesize that such a discrepancy (negative association studies but high heritability of the disorder) could be understandable through a paradigm shift, in which "plasticity" genes (rather than "vulnerability" genes) would be involved. Such a framework postulates a balance between positive and negative events, which interact with plasticity genes in the genesis of BPD. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. MicroRNAs in CAG trinucleotide repeat expansion disorders: an integrated review of the literature.

    Science.gov (United States)

    Dumitrescu, Laura; Popescu, Bogdan O

    2015-01-01

    MicroRNAs are small RNAs involved in gene silencing. They play important roles in transcriptional regulation and are selectively and abundantly expressed in the central nervous system. A considerable amount of the human genome is comprised of tandem repeating nucleotide streams. Several diseases are caused by above-threshold expansion of certain trinucleotide repeats occurring in a protein-coding or non-coding region. Though monogenic, CAG trinucleotide repeat expansion disorders have a complex pathogenesis, various combinations of multiple coexisting pathways resulting in one common final consequence: selective neurodegeneration. Mutant protein and mutant transcript gain of toxic function are considered to be the core pathogenic mechanisms. The profile of microRNAs in CAG trinucleotide repeat disorders is scarcely described, however microRNA dysregulation has been identified in these diseases and microRNA-related intereference with gene expression is considered to be involved in their pathogenesis. Better understanding of microRNAs functions and means of manipulation promises to offer further insights into the pathogenic pathways of CAG repeat expansion disorders, to point out new potential targets for drug intervention and to provide some of the much needed etiopathogenic therapeutic agents. A number of disease-modifying microRNA silencing strategies are under development, but several implementation impediments still have to be resolved. CAG targeting seems feasible and efficient in animal models and is an appealing approach for clinical practice. Preliminary human trials are just beginning.

  11. Some properties of dual and approximate dual of fusion frames

    OpenAIRE

    Arefijamaal, Ali Akbar; Neyshaburi, Fahimeh Arabyani

    2016-01-01

    In this paper we extend the notion of approximate dual to fusion frames and present some approaches to obtain dual and approximate alternate dual fusion frames. Also, we study the stability of dual and approximate alternate dual fusion frames.

  12. Assessment of the integration of a He-cooled divertor system in the power conversion system for the dual-coolant blanket concept (TW2-TRP-PPCS12D8)

    International Nuclear Information System (INIS)

    Norajitra, P.; Kruessmann, R.; Malang, S.; Reimann, G.

    2002-12-01

    Application of a helium-cooled divertor together with the dual-coolant blanket concept is considered favourable for achieving a high thermal efficiency of the power plant due to its relatively high coolant outlet temperature. A new FZK He-cooled modular divertor concept with integrated pin arrays (HEMP) is introduced. Its main features and function are described in detail. The result of the thermalhydraulic analysis shows that the HEMP divertor concept has the potential of resisting, a heat flow density of at least 10-15 MW/m 2 at a reachable heat transfer coefficient of approx. 60 kW/m 2 K and a reasonable pumping power. Integration of this divertor concept into the power conversion system using a closed Brayton gas turbine system with three-stage compression leads to a net efficiency of the blanket/divertor cycle of about 43%. (orig.)

  13. [Integrity].

    Science.gov (United States)

    Gómez Rodríguez, Rafael Ángel

    2014-01-01

    To say that someone possesses integrity is to claim that that person is almost predictable about responses to specific situations, that he or she can prudentially judge and to act correctly. There is a closed interrelationship between integrity and autonomy, and the autonomy rests on the deeper moral claim of all humans to integrity of the person. Integrity has two senses of significance for medical ethic: one sense refers to the integrity of the person in the bodily, psychosocial and intellectual elements; and in the second sense, the integrity is the virtue. Another facet of integrity of the person is la integrity of values we cherish and espouse. The physician must be a person of integrity if the integrity of the patient is to be safeguarded. The autonomy has reduced the violations in the past, but the character and virtues of the physician are the ultimate safeguard of autonomy of patient. A field very important in medicine is the scientific research. It is the character of the investigator that determines the moral quality of research. The problem arises when legitimate self-interests are replaced by selfish, particularly when human subjects are involved. The final safeguard of moral quality of research is the character and conscience of the investigator. Teaching must be relevant in the scientific field, but the most effective way to teach virtue ethics is through the example of the a respected scientist.

  14. Neurobiological foundations of multisensory processing integration in people with autism spectrum disorders: The role of the medial prefrontal cortex

    Directory of Open Access Journals (Sweden)

    Sonia eMartínez-Sanchis

    2014-12-01

    Full Text Available This review aims to relate the sensory processing problems in people with Autism spectrum disorders (ASD, especially Multisensory interaction (MSI, to the role of the medial prefrontal cortex (mPFC by exploring neuroanatomical findings; brain connectivity and Default Network (DN; global or locally directed attention; and temporal multisensory binding. The mPFC is part of the brain’s DN, which is deactivated when attention is focused on a particular task and activated on rest when spontaneous cognition emerges. In those with ASD, it is hypoactive and the higher the social impairment the greater the atypical activity. With an immature DN, cross-modal integration is impaired, resulting in a collection of disconnected fragments instead of a coherent global perception. The deficit in MSI may lie in the temporal synchronization of neural networks. The time interval in which the stimulation of one sensory channel could influence another would be higher, preventing integration in the typical shorter time range. Thus, the underconnectivity between distant brain areas would be involved in top-down information processes (relying on global integration of data from different sources and would enhance low level perception processes such as over focused attention to sensory details.

  15. The Desire for Amputation or Paralyzation: Evidence for Structural Brain Anomalies in Body Integrity Identity Disorder (BIID).

    Science.gov (United States)

    Blom, Rianne M; van Wingen, Guido A; van der Wal, Sija J; Luigjes, Judy; van Dijk, Milenna T; Scholte, H Steven; Denys, Damiaan

    2016-01-01

    Body Integrity Identity Disorder (BIID) is a condition in which individuals perceive a mismatch between their internal body scheme and physical body shape, resulting in an absolute desire to be either amputated or paralyzed. The condition is hypothesized to be of congenital nature, but evidence for a neuro-anatomical basis is sparse. We collected T1-weighted structural magnetic resonance imaging scans on a 3T scanner in eight individuals with BIID and 24 matched healthy controls, and analyzed the data using voxel-based morphometry. The results showed reduced grey matter volume in the left dorsal and ventral premotor cortices and larger grey matter volume in the cerebellum (lobule VIIa) in individuals with BIID compared to controls. The premotor cortex and cerebellum are thought to be crucial for the experience of body-ownership and the integration of multisensory information. Our results suggest that BIID is associated with structural brain anomalies and might result from a dysfunction in the integration of multisensory information, leading to the feeling of disunity between the mental and physical body shape.

  16. Genetic tests in major psychiatric disorders-integrating molecular medicine with clinical psychiatry-why is it so difficult?

    Science.gov (United States)

    Demkow, U; Wolańczyk, T

    2017-06-13

    With the advent of post-genomic era, new technologies create extraordinary possibilities for diagnostics and personalized therapy, transforming todays' medicine. Rooted in both medical genetics and clinical psychiatry, the paper is designed as an integrated source of information of the current and potential future application of emerging genomic technologies as diagnostic tools in psychiatry, moving beyond the classical concept of patient approach. Selected approaches are presented, starting from currently used technologies (next-generation sequencing (NGS) and microarrays), followed by newer options (reverse phenotyping). Next, we describe an old concept in a new light (endophenotypes), subsequently coming up with a sophisticated and complex approach (gene networks) ending by a nascent field (computational psychiatry). The challenges and barriers that exist to translate genomic research to real-world patient assessment are further discussed. We emphasize the view that only a paradigm shift can bring a fundamental change in psychiatric practice, allowing to disentangle the intricacies of mental diseases. All the diagnostic methods, as described, are directed at uncovering the integrity of the system including many types of relations within a complex structure. The integrative system approach offers new opportunity to connect genetic background with specific diseases entities, or concurrently, with symptoms regardless of a diagnosis. To advance the field, we propose concerted cross-disciplinary effort to provide a diagnostic platform operating at the general level of genetic pathogenesis of complex-trait psychiatric disorders rather than at the individual level of a specific disease.

  17. Appraisals to affect: Testing the integrative cognitive model of bipolar disorder.

    Science.gov (United States)

    Palmier-Claus, Jasper E; Dodd, Alyson; Tai, Sara; Emsley, Richard; Mansell, Warren

    2016-09-01

    Cognitive models have suggested that extreme appraisals of affective states and maladaptive affect regulation strategies are important in the development of bipolar symptomatology. Little is known about the pathway by which these appraisals and behaviours interact in the formation of activated and depressed affective states. This study tested the predictions that (1) ascent behaviours mediate the relationship between positive appraisals of activated mood and activation; and (2) descent behaviours mediate the relationship between negative appraisals of activated mood and depression. A total of 52 individuals with a DSM-IV diagnosis of bipolar I or II disorder (confirmed by structured interview) completed biweekly assessments of affect regulation behaviours and mood for 4 weeks. Positive and negative appraisals of affective states were assessed at baseline through the Hypomanic Attitudes and Positive Prediction Inventory. Multilevel mediation analysis was used to explore the data. Ascent behaviours partially mediated the relationship between positive appraisals of activated mood and activation. Descent behaviours, but not negative appraisals of activated mood, predicted levels of depression indicating the absence of a mediation effect. The results suggest that positive appraisals of activated mood can escalate activation in individuals with bipolar disorder. Such appraisals may be inherently rewarding and reinforcing directly elevating levels of activation, whilst increasing individuals' use of ascent behaviours. The results are consistent with the view that appraisals and behaviours should be targeted during cognitive behavioural therapy for bipolar disorder. It may be beneficial to target positive appraisals of activated mood in cognitive behavioural therapy for mania. Cognitive behavioural therapists may also wish to focus on identifying and targeting individuals' use of ascent behaviours to reduce highly activated states. © 2015 The British Psychological

  18. Postural Control Deficits in Autism Spectrum Disorder: The Role of Sensory Integration

    Science.gov (United States)

    Doumas, Michail; McKenna, Roisin; Murphy, Blain

    2016-01-01

    We investigated the nature of sensory integration deficits in postural control of young adults with ASD. Postural control was assessed in a fixed environment, and in three environments in which sensory information about body sway from visual, proprioceptive or both channels was inaccurate. Furthermore, two levels of inaccurate information were…

  19. A Comparison of Sensory Integrative and Behavioral Therapies as Treatment for Pediatric Feeding Disorders

    Science.gov (United States)

    Addison, Laura R.; Piazza, Cathleen C.; Patel, Meeta R.; Bachmeyer, Melanie H.; Rivas, Kristi M.; Milnes, Suzanne M.; Oddo, Jackie

    2012-01-01

    We compared the effects of escape extinction (EE) plus noncontingent reinforcement (NCR) with sensory integration therapy as treatment for the feeding problems of 2 children. Results indicated that EE plus NCR was more effective in increasing acceptance, decreasing inappropriate behavior, and increasing amount consumed relative to sensory…

  20. Restorative Integral Support (RIS) for Older Adults Experiencing Co-Occurring Disorders

    Science.gov (United States)

    Larkin, Heather; MacFarland, Nicole S.

    2012-01-01

    The Restorative Integral Support (RIS) model is a whole person response that assists people to overcome adversity. The Adverse Childhood Experiences (ACE) Study conducted by Kaiser Permanente and the Centers for Disease Control and Prevention shows the association between stressors in childhood and multiple later-life health and social problems.…

  1. The effect of an integrated perceived competence and motor intervention in children with developmental coordination disorder

    NARCIS (Netherlands)

    Noordstar, Johannes J.; van der Net, Janjaap; Voerman, Lia; Helders, Paul J M; Jongmans, Marian J.

    2017-01-01

    Background and aims Children with DCD have lower self-perceptions and are less physically active than typically developing children. The aim of this quasi-experimental study was to investigate whether an integrated perceived competence and motor intervention affects DCD children's motor performance,

  2. The effect of an integrated perceived competence and motor intervention in children with developmental coordination disorder

    NARCIS (Netherlands)

    Noordstar, Johannes J; van der Net, Janjaap; Voerman, Lia; Helders, Paul J M; Jongmans, Marian J

    BACKGROUND AND AIMS: Children with DCD have lower self-perceptions and are less physically active than typically developing children. The aim of this quasi-experimental study was to investigate whether an integrated perceived competence and motor intervention affects DCD children's motor

  3. Abnormal white matter integrity as a structural endophenotype for bipolar disorder.

    Science.gov (United States)

    Sarıçiçek, A; Zorlu, N; Yalın, N; Hıdıroğlu, C; Çavuşoğlu, B; Ceylan, D; Ada, E; Tunca, Z; Özerdem, A

    2016-05-01

    Several lines of evidence suggest that bipolar disorder (BD) is associated with white matter (WM) pathology. Investigation of unaffected first-degree relatives of BD patients may help to distinguish structural biomarkers of genetic risk without the confounding effects of burden of illness, medication or clinical state. In the present study, we applied tract-based spatial statistics to study WM changes in patients with BD, unaffected siblings and controls. A total of 27 euthymic patients with BD type I, 20 unaffected siblings of bipolar patients and 29 healthy controls who did not have any current or past diagnosis of Axis I psychiatric disorders were enrolled in the study. Fractional anisotropy (FA) was significantly lower in BD patients than in the control group in the corpus callosum, fornix, bilateral superior longitudinal fasciculus, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, anterior thalamic radiation, posterior thalamic radiation, cingulum, uncinate fasciculus, superior corona radiata, anterior corona radiata and left external capsule. In region-of-interest (ROI) analyses, we found that both unaffected siblings and bipolar patients had significantly reduced FA in the left posterior thalamic radiation, the left sagittal stratum, and the fornix compared with healthy controls. Average FA for unaffected siblings was intermediate between the healthy controls and bipolar patients within these ROIs. Decreased FA in the fornix, left posterior thalamic radiation and left sagittal stratum in both bipolar patients and unaffected siblings may represent a potential structural endophenotype or a trait-based marker for BD.

  4. Attention deficit hyperactivity disorder: integrating complementary therapy to care of children/adolescents

    Directory of Open Access Journals (Sweden)

    Juliane Pagliari Araujo

    2015-11-01

    Full Text Available The study aimed to identify the knowledge of caregivers of children and adolescents about the Attention Deficit Hyperactivity Disorder (ADHD and their perceptions regarding changes in daily and family life, after participating in sessions of Tui Na massage. Semistructured interviews in the months from September to November 2013 were held, with nine caregivers of children and adolescents diagnosed with ADHD who participated in massage sessions. The data were subjected to content analysis with a qualitative approach. It was identified that some mothers have little knowledge about the disorder of their children. Regarding the participation of children and adolescents, it was related a positive response, an immediate valuable result, with improved communication with family, more tranquility after the massage, restful sleep, improved mood and better performance school. The caregivers of children and adolescents related that their participation in the Tui Na massage sessions was productive, with acceptance by them with positive changes in daily and family life. The study participants pointed that daily difficulties of ADHD approach them to their son, decreasing anxiety and improving the quality life for the whole family. Sharing information between health professionals and family of children and adolescents about ADHD is important to understand the pathology, as well as for monitoring and further treatment.

  5. Effect of integrated treatment on the use of coercive measures in first-episode schizophrenia-spectrum disorder. A randomized clinical trial

    DEFF Research Database (Denmark)

    Ohlenschlaeger, Johan; Nordentoft, Merete; Thorup, Anne

    2008-01-01

    The effect of integrated treatment on the use of coercive measures in first-episode schizophrenia-spectrum disorder in Denmark is not known. A total of 328 patients were randomly assigned to integrated treatment (167 patients) or standard treatment (161 patients). Integrated treatment consisted...... of assertive community treatment, psycho-educational multi-family groups, and social skills training. Data on coercion were extracted from the register from the National Board of Health, and data on continuity from medical records. Even though the level of continuity seemed higher in integrated treatment...

  6. High order three part split symplectic integrators: Efficient techniques for the long time simulation of the disordered discrete nonlinear Schrödinger equation

    Energy Technology Data Exchange (ETDEWEB)

    Skokos, Ch., E-mail: haris.skokos@uct.ac.za [Physics Department, Aristotle University of Thessaloniki, GR-54124 Thessaloniki (Greece); Department of Mathematics and Applied Mathematics, University of Cape Town, Rondebosch 7701 (South Africa); Gerlach, E. [Lohrmann Observatory, Technical University Dresden, D-01062 Dresden (Germany); Bodyfelt, J.D., E-mail: J.Bodyfelt@massey.ac.nz [Centre for Theoretical Chemistry and Physics, The New Zealand Institute for Advanced Study, Massey University, Albany, Private Bag 102904, North Shore City, Auckland 0745 (New Zealand); Papamikos, G. [School of Mathematics, Statistics and Actuarial Science, University of Kent, Canterbury, CT2 7NF (United Kingdom); Eggl, S. [IMCCE, Observatoire de Paris, 77 Avenue Denfert-Rochereau, F-75014 Paris (France)

    2014-05-01

    While symplectic integration methods based on operator splitting are well established in many branches of science, high order methods for Hamiltonian systems that split in more than two parts have not been studied in great detail. Here, we present several high order symplectic integrators for Hamiltonian systems that can be split in exactly three integrable parts. We apply these techniques, as a practical case, for the integration of the disordered, discrete nonlinear Schrödinger equation (DDNLS) and compare their efficiencies. Three part split algorithms provide effective means to numerically study the asymptotic behavior of wave packet spreading in the DDNLS – a hotly debated subject in current scientific literature.

  7. High order three part split symplectic integrators: Efficient techniques for the long time simulation of the disordered discrete nonlinear Schrödinger equation

    International Nuclear Information System (INIS)

    Skokos, Ch.; Gerlach, E.; Bodyfelt, J.D.; Papamikos, G.; Eggl, S.

    2014-01-01

    While symplectic integration methods based on operator splitting are well established in many branches of science, high order methods for Hamiltonian systems that split in more than two parts have not been studied in great detail. Here, we present several high order symplectic integrators for Hamiltonian systems that can be split in exactly three integrable parts. We apply these techniques, as a practical case, for the integration of the disordered, discrete nonlinear Schrödinger equation (DDNLS) and compare their efficiencies. Three part split algorithms provide effective means to numerically study the asymptotic behavior of wave packet spreading in the DDNLS – a hotly debated subject in current scientific literature.

  8. Properties of linear integral equations related to the six-vertex model with disorder parameter II

    International Nuclear Information System (INIS)

    Boos, Hermann; Göhmann, Frank

    2012-01-01

    We study certain functions arising in the context of the calculation of correlation functions of the XXZ spin chain and of integrable field theories related to various scaling limits of the underlying six-vertex model. We show that several of these functions that are related to linear integral equations can be obtained by acting with (deformed) difference operators on a master function Φ. The latter is defined in terms of a functional equation and of its asymptotic behavior. Concentrating on the so-called temperature case, we show that these conditions uniquely determine the high-temperature series expansions of the master function. This provides an efficient calculation scheme for the high-temperature expansions of the derived functions as well. (paper)

  9. Altered Cortical Thickness and Tract Integrity of the Mirror Neuron System and Associated Social Communication in Autism Spectrum Disorder.

    Science.gov (United States)

    Chien, Hsiang-Yun; Gau, Susan Shur-Fen; Hsu, Yung-Chin; Chen, Yu-Jen; Lo, Yu-Chun; Shih, Yao-Chia; Tseng, Wen-Yih Isaac

    2015-12-01

    Previous studies using neural activity recording and neuroimaging techniques have reported functional deficits in the mirror neuron system (MNS) for individuals with autism spectrum disorder (ASD). However, a few studies focusing on gray and white matter structures of the MNS have yielded inconsistent results. The current study recruited adolescents and young adults with ASD (aged 15-26 years) and age-matched typically developing (TD) controls (aged 14-25 years). The cortical thickness (CT) and microstructural integrity of the tracts connecting the regions forming the classical MNS were investigated. High-resolution T1-weighted imaging and diffusion spectrum imaging were performed to quantify the CT and tract integrity, respectively. The structural covariance of the CT of the MNS regions revealed a weaker coordination of the MNS network in ASD. A strong correlation was found between the integrity of the right frontoparietal tracts and the social communication subscores measured by the Chinese version of the Social Communication Questionnaire. The results showed that there were no significant mean differences in the CTs and tract integrity between the ASD and TD groups, but revealed a moderate or even reverse age effect on the frontal MNS structures in ASD. In conclusion, aberrant structural coordination may be an underlying factor affecting the function of the MNS in ASD patients. The association between the right frontoparietal tracts and social communication performance implies a neural correlate of communication processing in the autistic brain. This study provides evidence of abnormal MNS structures and their influence on social communication in individuals with ASD. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

  10. Promoting a Shared Representation of Workers' Activities to Improve Integrated Prevention of Work-Related Musculoskeletal Disorders

    Directory of Open Access Journals (Sweden)

    Yves Roquelaure

    2016-06-01

    Full Text Available Effective and sustainable prevention of work-related musculoskeletal disorders (WR-MSDs remains a challenge for preventers and policy makers. Coordination of stakeholders involved in the prevention of WR-MSDs is a key factor that requires greater reflection on common knowledge and shared representation of workers' activities among stakeholders. Information on workers' strategies and operational leeway should be the core of common representations, because it places workers at the center of the “work situation system” considered by the intervention models. Participatory ergonomics permitting debates among stakeholders about workers' activity and strategies to cope with the work constraints in practice could help them to share representations of the “work situation system” and cooperate. Sharing representation therefore represents a useful tool for prevention, and preventers should provide sufficient space and time for dialogue and discussion of workers' activities among stakeholders during the conception, implementation, and management of integrated prevention programs.

  11. Dual antagonists of integrins.

    Science.gov (United States)

    Nadrah, K; Dolenc, M Sollner

    2005-01-01

    The roles of integrins in pathologies have been studied intensively and only partially explained. This has resulted in the development of several nanomolar antagonists to certain integrins. In most cases, the aim was to produce compounds which are highly selective towards specific integrins. This paradigm has recently shifted a little. Targeting two or more integrins with one compound has become a very attractive concept, especially since it has become clear that several severe disorders, such as pathological angiogenesis, cannot be treated just with highly specific integrin antagonists. This review is aimed to elucidate some aspects regarding the design of drugs with dual activity towards integrins. Integrin structure and tissue distribution will first be described, in order to provide the basis for their functions in various pathologies which will follow. Inhibitors of several pairs of integrins will be described.

  12. Spiritually Integrated Cognitive Processing Therapy: A New Treatment for Post-traumatic Stress Disorder That Targets Moral Injury

    Science.gov (United States)

    Pearce, Michelle; Haynes, Kerry; Rivera, Natalia R; Koenig, Harold G.

    2018-01-01

    Background Post-traumatic stress disorder (PTSD) is a debilitating disorder, and current treatments leave the majority of patients with unresolved symptoms. Moral injury (MI) may be one of the barriers that interfere with recovery from PTSD, particularly among current or former military service members. Objective Given the psychological and spiritual aspects of MI, an intervention that addresses MI using spiritual resources in addition to psychological resources may be particularly effective in treating PTSD. To date, there are no existing empirically based individual treatments for PTSD and MI that make explicit use of a patient’s spiritual resources, despite the evidence that spiritual beliefs/activities predict faster recovery from PTSD. Method To address this gap, we adapted Cognitive Processing Therapy (CPT), an empirically validated treatment for PTSD, to integrate clients’ spiritual beliefs, practices, values, and motivations. We call this treatment Spiritually Integrated CPT (SICPT). Results This article describes this novel manualized therapeutic approach for treating MI in the setting of PTSD for spiritual/religious clients. We provide a description of SICPT and a brief summary of the 12 sessions. Then, we describe a case study in which the therapist helps a client use his spiritual resources to resolve MI and assist in the recovery from PTSD. Conclusion SICPT may be a helpful way to reduce PTSD by targeting MI, addressing spiritual distress, and using a client’s spiritual resources. In addition to the spiritual version (applicable for those of any religion and those who do not identify as religious), we have also developed 5 religion-specific manuals (Christianity, Judaism, Islam, Buddhism, and Hinduism) for clients who desire a more religion-specific approach. PMID:29497585

  13. Case management services for work related upper extremity disorders. Integrating workplace accommodation and problem solving.

    Science.gov (United States)

    Shaw, W S; Feuerstein, M; Lincoln, A E; Miller, V I; Wood, P M

    2001-08-01

    A case manager's ability to obtain worksite accommodations and engage workers in active problem solving may improve health and return to work outcomes for clients with work related upper extremity disorders (WRUEDs). This study examines the feasibility of a 2 day training seminar to help nurse case managers identify ergonomic risk factors, provide accommodation, and conduct problem solving skills training with workers' compensation claimants recovering from WRUEDs. Eight procedural steps to this case management approach were identified, translated into a training workshop format, and conveyed to 65 randomly selected case managers. Results indicate moderate to high self ratings of confidence to perform ergonomic assessments (mean = 7.5 of 10) and to provide problem solving skills training (mean = 7.2 of 10) after the seminar. This training format was suitable to experienced case managers and generated a moderate to high level of confidence to use this case management approach.

  14. Integrated case management for work-related upper-extremity disorders: impact of patient satisfaction on health and work status.

    Science.gov (United States)

    Feuerstein, Michael; Huang, Grant D; Ortiz, Jose M; Shaw, William S; Miller, Virginia I; Wood, Patricia M

    2003-08-01

    An integrated case management (ICM) approach (ergonomic and problem-solving intervention) to work-related upper-extremity disorders was examined in relation to patient satisfaction, future symptom severity, function, and return to work (RTW). Federal workers with work-related upper-extremity disorder workers' compensation claims (n = 205) were randomly assigned to usual care or ICM intervention. Patient satisfaction was assessed after the 4-month intervention period. Questionnaires on clinical outcomes and ergonomic exposure were administered at baseline and at 6- and 12-months postintervention. Time from intervention to RTW was obtained from an administrative database. ICM group assignment was significantly associated with greater patient satisfaction. Regression analyses found higher patient satisfaction levels predicted decreased symptom severity and functional limitations at 6 months and a shorter RTW. At 12 months, predictors of positive outcomes included male gender, lower distress, lower levels of reported ergonomic exposure, and receipt of ICM. Findings highlight the utility of targeting workplace ergonomic and problem solving skills.

  15. Notch-deficient skin induces a lethal systemic B-lymphoproliferative disorder by secreting TSLP, a sentinel for epidermal integrity.

    Directory of Open Access Journals (Sweden)

    Shadmehr Demehri

    2008-05-01

    Full Text Available Epidermal keratinocytes form a highly organized stratified epithelium and sustain a competent barrier function together with dermal and hematopoietic cells. The Notch signaling pathway is a critical regulator of epidermal integrity. Here, we show that keratinocyte-specific deletion of total Notch signaling triggered a severe systemic B-lymphoproliferative disorder, causing death. RBP-j is the DNA binding partner of Notch, but both RBP-j-dependent and independent Notch signaling were necessary for proper epidermal differentiation and lipid deposition. Loss of both pathways caused a persistent defect in skin differentiation/barrier formation. In response, high levels of thymic stromal lymphopoietin (TSLP were released into systemic circulation by Notch-deficient keratinocytes that failed to differentiate, starting in utero. Exposure to high TSLP levels during neonatal hematopoiesis resulted in drastic expansion of peripheral pre- and immature B-lymphocytes, causing B-lymphoproliferative disorder associated with major organ infiltration and subsequent death, a previously unappreciated systemic effect of TSLP. These observations demonstrate that local skin perturbations can drive a lethal systemic disease and have important implications for a wide range of humoral and autoimmune diseases with skin manifestations.

  16. Neuromodulation integrating rTMS and neurofeedback for the treatment of autism spectrum disorder: An exploratory study

    Science.gov (United States)

    Sokhadze, Estate M.; El-Baz, Ayman S.; Tasman, Allan; Sears, Lonnie L.; Wang, Yao; Lamina, Eva V.; Casanova, Manuel F.

    2014-01-01

    Autism spectrum disorder (ASD) is a pervasive developmental disorder characterized by deficits in social interaction, language, stereotyped behaviors, and restricted range of interests. In previous studies low frequency repetitive transcranial magnetic stimulation (rTMS) has been used, with positive behavioral and electrophysiological results, for the experimental treatment in ASD. In this study we combined prefrontal rTMS sessions with electroencephalographic (EEG) neurofeedback (NFB) to prolong and reinforce TMS-induced EEG changes. The pilot trial recruited 42 children with ASD (~14.5 yrs). Outcome measures included behavioral evaluations and reaction time test with event-related potential (ERP) recording. For the main goal of this exploratory study we used rTMS-neurofeedback combination (TMS-NFB, N=20) and waitlist (WTL, N=22) groups to examine effects of 18 sessions of integrated rTMS-NFB treatment or wait period) on behavioral responses, stimulus and response-locked ERPs, and other functional and clinical outcomes. The underlying hypothesis was that combined TMS-NFB will improve executive functions in autistic patients as compared to the waitlist group. Behavioral and ERP outcomes were collected in pre- and post-treatment tests in both groups. Results of the study supported our hypothesis by demonstration of positive effects of combined TMS-NFB neurotherapy in active treatment group as compared to control waitlist group, as the TMS-NFB group showed significant improvements in behavioral and functional outcomes as compared to the waitlist group. PMID:25267414

  17. Integrated, exposure-based treatment for PTSD and comorbid substance use disorders: Predictors of treatment dropout.

    Science.gov (United States)

    Szafranski, Derek D; Snead, Alexandra; Allan, Nicholas P; Gros, Daniel F; Killeen, Therese; Flanagan, Julianne; Pericot-Valverde, Irene; Back, Sudie E

    2017-10-01

    High rates of comorbid posttraumatic stress disorder (PTSD) and substance use disorders (SUD) have been noted in veteran populations. Fortunately, there are a number of evidence-based psychotherapies designed to address comorbid PTSD and SUD. However, treatments targeting PTSD and SUD simultaneously often report high dropout rates. To date, only one study has examined predictors of dropout from PTSD/SUD treatment. To address this gap in the literature, this study aimed to 1) examine when in the course of treatment dropout occurred, and 2) identify predictors of dropout from a concurrent treatment for PTSD and SUD. Participants were 51 male and female veterans diagnosed with current PTSD and SUD. All participants completed at least one session of a cognitive-behavioral treatment (COPE) designed to simultaneously address PTSD and SUD symptoms. Of the 51 participants, 22 (43.1%) dropped out of treatment prior to completing the full 12 session COPE protocol. Results indicated that the majority of dropout (55%) occurred after session 6, with the largest amount of dropout occurring between sessions 9 and 10. Results also indicated a marginally significant relationship between greater baseline PTSD symptom severity and premature dropout. These findings highlight inconsistencies related to timing and predictors of dropout, as well as the dearth of information noted about treatment dropout within PTSD and SUD literature. Suggestions for procedural changes, such as implementing continual symptom assessments during treatment and increasing dialog between provider and patient about dropout were made with the hopes of increasing consistency of findings and eventually reducing treatment dropout. Published by Elsevier Ltd.

  18. The pathological consequences of impaired genome integrity in humans; disorders of the DNA replication machinery.

    Science.gov (United States)

    O'Driscoll, Mark

    2017-01-01

    Accurate and efficient replication of the human genome occurs in the context of an array of constitutional barriers, including regional topological constraints imposed by chromatin architecture and processes such as transcription, catenation of the helical polymer and spontaneously generated DNA lesions, including base modifications and strand breaks. DNA replication is fundamentally important for tissue development and homeostasis; differentiation programmes are intimately linked with stem cell division. Unsurprisingly, impairments of the DNA replication machinery can have catastrophic consequences for genome stability and cell division. Functional impacts on DNA replication and genome stability have long been known to play roles in malignant transformation through a variety of complex mechanisms, and significant further insights have been gained from studying model organisms in this context. Congenital hypomorphic defects in components of the DNA replication machinery have been and continue to be identified in humans. These disorders present with a wide range of clinical features. Indeed, in some instances, different mutations in the same gene underlie different clinical presentations. Understanding the origin and molecular basis of these features opens a window onto the range of developmental impacts of suboptimal DNA replication and genome instability in humans. Here, I will briefly overview the basic steps involved in DNA replication and the key concepts that have emerged from this area of research, before switching emphasis to the pathological consequences of defects within the DNA replication network; the human disorders. Copyright © 2016 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. Copyright © 2016 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

  19. Role of Sexuality in Body Integrity Identity Disorder (BIID): A Cross-Sectional Internet-Based Survey Study.

    Science.gov (United States)

    Blom, Rianne M; van der Wal, Sija J; Vulink, Nienke C; Denys, Damiaan

    2017-08-01

    Body integrity identity disorder (BIID)-a strong desire for amputation or paralysis-is often accompanied by feelings and cognitions of sexual arousal, although this sexual component has been largely neglected in the recent literature. To examine the presence of BIID-related sexual arousal in subjects with BIID and explore clinical and demographic variables of subjects with BIID who do and do not possess this sexual arousal. Eighty individuals with BIID responded to an internet-based survey we created. For all subjects, restoring identity was the primary motivation for preferred body modification. We collected data about respondents' demographic, clinical, and sexual characteristics. Based on responses to questions about BIID-specific sexual desires, subjects were assigned to the group with BIID-related sexual feelings (S-BIID; n = 57) or the group without such feelings (NS-BIID; n = 23). Differences in clinical, demographic, and sexual characteristics between S-BIID and NS-BIID groups. Of the respondents, 71.3% endorsed S-BIID. Subjects with S-BIID were significantly more often men, religious, and of a homosexual identity compared with the NS-BIID group. Subjects with S-BIID also significantly more often reported a change in localization and/or intensity of their BIID feelings over time. Furthermore, 66.7% of subjects with S-BIID reported S-BIID as an additional motivation for body modification. Seven of the 57 subjects with S-BIID achieved their preferred body modification through (self)-amputation, whereas none of the subjects with NS-BIID did. BIID is a heterogeneous disorder in which subjects who self-reported comorbid sexual arousal more often resorted to (self-induced) amputation. This study contains the largest BIID cohort presented in the literature and is the first to genuinely research sexuality in BIID. The first limitation is the lack of face-to-face interviews with the subjects, so no clinical diagnoses could be made. Moreover, there is an

  20. Sensor Fusion Based on an Integrated Neural Network and Probability Density Function (PDF) Dual Kalman Filter for On-Line Estimation of Vehicle Parameters and States.

    Science.gov (United States)

    Vargas-Melendez, Leandro; Boada, Beatriz L; Boada, Maria Jesus L; Gauchia, Antonio; Diaz, Vicente

    2017-04-29

    Vehicles with a high center of gravity (COG), such as light trucks and heavy vehicles, are prone to rollover. This kind of accident causes nearly 33 % of all deaths from passenger vehicle crashes. Nowadays, these vehicles are incorporating roll stability control (RSC) systems to improve their safety. Most of the RSC systems require the vehicle roll angle as a known input variable to predict the lateral load transfer. The vehicle roll angle can be directly measured by a dual antenna global positioning system (GPS), but it is expensive. For this reason, it is important to estimate the vehicle roll angle from sensors installed onboard in current vehicles. On the other hand, the knowledge of the vehicle's parameters values is essential to obtain an accurate vehicle response. Some of vehicle parameters cannot be easily obtained and they can vary over time. In this paper, an algorithm for the simultaneous on-line estimation of vehicle's roll angle and parameters is proposed. This algorithm uses a probability density function (PDF)-based truncation method in combination with a dual Kalman filter (DKF), to guarantee that both vehicle's states and parameters are within bounds that have a physical meaning, using the information obtained from sensors mounted on vehicles. Experimental results show the effectiveness of the proposed algorithm.

  1. Integrated mental health care and vocational rehabilitation to improve return to work rates for people on sick leave because of exhaustion disorder, adjustment disorder, and distress (the Danish IBBIS trial): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Poulsen, Rie; Fisker, Jonas; Hoff, Andreas; Hjorthøj, Carsten; Eplov, Lene Falgaard

    2017-12-02

    Common mental disorders are important contributors to the global burden of disease and cause negative effects on both the individual and society. Stress-related disorders influence the individual's workability and cause early retirement pensions in Denmark. There is no clear evidence that mental health care alone will provide sufficient support for vocational recovery for this group. Integrated vocational and health care services have shown good effects on return to work in other similar welfare contexts. The purpose of the Danish IBBIS (Integreret Behandlings- og BeskæftigelsesIndsats til Sygemeldte) study is to examine the efficacy of (1) a stepped mental health care intervention with individual stress coaching and/or group-based MBSR and (2) an integrated stepped mental health care with individual stress coaching and/or group-based MBSR and vocational rehabilitation intervention for people on sick leave because of exhaustion disorder, adjustment disorder or distress in Denmark. This three-armed, parallel-group, randomized superiority trial is set up to investigate the effectiveness of a stepped mental health care intervention and an integrated mental health care and vocational rehabilitation intervention for people on sick leave because of exhaustion disorder, adjustment disorder or distress in Denmark. The trial has an investigator-initiated multicenter design. Six hundred and three patients will be recruited from Danish vocational rehabilitation centers in four municipalities and randomly assigned into three groups: (1) IBBIS mental health care integrated with IBBIS vocational rehabilitation, (2) IBBIS mental health care and standard vocational rehabilitation, and (3) standard mental health care and standard vocational rehabilitation. The primary outcome is register-based return to work at 12 months. The secondary outcome measures are self-assessed level of depression (BDI), anxiety (BAI), distress symptoms (4DSQ), work- and social functioning (WSAS), and

  2. A pilot randomized clinical trial testing integrated 12-Step facilitation (iTSF) treatment for adolescent substance use disorder.

    Science.gov (United States)

    Kelly, John F; Kaminer, Yifrah; Kahler, Christopher W; Hoeppner, Bettina; Yeterian, Julie; Cristello, Julie V; Timko, Christine

    2017-12-01

    The integration of 12-Step philosophy and practices is common in adolescent substance use disorder (SUD) treatment programs, particularly in North America. However, although numerous experimental studies have tested 12-Step facilitation (TSF) treatments among adults, no studies have tested TSF-specific treatments for adolescents. We tested the efficacy of a novel integrated TSF. Explanatory, parallel-group, randomized clinical trial comparing 10 sessions of either motivational enhancement therapy/cognitive-behavioral therapy (MET/CBT; n = 30) or a novel integrated TSF (iTSF; n = 29), with follow-up assessments at 3, 6 and 9 months following treatment entry. Out-patient addiction clinic in the United States. Adolescents [n = 59; mean age = 16.8 (1.7) years; range = 14-21; 27% female; 78% white]. The iTSF integrated 12-Step with motivational and cognitive-behavioral strategies, and was compared with state-of-the-art MET/CBT for SUD. Primary outcome: percentage days abstinent (PDA); secondary outcomes: 12-Step attendance, substance-related consequences, longest period of abstinence, proportion abstinent/mostly abstinent, psychiatric symptoms. Primary outcome: PDA was not significantly different across treatments [b = 0.08, 95% confidence interval (CI) = -0.08 to 0.24, P = 0.33; Bayes' factor = 0.28). during treatment, iTSF patients had substantially greater 12-Step attendance, but this advantage declined thereafter (b = -0.87; 95% CI = -1.67 to 0.07, P = 0.03). iTSF did show a significant advantage at all follow-up points for substance-related consequences (b = -0.42; 95% CI = -0.80 to -0.04, P Step meeting attendance was associated significantly with longer abstinence during (r = 0.39, P = 0.008), and early following (r = 0.30, P = 0.049), treatment. Compared with motivational enhancement therapy/cognitive-behavioral therapy (MET/CBT), in terms of abstinence, a novel integrated 12-Step facilitation treatment for adolescent

  3. [Thalamic Stroke and Associated Behavior Disorders. Possibilities for Integral Management: Case Report].

    Science.gov (United States)

    Camargo, Loida Camargo; Sánchez, Katherine Parra

    2012-06-01

    Since ancient Greece, cerebrovascular accidents have been described with no variation. Even today, they are still a catastrophic event in the lives of patients with a high risk of disabling sequelae. Case report of a 56-year male patient with thalamic ischemia. The intervention with integral strategies involving pharmacological management and cognitive interventions was decisive for the satisfactory evolution of the patient. The management of patients with cerebrovascular accidents cannot be limited to the emergency room. Pharmacological advances in programs and cognitive intervention methods provide intervention tools from the very beginning of the stroke thus reducing the impact of long-term sequelae, and consequently enabling a better reintegration of the patient to his family. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  4. The efficacy of Le Bon Départ and Sensory Integration treatment for children with developmental coordination disorder: a randomized study with six single cases.

    NARCIS (Netherlands)

    Leemrijse, C.; Meijer, O.G.; Vermeer, A.; Ader, H.J.; Diemel, S.

    2000-01-01

    Objective: evaluation of the efficacy of Le Bon Départ (LBD) treatment and Sensory Integration (SI) treatment on motor performance on children with developmental coordination disorder. Design: a single subject design with multiple baseline and alternating treatments. Order of treatment and lenght of

  5. A Test of the Integrity of the Components of Baddeley's Model of Working Memory in Attention-Deficit/Hyperactivity Disorder (ADHD)

    Science.gov (United States)

    Karatekin, Canan

    2004-01-01

    Background: The integrity of working memory in attention-deficit/hyperactivity disorder (ADHD) was tested within the framework of Baddeley's model. Methods-1: Buffers and rehearsal mechanisms were assessed by presenting children with or without ADHD (ages 8 to 15) with 1-7 target letters and a probe after 2-10 s. They decided if the probe was the…

  6. Dual-In/Out strategy for genes integration into bacterial chromosome: a novel approach to step-by-step construction of plasmid-less marker-less recombinant E. coli strains with predesigned genome structure

    Directory of Open Access Journals (Sweden)

    Biryukova Irina V

    2008-08-01

    Full Text Available Abstract Background The development of modern producer strains with metabolically engineered pathways poses special problems that often require manipulating many genes and expressing them individually at different levels or under separate regulatory controls. The construction of plasmid-less marker-less strains has many advantages for the further practical exploitation of these bacteria in industry. Such producer strains are usually constructed by sequential chromosome modifications including deletions and integration of genetic material. For these purposes complex methods based on in vitro and in vivo recombination processes have been developed. Results Here, we describe the new scheme of insertion of the foreign DNA for step-by-step construction of plasmid-less marker-less recombinant E. coli strains with chromosome structure designed in advance. This strategy, entitled as Dual-In/Out, based on the initial Red-driven insertion of artificial φ80-attB sites into desired points of the chromosome followed by two site-specific recombination processes: first, the φ80 system is used for integration of the recombinant DNA based on selective marker-carrier conditionally-replicated plasmid with φ80-attP-site, and second, the λ system is used for excision of inserted vector part, including the plasmid ori-replication and the marker, flanked by λ-attL/R-sites. Conclusion The developed Dual-In/Out strategy is a rather straightforward, but convenient combination of previously developed recombination methods: phages site-specific and general Red/ET-mediated. This new approach allows us to detail the design of future recombinant marker-less strains, carrying, in particular, rather large artificial insertions that could be difficult to introduce by usually used PCR-based Recombineering procedure. The developed strategy is simple and could be particularly useful for construction of strains for the biotechnological industry.

  7. Universal Birkhoff intergrabIility in dual Banach spaces | Rodr& ...

    African Journals Online (AJOL)

    We show that some classical results on universal Pettis integrability in dual Banach spaces can be formulated in terms of the Birkhoff integral, thanks to the link between Birkhoff integrability and the Bourgain property. Keywords: Birkhoff integral; Pettis integral; Bourgain property. Quaestiones Mathematicae 28(2005), 525– ...

  8. Integrated care for comorbid alcohol dependence and anxiety and/or depressive disorder: study protocol for an assessor-blind, randomized controlled trial.

    Science.gov (United States)

    Morley, Kirsten C; Baillie, Andrew; Sannibale, Claudia; Teesson, Maree; Haber, Paul S

    2013-11-19

    A major barrier to successful treatment in alcohol dependence is psychiatric comorbidity. During treatment, the time to relapse is shorter, the drop-out rate is increased, and long-term alcohol consumption is greater for those with comorbid major depression or anxiety disorder than those with an alcohol use disorder with no comorbid mental disorder. The treatment of alcohol dependence and psychological disorders is often the responsibility of different services, and this can hinder the treatment process. Accordingly, there is a need for an effective integrated treatment for alcohol dependence and comorbid anxiety and/or depression. We aim to assess the effectiveness of a specialized, integrated intervention for alcohol dependence with comorbid anxiety and/or mood disorder using a randomized design in an outpatient hospital setting. Following a three-week stabilization period (abstinence or significantly reduced consumption), participants will undergo complete formal assessment for anxiety and depression. Those patients with a diagnosis of an anxiety and/or depressive disorder will be randomized to either 1) integrated intervention (cognitive behavioral therapy) for alcohol, anxiety, and/or depression; or 2) usual counseling care for alcohol problems. Patients will then be followed up at weeks 12, 16, and 24. The primary outcome measure is alcohol consumption (total abstinence, time to lapse, and time to relapse). Secondary outcome measures include changes in alcohol dependence severity, depression, or anxiety symptoms and changes in clinician-rated severity of anxiety and depression. The study findings will have potential implications for clinical practice by evaluating the implementation of specialized integrated treatment for comorbid anxiety and/or depression in an alcohol outpatient service. ClinicalTrials.gov Identifier: NCT01941693.

  9. Altered Processing and Integration of Multisensory Bodily Representations and Signals in Eating Disorders: A Possible Path Toward the Understanding of Their Underlying Causes.

    Science.gov (United States)

    Riva, Giuseppe; Dakanalis, Antonios

    2018-01-01

    According to the Diagnostic and Statistical Manual of Mental Disorders (DSM V) eating problems are the clinical core of eating disorders (EDs). However, the importance of shape and weight overvaluation symptoms in these disorders underlines the critical role of the experience of the body in the etiology of EDs. This article suggests that the transdiagnostic centrality of these symptoms in individuals with EDs may reflect a deficit in the processing and integration of multisensory bodily representations and signals. Multisensory body integration is a critical cognitive and perceptual process, allowing the individual to protect and extend her/his boundaries at both the homeostatic and psychological levels. To achieve this goal the brain integrates sensory data arriving from real-time multiple sensory modalities and internal bodily information with predictions made using the stored information about the body from conceptual, perceptual, and episodic memory. In this view the emotional, visual, tactile, proprioceptive and interoceptive deficits reported by many authors in individuals with EDs may reflect a broader impairment in multisensory body integration that affects the individual's abilities: (a) to identify the relevant interoceptive signals that predict potential pleasant (or aversive) consequences; and (b) to modify/correct the autobiographical allocentric (observer view) memories of body related events (self-objectified memories). Based on this view, the article also proposes a strategy, based on new technologies (i.e., virtual reality and brain/body stimulation), for using crossmodal associations to reactivate and correct the multisensory body integration processes.

  10. Wireless Data Transmission at Terahertz Carrier Waves Generated from a Hybrid InP-Polymer Dual Tunable DBR Laser Photonic Integrated Circuit.

    Science.gov (United States)

    Carpintero, Guillermo; Hisatake, Shintaro; de Felipe, David; Guzman, Robinson; Nagatsuma, Tadao; Keil, Norbert

    2018-02-14

    We report for the first time the successful wavelength stabilization of two hybrid integrated InP/Polymer DBR lasers through optical injection. The two InP/Polymer DBR lasers are integrated into a photonic integrated circuit, providing an ideal source for millimeter and Terahertz wave generation by optical heterodyne technique. These lasers offer the widest tuning range of the carrier wave demonstrated to date up into the Terahertz range, about 20 nm (2.5 THz) on a single photonic integrated circuit. We demonstrate the application of this source to generate a carrier wave at 330 GHz to establish a wireless data transmission link at a data rate up to 18 Gbit/s. Using a coherent detection scheme we increase the sensitivity by more than 10 dB over direct detection.

  11. The development of co-speech gesture and its semantic integration with speech in 6- to 12-year-old children with autism spectrum disorders.

    Science.gov (United States)

    So, Wing-Chee; Wong, Miranda Kit-Yi; Lui, Ming; Yip, Virginia

    2015-11-01

    Previous work leaves open the question of whether children with autism spectrum disorders aged 6-12 years have delay in producing gestures compared to their typically developing peers. This study examined gestural production among school-aged children in a naturalistic context and how their gestures are semantically related to the accompanying speech. Delay in gestural production was found in children with autism spectrum disorders through their middle to late childhood. Compared to their typically developing counterparts, children with autism spectrum disorders gestured less often and used fewer types of gestures, in particular markers, which carry culture-specific meaning. Typically developing children's gestural production was related to language and cognitive skills, but among children with autism spectrum disorders, gestural production was more strongly related to the severity of socio-communicative impairment. Gesture impairment also included the failure to integrate speech with gesture: in particular, supplementary gestures are absent in children with autism spectrum disorders. The findings extend our understanding of gestural production in school-aged children with autism spectrum disorders during spontaneous interaction. The results can help guide new therapies for gestural production for children with autism spectrum disorders in middle and late childhood. © The Author(s) 2014.

  12. Integrated Cognitive Behavioral Therapy Versus Cognitive Processing Therapy for Adults With Depression, Substance Use Disorder, and Trauma.

    Science.gov (United States)

    Haller, Moira; Norman, Sonya B; Cummins, Kevin; Trim, Ryan S; Xu, Xiaomin; Cui, Ruifeng; Allard, Carolyn B; Brown, Sandra A; Tate, Susan R

    2016-03-01

    The comorbidity of substance use disorder (SUD), depression, and PTSD is common among veterans. Prior research has shown that among veterans with SUD and depression, those with PTSD did not maintain cognitive-behavioral treatment gains as well as those without PTSD. Thus, the current study was designed to evaluate whether adding trauma-focused treatment following an initial group-based integrated cognitive behavioral treatment (ICBT) for SUD and depression improved treatment outcomes. Participants were 123 veterans (89% male) recruited from the VA San Diego Healthcare System. All participants received ICBT in twice weekly, group-delivered sessions for 12 weeks (Phase 1). Participants were then randomized to receive 12 sessions of individual follow-up sessions (Phase 2) utilizing either ICBT or cognitive processing therapy that was modified to integrate SUD treatment (CPT-M). Results indicated that PTSD and depression symptoms slightly improved at the end of Phase 1 group ICBT and further improved through Phase 2 individual treatment (except for participants without PTSD who received CPT-M), with treatment gains maintained one year later. Substance use significantly improved at the end of Phase 1 group ICBT and these improvements were maintained through Phase 2 and the one year follow-up. Participants in the trauma-focused Phase 2 treatment (CPT-M) exhibited similar levels of symptom reduction and maintenance of treatment gains as those in the non-trauma-focused Phase 2 treatment (ICBT). However, there was a slight advantage for Phase 2 CPT-M over Phase 2 ICBT with respect to heavy drinking outcomes for individuals with PTSD. Overall, the combination of group ICBT followed by either CPT-M or ICBT individual therapy appears to be effective for veterans with depression, SUD, and trauma history. Copyright © 2015. Published by Elsevier Inc.

  13. An Overwhelming Desire to Be Blind: Similarities and Differences between Body Integrity Identity Disorder and the Wish for Blindness.

    Science.gov (United States)

    Gutschke, Katja; Stirn, Aglaja; Kasten, Erich

    2017-01-01

    The urge to be permanently blind is an extremely rare mental health disturbance. The underlying cause of this desire has not been determined yet, and it is uncertain whether the wish for blindness is a condition that can be included in the context of body integrity identity disorder, a condition where people feel an overwhelming need to be disabled, in many cases by amputation of a limb or through paralysis. The aim of this study is to test the hypothesis that people with a desire for blindness suffer from a greater degree of visual stress in daily activities than people in a healthy visual control group. We created a Likert scale questionnaire to measure visual stress, covering a wide range of everyday situations. The wish for blindness is extremely rare and worldwide only 5 people with an urge to be blind were found to participate in the study (4 female, 1 male). In addition, a control group of 35 (28 female, 7 male) visually healthy people was investigated. Questions addressing issues that may be experienced by participants with a desire to be blind were integrated into the questionnaire. The hypothesis that people with a desire for blindness suffer from a significantly higher visual overload in activities of daily living than visually healthy subjects was confirmed; the significance of visual stress between these groups was p < 0.01. In addition, an interview with the 5 affected participants supported the causal role of visual overload. The desire for blindness seems to originate from visual overload caused by either ophthalmologic or organic brain disturbances. In addition, psychological reasons such as certain personal character traits may play an active role in developing, maintaining, and reinforcing one's desire to be blind.

  14. An Overwhelming Desire to Be Blind: Similarities and Differences between Body Integrity Identity Disorder and the Wish for Blindness

    Directory of Open Access Journals (Sweden)

    Katja Gutschke

    2017-03-01

    Full Text Available Background: The urge to be permanently blind is an extremely rare mental health disturbance. The underlying cause of this desire has not been determined yet, and it is uncertain whether the wish for blindness is a condition that can be included in the context of body integrity identity disorder, a condition where people feel an overwhelming need to be disabled, in many cases by amputation of a limb or through paralysis. Objective: The aim of this study is to test the hypothesis that people with a desire for blindness suffer from a greater degree of visual stress in daily activities than people in a healthy visual control group. Method: We created a Likert scale questionnaire to measure visual stress, covering a wide range of everyday situations. The wish for blindness is extremely rare and worldwide only 5 people with an urge to be blind were found to participate in the study (4 female, 1 male. In addition, a control group of 35 (28 female, 7 male visually healthy people was investigated. Questions addressing issues that may be experienced by participants with a desire to be blind were integrated into the questionnaire. Results: The hypothesis that people with a desire for blindness suffer from a significantly higher visual overload in activities of daily living than visually healthy subjects was confirmed; the significance of visual stress between these groups was p < 0.01. In addition, an interview with the 5 affected participants supported the causal role of visual overload. Conclusions: The desire for blindness seems to originate from visual overload caused by either ophthalmologic or organic brain disturbances. In addition, psychological reasons such as certain personal character traits may play an active role in developing, maintaining, and reinforcing one’s desire to be blind.

  15. Dual Youla parameterization

    DEFF Research Database (Denmark)

    Niemann, Hans Henrik

    2003-01-01

    A different aspect of using the parameterisation of all systems stabilised by a given controller, i.e. the dual Youla parameterisation, is considered. The relation between system change and the dual Youla parameter is derived in explicit form. A number of standard uncertain model descriptions...... are considered and the relation with the dual Youla parameter given. Some applications of the dual Youla parameterisation are considered in connection with the design of controllers and model/performance validation....

  16. In Vivo Evidence of Reduced Integrity of the Gray-White Matter Boundary in Autism Spectrum Disorder.

    Science.gov (United States)

    Andrews, Derek Sayre; Avino, Thomas A; Gudbrandsen, Maria; Daly, Eileen; Marquand, Andre; Murphy, Clodagh M; Lai, Meng-Chuan; Lombardo, Michael V; Ruigrok, Amber N V; Williams, Steven C; Bullmore, Edward T; The Mrc Aims Consortium; Suckling, John; Baron-Cohen, Simon; Craig, Michael C; Murphy, Declan G M; Ecker, Christine

    2017-02-01

    Atypical cortical organization and reduced integrity of the gray-white matter boundary have been reported by postmortem studies in individuals with autism spectrum disorder (ASD). However, there are no in vivo studies that examine these particular features of cortical organization in ASD. Hence, we used structural magnetic resonance imaging to examine differences in tissue contrast between gray and white matter in 98 adults with ASD and 98 typically developing controls, to test the hypothesis that individuals with ASD have significantly reduced tissue contrast. More specifically, we examined contrast as a percentage between gray and white matter tissue signal intensities (GWPC) sampled at the gray-white matter boundary, and across different cortical layers. We found that individuals with ASD had significantly reduced GWPC in several clusters throughout the cortex (cluster, P gray-white matter interface, which indicates a less distinct gray-white matter boundary in ASD. Our in vivo findings of reduced GWPC in ASD are therefore consistent with prior postmortem findings of a less well-defined gray-white matter boundary in ASD. Taken together, these results indicate that GWPC might be utilized as an in vivo proxy measure of atypical cortical microstructural organization in future studies. © The Author 2017. Published by Oxford University Press.

  17. Energy, Exergy and Economic Evaluation Comparison of Small-Scale Single and Dual Pressure Organic Rankine Cycles Integrated with Low-Grade Heat Sources

    Directory of Open Access Journals (Sweden)

    Armando Fontalvo

    2017-09-01

    Full Text Available Low-grade heat sources such as solar thermal, geothermal, exhaust gases and industrial waste heat are suitable alternatives for power generation which can be exploited by means of small-scale Organic Rankine Cycle (ORC. This paper combines thermodynamic optimization and economic analysis to assess the performance of single and dual pressure ORC operating with different organic fluids and targeting small-scale applications. Maximum power output is lower than 45 KW while the temperature of the heat source varies in the range 100–200 °C. The studied working fluids, namely R1234yf, R1234ze(E and R1234ze(Z, are selected based on environmental, safety and thermal performance criteria. Levelized Cost of Electricity (LCOE and Specific Investment Cost (SIC for two operation conditions are presented: maximum power output and maximum thermal efficiency. Results showed that R1234ze(Z achieves the highest net power output (up to 44 kW when net power output is optimized. Regenerative ORC achieves the highest performance when thermal efficiency is optimized (up to 18%. Simple ORC is the most cost-effective among the studied cycle configurations, requiring a selling price of energy of 0.3 USD/kWh to obtain a payback period of 8 years. According to SIC results, the working fluid R1234ze(Z exhibits great potential for simple ORC when compared to conventional R245fa.

  18. Estimation of rice grain yield from dual-polarization Radarsat-2 SAR data by integrating a rice canopy scattering model and a genetic algorithm

    Science.gov (United States)

    Zhang, Yuan; Yang, Bin; Liu, Xiaohui; Wang, Cuizhen

    2017-05-01

    Fast and accurate estimation of rice yield plays a role in forecasting rice productivity for ensuring regional or national food security. Microwave synthetic aperture radar (SAR) data has been proved to have a great potential for rice monitoring and parameters retrieval. In this study, a rice canopy scattering model (RCSM) was revised and then was applied to simulate the backscatter of rice canopy. The combination of RCSM and genetic algorithm (GA) was proposed for retrieving two important rice parameters relating to grain yield, ear length and ear number density, from a C-band, dual-polarization (HH and HV) Radarsat-2 SAR data. The stability of retrieved results of GA inversion was also evaluated by changing various parameter configurations. Results show that RCSM can effectively simulate backscattering coefficients of rice canopy at HH and HV mode with an error of <1 dB. Reasonable selection of GA's parameters is essential for stability and efficiency of rice parameter retrieval. Two rice parameters are retrieved by the proposed RCSM-GA technology with better accuracy. The rice ear length are estimated with error of <1.5 cm, and ear number density with error of <23 #/m2. Rice grain yields are effectively estimated and mapped by the retrieved ear length and number density via a simple yield regression equation. This study further illustrates the capability of C-band Radarsat-2 SAR data on retrieval of rice ear parameters and the practicability of radar remote sensing technology for operational yield estimation.

  19. Actual neurosis as the underlying psychic structure of panic disorder, somatization, and somatoform disorder: an integration of Freudian and attachment perspectives.

    Science.gov (United States)

    Verhaeghe, Paul; Vanheule, Stijn; De Rick, Ann

    2007-10-01

    Starting from a contemporary critique of the DSM-IV, this paper argues that the diagnostic categories of panic disorder somatization, and undifferentiated somatoform disorders can be understood as belonging to a common type of psychopathology--i.e., the Freudian actual neuroses. In addition to their strong clinical similarity, these disorders share an etiological similarity; and the authors propose a combination of Freud's focus on this type of patient's inability to represent an endogenous drive arousal with the post-Freudian focus on separation anxiety. An etiological hypothesis is put forward based on contemporary psychoanalytic attachment theory, highlighting mentalization. Concrete implications for a psychoanalytically based treatment are proposed.

  20. Dual role of an ac driving force and the underlying two distinct order–disorder transitions in the vortex phase diagram of Ca3Ir4Sn13

    International Nuclear Information System (INIS)

    Kumar, Santosh; Singh, Ravi P.; Thamizhavel, A.; Tomy, C.V.; Grover, A.K.

    2014-01-01

    Highlights: • This work pertains to new findings related to a broad SMP anomaly. • Broad SMP prima facie encompasses two phase transformations in vortex matter. • We demarcated two phase boundaries pertaining to order–disorder transitions which have quasi first-order nature. - Abstract: We present distinct demarcation of the Bragg glass (BG) to multi-domain vortex glass (VG) transition line and the eventual amorphization of the VG phase in a weakly pinned single crystal of the superconducting compound Ca 3 Ir 4 Sn 13 on the basis of comprehension of the different yields about the second magnetization peak (SMP) anomaly in the dc magnetization and the corresponding anomalous feature in the ac susceptibility measurements. The shaking by a small ac magnetic field, inevitably present in the ac susceptibility measurements, is seen to result in contrasting responses in two different portions of the field-temperature (H, T) phase space of the multi-domain VG. In one of the portions, embracing the BG to VG transition across the onset of the SMP anomaly, the ac drive is surprisingly seen to assist the transformation of the well ordered BG phase to a lesser ordered VG phase. The BG phase exists as a superheated state over a small portion of the VG space and this attests to the first order nature of the BG to VG transition

  1. Dual affine isoperimetric inequalities

    Directory of Open Access Journals (Sweden)

    Bin Xiong

    2006-01-01

    Full Text Available We establish some inequalities for the dual -centroid bodies which are the dual forms of the results by Lutwak, Yang, and Zhang. Further, we establish a Brunn-Minkowski-type inequality for the polar of dual -centroid bodies.

  2. Obesity and eating disorders in integrative prevention programmes for adolescents: Protocol for a systematic review and meta-analysis

    Science.gov (United States)

    Obesity and eating disorders are public health problems that have lifelong financial and personal costs and common risk factors, for example, body dissatisfaction, weight teasing and disordered eating. Obesity prevention interventions might lead to the development of an eating disorder since focusin...

  3. Two-dimensional exactly and completely integrable dynamic systems (Monopoles, instantons, dual models, relativistic strings, Lund-Regge model, generalized Toda lattice, etc)

    International Nuclear Information System (INIS)

    Leznov, A.N.; Saveliev, M.V.

    1982-01-01

    An investigation of two-dimensional exactly and completely integrable dynamical systems associated with the local part of an arbitrary Lie algebra g whose grading is consistent with an arbitrary integral embedding of 3d-subalgebra in g has been carried out. The corresponding systems of nonlinear partial differential equations of the second order h been constructed in an explicit form and their genral solutions in the sense of a Goursat problem have been obtained. A method for the construction of a wide class of infinite-dimensional Lie algebras of finite growth has been proposed

  4. Generation of urine iPS cell line from a patient with obsessive-compulsive disorder using a non-integrative method

    Directory of Open Access Journals (Sweden)

    Jaroslaw Sochacki

    2016-07-01

    Full Text Available Urine sample was collected from a 29-year-old male patient with an early onset form of DSM-5 obsessive-compulsive disorder (OCD, comorbid body dysmorphic and excoriation (skin-picking disorders, and a positive family history for OCD. Urine cell line was established and expanded for the reprogramming procedure. Induced pluripotent stem (iPS cells were derived using the integration-free CytoTune®-iPS 2.0 Sendai Reprogramming Kit, which includes Sendai virus particles of the four Yamanaka factors Oct3/4, Sox2, Klf4 and c-Myc.

  5. Craniosacral therapy as a relaxation method for hyperreactivity in a child with sensory integration disorder – a case report

    Directory of Open Access Journals (Sweden)

    Katarzyna Strojek

    2017-06-01

    Full Text Available Impaired sensory processing, the so-called sensory integration disorder, occurs when the brain is unable to correctly process the stimuli coming from the internal and the external environment. Proper sensory integration allows the child for normal everyday functioning (learning, playing, resting, whereas children with impaired sensory integration often lack the psycho-affective balance. They suffer from psychosomatic disorders, which may be caused by e.g. stress due to peer competition at school. Children affected by this disorder need relaxation to regain the balance necessary for proper physical and mental development. The aim of the study is to assess the therapeutic outcomes in a 7-year-old girl diagnosed with vestibular, tactile and proprioceptive deficits. Craniosacral therapy and somatosensory integration method were used. Relaxation therapy had beneficial effects on child’s development, behaviour and the manner of communication with the environment. The hyperesthesia sites, which were present before the therapy, resolved. Previously reported self-aggressive behaviours are no longer observed. Furthermore, the child’s independence, which is crucial for the psychosocial development, also increased during the therapy.

  6. DUAL TIMELIKE NORMAL AND DUAL TIMELIKE SPHERICAL CURVES IN DUAL MINKOWSKI SPACE

    OpenAIRE

    ÖNDER, Mehmet

    2009-01-01

    Abstract: In this paper, we give characterizations of dual timelike normal and dual timelike spherical curves in the dual Minkowski 3-space and we show that every dual timelike normal curve is also a dual timelike spherical curve. Keywords: Normal curves, Dual Minkowski 3-Space, Dual Timelike curves. Mathematics Subject Classifications (2000): 53C50, 53C40. DUAL MINKOWSKI UZAYINDA DUAL TIMELIKE NORMAL VE DUAL TIMELIKE KÜRESEL EĞRİLER Özet: Bu çalışmada, dual Minkowski 3-...

  7. 'Integration'

    DEFF Research Database (Denmark)

    Olwig, Karen Fog

    2011-01-01

    , while the countries have adopted disparate policies and ideologies, differences in the actual treatment and attitudes towards immigrants and refugees in everyday life are less clear, due to parallel integration programmes based on strong similarities in the welfare systems and in cultural notions...... of equality in the three societies. Finally, it shows that family relations play a central role in immigrants’ and refugees’ establishment of a new life in the receiving societies, even though the welfare society takes on many of the social and economic functions of the family....

  8. F-band millimeter-wave signal generation for wireless link data transmission using on-chip photonic integrated dual-wavelength sources

    NARCIS (Netherlands)

    Guzman, Robinson; Carpintero, G.; Gordon Gallegos, Carlos; Lawniczuk, Katarzyna; Leijtens, Xaveer

    2015-01-01

    Millimeter-waves (30-300 GHz) have interest due to the wide bandwidths available for carrying information, enabling broadband wireless communications. Photonics is a key technology for millimeter wave signal generation, recently demonstrating the use of photonic integration to reduce size and cost.

  9. A fast spectrum dual path flow cermet reactor

    International Nuclear Information System (INIS)

    Anghaie, S.; Feller, G.J.; Peery, S.D.; Parsley, R.C.

    1993-01-01

    A cermet fueled, dual path fast reactor for space nuclear propulsion applications is conceptually designed. The reactor utilizes an outer annulus core and an inner cylindrical core with radial and axial reflector. The dual path flow minimizes the impact of power peaking near the radial reflector. Basic neutronics and core design aspects of the reactor are discussed. The dual path reactor is integrated into a 25000 lbf thrust nuclear rocket

  10. Dual-Doppler Feasibility Study

    Science.gov (United States)

    Huddleston, Lisa L.

    2012-01-01

    radar geometry issues at the NWS MLB radar, such as the "cone of silence" or beam blockage. In the event of a radar outage at one of the sites, the multi-radar algorithms would provide continuing coverage of the area through use of the data from the remaining operational radar sites. There are several options to collect, edit, synthesize and display dual-Doppler data sets. These options include commercial packages available for purchase and a variety of freeware packages available from the National Center for Atmospheric Research (NCAR) for processing raw radar data. However, evaluation of the freeware packages revealed that they do not have sufficient documentation and configuration control to be certified for 45 SW use. Additionally, a TI data line must be installed/leased from the NWS MLB office and CCAFS to enable the receipt of NWS MLB raw radar data to use in the dual-Doppler synthesis. Integration of the TI data line into the Eastern Range infrastructure that will meet the security requirements necessary for 45 SW use is time-consuming and costly. Overall evaluation indicates that establishment of the dual-Doppler capability using the existing operational radar systems is desirable and feasible with no technical concerns. Installation of such a system represents a significant enhancement to forecasting capabilities at the 45 WS and at NWS MLB. However, data security and cost considerations must be evaluated in light of current budgetary constraints. In any case, gaining the dual-Doppler capability will provide opportunities for better visualization of the wind field and better forecasting of the onset of convection and severe weather events to support space launch operations at KSC and CCAFS.

  11. A Randomized Controlled Trial Comparing Integrated Cognitive Behavioral Therapy Versus Individual Addiction Counseling for Co-occurring Substance Use and Posttraumatic Stress Disorders.

    Science.gov (United States)

    McGovern, Mark P; Lambert-Harris, Chantal; Alterman, Arthur I; Xie, Haiyi; Meier, Andrea

    2011-01-01

    OBJECTIVE: Co-occurring posttraumatic stress (PTSD) and substance use disorders provide clinical challenges to addiction treatment providers. Interventions are needed that are effective, well-tolerated by patients, and capable of being delivered by typical clinicians in community settings. This is a randomized controlled trial of integrated cognitive behavioral therapy for co-occurring PTSD and substance use disorders. METHODS: Fifty-three participants sampled from seven community addiction treatment programs were randomized to integrated cognitive behavioral therapy plus standard care or individual addiction counseling plus standard care. Fourteen community therapists employed by these programs delivered both manual-guided therapies. Primary outcomes were PTSD symptoms, substance use symptoms and therapy retention. Participants were assessed at baseline, 3- and 6-month follow-up. RESULTS: Integrated cognitive behavioral therapy was more effective than individual addiction counseling in reducing PTSD re-experiencing symptoms and PTSD diagnosis. Individual addiction counseling was comparably effective to integrated cognitive behavioral therapy in substance use outcomes and on other measures of psychiatric symptom severity. Participants assigned to individual addiction counseling with severe PTSD were less likely to initiate and engage in the therapy than those assigned to integrated cognitive behavioral therapy. In general, participants with severe PTSD were more likely to benefit from integrated cognitive behavioral therapy. CONCLUSIONS: The findings support the promise of efficacy of integrated cognitive behavioral therapy in improving outcomes for persons in addiction treatment with PTSD. Community counselors delivered both interventions with satisfactory adherence and competence. Despite several limitations to this research, a larger randomized controlled trial of integrated cognitive behavioral therapy appears warranted.

  12. Effect of automated tube voltage selection, integrated circuit detector and advanced iterative reconstruction on radiation dose and image quality of 3rd generation dual-source aortic CT angiography: An intra-individual comparison.

    Science.gov (United States)

    Mangold, Stefanie; De Cecco, Carlo N; Wichmann, Julian L; Canstein, Christian; Varga-Szemes, Akos; Caruso, Damiano; Fuller, Stephen R; Bamberg, Fabian; Nikolaou, Konstantin; Schoepf, U Joseph

    2016-05-01

    To compare, on an intra-individual basis, the effect of automated tube voltage selection (ATVS), integrated circuit detector and advanced iterative reconstruction on radiation dose and image quality of aortic CTA studies using 2nd and 3rd generation dual-source CT (DSCT). We retrospectively evaluated 32 patients who had undergone CTA of the entire aorta with both 2nd generation DSCT at 120kV using filtered back projection (FBP) (protocol 1) and 3rd generation DSCT using ATVS, an integrated circuit detector and advanced iterative reconstruction (protocol 2). Contrast-to-noise ratio (CNR) was calculated. Image quality was subjectively evaluated using a five-point scale. Radiation dose parameters were recorded. All studies were considered of diagnostic image quality. CNR was significantly higher with protocol 2 (15.0±5.2 vs 11.0±4.2; p<.0001). Subjective image quality analysis revealed no significant differences for evaluation of attenuation (p=0.08501) but image noise was rated significantly lower with protocol 2 (p=0.0005). Mean tube voltage and effective dose were 94.7±14.1kV and 6.7±3.9mSv with protocol 2; 120±0kV and 11.5±5.2mSv with protocol 1 (p<0.0001, respectively). Aortic CTA performed with 3rd generation DSCT, ATVS, integrated circuit detector, and advanced iterative reconstruction allow a substantial reduction of radiation exposure while improving image quality in comparison to 120kV imaging with FBP. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. How Are Service Dogs for Adults with Post Traumatic Stress Disorder Integrated with Rehabilitation in Denmark? A Case Study.

    Science.gov (United States)

    Glintborg, Chalotte; Hansen, Tia G B

    2017-04-25

    A severe mental illness like Post Traumatic Stress Disorder (PTSD) is known to have psychosocial consequences that can lead to a decreased quality of life. Research in Animal-Assisted Therapy (AAT) has revealed that the presence of a dog can have a positive effect on health, e.g., increase quality of life and lessen depression and anxiety. However, canine companionship is not a catch-all solution. Previous research has revealed methodological limitations that prohibit any clear conclusions, as well as a sparsity of critical reflection in anecdotal reports and case studies, which means that more research is needed to contextualize the findings. There has been an increasing interest in animal-assisted intervention in Denmark in recent years. Previously, authorities could only grant service dogs to adults with physical disabilities, but now this has been extended to adults with mental illnesses. Therefore, it has become important to explore how these service dogs are incorporated into rehabilitation practices in mental health, and how rehabilitation professionals react to the use of service dogs. This paper is a case study of a person who suffers from PTSD. This study examines how the person describes the significance of having a dog during her rehabilitation process, and how this is integrated with existing rehabilitation. The case study has been developed based on a semi-structured interview. A Thematic Content analysis was used to reveal dominant patterns and categories. This study revealed a lack of communication and collaboration between public administration (social service), service dog providers, health rehabilitation services, and providers of psychological treatment. It also revealed limited access for the dog to public services, limited success in incorporating the dog into goal-directed treatment and rehabilitation procedures, a strongly felt emotional support from the dog, and a perceived stigma by having the dog wearing a vest with he words "mentally ill

  14. Music Therapy as an Integrative Tool for Pupils with Attention-Deficit Hyperactivity Disorder (ADHD) in the Music Classrooms at Elementary Schools

    OpenAIRE

    Alberto Acebes-de Pablo; David Carabias-Galindo

    2016-01-01

    Music Therapy, whose aim is to obtain benefits in people health in different aspects of life and in relation to various kinds of pathologies and diseases, is proposed in this research as a means of providing educational attention to children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) through Music Education. Educational as well as therapeutic objectives were also considered, as the study focused on the integration of such children into mainstream classes. The methodology e...

  15. PhenomeCentral: An Integrated Portal for Sharing and Searching Patient Phenotype Data for Rare Genetic Disorders.

    OpenAIRE

    Brudno, Michael; Girdea, Marta; Dumitriu, Sergiu; Buske, Orion; Köhler, Sebastian; Robinson, Peter N.; Brookes, Andrew J.; Boycott, Kym; Boerkoel, Cornelius F.; Gahl, William A.; CARE RARE, Canadian for Consortium; NIH, Undiagnosed Diseases Program

    2014-01-01

    The availability of low-cost genome sequencing has allowed for the identification of the molecular cause of hundreds of rare genetic disorders. Solved disorders, however, only represent the “tip of the iceberg”. Because the discovery of disease-causing variants typically requires confirmation of the mutation or gene in multiple unrelated individuals, an even larger number of genetic disorders remain unsolved due to difficulty identifying second families. With many groups now tackling these re...

  16. Obsessive-compulsive disorder, which genes? Which functions? Which pathways? An integrated holistic view regarding OCD and its complex genetic etiology.

    Science.gov (United States)

    Bozorgmehr, Ali; Ghadirivasfi, Mohammad; Shahsavand Ananloo, Esmaeil

    2017-09-01

    Obsessive-compulsive disorder (OCD) is characterized by recurrent obtrusive and repetitive acts typically occurred following anxiety. In the last two decades, studies done on the gene sequences, large-scale and point mutations and gene-gene, gene-environment and gene-drug interactions have led to the discovery of hundreds of genes associated with OCD. Although each gene in turn is a part of the etiology of this disorder; however, OCD, like other mental disorders is complex and a comprehensive and integrated view is necessary to understand its genetic basis. In this study, through an extensive review of existing published studies, all genes associated with OCD were found. Then, in order to integrate the results, all the interactions between these genes were explored and the achievement was represented as an interactive genetic network. Furthermore, the reconstructed network was analyzed. It was found that GRIN2A, GRIN2B and GRIA2 are the most central nodes in the network. Functional and pathway enrichment analysis showed that glutamate-related pathways are the main deficient systems in patients with OCD. By studying genes shared between OCD and other diseases, it was cleared that OCD, epilepsy and some types of cancer have the most number of shared genes. The results of this study, in addition to reviewing the available results as a comprehensive and integrated manner, provide new hypotheses for future studies.

  17. Optoelectronic cross-injection locking of a dual-wavelength photonic integrated circuit for low-phase-noise millimeter-wave generation.

    Science.gov (United States)

    Kervella, Gaël; Van Dijk, Frederic; Pillet, Grégoire; Lamponi, Marco; Chtioui, Mourad; Morvan, Loïc; Alouini, Mehdi

    2015-08-01

    We report on the stabilization of a 90-GHz millimeter-wave signal generated from a fully integrated photonic circuit. The chip consists of two DFB single-mode lasers whose optical signals are combined on a fast photodiode to generate a largely tunable heterodyne beat note. We generate an optical comb from each laser with a microwave synthesizer, and by self-injecting the resulting signal, we mutually correlate the phase noise of each DFB and stabilize the beatnote on a multiple of the frequency delivered by the synthesizer. The performances achieved beat note linewidth below 30 Hz.

  18. Nondestructive Analysis of Tumor-Associated Membrane Protein Integrating Imaging and Amplified Detection in situ Based on Dual-Labeled DNAzyme.

    Science.gov (United States)

    Chen, Xiaoxia; Zhao, Jing; Chen, Tianshu; Gao, Tao; Zhu, Xiaoli; Li, Genxi

    2018-01-01

    Comprehensive analysis of the expression level and location of tumor-associated membrane proteins (TMPs) is of vital importance for the profiling of tumor cells. Currently, two kinds of independent techniques, i.e. ex situ detection and in situ imaging, are usually required for the quantification and localization of TMPs respectively, resulting in some inevitable problems. Methods: Herein, based on a well-designed and fluorophore-labeled DNAzyme, we develop an integrated and facile method, in which imaging and quantification of TMPs in situ are achieved simultaneously in a single system. The labeled DNAzyme not only produces localized fluorescence for the visualization of TMPs but also catalyzes the cleavage of a substrate to produce quantitative fluorescent signals that can be collected from solution for the sensitive detection of TMPs. Results: Results from the DNAzyme-based in situ imaging and quantification of TMPs match well with traditional immunofluorescence and western blotting. In addition to the advantage of two-in-one, the DNAzyme-based method is highly sensitivity, allowing the detection of TMPs in only 100 cells. Moreover, the method is nondestructive. Cells after analysis could retain their physiological activity and could be cultured for other applications. Conclusion: The integrated system provides solid results for both imaging and quantification of TMPs, making it a competitive method over some traditional techniques for the analysis of TMPs, which offers potential application as a toolbox in the future.

  19. Dual modal ultra-bright nanodots with aggregation-induced emission and gadolinium-chelation for vascular integrity and leakage detection.

    Science.gov (United States)

    Feng, Guangxue; Li, Jackson Liang Yao; Claser, Carla; Balachander, Akhila; Tan, Yingrou; Goh, Chi Ching; Kwok, Immanuel Weng Han; Rénia, Laurent; Tang, Ben Zhong; Ng, Lai Guan; Liu, Bin

    2018-01-01

    The study of blood brain barrier (BBB) functions is important for neurological disorder research. However, the lack of suitable tools and methods has hampered the progress of this field. Herein, we present a hybrid nanodot strategy, termed AIE-Gd dots, comprising of a fluorogen with aggregation-induced emission (AIE) characteristics as the core to provide bright and stable fluorescence for optical imaging, and gadolinium (Gd) for accurate quantification of vascular leakage via inductively-coupled plasma mass spectrometry (ICP-MS). In this report, we demonstrate that AIE-Gd dots enable direct visualization of brain vascular networks under resting condition, and that they form localized punctate aggregates and accumulate in the brain tissue during experimental cerebral malaria, indicative of hemorrhage and BBB malfunction. With its superior detection sensitivity and multimodality, we hereby propose that AIE-Gd dots can serve as a better alternative to Evans blue for visualization and quantification of changes in brain barrier functions. Copyright © 2017. Published by Elsevier Ltd.

  20. Professionals' perceptions about healthcare resources for co-occuring disorders in Spain.

    Science.gov (United States)

    Roncero, Carlos; Vega, Pablo; Martínez-Raga, Jose; Barral, Carmen; Basurte-Villamor, Ignacio; Rodríguez-Cintas, Laia; Mesías, Beatriz; Grau-López, Lara; Casas, Miguel; Szerman, Nestor

    2014-01-01

    Since provision of integrated services for patients with dual pathology or dual disorders (coexistence of an addictive disorder and other psychiatric disorders) constitutes an important challenge, this study compared the perceptions of health-care professionals with the existing, current state of specific resources for patients with dual pathology in Spain. Epidemiological, observational, cross-sectional, multicenter study with a large, representative sample of health care professionals attending patients with dual pathology in treatment resources throughout Spain. Participants completed a specifically designed ad-hoc on-line questionnaire about their perceptions on the existence of available resources and treatment needs for patients with dual pathology. To compare professionals' perceptions with existing available resources, the same on-line questionnaire was also completed by commissioners and managers responsible for national and regional healthcare plans on drug abuse. A total of 659 professionals, mostly psychologists (43.40%) or psychiatrists (32.93%) agreed to participate in the study. The highest degree of concordance between the perceptions of professional and the actual situation was found regarding the existence of mental health and addiction networks (either separately or unified) (74.48%), followed by specific workshops (73.08%) and sub-acute inpatient units (67.38%), specific hospitalization units (66.26%), detoxification units (63.15%) and outpatient programs (60.73%). We detected a lower degree of agreement regarding specific occupational rehabilitation centers (59.34%) day hospitals (58.93%), day centers (57.88%), outpatient intermediate resources (48.87%), psychiatric acute admission units (46.54%) and therapeutic communities (43.77%). In addition, on average, health care professionals underestimated the number of resources present in their respective communities. Relevant differences exist between the perceptions of professional and existing

  1. Integrated characterization of natural attenuation of a PCE plume after thermal remediation of the source zone - incl. dual isotope and microbial techniques

    DEFF Research Database (Denmark)

    Broholm, Mette Martina

    dechlorination 1-1.5 km downstream the source area, where the plume descends into more reduced groundwater. The objective of the new (2014) study is to evaluate how the source remediation has impacted the plume and in particular the natural attenuation within the plume. A large monitoring campaign including...... down-gradient which co-inside with the reduction in redox conditions. The findings document a significant increase in cDCE degradation without accumulation of VC. This reduces the risk posed by the contaminant plume to the drinking water resource. This project is unique in the integrated...... area, resulted in the release of dissolved organic matter and some geochemical changes. This has had an effect on redox conditions and biodegradation by reductive dechlorination particularly in the near source area. However, also in the further downstream area of the plume redox and contaminant levels...

  2. SysBioCube: A Data Warehouse and Integrative Data Analysis Platform Facilitating Systems Biology Studies of Disorders of Military Relevance.

    Science.gov (United States)

    Chowbina, Sudhir; Hammamieh, Rasha; Kumar, Raina; Chakraborty, Nabarun; Yang, Ruoting; Mudunuri, Uma; Jett, Marti; Palma, Joseph M; Stephens, Robert

    2013-01-01

    SysBioCube is an integrated data warehouse and analysis platform for experimental data relating to diseases of military relevance developed for the US Army Medical Research and Materiel Command Systems Biology Enterprise (SBE). It brings together, under a single database environment, pathophysio-, psychological, molecular and biochemical data from mouse models of post-traumatic stress disorder and (pre-) clinical data from human PTSD patients.. SysBioCube will organize, centralize and normalize this data and provide an access portal for subsequent analysis to the SBE. It provides new or expanded browsing, querying and visualization to provide better understanding of the systems biology of PTSD, all brought about through the integrated environment. We employ Oracle database technology to store the data using an integrated hierarchical database schema design. The web interface provides researchers with systematic information and option to interrogate the profiles of pan-omics component across different data types, experimental designs and other covariates.

  3. Pain and major depressive disorder: Associations with cognitive impairment as measured by the THINC-integrated tool (THINC-it).

    Science.gov (United States)

    Cha, Danielle S; Carmona, Nicole E; Mansur, Rodrigo B; Lee, Yena; Park, Hyun Jung; Rodrigues, Nelson B; Subramaniapillai, Mehala; Rosenblat, Joshua D; Pan, Zihang; Lee, Jae Hon; Lee, JungGoo; Almatham, Fahad; Alageel, Asem; Shekotikhina, Margarita; Zhou, Aileen J; Rong, Carola; Harrison, John; McIntyre, Roger S

    2017-04-01

    To examine the role of pain on cognitive function in adults with major depressive disorder (MDD). Adults (18-65) with a Diagnostic and Statistical Manual - Fifth Edition (DSM-5)-defined diagnosis of MDD experiencing a current major depressive episode (MDE) were enrolled (n MDD =100). All subjects with MDD were matched in age, sex, and years of education to healthy controls (HC) (n HC =100) for comparison. Cognitive function was assessed using the recently validated THINC-integrated tool (THINC-it), which comprises variants of the choice reaction time (i.e., THINC-it: Spotter), One-Back (i.e., THINC-it: Symbol Check), Digit Symbol Substitution Test (i.e., THINC-it: Codebreaker), Trail Making Test - Part B (i.e., THINC-it: Trails), as well as the Perceived Deficits Questionnaire for Depression - 5-item (i.e., THINC-it: PDQ-5-D). A global index of objective cognitive function was computed using objective measures from the THINC-it, while self-rated cognitive deficits were measured using the PDQ-5-D. Pain was measured using a Visual Analogue Scale (VAS). Regression analyses evaluated the role of pain in predicting objective and subjective cognitive function. A significant between-group differences on the VAS was observed (p<0.001), with individuals with MDD reporting higher pain severity as evidenced by higher scores on the VAS than HC. Significant interaction effects were observed between self -rated cognitive deficits and pain ratings (p<0.001) on objective cognitive performance (after adjusting for MADRS total score), suggesting that pain moderates the association between self-rated and objective cognitive function. Results indicated that pain is associated with increased self-rated and objective cognitive deficits in adults with MDD. The study herein provides preliminary evidence demonstrating that adults with MDD reporting pain symptomatology and poorer subjective cognitive function is predictive of poorer objective cognitive performance. THINC-it is capable of

  4. Attention-deficit hyperactivity disorder (ADHD and glial integrity: S100B, cytokines and kynurenine metabolism - effects of medication

    Directory of Open Access Journals (Sweden)

    Schwarz Markus J

    2010-05-01

    Full Text Available Abstract Background Children with attention-deficit/hyperactivity disorder (ADHD show a marked temporal variability in their display of symptoms and neuropsychological performance. This could be explained in terms of an impaired glial supply of energy to support neuronal activity. Method We pursued one test of the idea with measures of a neurotrophin reflecting glial integrity (S100B and the influences of 8 cytokines on the metabolism of amino-acids, and of tryptophan/kynurenine to neuroprotective or potentially toxic products that could modulate glial function. Serum samples from 21 medication-naïve children with ADHD, 21 typically-developing controls, 14 medicated children with ADHD and 7 healthy siblings were analysed in this preliminary exploration of group differences and associations. Results There were no marked group differences in levels of S100B, no major imbalance in the ratios of pro- to anti-inflammatory interleukins nor in the metabolism of kynurenine to toxic metabolites in ADHD. However, four trends are described that may be worthy of closer examination in a more extensive study. First, S100B levels tended to be lower in ADHD children that did not show oppositional/conduct problems. Second, in medicated children raised interleukin levels showed a trend to normalisation. Third, while across all children the sensitivity to allergy reflected increased levels of IL-16 and IL-10, the latter showed a significant inverse relationship to measures of S100B in the ADHD group. Fourthly, against expectations healthy controls tended to show higher levels of toxic 3-hydroxykynurenine (3 HK than those with ADHD. Conclusions Thus, there were no clear signs (S100B that the glial functions were compromised in ADHD. However, other markers of glial function require examination. Nonetheless there is preliminary evidence that a minor imbalance of the immunological system was improved on medication. Finally, if lower levels of the potentially toxic 3

  5. Training Changes Professionals’ Attitudes Towards Dual Diagnosis

    DEFF Research Database (Denmark)

    Pinderup, Pernille

    2016-01-01

    Studies have shown that mental health professionals in many cases have counterproductive attitudes towards patients with mental illnesses and comorbid substance use disorders (dual diagnosis). This is problematic because professionals’ attitudes are important for both the therapeutic alliance...... and treatment outcome. This study tested whether providing training in dual diagnosis treatment to mental health professionals will affect their attitudes positively. Twenty-one professionals completed a questionnaire on attitudes towards working with dual diagnosis (Comorbidity Problems Perceptions...... Questionnaire, CMPPQ) pre-training and post-training. Results showed that there was a significant positive change in total CMPPQ scores and a positive change in all six subscales of the CMPPQ following training, indicating that the training resulted in more positive attitudes. The study suggests that training...

  6. Hepatic MR imaging for in vivo differentiation of steatosis, iron deposition and combined storage disorder: Single-ratio in/opposed phase analysis vs. dual-ratio Dixon discrimination

    International Nuclear Information System (INIS)

    Bashir, Mustafa R.; Merkle, Elmar M.; Smith, Alastair D.; Boll, Daniel T.

    2012-01-01

    Objective: To assess whether in vivo dual-ratio Dixon discrimination can improve detection of diffuse liver disease, specifically steatosis, iron deposition and combined disease over traditional single-ratio in/opposed phase analysis. Methods: Seventy-one patients with biopsy-proven (17.7 ± 17.0 days) hepatic steatosis (n = 16), iron deposition (n = 11), combined deposition (n = 3) and neither disease (n = 41) underwent MR examinations. Dual-echo in/opposed-phase MR with Dixon water/fat reconstructions were acquired. Analysis consisted of: (a) single-ratio hepatic region-of-interest (ROI)-based assessment of in/opposed ratios; (b) dual-ratio hepatic ROI assessment of in/opposed and fat/water ratios; (c) computer-aided dual-ratio assessment evaluating all hepatic voxels. Disease-specific thresholds were determined; statistical analyses assessed disease-dependent voxel ratios, based on single-ratio (a) and dual-ratio (b and c) techniques. Results: Single-ratio discrimination succeeded in identifying iron deposition (I/O Ironthreshold Fatthreshold>1.15 ) from normal parenchyma, sensitivity 70.0%; it failed to detect combined disease. Dual-ratio discrimination succeeded in identifying abnormal hepatic parenchyma (F/W Normalthreshold > 0.05), sensitivity 96.7%; logarithmic functions for iron deposition (I/O Iron d iscriminator (0.01−F/W Iron )/0.48 ) and for steatosis (I/O Fatdiscriminator > e (F/W Fat −0.01)/0.48 ) differentiated combined from isolated diseases, sensitivity 100.0%; computer-aided dual-ratio analysis was comparably sensitive but less specific, 90.2% vs. 97.6%. Conclusion: MR two-point-Dixon imaging using dual-ratio post-processing based on in/opposed and fat/water ratios improved in vivo detection of hepatic steatosis, iron deposition, and combined storage disease beyond traditional in/opposed analysis.

  7. Integrated mental health care and vocational rehabilitation to improve return to work rates for people on sick leave because of exhaustion disorder, adjustment disorder, and distress (the Danish IBBIS trial)

    DEFF Research Database (Denmark)

    Poulsen, Rie; Fisker, Jonas; Hoff, Andreas

    2017-01-01

    that mental health care alone will provide sufficient support for vocational recovery for this group. Integrated vocational and health care services have shown good effects on return to work in other similar welfare contexts. The purpose of the Danish IBBIS (Integreret Behandlings- og Beskæftigelses...... of the current organizational separation of health care interventions and vocational rehabilitation regarding the individual's process of returning to work after sick leave because of exhaustion disorder, adjustment disorder or distress. If the effect on return to work, symptom level, and recurrent sick leave...... is different in the intervention groups, this study can contribute with new knowledge on shared care models and the potential for preventing deterioration in stress symptoms, prolonged sick leave, and recurrent sick leave. TRIAL REGISTRATION: ClinicalTrials.gov, registration number: NCT02885519...

  8. Prevalence and consequences of the dual diagnosis of substance abuse and severe mental illness.

    Science.gov (United States)

    Buckley, Peter F

    2006-01-01

    The co-occurrence of a severe mental illness and a substance use or abuse disorder is common in the United States as well as internationally and could be considered as more the expectation than the exception when assessing patients with serious mental illness. Substance use disorders can occur at any phase of the mental illness, perhaps even inducing psychosis. Causes of this comorbidity may include self-medication, genetic vulnerability, environment or lifestyle, underlying shared origins, and/or a common neural substrate. The consequences of dual diagnosis include poor medication compliance, physical comorbidities and poor health, poor self-care, increased suicide risk or aggression, increased sexual behavior, and possible incarceration. All of these factors contribute to a greater health burden, which reduces the health care system's capacity to adequately treat patients. Therefore, screening, assessment, and integrated treatment plans for dual diagnosis that can address both the addiction disorder and the mental illness are recommended in order to provide accurate treatment, after-care, and other health care to accommodate patients' social and vocational needs.

  9. Mental health nurses' attitudes, behaviour, experience and knowledge regarding adults with a diagnosis of borderline personality disorder: systematic, integrative literature review.

    Science.gov (United States)

    Dickens, Geoffrey L; Lamont, Emma; Gray, Sarah

    2016-07-01

    To establish whether mental health nurses responses to people with borderline personality disorder are problematic and, if so, to inform solutions to support change. There is some evidence that people diagnosed with borderline personality disorder are unpopular among mental health nurses who respond to them in ways which could be counter-therapeutic. Interventions to improve nurses' attitudes have had limited success. Systematic, integrative literature review. Computerised databases were searched from inception to April 2015 for papers describing primary research focused on mental health nurses' attitudes, behaviour, experience, and knowledge regarding adults diagnosed with borderline personality disorder. Analysis of qualitative studies employed metasynthesis; analysis of quantitative studies was informed by the theory of planned behaviour. Forty studies were included. Only one used direct observation of clinical practice. Nurses' knowledge and experiences vary widely. They find the group very challenging to work with, report having many training needs, and, objectively, their attitudes are poorer than other professionals' and poorer than towards other diagnostic groups. Nurses say they need a coherent therapeutic framework to guide their practice, and their experience of caregiving seems improved where this exists. Mental health nurses' responses to people with borderline personality disorder are sometimes counter-therapeutic. As interventions to change them have had limited success there is a need for fresh thinking. Observational research to better understand the link between attitudes and clinical practice is required. Evidence-based education about borderline personality disorder is necessary, but developing nurses to lead in the design, implementation and teaching of coherent therapeutic frameworks may have greater benefits. There should be greater focus on development and implementation of a team-wide approach, with nurses as equal partners, when working

  10. Comorbidity of chronic somatic diseases in patients with psychotic disorders and their influence on 4-year outcomes of integrated care treatment (ACCESS II study).

    Science.gov (United States)

    Lambert, Martin; Ruppelt, Friederike; Siem, Anna-Katharina; Rohenkohl, Anja Christine; Kraft, Vivien; Luedecke, Daniel; Sengutta, Mary; Schröter, Romy; Daubmann, Anne; Correll, Christoph U; Gallinat, Jürgen; Karow, Anne; Wiedemann, Klaus; Schöttle, Daniel

    2018-03-01

    People with psychotic disorders fulfilling criteria of a severe and persistent mental illness (SPMI) display a high risk of somatic comorbidity (SC). ACCESS II is a prospective, long-term study examining the effectiveness of Integrated Care for people with psychotic disorders fulfilling SPMI criteria. Chronic comorbid somatic disorders were systematically assessed according to ICD-10-GM criteria. Patients treated for ≥4years in ACCESS were categorized as early psychosis (treatment: ≤2years) or non-early psychosis (treatment: >2years) patients. Of 187 patients treated in ACCESS for ≥4years (mean age=41.8years, males=44.4%), 145 (77.5%) had SC, (mean=2.1±2.1). Overall, 55 different diseases from 15 different ICD-10-GM disease areas were identified. Prevalence of ≥1 SC (p=0.09) and specific types of SC (p=0.08-1.00) did not differ between early and non-early psychosis patients, but non-early psychosis patients had a higher mean number of SC (2.3±2.2 vs. 1.3±1.3, p=0.002). SC patients had higher rates of comorbid mental disorders (93% vs. 81%, p=0.002), specifically posttraumatic stress disorder (23% vs. 7%, p=0.002), and suicide attempts (43% vs. 19%, p<0.001). At the 4-year endpoint, both patients with and without comorbidity displayed major improvements in psychopathology, severity of illness, functioning, quality of life and satisfaction with care. SC is frequent in patients with severe psychotic disorders, even in the early psychosis phase. The magnitude of the problem underlines the need for regular screening, comprehensive assessment, preventive pharmacotherapy, and targeted SC management. Copyright © 2017. Published by Elsevier B.V.

  11. Integrating Psychopathology and Personality Disorders Conceptualized by the MMPI-2-RF and the MCMI-III: A Structural Validity Study

    NARCIS (Netherlands)

    Heijden, P.T. van der; Egger, J.I.M.; Rossi, G.M.P.; Derksen, J.J.L.

    2012-01-01

    The Minnesota Multiphasic Personality Inventory-2-Restructured Form (Ben-Porath & Tellegen, 2008) Restructured Clinical scales and Higher Order scales were linked to the Millon Clinical Multiaxial Inventory-III ( Millon, Millon, Davis, & Grossman, 2009) personality disorder scales and clinical

  12. An overview of posttraumatic stress disorder genetic studies by analyzing and integrating genetic data into genetic database PTSDgene

    NARCIS (Netherlands)

    Zhang, Kunlin; Qu, Susu; Chang, Suhua; Li, Gen; Cao, Chengqi; Fang, Kechi; Olff, Miranda; Wang, Li; Wang, Jing

    2017-01-01

    Posttraumatic stress disorder (PTSD) is a debilitating psychiatric syndrome with complex etiology. Studies aiming to explore genetic susceptibility and environmental triggers of PTSD have been increasing. However, the results are limited and highly heterogeneous. To understand the genetic study

  13. Toward an Interdisciplinary Understanding of Sensory Dysfunction in Autism Spectrum Disorder: An Integration of the Neural and Symptom Literatures

    OpenAIRE

    Schauder, Kimberly B.; Bennetto, Loisa

    2016-01-01

    Sensory processing differences have long been associated with autism spectrum disorder (ASD), and they have recently been added to the diagnostic criteria for the disorder. The focus on sensory processing in ASD research has increased substantially in the last decade. This research has been approached from two different perspectives: the first focuses on characterizing the symptoms that manifest in response to real world sensory stimulation, and the second focuses on the neural pathways and m...

  14. How semantic deficits in schizotypy help understand language and thought disorders in schizophrenia: a systematic and integrative review

    Directory of Open Access Journals (Sweden)

    Hélio Anderson Tonelli

    2014-04-01

    Full Text Available Introduction: Disorders of thought are psychopathological phenomena commonly present in schizophrenia and seem to result from deficits of semantic processing. Schizotypal personality traits consist of tendencies to think and behave that are qualitatively similar to schizophrenia, with greater vulnerability to such disorder. This study reviewed the literature about semantic processing deficits in samples of individuals with schizotypal traits and discussed the impact of current knowledge upon the comprehension of schizophrenic thought disorders. Studies about the cognitive performance of healthy individuals with schizotypal traits help understand the semantic deficits underlying psychotic thought disorders with the advantage of avoiding confounding factors usually found in samples of individuals with schizophrenia, such as the use of antipsychotics and hospitalizations. Methods: A search for articles published in Portuguese or English within the last 10 years on the databases MEDLINE, Web of Science, PsycInfo, LILACS and Biological Abstracts was conducted, using the keywords semantic processing, schizotypy and schizotypal personality disorder. Results: The search retrieved 44 manuscripts, out of which 11 were firstly chosen. Seven manuscripts were additionally included after reading these papers. Conclusion: The great majority of the included studies showed that schizotypal subjects might exhibit semantic processing deficits. They help clarify about the interfaces between cognitive, neurophysiological and neurochemical mechanisms underlying not only thought disorders, but also healthy human mind's creativity.

  15. Gene Prioritization by Integrated Analysis of Protein Structural and Network Topological Properties for the Protein-Protein Interaction Network of Neurological Disorders

    Directory of Open Access Journals (Sweden)

    Yashna Paul

    2016-01-01

    Full Text Available Neurological disorders are known to show similar phenotypic manifestations like anxiety, depression, and cognitive impairment. There is a need to identify shared genetic markers and molecular pathways in these diseases, which lead to such comorbid conditions. Our study aims to prioritize novel genetic markers that might increase the susceptibility of patients affected with one neurological disorder to other diseases with similar manifestations. Identification of pathways involving common candidate markers will help in the development of improved diagnosis and treatments strategies for patients affected with neurological disorders. This systems biology study for the first time integratively uses 3D-structural protein interface descriptors and network topological properties that characterize proteins in a neurological protein interaction network, to aid the identification of genes that are previously not known to be shared between these diseases. Results of protein prioritization by machine learning have identified known as well as new genetic markers which might have direct or indirect involvement in several neurological disorders. Important gene hubs have also been identified that provide an evidence for shared molecular pathways in the neurological disease network.

  16. Dual Enrollment Academy Programs

    Science.gov (United States)

    Gonzalez, Nicolas; Chavez, Guadalupe

    2009-01-01

    Dual Enrollment Engineering (DEEA) and Medical Science (DEMSA) Academies are two-year dual enrollment programs for high school students. Students explore engineering and medical careers through college coursework. Students prepare for higher education in engineering and medical fields while completing associate degrees in biology or engineering…

  17. A Dual Egalitarian Solution

    NARCIS (Netherlands)

    Klijn, F.; Slikker, M.; Tijs, S.H.

    2000-01-01

    In this note we introduce an egalitarian solution, called the dual egalitarian solution, that is the natural counterpart of the egalitarian solution of Dutta and Ray (1989).We prove, among others, that for a convex game the egalitarian solution coincides with the dual egalitarian solution for its

  18. Dual Credit Report

    Science.gov (United States)

    Light, Noreen

    2016-01-01

    In 2015, legislation to improve access to dual-credit programs and to reduce disparities in access and completion--particularly for low income and underrepresented students--was enacted. The new law focused on expanding access to College in the High School but acknowledged issues in other dual-credit programs and reinforced the notion that cost…

  19. Development and preliminary evaluation of an integrated treatment targeting parenting and depressive symptoms in mothers of children with attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Chronis-Tuscano, Andrea; Clarke, Tana L; O'Brien, Kelly A; Raggi, Veronica L; Diaz, Yamalis; Mintz, Abigail D; Rooney, Mary E; Knight, Laura A; Seymour, Karen E; Thomas, Sharon R; Seeley, John; Kosty, Derek; Lewinsohn, Peter

    2013-10-01

    More than 50% of mothers of children with attention-deficit/hyperactivity disorder (ADHD) have a lifetime history of major depressive disorder (MDD). Maternal depressive symptoms are associated with impaired parenting and predict adverse developmental and treatment outcomes for children with ADHD. For these reasons, we developed and examined the preliminary efficacy of an integrated treatment targeting parenting and depressive symptoms for mothers of children with ADHD. This integrated intervention incorporated elements of 2 evidence-based treatments: behavioral parent training (BPT) and cognitive behavioral depression treatment. Ninety-eight mothers with at least mild depressive symptoms were randomized to receive either standard BPT (n = 51) or the integrated parenting intervention for ADHD (IPI-A; n = 47). Participants were assessed at baseline, posttreatment, and 3- to 6-month follow-up on measures of (a) self-reported maternal depressive symptoms, (b) observed positive and negative parenting, and (c) observed and mother-reported child disruptive behavior and mother-reported child and family impairment. The IPI-A produced effects of small to moderate magnitude relative to BPT on maternal depressive symptoms, observed negative parenting, observed child deviance, and child impairment at posttreatment and on maternal depressive symptoms, child disruptive behavior, child impairment and family functioning at follow-up. Contrary to expectations, the BPT group demonstrated moderate to large effects relative to IPI-A on observed positive parenting at follow-up. This treatment development study provides encouraging preliminary support for the integrated intervention targeting parenting and depressive symptoms in mothers of children with ADHD. Future studies should examine whether this integrated intervention improves long-term developmental outcomes for children with ADHD. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

  20. PPAR-gamma agonist pioglitazone modifies craving intensity and brain white matter integrity in patients with primary cocaine use disorder: a double-blind randomized controlled pilot trial.

    Science.gov (United States)

    Schmitz, Joy M; Green, Charles E; Hasan, Khader M; Vincent, Jessica; Suchting, Robert; Weaver, Michael F; Moeller, F Gerard; Narayana, Ponnada A; Cunningham, Kathryn A; Dineley, Kelly T; Lane, Scott D

    2017-10-01

    Pioglitazone (PIO), a potent agonist of PPAR-gamma, is a promising candidate treatment for cocaine use disorder (CUD). We tested the effects of PIO on targeted mechanisms relevant to CUD: cocaine craving and brain white matter (WM) integrity. Feasibility, medication compliance and tolerability were evaluated. Two-arm double-blind randomized controlled proof-of-concept pilot trial of PIO or placebo (PLC). Single-site out-patient treatment research clinic in Houston, TX, USA. Thirty treatment-seeking adults, 18 to 60 years old, with CUD. Eighteen participants (8 = PIO; 10 = PLC) completed diffusion tensor imaging (DTI) of WM integrity at pre-/post-treatment. Study medication was dispensed at thrice weekly visits along with once-weekly cognitive behavioral therapy for 12 weeks. Measures of target engagement mechanisms of interest included cocaine craving assessed by the Brief Substance Craving Scale (BSCS), the Obsessive Compulsive Drug Use Scale (OCDUS), a visual analog scale (VAS) and change in WM integrity. Feasibility measures included number completing treatment, medication compliance (riboflavin detection) and tolerability (side effects, serious adverse events). Target engagement change in mechanisms of interest, defined as a ≥ 0.75 Bayesian posterior probability of an interaction existing favoring PIO over PLC, was demonstrated on measures of craving (BSCS, VAS) and WM integrity indexed by fractional anisotropy (FA) values. Outcomes indicated greater decrease in craving and greater increase in FA values in the PIO group. Feasibility was demonstrated by high completion rates among those starting treatment (21/26 = 80%) and medication compliance (≥ 80%). There were no reported serious adverse events for PIO. Compared with placebo, patients receiving pioglitazone show a higher likelihood of reduced cocaine craving and improved brain white matter integrity as a function of time in treatment. Pioglitazone shows good feasibility as a treatment for cocaine

  1. Reduced tract integrity of the model for social communication is a neural substrate of social communication deficits in autism spectrum disorder.

    Science.gov (United States)

    Lo, Yu-Chun; Chen, Yu-Jen; Hsu, Yung-Chin; Tseng, Wen-Yih Isaac; Gau, Susan Shur-Fen

    2017-05-01

    Autism spectrum disorder (ASD) is a neurodevelopmental disorder with social communication deficits as one of the core symptoms. Recently, a five-level model for the social communication has been proposed in which white matter tracts corresponding to each level of the model are identified. Given that the model for social communication subserves social language functions, we hypothesized that the tract integrity of the model for social communication may be reduced in ASD, and the reduction may be related to social communication deficits. Sixty-two right-handed boys with ASD and 55 typically developing (TD) boys received clinical evaluations, intelligence tests, the Social Communication Questionnaire (SCQ), and MRI scans. Generalized fractional anisotropy (GFA) was measured by diffusion spectrum imaging to indicate the microstructural integrity of the tracts for each level of the social communication model. Group difference in the tract integrity and its relationship with the SCQ subscales of social communication and social interaction were investigated. We found that the GFA values of the superior longitudinal fasciculus III (SLF III, level 1) and the frontal aslant tracts (FAT, level 2) were decreased in ASD compared to TD. Moreover, the GFA values of the SLF III and the FAT were associated with the social interaction subscale in ASD. The tract integrity of the model for social communication is reduced in ASD, and the reduction is associated with impaired social interaction. Our results support that reduced tract integrity of the model for social communication might be a neural substrate of social communication deficits in ASD. © 2016 Association for Child and Adolescent Mental Health.

  2. An update on narcissistic personality disorder.

    Science.gov (United States)

    Ronningstam, Elsa

    2013-01-01

    This article will discuss the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5 proposal for narcissistic personality disorder (NPD), and highlight some of the advantages of introducing a dual diagnostic approach that includes a dimensional conceptualization for identifying and diagnosing pathological narcissism and NPD, in addition to specific traits. Reviews and studies have specifically highlighted how people with NPD behave and are observed by others, and the negative consequences of their behavior. Accounts on the subjective perspectives of pathological narcissism stem foremost from psychoanalytic and psychodynamic accounts, but they have remained relatively separated from diagnostic and empirical studies. The new diagnostic approach to NPD can encourage a better integration of the clinicians' observations of indicators of pathological narcissism from an external perspective and the patients' formulations of their own subjective experiences and understanding of their problems.

  3. A 10-year follow-up study of completers versus dropouts following treatment with an integrated cognitive-behavioral group therapy for eating disorders.

    Science.gov (United States)

    Okamoto, Yuri; Miyake, Yoshie; Nagasawa, Ichie; Shishida, Kazuhiro

    2017-01-01

    Cognitive-behavioral therapy (CBT) has been recommended for the treatment of eating disorders, and group therapy is known to have certain advantages over individual therapy. The aim of the current study was to compare the 10-year prognosis of patients who completed integrated group CBT with those who dropped out and to examine the effect of completion of group CBT on the prognosis. The participants were 65 adult patients with eating disorders. All patients were women and Japanese. The average age (19-37) of the patients was 25.1 ± 3.8 years, and the average body mass index (BMI) was 17.7 ± 2.0. We conducted integrated group CBT with the patients and compared eating disorder symptoms, mood states, coping styles, and self-esteem before and after therapy. Furthermore, we compared clinical features and the 10-year prognosis of patients who completed the treatment and those who dropped out. After 10 sessions of group therapy, Eating Attitudes Test scores, Profile of Mood States depression scores, and Coping Inventory for Stressful Situations emotion-oriented scores decreased, while Rosenberg's Self-Esteem Scale scores increased. Regarding the results of the 10-year follow up, the completer group had more patients with a good prognosis. In contrast, the dropout group had more patients with a poor prognosis. Those who completed the integrated group CBT had a good prognosis. Group therapy gives the patients an opportunity to form peer relationships, and helps them to develop communication and socialization skills. Furthermore, in the group therapy sessions, the patients develop self-awareness by listening to other members of the group and they also develop interpersonal relationships. This effect may be temporary, but experience of group therapy may provide hope for the patient and increase the chance of the patient continuing treatment. Retrospectively registered in University Hospital Medical Information Network in Japan: No. 000028868 (May 19th, 2017).

  4. Dual fluorescence of single LH2 antenna nanorings

    International Nuclear Information System (INIS)

    Freiberg, A.; Raetsep, M.; Timpmann, K.; Trinkunas, G.

    2004-01-01

    A dual nature of fluorescence from LH2 pigment-protein complexes, which is a part of the light harvesting system of purple bacteria, is confirmed by fluorescence-lifetime dependence on recording wavelength and spectrally selective spectroscopy. An analysis based on the Holstein molecular crystal model, modified by allowing diagonal disorder, suggests coexistence of large- and small-radius self-trapped excitons, which serve as the origin of the dual fluorescence

  5. Interaction of the carbon monoxide-releasing molecule Ru(CO)3Cl(glycinate) (CORM-3) with Salmonella enterica serovar Typhimurium: in situ measurements of carbon monoxide binding by integrating cavity dual-beam spectrophotometry.

    Science.gov (United States)

    Rana, Namrata; McLean, Samantha; Mann, Brian E; Poole, Robert K

    2014-12-01

    Carbon monoxide (CO) is a toxic gas that binds to haems, but also plays critical signalling and cytoprotective roles in mammalian systems; despite problems associated with systemic delivery by inhalation of the gas, it may be employed therapeutically. CO delivered to cells and tissues by CO-releasing molecules (CO-RMs) has beneficial and toxic effects not mimicked by CO gas; CO-RMs are also attractive candidates as novel antimicrobial agents. Salmonella enterica serovar Typhimurium is an enteropathogen causing gastroenteritis in humans. Recent studies have implicated haem oxygenase-1 (HO-1), the protein that catalyses the degradation of haem into biliverdin, free iron and CO, in the host immune response to Salmonella infection. In several studies, CO administration via CO-RMs elicited many of the protective roles of HO-1 induction and so we investigated the effects of a well-characterized water-soluble CO-RM, Ru(CO)3Cl(glycinate) (CORM-3), on Salmonella. CORM-3 exhibits toxic effects at concentrations significantly lower than those reported to cause toxicity to RAW 264.7 macrophages. We demonstrated here, through oxyhaemoglobin assays, that CORM-3 did not release CO spontaneously in phosphate buffer, buffered minimal medium or very rich medium. CORM-3 was, however, accumulated to high levels intracellularly (as shown by inductively coupled plasma MS) and released CO inside cells. Using growing Salmonella cultures without prior concentration, we showed for the first time that sensitive dual-beam integrating cavity absorption spectrophotometry can detect directly the CO released from CORM-3 binding in real-time to haems of the bacterial electron transport chain. The toxic effects of CO-RMs suggested potential applications as adjuvants to antibiotics in antimicrobial therapy. © 2014 The Authors.

  6. Dual-time point scanning of integrated FDG PET/CT for the evaluation of mediastinal and hilar lymph nodes in non-small cell lung cancer diagnosed as operable by contrast-enhanced CT

    Energy Technology Data Exchange (ETDEWEB)

    Kasai, Takami, E-mail: takaby@hotmail.co [Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba-ken 260-8677 (Japan); Motoori, Ken, E-mail: motoorik@faculty.chiba-u.j [Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba-ken 260-8677 (Japan); Horikoshi, Takuro, E-mail: taku_steelfish@yahoo.co.j [Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba-ken 260-8677 (Japan); Uchiyama, Katsuhiro, E-mail: ka-uchiyama@nifty.co [Diagnostic PET Imaging Center, Department of Radiology, Sannoh Medical Center, 166-2 Sannohcho, Inage-ku, Chiba City, Chiba-ken 263-0002 (Japan); Yasufuku, Kazuhiro, E-mail: kyasufuku@faculty.chiba-u.j [Department of Thoracic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba-ken 260-8670 (Japan); Takiguchi, Yuichi, E-mail: takiguchi@faculty.chiba-u.j [Department of Respirology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba-ken 260-8670 (Japan); Takahashi, Fumiaki, E-mail: takahashifu@pharm.kitasato-u.ac.j [Division of Biostatistics, Graduate School of Pharmaceutical Sciences, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108-8641 (Japan); Kuniyasu, Yoshio, E-mail: kuniyasu@ace.ocn.ne.j [Diagnostic PET Imaging Center, Department of Radiology, Sannoh Medical Center, 166-2 Sannohcho, Inage-ku, Chiba City, Chiba-ken 263-0002 (Japan); Ito, Hisao, E-mail: hisao@faculty.chiba-u.j [Department of Radiology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba-ken 260-8677 (Japan)

    2010-08-15

    Purpose: To evaluate whether dual-time point scanning with integrated fluorine-18 fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography and computed tomography (PET/CT) is useful for evaluation of mediastinal and hilar lymph nodes in non-small cell lung cancer diagnosed as operable by contrast-enhanced CT. Materials and methods: PET/CT data and pathological findings of 560 nodal stations in 129 patients with pathologically proven non-small cell lung cancer diagnosed as operable by contrast-enhanced CT were reviewed retrospectively. Standardized uptake values (SUVs) on early scans (SUVe) 1 h, and on delayed scans (SUVd) 2 h after FDG injection of each nodal station were measured. Retention index (RI) (%) was calculated by subtracting SUVe from SUVd and dividing by SUVe. Logistic regression analysis was performed with seven kinds of models, consisting of (1) SUVe, (2) SUVd, (3) RI, (4) SUVe and SUVd, (5) SUVe and RI, (6) SUVd and RI, and (7) SUVe, SUVd and RI. The seven derived models were compared by receiver-operating characteristic (ROC) analysis. k-Fold cross-validation was performed with k values of 5 and 10. p < 0.05 was considered statistically significant. Results: Model (1) including the term of SUVe showed the largest area under the ROC curve among the seven models. The cut-off probability of metastasis of 3.5% with SUVe of 2.5 revealed a sensitivity of 78% and a specificity of 81% on ROC analysis, and approximately 60% and 80% on k-fold cross-validation. Conclusion: Single scanning of PET/CT is sufficiently useful for evaluating mediastinal and hilar nodes for metastasis.

  7. Dual-time point scanning of integrated FDG PET/CT for the evaluation of mediastinal and hilar lymph nodes in non-small cell lung cancer diagnosed as operable by contrast-enhanced CT

    International Nuclear Information System (INIS)

    Kasai, Takami; Motoori, Ken; Horikoshi, Takuro; Uchiyama, Katsuhiro; Yasufuku, Kazuhiro; Takiguchi, Yuichi; Takahashi, Fumiaki; Kuniyasu, Yoshio; Ito, Hisao

    2010-01-01

    Purpose: To evaluate whether dual-time point scanning with integrated fluorine-18 fluorodeoxyglucose ( 18 F-FDG) positron emission tomography and computed tomography (PET/CT) is useful for evaluation of mediastinal and hilar lymph nodes in non-small cell lung cancer diagnosed as operable by contrast-enhanced CT. Materials and methods: PET/CT data and pathological findings of 560 nodal stations in 129 patients with pathologically proven non-small cell lung cancer diagnosed as operable by contrast-enhanced CT were reviewed retrospectively. Standardized uptake values (SUVs) on early scans (SUVe) 1 h, and on delayed scans (SUVd) 2 h after FDG injection of each nodal station were measured. Retention index (RI) (%) was calculated by subtracting SUVe from SUVd and dividing by SUVe. Logistic regression analysis was performed with seven kinds of models, consisting of (1) SUVe, (2) SUVd, (3) RI, (4) SUVe and SUVd, (5) SUVe and RI, (6) SUVd and RI, and (7) SUVe, SUVd and RI. The seven derived models were compared by receiver-operating characteristic (ROC) analysis. k-Fold cross-validation was performed with k values of 5 and 10. p < 0.05 was considered statistically significant. Results: Model (1) including the term of SUVe showed the largest area under the ROC curve among the seven models. The cut-off probability of metastasis of 3.5% with SUVe of 2.5 revealed a sensitivity of 78% and a specificity of 81% on ROC analysis, and approximately 60% and 80% on k-fold cross-validation. Conclusion: Single scanning of PET/CT is sufficiently useful for evaluating mediastinal and hilar nodes for metastasis.

  8. Addictive Disorders in Adolescents.

    Science.gov (United States)

    Truong, Anh; Moukaddam, Nidal; Toledo, Alexander; Onigu-Otite, Edore

    2017-09-01

    Addictive disorders in youth represent a dynamic field characterized by shifting patterns of substance use and high rates of experimentation, while retaining the risky behaviors and negative outcomes associated with established drug classes. Youth/adolescents are also at the forefront of use of new technologies, and non-substance-related disorders are pertinent. These disorders present with similar pictures of impairment, and can be diagnosed following the same principles. An underlying mental disorder and the possibility of a dual diagnosis need to be assessed carefully, and optimal treatment includes psychosocial treatments with applicable pharmacologic management, the latter representing an expanding field. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. [Comorbidity of substance use with mental disorders].

    Science.gov (United States)

    Leonidaki, V; Maliori, M

    2009-01-01

    This contribution reviews the international literature about dual diagnosis, meaning patients who have simultaneously mental health problems and substance use disorders and discusses epidemiology, clinical characteristics, but primarily etiopathogenesis and different treatment models and interventions. The epidemiological data coming from large-scale studies in the general population in USA, Australia and UK demonstrate the close relationship between mental health problems and substance use disorders. Also, the results from Greek research projects support this close relationship, but their research designs have significant limitations. Multiple and high risks are common in this population, like violent or suicidal behavior, self-harm, physical problems, while they appear less responsive to treatment. Subsequently, different models for etiopathogenesis of dual diagnosis have been suggested: (a) Causal relationship: secondary substance use disorder is subsequent of primary mental illness (self-medication hypothesis, supersenstivity model) or vice versa (alcohol, cannabis, and cocaine use trigger or contribute to development of mental illness). (b) Third factor as the cause of both mental and substance use disorders (genetic factor, neuropathology, traumatic experience, personality characteristics, multiple factors). (c) Comorbidty is due to chance. (d) Each disorder mutually exacerbates the other, regardless the cause. Here, the relationship between alcohol and depression is discussed further as example. The ideas and the research-evidence which support each of these models are presented. Also there is an overview of different treatment models: (a) Consecutive treatment: mental health treatment and substance misuse treatment are provided consecutively. (b) Parallel treatments: the patient attends programs of both mental health and substance use services simultaneously. (c) Integrated treatment: the same clinical team addresses both mental health issues and substance

  10. Dual Credit/Dual Enrollment and Data Driven Policy Implementation

    Science.gov (United States)

    Lichtenberger, Eric; Witt, M. Allison; Blankenberger, Bob; Franklin, Doug

    2014-01-01

    The use of dual credit has been expanding rapidly. Dual credit is a college course taken by a high school student for which both college and high school credit is given. Previous studies provided limited quantitative evidence that dual credit/dual enrollment is directly connected to positive student outcomes. In this study, predictive statistics…

  11. Relationship between white matter integrity and serum cortisol levels in drug-naive patients with major depressive disorder: diffusion tensor imaging study using tract-based spatial statistics.

    Science.gov (United States)

    Liu, Xiaodan; Watanabe, Keita; Kakeda, Shingo; Yoshimura, Reiji; Abe, Osamu; Ide, Satoru; Hayashi, Kenji; Katsuki, Asuka; Umene-Nakano, Wakako; Watanabe, Rieko; Ueda, Issei; Nakamura, Jun; Korogi, Yukunori

    2016-06-01

    Higher daytime cortisol levels because of a hyperactive hypothalamic-pituitary-adrenal axis have been reported in patients with major depressive disorder (MDD). The elevated glucocorticoids inhibit the proliferation of the oligodendrocytes that are responsible for myelinating the axons of white matter fibre tracts. To evaluate the relationship between white matter integrity and serum cortisol levels during a first depressive episode in drug-naive patients with MDD (MDD group) using a tract-based spatial statistics (TBSS) method. The MDD group (n = 29) and a healthy control group (n = 47) underwent diffusion tensor imaging (DTI) scans and an analysis was conducted using TBSS. Morning blood samples were obtained from both groups for cortisol measurement. Compared with the controls, the MDD group had significantly reduced fractional anisotropy values (Plevels in the MDD group (Plevels in the MDD group may injure the white matter integrity in the frontal-subcortical and frontal-limbic circuits. © The Royal College of Psychiatrists 2016.

  12. Dual thyroid ectopia

    International Nuclear Information System (INIS)

    Al-Akeely, Mohammed H.

    2003-01-01

    Ectopic thyroid gland is a rare embryological fault of thyroid development .Dual ectopic thyroid is more rare and only 8 cases have been reported in the literature. The author presents a case of dual ectopic thyroid in a 16 year old boy with an anterior red neck mass, which is gradually growing in size particularly in last 2 years. The initial diagnosis was thyroglossal duct cyst. Thyroid function test revealed elevated thyroid-stimulating hormone. Ultrasound of the neck did not show thyroid gland in its normal pre tracheal position. Thyroid scan (Technetium 99)revealed the diagnosis of dual thyroid ectopia(lingual and subhyoid). (author)

  13. Dual energy CT

    DEFF Research Database (Denmark)

    Al-Najami, Issam; Drue, Henrik Christian; Steele, Robert

    2017-01-01

    and inaccurate with existing methods. Dual Energy Computed Tomography (DECT) enables qualitative tissue differentiation by simultaneous scanning with different levels of energy. We aimed to assess the feasibility of DECT in quantifying tumor response to neoadjuvant therapy in loco-advanced rectal cancer. METHODS...... to determine the average quantitative parameters; effective-Z, water- and iodine-concentration, Dual Energy Index (DEI), and Dual Energy Ratio (DER). These parameters were compared to the regression in the resection specimen as measured by the pathologist. RESULTS: Changes in the quantitative parameters...

  14. Dual coil ignition system

    Energy Technology Data Exchange (ETDEWEB)

    Huberts, Garlan J.; Qu, Qiuping; Czekala, Michael Damian

    2017-03-28

    A dual coil ignition system is provided. The dual coil ignition system includes a first inductive ignition coil including a first primary winding and a first secondary winding, and a second inductive ignition coil including a second primary winding and a second secondary winding, the second secondary winding connected in series to the first secondary winding. The dual coil ignition system further includes a diode network including a first diode and a second diode connected between the first secondary winding and the second secondary winding.

  15. Family relations and eating disorders. The effectiveness of an integrated approach in the treatment of anorexia and bulimia in teenagers: results of a case-control systemic research.

    Science.gov (United States)

    Onnis, L; Barbara, E; Bernardini, M; Caggese, A; Di Giacomo, S; Giambartolomei, A; Leonelli, A; Mule', A M; Nicoletti, P G; Vietri, A

    2012-03-01

    This article presents the results of a broader clinical research into the effectiveness of integrated treatments in teenage eating disorders, carried out at the Complex Operative Unit of Psychotherapy (Unità Operativa Complessa or U.O.C.) of the Department of Psychiatric Sciences and Psychological Medicine in collaboration with the Department of Neuropsychiatric Science for Child Development (Dipartimento di Scienze Neuropsichiatriche dell'Età Evolutiva), both at the "La Sapienza" University of Rome. The hypothesis of this research project is that in diagnosticable situations such as anorexia or bulimia, an integrated and multidisciplinary treatment, which combines medical-nutritional interventions and family psychotherapy, allows better results than a single kind of treatment, which is the usual medical- nutritional intervention supported by psychiatric counselling. Twenty-eight cases (16 of bulimia and 12 of anorexia) were selected and then subdivided, with a randomized distribution, into two (experimental and control) homogeneous groups of 14 patients. The grouping variables were the diagnosis, the disorder's seriousness and duration, BMI, gender, age, family composition and social status. The variables which have been examined in this article are the clinical parameters, which were valuated in accordance with the DSM IV-TR criteria, and relational parameters which were explored through the use of the W.F.T. Test (Wiltwyck Family Tasks). These parameters were tested at beginning as well as at the end of the therapies, in both the experimental group and the control group. Statistical analysis has shown that the experimental group, which was followed with the integrated treatment, experienced a significant improvement of the parameters as related to dysfunctional family interaction modalities, and that this improvement was correlated to the positive evolution of the clinical parameters. This improvement was not present or not of the same degree in the control

  16. Integrating Family Capacity-Building and Child Outcomes to Support Social Communication Development in Young Children with Autism Spectrum Disorder

    Science.gov (United States)

    Woods, Juliann J.; Brown, Jennifer A.

    2011-01-01

    The focus of this article is on the transactional relationship of research and practice for speech-language pathologists serving infants and toddlers with and at risk for autism spectrum disorder in Individuals with Disabilities Education Act supported early intervention. Specifically, information is provided on (a) the relationship between…

  17. Common Cognitive Deficits in Children with Attention-Deficit/Hyperactivity Disorder and Autism: Working Memory and Visual-Motor Integration

    Science.gov (United States)

    Englund, Julia A.; Decker, Scott L.; Allen, Ryan A.; Roberts, Alycia M.

    2014-01-01

    Cognitive deficits in working memory (WM) are characteristic features of Attention-Deficit/Hyperactivity Disorder (ADHD) and autism. However, few studies have investigated cognitive deficits using a wide range of cognitive measures. We compared children with ADHD ("n" = 49) and autism ("n" = 33) with a demographically matched…

  18. Clinical Responses to Atomoxetine in Attention-Deficit/Hyperactivity Disorder: The Integrated Data Exploratory Analysis (IDEA) Study

    Science.gov (United States)

    Newcorn, Jeffrey H.; Sutton, Virginia K.; Weiss, Margaret D.; Sumner, Calvin R.

    2009-01-01

    Data from six randomized controlled trials in the U.S. reveal that 47 percent of patients aged six to 18 years showed a much improved clinical response to atomoxetine as a treatment for attention deficit hyperactivity disorder while 40 percent did not have a response. Augmenting or switching treatment in non-responders by week 4 is suggested.

  19. Counseling a Biracial Female College Student with an Eating Disorder: A Case Study Applying an Integrative Biopsychosocialcultural Perspective

    Science.gov (United States)

    Smart, Rebekah

    2010-01-01

    This case study describes short-term counseling with a young biracial woman experiencing an eating disorder. A biopsychosocialcultural conceptualization of the problem is described. The counseling approach is informed by feminist and multicultural theory and uses both interpersonal and cognitive behavior therapy. (Contains 1 figure.)

  20. Microresonator soliton dual-comb spectroscopy

    Science.gov (United States)

    Suh, Myoung-Gyun; Yang, Qi-Fan; Yang, Ki Youl; Yi, Xu; Vahala, Kerry J.

    2016-11-01

    Measurement of optical and vibrational spectra with high resolution provides a way to identify chemical species in cluttered environments and is of general importance in many fields. Dual-comb spectroscopy has emerged as a powerful approach for acquiring nearly instantaneous Raman and optical spectra with unprecedented resolution. Spectra are generated directly in the electrical domain, without the need for bulky mechanical spectrometers. We demonstrate a miniature soliton-based dual-comb system that can potentially transfer the approach to a chip platform. These devices achieve high-coherence pulsed mode locking. They also feature broad, reproducible spectral envelopes, an essential feature for dual-comb spectroscopy. Our work shows the potential for integrated spectroscopy with high signal-to-noise ratios and fast acquisition rates.

  1. Non-self-dual nonlinear gravitons

    International Nuclear Information System (INIS)

    Yasskin, P.B.; Isenberg, J.A.

    1982-01-01

    Penrose has given a twistor description of all self-dual complex Riemannian space-times. This construction is modified to characterize all complex Riemannian space-times and all complex teleparallel space-times. This construction may be useful in finding non-self-dual solutions to the gravitational field equations (Einstein's or otherwise) without or with sources. It may also lead to a nonperturbative method for computing path integrals. Whereas Penrose shows that a self-dual space-time may be specified by a deformation of projective twistor space (the set of α planes in complex Minkowski space), it is found that a Riemannian or teleparallel space-time may be described by a deformation of projective ambitwistor space (the set of null geodesics in complex Minkowski space). (author)

  2. Severe Multisensory Speech Integration Deficits in High-Functioning School-Aged Children with Autism Spectrum Disorder (ASD) and Their Resolution During Early Adolescence

    Science.gov (United States)

    Foxe, John J.; Molholm, Sophie; Del Bene, Victor A.; Frey, Hans-Peter; Russo, Natalie N.; Blanco, Daniella; Saint-Amour, Dave; Ross, Lars A.

    2015-01-01

    Under noisy listening conditions, visualizing a speaker's articulations substantially improves speech intelligibility. This multisensory speech integration ability is crucial to effective communication, and the appropriate development of this capacity greatly impacts a child's ability to successfully navigate educational and social settings. Research shows that multisensory integration abilities continue developing late into childhood. The primary aim here was to track the development of these abilities in children with autism, since multisensory deficits are increasingly recognized as a component of the autism spectrum disorder (ASD) phenotype. The abilities of high-functioning ASD children (n = 84) to integrate seen and heard speech were assessed cross-sectionally, while environmental noise levels were systematically manipulated, comparing them with age-matched neurotypical children (n = 142). Severe integration deficits were uncovered in ASD, which were increasingly pronounced as background noise increased. These deficits were evident in school-aged ASD children (5–12 year olds), but were fully ameliorated in ASD children entering adolescence (13–15 year olds). The severity of multisensory deficits uncovered has important implications for educators and clinicians working in ASD. We consider the observation that the multisensory speech system recovers substantially in adolescence as an indication that it is likely amenable to intervention during earlier childhood, with potentially profound implications for the development of social communication abilities in ASD children. PMID:23985136

  3. The process of recovery from bipolar I disorder: a qualitative analysis of personal accounts in relation to an integrative cognitive model.

    Science.gov (United States)

    Mansell, Warren; Powell, Seth; Pedley, Rebecca; Thomas, Nia; Jones, Sarah Amelia

    2010-06-01

    This study explored the process of recovery from bipolar I disorder from a phenomenological and cognitive perspective. A semi-structured interview was coded and analysed using interpretative phenomenological analysis. Eleven individuals over the age of 30 with a history of bipolar disorder were selected on the basis of having remained free from relapse, and without hospitalization for at least 2 years, as confirmed by a diagnostic interview (Standardised Interview for DSM-IV; SCID-I). This arbitrary and equivocal criterion for 'recovery' provided an objective method of defining the sample for the study. The analysis revealed two overarching themes formed from four themes each. Ambivalent approaches referred to approaches that participants felt had both positive and negative consequences: avoidance of mania, taking medication, prior illness versus current wellness, and sense of identity following diagnosis. Helpful approaches referred to approaches that were seen as universally helpful: understanding, life-style fundamentals, social support and companionship, and social change. These themes were then interpreted in the light of the existing literature and an integrative cognitive model of bipolar disorder. Limitations and future research directions are discussed.

  4. Dual Dynamic Programming - DDP

    International Nuclear Information System (INIS)

    Velasquez Bermudez, Jesus M

    1998-01-01

    Objections are presented to the mathematical formulation of the denominated Dual Dynamic programming-PDD that is the theoretical base of several computational model available for the optimal formulation of interconnected hydrothermal systems

  5. The implementation and evaluation of cognitive milieu therapy for dual diagnosis inpatients: A pragmatic clinical trial

    DEFF Research Database (Denmark)

    Lykke, Jørn; Oestrich, Irene; Austin, Stephen

    2010-01-01

    milieu therapy (CMT) among a group of dual diagnosis inpatients. CMT is an integrated treatment for both mental illness and substance abuse based on cognitive behavioral principles and carried out within a supportive inpatient environment. A convenience sample of dual diagnosis inpatients (N = 136......Dual diagnosis is chronic psychiatric condition involving serious mental illness and substance abuse. Experts recommend the integration of treatment for concurrent substance abuse and serious psychiatric problems. The following pragmatic trial examined the implementation and outcomes of cognitive...

  6. A Direct Comparison of Local-Global Integration in Autism and other Developmental Disorders: Implications for the Central Coherence Hypothesis

    OpenAIRE

    Bernardiono, I; Mouga, S; Almeida, J; van Asselen, M; Oliveira, G

    2012-01-01

    The weak central coherence hypothesis represents one of the current explanatory models in Autism Spectrum Disorders (ASD). Several experimental paradigms based on hierarchical figures have been used to test this controversial account. We addressed this hypothesis by testing central coherence in ASD (n = 19 with intellectual disability and n = 20 without intellectual disability), Williams syndrome (WS, n = 18), matched controls with intellectual disability (n = 20) and chronological age-matche...

  7. [Psychological features of body integrity identity disorder (BIID): personality traits, interpersonal aspects, coping mechanisms regarding stress and conflicts, body perception].

    Science.gov (United States)

    Oddo, S; Möller, J; Skoruppa, S; Stirn, A

    2014-05-01

    In BIID a disorder of body identity, concerned subjects desire an amputation of a healthy limb. So far, no psychiatric comorbidity was found in the few studies on BIID-subjects. This study explored clinical symptoms, personality characteristics, interpersonal aspects and coping strategies in 15 BIID persons. Psychometric testing on the topics (1) clinical symptoms, (2) personality and interpersonal aspects, (3) coping strategies, (4) attitudes towards the body were used and statistically evaluated with the T-test for one sample. Some psychopathologies such as depression, anxiety and obsessive-compulsive disorders (OCD) could be excluded although an increased tendency of depressiveness was found. BIID subjects showed specific personality and interpersonal characteristics: high agreeableness, autonomy, autarky and restrained behaviour towards others. Stress and conflicts are managed by self-control and self-affirmation. Their subjective physical attractiveness was low. BIID persons do not exhibit psychopathological characteristics (such as anxiety, depression or OCD), but do show specifics in personality, relationships and coping mechanisms. In the future, further personality traits and personality disorders should be investigated to shed more light on the categorisation and treatment of BIID. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Linking the dual system with higher education in Denmark

    DEFF Research Database (Denmark)

    Jørgensen, Christian Helms

    2013-01-01

    As more than half of every new generation of youth enter higher education in Den-mark the strength of the dual system of vocational education is becoming its weakness. Completing a programme in the dual system doesn’t give access to higher ed-ucation, and the system is increasingly seen as a ‘blind...... alley’. This weakness is closely related to the strengths of the dual system. The dual system is successful in giving direct and fast access to employment for the students, and this contributes to a very low rate of youth unemployment in Denmark. Students who complete a programme in the dual system......, become well integrated into the labour market, but at the same time they are diverted from higher education. This has lately put the question of hybrid qualifications on the agenda in Denmark....

  9. New Fukui, dual and hyper-dual kernels as bond reactivity descriptors.

    Science.gov (United States)

    Franco-Pérez, Marco; Polanco-Ramírez, Carlos-A; Ayers, Paul W; Gázquez, José L; Vela, Alberto

    2017-06-21

    We define three new linear response indices with promising applications for bond reactivity using the mathematical framework of τ-CRT (finite temperature chemical reactivity theory). The τ-Fukui kernel is defined as the ratio between the fluctuations of the average electron density at two different points in the space and the fluctuations in the average electron number and is designed to integrate to the finite-temperature definition of the electronic Fukui function. When this kernel is condensed, it can be interpreted as a site-reactivity descriptor of the boundary region between two atoms. The τ-dual kernel corresponds to the first order response of the Fukui kernel and is designed to integrate to the finite temperature definition of the dual descriptor; it indicates the ambiphilic reactivity of a specific bond and enriches the traditional dual descriptor by allowing one to distinguish between the electron-accepting and electron-donating processes. Finally, the τ-hyper dual kernel is defined as the second-order derivative of the Fukui kernel and is proposed as a measure of the strength of ambiphilic bonding interactions. Although these quantities have never been proposed, our results for the τ-Fukui kernel and for τ-dual kernel can be derived in zero-temperature formulation of the chemical reactivity theory with, among other things, the widely-used parabolic interpolation model.

  10. The IntFOLD server: an integrated web resource for protein fold recognition, 3D model quality assessment, intrinsic disorder prediction, domain prediction and ligand binding site prediction.

    Science.gov (United States)

    Roche, Daniel B; Buenavista, Maria T; Tetchner, Stuart J; McGuffin, Liam J

    2011-07-01

    The IntFOLD server is a novel independent server that integrates several cutting edge methods for the prediction of structure and function from sequence. Our guiding principles behind the server development were as follows: (i) to provide a simple unified resource that makes our prediction software accessible to all and (ii) to produce integrated output for predictions that can be easily interpreted. The output for predictions is presented as a simple table that summarizes all results graphically via plots and annotated 3D models. The raw machine readable data files for each set of predictions are also provided for developers, which comply with the Critical Assessment of Methods for Protein Structure Prediction (CASP) data standards. The server comprises an integrated suite of five novel methods: nFOLD4, for tertiary structure prediction; ModFOLD 3.0, for model quality assessment; DISOclust 2.0, for disorder prediction; DomFOLD 2.0 for domain prediction; and FunFOLD 1.0, for ligand binding site prediction. Predictions from the IntFOLD server were found to be competitive in several categories in the recent CASP9 experiment. The IntFOLD server is available at the following web site: http://www.reading.ac.uk/bioinf/IntFOLD/.

  11. The Relationship between Treatment Integrity and Acceptability of Reading Interventions for Children with Attention-Deficit/Hyperactivity Disorder

    Science.gov (United States)

    Mautone, Jennifer A.; DuPaul, George J.; Jitendra, Asha K.; Tresco, Katy E.; Junod, Rosemary Vile; Volpe, Robert J.

    2009-01-01

    This study examined the relationship between treatment integrity and acceptability for reading interventions across two consultation models, intensive data-based academic intervention (IDAI) and traditional data-based academic intervention (TDAI). Participants included 83 first- through fourth-grade students who met research criteria for…

  12. Cloud storage based mobile assessment facility for patients with post-traumatic stress disorder using integrated signal processing algorithm

    Science.gov (United States)

    Balbin, Jessie R.; Pinugu, Jasmine Nadja J.; Basco, Abigail Joy S.; Cabanada, Myla B.; Gonzales, Patrisha Melrose V.; Marasigan, Juan Carlos C.

    2017-06-01

    The research aims to build a tool in assessing patients for post-traumatic stress disorder or PTSD. The parameters used are heart rate, skin conductivity, and facial gestures. Facial gestures are recorded using OpenFace, an open-source face recognition program that uses facial action units in to track facial movements. Heart rate and skin conductivity is measured through sensors operated using Raspberry Pi. Results are stored in a database for easy and quick access. Databases to be used are uploaded to a cloud platform so that doctors have direct access to the data. This research aims to analyze these parameters and give accurate assessment of the patient.

  13. The role of mindfulness based interventions in the treatment of obesity and eating disorders: an integrative review.

    Science.gov (United States)

    Godsey, Judi

    2013-08-01

    More than one-third of U.S. adults over the age of 20 years are classified as obese and nearly two-thirds are overweight or obese. The prevalence of obesity among U.S. children and adolescents has almost tripled since 1980, with 17% of all youth and children now considered obese. Nine million children aged 6-19 years are overweight, making obesity the largest health care threat facing today's children. Historically, the arsenal against obesity has been primarily focused on interventions that increase physical activity and decrease caloric intake. American weight loss strategies that incorporate dietary modifications and exercise have proven effective in achieving weight loss, but most of the weight is regained over time. Mindfulness based interventions, combined with other traditional weight loss strategies, have the potential to offer a long-term, holistic approach to wellness. However, research reports examining the complementary addition of mindfulness based approaches in the treatment obesity and eating disorders are relatively scarce in the empirical literature. This paper describes what is currently known about the role of mindfulness based interventions when used alone, or in combination with, other traditional approaches in the treatment of obesity and eating disorders. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Self-dual Hopf quivers

    International Nuclear Information System (INIS)

    Huang Hualin; Li Libin; Ye Yu

    2004-07-01

    We study pointed graded self-dual Hopf algebras with a help of the dual Gabriel theorem for pointed Hopf algebras. Quivers of such Hopf algebras are said to be self-dual. An explicit classification of self-dual Hopf quivers is obtained. We also prove that finite dimensional coradically graded pointed self-dual Hopf algebras are generated by group-like and skew-primitive elements as associative algebras. This partially justifies a conjecture of Andruskiewitsch and Schneider and may help to classify finite dimensional self-dual pointed Hopf algebras

  15. Dual electromagnetism: helicity, spin, momentum and angular momentum

    International Nuclear Information System (INIS)

    Bliokh, Konstantin Y; Nori, Franco; Bekshaev, Aleksandr Y

    2013-01-01

    The dual symmetry between electric and magnetic fields is an important intrinsic property of Maxwell equations in free space. This symmetry underlies the conservation of optical helicity and, as we show here, is closely related to the separation of spin and orbital degrees of freedom of light (the helicity flux coincides with the spin angular momentum). However, in the standard field-theory formulation of electromagnetism, the field Lagrangian is not dual symmetric. This leads to problematic dual-asymmetric forms of the canonical energy–momentum, spin and orbital angular-momentum tensors. Moreover, we show that the components of these tensors conflict with the helicity and energy conservation laws. To resolve this discrepancy between the symmetries of the Lagrangian and Maxwell equations, we put forward a dual-symmetric Lagrangian formulation of classical electromagnetism. This dual electromagnetism preserves the form of Maxwell equations, yields meaningful canonical energy–momentum and angular-momentum tensors, and ensures a self-consistent separation of the spin and orbital degrees of freedom. This provides a rigorous derivation of the results suggested in other recent approaches. We make the Noether analysis of the dual symmetry and all the Poincaré symmetries, examine both local and integral conserved quantities and show that only the dual electromagnetism naturally produces a complete self-consistent set of conservation laws. We also discuss the observability of physical quantities distinguishing the standard and dual theories, as well as relations to quantum weak measurements and various optical experiments. (paper)

  16. Dual-band infrared camera

    Science.gov (United States)

    Vogel, H.; Schlemmer, H.

    2005-10-01

    Every year, numerous accidents happen on European roads due to bad visibility (fog, night, heavy rain). Similarly, the dramatic aviation accidents of year 2001 in Milan and Zurich have reminded us that aviation safety is equally affected by reduced visibility. A dual-band thermal imager was developed in order to raise human situation awareness under conditions of reduced visibility especially in the automotive and aeronautical context but also for all transportation or surveillance tasks. The chosen wavelength bands are the Short Wave Infrared SWIR and the Long Wave Infrared LWIR band which are less obscured by reduced visibility conditions than the visible band. Furthermore, our field tests clearly show that the two different spectral bands very often contain complementary information. Pyramidal fusion is used to integrate complementary and redundant features of the multi-spectral images into a fused image which can be displayed on a monitor to provide more and better information for the driver or pilot.

  17. How Are Service Dogs for Adults with Post Traumatic Stress Disorder Integrated with Rehabilitation in Denmark? A Case Study

    OpenAIRE

    Glintborg, Chalotte; Hansen, Tia G. B.

    2017-01-01

    Simple Summary The use of service dogs for adults with mental illnesses has become generally accepted. With reference to a single case study of a client with Post Traumatic Stress (PTSD), this study illustrates some of the potential advantages, but also note an important concern that appears to have gone unnoticed. The provision of service animals/therapy animals for adults with mental illnesses must be sufficiently informed by relevant knowledge and integrated with concurrent rehabilitation ...

  18. Coherent cavity-enhanced dual-comb spectroscopy

    OpenAIRE

    Fleisher, Adam J.; Long, David A.; Reed, Zachary D.; Hodges, Joseph T.; Plusquellic, David F.

    2016-01-01

    Dual-comb spectroscopy allows for the rapid, multiplexed acquisition of high-resolution spectra without the need for moving parts or low-resolution dispersive optics. This method of broadband spectroscopy is most often accomplished via tight phase locking of two mode-locked lasers or via sophisticated signal processing algorithms, and therefore, long integration times of phase coherent signals are difficult to achieve. Here we demonstrate an alternative approach to dual-comb spectroscopy usin...

  19. The dual formulation of cosmic strings and vortices

    CERN Document Server

    Lee, Ki-Myeong

    1993-01-01

    We study four dimensional systems of global, axionic and local strings. By using the path integral formalism, we derive the dual formulation of these systems, where Goldstone bosons, axions and missive vector bosons are described by antisymmetric tensor fields, and strings appear as a source for these tensor fields. We show also how magnetic monopoles attached to local strings are described in the dual formulation. We conclude with some remarks.

  20. Dual source CT imaging

    International Nuclear Information System (INIS)

    Seidensticker, Peter R.; Hofmann, Lars K.

    2008-01-01

    The introduction of Dual Source Computed Tomography (DSCT) in 2005 was an evolutionary leap in the field of CT imaging. Two x-ray sources operated simultaneously enable heart-rate independent temporal resolution and routine spiral dual energy imaging. The precise delivery of contrast media is a critical part of the contrast-enhanced CT procedure. This book provides an introduction to DSCT technology and to the basics of contrast media administration followed by 25 in-depth clinical scan and contrast media injection protocols. All were developed in consensus by selected physicians on the Dual Source CT Expert Panel. Each protocol is complemented by individual considerations, tricks and pitfalls, and by clinical examples from several of the world's best radiologists and cardiologists. This extensive CME-accredited manual is intended to help readers to achieve consistently high image quality, optimal patient care, and a solid starting point for the development of their own unique protocols. (orig.)

  1. Association between abnormal serum myelin-specific protein levels and white matter integrity in first-episode and drug-naïve patients with major depressive disorder.

    Science.gov (United States)

    Jiang, Linling; Cheng, Yuqi; Jiang, Hongyan; Xu, Jian; Lu, Jin; Shen, Zonglin; Lu, Yi; Liu, Fang; Li, Luqiong; Xu, Xiufeng

    2018-05-01

    Although the structural abnormalities of white matter (WM) have been described in patients with major depressive disorder (MDD), the neuropathological changes remain unclear. The current study aimed to investigate the myelin oligodendrocyte glycoprotein (MOG) and myelin-associated glycoprotein (MAG) levels and their correlations with WM integrity in first-episode, drug-naïve MDD patients. We obtained diffusion tensor images of 102 first-episode, drug-naïve MDD patients and 81 age- and sex-matched controls. Serum MOG and MAG levels of all participants were measured and compared between the two groups. The correlations between WM integrity and MOG and MAG levels were examined. MOG and MAG serum levels were significantly higher in MDD patients than in controls. Patients with MDD also showed decreased fractional anisotropy (FA) and axial diffusivity in the WM of the bilateral thalamus, right hippocampus, right temporal lobe, and left pulvinar. At the whole-brain level, no regions showed any correlations of diffusivity parameters with MOG or MAG levels in healthy subjects. However, we observed two-way correlations between the MOG and MAG levels and the FA and mean diffusivity values in the WM of the left middle frontal lobe, right inferior parietal lobe, and right supplementary motor area in MDD patients. Further investigation with a larger sample size and longitudinal studies are required to better understand the neuropathology of WM integrity in MDD. Our findings represent the first evidence of a relationship between abnormal serum myelin-specific protein levels and impaired WM integrity, which may help to better understand the neurobiological mechanisms of MDD. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Provider Experiences with Prison Care and Aftercare for Women with Co-occurring Mental Health and Substance Use Disorders: Treatment, Resource, and Systems Integration Challenges.

    Science.gov (United States)

    Johnson, Jennifer E; Schonbrun, Yael Chatav; Peabody, Marlanea E; Shefner, Ruth T; Fernandes, Karen M; Rosen, Rochelle K; Zlotnick, Caron

    2015-10-01

    Incarcerated women with co-occurring mental health and substance use disorders (COD) face complex psychosocial challenges at community reentry. This study used qualitative methods to evaluate the perspectives of 14 prison and aftercare providers about service delivery challenges and treatment needs of reentering women with COD. Providers viewed the needs of women prisoners with COD as distinct from those of women with substance use alone and from men with COD. Providers described optimal aftercare for women with COD as including contact with the same provider before and after release, access to services within 24-72 hours after release, assistance with managing multiple social service agencies, assistance with relationship issues, and long-term follow-up. Providers also described larger service system and societal issues, including systems integration and ways in which a lack of prison and community aftercare resources impacted quality of care and reentry outcomes. Practice and policy implications are provided.

  3. The Role of Self-Care for Parents in Recovery From Substance Use Disorders: An Integrative Review of Parental Self-Care.

    Science.gov (United States)

    Raynor, Phyllis; Pope, Charlene

    2016-01-01

    Lack of stress modifiers, such as self-care behaviors (SCBs), can increase vulnerability to drug use for parents in recovery from substance use disorders (SUDs). The purpose of this integrative review was to determine how the existing literature describes, conceptualizes, and measures SCB for parents in the general population for its application to parents with a history of SUD. Framed by Bandura's Social Cognitive Theory of Substance Abuse, four qualitative and five quantitative studies identify SCB, although only one study describes SCB of parents in recovery. Few studies addressed parental SCB, and most of those studies focused on behaviors for new mothers with or without SUDs during the early child years. Exploring the role of SCB in relation to parental well-being for the general population is a needed area for further research, even more so for parents who are recovering from SUDs.

  4. Provider Experiences with Prison Care and Aftercare for Women with Co-occurring Mental Health and Substance Use Disorders: Treatment, Resource, and Systems Integration Challenges

    Science.gov (United States)

    Johnson, Jennifer E.; Schonbrun, Yael Chatav; Peabody, Marlanea E.; Shefner, Ruth T.; Fernandes, Karen M.; Rosen, Rochelle K.; Zlotnick, Caron

    2014-01-01

    Incarcerated women with co-occurring mental health and substance use disorders (COD) face complex psychosocial challenges at community reentry. This study used qualitative methods to evaluate the perspectives of 14 prison and aftercare providers about service delivery challenges and treatment needs of reentering women with COD. Providers viewed the needs of women prisoners with COD as distinct from those of women with substance use alone and from men with COD. Providers described optimal aftercare for women with COD as including contact with the same provider before and after release, access to services within 24–72 hours after release, assistance with managing multiple social service agencies, assistance with relationship issues, and long-term follow-up. Providers also described larger service system and societal issues, including systems integration and ways in which a lack of prison and community aftercare resources impacted quality of care and reentry outcomes. Practice and policy implications are provided. PMID:24595815

  5. Client interpersonal impacts as mediators of long-term outcome in cognitive-behavioral therapy integrated with motivational interviewing for generalized anxiety disorder.

    Science.gov (United States)

    Constantino, Michael J; Romano, Felicia M; Coyne, Alice E; Westra, Henny A; Antony, Martin M

    2017-03-24

    A recent trial of generalized anxiety disorder treatment (Westra, H. A., Constantino, M. J., & Antony, M. M. (2016). Integrating Motivational Interviewing With Cognitive-Behavioral Therapy for Severe Generalized Anxiety Disorder: An Allegiance-Controlled Randomized Clinical Trial. Journal of Consulting and Clinical Psychology, 84, 768-782. doi: 10.1037/ccp0000098 ) revealed that cognitive-behavioral therapy (CBT) integrated with motivational interviewing (MI) outperformed CBT alone across a 12-month follow up. The present study examined whether this treatment effect was mediated by MI-CBT clients engaging over time in during-session interpersonal behaviors reflecting more friendly dominance, or agentic actions, and less friendly submissiveness (FS), or trustingly compliant actions both theory-specific MI mechanisms. Clients received 15 sessions of MI-CBT (n = 42) or CBT alone (n = 43). Therapists rated client interpersonal behavior following five sessions, and clients rated their worry at baseline, each session, and 6- and 12-month follow up. Mediator and outcome variables were derived from multilevel models. Mediation was tested using a bootstrapping procedure. There was a significant indirect effect for FS. As expected, CBT clients evidenced greater increases in FS than MI-CBT clients, which in turn, though unexpectedly, related to lower 12-month worry. However, long-term CBT outcomes remained inferior to MI-CBT outcomes even with CBT clients'greater increase in FS. Results suggest that CBT outcomes are more positive when clients trustingly comply; however, MI-CBT remained superior, but for as yet unexplained reasons. Clinical or methodological significance of this article: The findings highlight the clinical importance of GAD clients becoming more friendly dominant in the therapy relationship irrespective of whether they received CBT or integrative MI-CBT. Moreover, it seems clinically indicated to incorporate MI spirit and techniques into CBT when

  6. [Madrid study on the prevalence and characteristics of outpatients with dual pathology in community mental health and substance misuse services].

    Science.gov (United States)

    Arias, Francisco; Szerman, Nestor; Vega, Pablo; Mesias, Beatriz; Basurte, Ignacio; Morant, Consuelo; Ochoa, Enriqueta; Poyo, Félix; Babín, Francisco

    2013-01-01

    The objective was to quantify the prevalence of dual diagnosis and to evaluate the characteristics of these patients from community mental health and substance misuse services in Madrid. The sample consisted of 837 outpatients from Madrid, 208 from mental health services and 629 from substance misuse services. We used the Mini International Neuropsychiatric Interview (MINI) and Personality Disorder Questionnaire (PDQ4+) to evaluate disorders from axis I and II. It was considered that 517 (61.8%) patients had dual pathology (current diagnoses of axis I or II disorders and an addictive disorder): 36,1% in mental health services and 70,3% in substance misuse services. There were fewer males amongst the dual patients and it was also found that they had a worse employment situation, along with higher figures of alcohol and cannabis dependence than addicts without dual diagnoses (n=194). When comparing them with patients with mental disorder diagnoses only, excluding substance use disorder (n=126), there were differences in all socio-demographic characteristics analyzed, and dual patients were associated with diagnoses of bipolar disorder, agoraphobia, generalized anxiety disorder, post-traumatic stress disorder, and had more suicide risk and different personality disorders. Thus, dual pathology is higher in patients who are in treatment and have differential characteristics (higher suicide risk, worse employment situation) that suggest greater severity that could be of help in the planning of care resource policies for these patients.

  7. Safety and tolerability of atomoxetine in treatment of attention deficit hyperactivity disorder in adult patients: an integrated analysis of 15 clinical trials.

    Science.gov (United States)

    Camporeale, Angelo; Porsdal, Vibeke; De Bruyckere, Katrien; Tanaka, Yoko; Upadhyaya, Himanshu; Deix, Claudia; Deberdt, Walter

    2015-01-01

    The safety profile of atomoxetine in the treatment of attention deficit hyperactivity disorder has been studied in many clinical trials. We performed an integrated safety analysis of 15 clinical trials in adults with attention deficit hyperactivity disorder. The analysis pooled patient data into three groups: acute placebo-controlled trials; long-term placebo-controlled trials; all trials. In total, 4829 adults (18-77 years, median: 36 years) were exposed to atomoxetine. Statistically significantly more atomoxetine-treated than placebo-treated patients experienced treatment-emergent adverse events (81.3% vs. 68.3% acute; 90.6% vs. 76.8% long term) and discontinued due to adverse events (8.9% vs. 4.0% acute; 17.9% vs. 6.3% long term). No statistically significant differences were observed in the proportion of patients experiencing serious adverse events. No previously unknown adverse events were identified. The most common adverse events included nausea, dry mouth, decreased appetite, insomnia and erectile dysfunction. Mean increases in heart rate (+5.2 beats per min) and blood pressure (systolic +2 mmHg, diastolic +1.9 mmHg) were modest. The proportion of patients experiencing clinically significant increases in blood pressure and heart rate at any time was statistically significantly higher with atomoxetine (systolic blood pressure 13-17%, diastolic blood pressure 37-40%, heart rate 42-43%) compared to placebo (systolic blood pressure 8-13%, diastolic blood pressure 29-34%, heart rate 21-26%). There was no increased risk of suicidal ideation or behaviour. Our findings confirm atomoxetine's known safety profile. From a safety perspective, atomoxetine is a useful treatment option for adults with attention deficit hyperactivity disorder. © The Author(s) 2014.

  8. Integrating evidence-based treatments for common mental disorders in routine primary care: feasibility and acceptability of the MANAS intervention in Goa, India.

    Science.gov (United States)

    Chatterjee, Sudipto; Chowdhary, Neerja; Pednekar, Sulochana; Cohen, Alex; Andrew, Gracy; Andrew, Gracy; Araya, Ricardo; Simon, Gregory; King, Michael; Telles, Shirley; Verdeli, Helena; Clougherty, Kathleen; Kirkwood, Betty; Patel, Vikram

    2008-02-01

    Common mental disorders, such as depression and anxiety, pose a major public health burden in developing countries. Although these disorders are thought to be best managed in primary care settings, there is a dearth of evidence about how this can be achieved in low resource settings. The MANAS project is an attempt to integrate an evidence based package of treatments into routine public and private primary care settings in Goa, India. Before initiating the trial, we carried out extensive preparatory work, over a period of 15 months, to examine the feasibility and acceptability of the planned intervention. This paper describes the systematic development and evaluation of the intervention through this preparatory phase. The preparatory stage, which was implemented in three phases, utilized quantitative and qualitative methods to inform our understanding of the potential problems and possible solutions in implementing the trial and led to critical modifications of the original intervention plan. Investing in systematic formative work prior to conducting expensive trials of the effectiveness of complex interventions is a useful exercise which potentially improves the likelihood of a positive result of such trials.

  9. Limbic-thalamo-cortical projections and reward-related circuitry integrity affects eating behavior: A longitudinal DTI study in adolescents with restrictive eating disorders.

    Directory of Open Access Journals (Sweden)

    Gaia Olivo

    Full Text Available Few studies have used diffusion tensor imaging (DTI to investigate the micro-structural alterations of WM in patients with restrictive eating disorders (rED, and longitudinal data are lacking. Twelve patients with rED were scanned at diagnosis and after one year of family-based treatment, and compared to twenty-four healthy controls (HCs through DTI analysis. A tract-based spatial statistics procedure was used to investigate diffusivity parameters: fractional anisotropy (FA and mean, radial and axial diffusivities (MD, RD and AD, respectively. Reduced FA and increased RD were found in patients at baseline in the corpus callosum, corona radiata and posterior thalamic radiation compared with controls. However, no differences were found between follow-up patients and controls, suggesting a partial normalization of the diffusivity parameters. In patients, trends for a negative correlation were found between the baseline FA of the right anterior corona radiata and the Eating Disorder Examination Questionnaire total score, while a positive trend was found between the baseline FA in the splenium of corpus callosum and the weight loss occurred between maximal documented weight and time of admission. A positive trend for correlation was also found between baseline FA in the right anterior corona radiata and the decrease in the Obsessive-Compulsive Inventory Revised total score over time. Our results suggest that the integrity of the limbic-thalamo-cortical projections and the reward-related circuitry are important for cognitive control processes and reward responsiveness in regulating eating behavior.

  10. Dual Pathology of Mandible.

    Science.gov (United States)

    Rajurkar, Suday G; Deshpande, Mohan D; Kazi, Noaman; Jadhav, Dhanashree; Ranadive, Pallavi; Ingole, Snehal

    2017-01-01

    Aneurysmal Bone cyst (ABC)is a rare benign lesion of the bone which is infrequent in craniofacial region (12%). Rapid growth pattern causing bone expansion and facial asymmetry is a characteristic feature of ABC. Giant cell lesion is another distinct pathological entity. Here we present to you a rare case of dual pathology in an 11 year old female patient who presented with a large expansile lesion in the left hemimandible. All radiographic investigations were suggestive of ABC, aspiration of the lesion resulted in blood aspirate. However only after a histologic examination the dual nature of the lesion was revealed.

  11. Dual phase evolution

    CERN Document Server

    Green, David G; Abbass, Hussein A

    2014-01-01

    This book explains how dual phase evolution operates in all these settings and provides a detailed treatment of the subject. The authors discuss the theoretical foundations for the theory, how it relates to other phase transition phenomena and its advantages in evolutionary computation and complex adaptive systems. The book provides methods and techniques to use this concept for problem solving. Dual phase evolution concerns systems that evolve via repeated phase shifts in the connectivity of their elements. It occurs in vast range of settings, including natural systems (species evolution, landscape ecology, geomorphology), socio-economic systems (social networks) and in artificial systems (annealing, evolutionary computing).

  12. Dual-Mode Combustor

    Science.gov (United States)

    Trefny, Charles J (Inventor); Dippold, Vance F (Inventor)

    2013-01-01

    A new dual-mode ramjet combustor used for operation over a wide flight Mach number range is described. Subsonic combustion mode is usable to lower flight Mach numbers than current dual-mode scramjets. High speed mode is characterized by supersonic combustion in a free-jet that traverses the subsonic combustion chamber to a variable nozzle throat. Although a variable combustor exit aperture is required, the need for fuel staging to accommodate the combustion process is eliminated. Local heating from shock-boundary-layer interactions on combustor walls is also eliminated.

  13. Dual-anticipating, dual and dual-lag synchronization in modulated time-delayed systems

    International Nuclear Information System (INIS)

    Ghosh, Dibakar; Chowdhury, A. Roy

    2010-01-01

    In this Letter, dual synchronization in modulated time delay system using delay feedback controller is proposed. Based on Lyapunov stability theory, we suggest a general method to achieve the dual-anticipating, dual, dual-lag synchronization of time-delayed chaotic systems and we find both its existing and sufficient stability conditions. Numerically it is shown that the dual synchronization is also possible when driving system contain two completely different systems. Effect of parameter mismatch on dual synchronization is also discussed. As an example, numerical simulations for the Mackey-Glass and Ikeda systems are conducted, which is in good agreement with the theoretical analysis.

  14. Dual Modulators of GABA-A and Alpha 7 Nicotinic Receptors for Treating Autism

    Science.gov (United States)

    2015-10-01

    AWARD NUMBER: W81XWH-13-1-0144 TITLE: Dual Modulators of GABA-A and Alpha 7 Nicotinic Receptors for Treating Autism PRINCIPAL INVESTIGATOR...SUBTITLE 5a. CONTRACT NUMBER Dual Modulators of GABA-A and Alpha 7 Nicotinic Receptors for Treating Autism 5b. GRANT NUMBER W81XWH-13-1-0144 5c...ABSTRACT Autism spectrum disorder (ASD) is a polygenic signaling disorder that may result, in part, from an imbalance in excitatory and inhibitory

  15. spinning self-dual particles

    International Nuclear Information System (INIS)

    Gamboa, J.; Rivelles, V.O.

    1989-01-01

    Self-dual particles in two-dimensions are presented. They were obtained from chiral boson particle by square root technique. The propagator of spinning self-dual particle is calculated using the BFV formalism. (M.C.K.)

  16. Meeting Disorders.

    Science.gov (United States)

    Yager, Joel; Katzman, Jeffrey W

    2017-12-01

    Although meetings are central to organizational work, considerable time devoted to meetings in Academic Health Centers appears to be unproductively spent. The primary purposes of this article are to delineate and describe Meeting Disorders, pathological processes resulting in these inefficient and ineffective scenarios, and Meeting Fatigue Disorder (MFD), a clinical syndrome. The paper also offers preliminary approaches to remedies. The authors integrate observations made during tens of thousands of hours in administrative meetings in academic medical settings with information in the literature regarding the nature, causes and potential interventions for dysfunctional groups and meetings. Meeting Disorders, resulting from distinct pathologies of leadership and organization, constitute prevalent subgroups of the bureaucrapathologies, pathological conditions caused by dysfunctional bureaucratic processes that generate excesses of wasted time, effort, and other resources. These disorders also generate frustration and demoralization among participants, contributing to professional burnout. Meeting Fatigue Disorder (MFD) is a subjective condition that develops in individuals who overdose on these experiences and may reflect one manifestation of burnout. Meeting disorders and Meeting Fatigue Disorder occur commonly in bureaucratic life. Resources and potential remedies are available to help ameliorate their more deleterious effects.

  17. Effectiveness of Inhaled Loxapine in Dual-Diagnosis Patients: A Case Series.

    Science.gov (United States)

    Roncero, Carlos; Ros-Cucurull, Elena; Grau-López, Lara; Fadeuilhe, Christian; Casas, Miguel

    2016-01-01

    Episodes of psychotic agitation are frequent in patients with dual diagnosis, that is, in patients with concomitant psychiatric and substance use disorders. Rapid intervention is needed to treat the agitation at a mild stage to prevent the escalation to aggressive behavior. Inhaled loxapine has been demonstrated to rapidly improve symptoms of mild-to-moderate agitation in adults with psychiatric disorders (schizophrenia and bipolar disorder), but data on patients with dual diagnosis are scarce. This study is a retrospective review of data from a case series of patients with dual diagnosis, which were attended for symptoms of agitation while at the emergency room (n = 9), in the outpatient clinic (n = 4), or during hospitalization (n = 1) at 1 center in Spain. All patients received inhaled loxapine for treating the agitation episodes. Data from 14 patients with dual diagnosis were reviewed. All patients had 1 or more psychiatric disorders (schizophrenia, bipolar I disorder, drug-induced psychotic disorder, posttraumatic stress, borderline or antisocial personality disorder, depression, or anxiety) along with a variety of substance use disorders (alcohol, cocaine, cannabis, amphetamines, hypnotics and antianxiety drugs, caffeine, or street drugs). Overall, only 1 dose of inhaled loxapine (9.1 mg) was needed to calm each patient during an acute episode of agitation. Inhaled loxapine was rapid, effective, and well accepted in all dual-pathology patients presenting with acute agitation in the emergency setting. Inhaled loxapine facilitated both patient cooperation and an adequate management of his or her disease.

  18. Prevalence of Victimization in Patients With Dual Diagnosis

    NARCIS (Netherlands)

    de Waal, Marleen Maria; Dekker, Jacobus Johannes Maria; Goudriaan, Anna Emma

    2017-01-01

    Objective: The purpose of this study was to determine the prevalence of victimization in patients with co-occurring mental health and substance use disorders (dual diagnosis) and compare them to the general population. Methods: In this cross-sectional survey study conducted in the Netherlands, 9

  19. Giftedness and ADHD: Identification, Misdiagnosis, and Dual Diagnosis

    Science.gov (United States)

    Mullet, Dianna R.; Rinn, Anne N.

    2015-01-01

    Many gifted characteristics overlap the symptoms of attention deficity-hyperactivity disorder (ADHD). The potential for the misdiagnosis of giftedness as ADHD exists, but so does the potential for a dual diagnosis of giftedness and ADHD. A decade after the misdiagnosis of giftedness as ADHD was first investigated we examine lessons learned…

  20. Dual Smarandache Curves and Smarandache Ruled Surfaces

    OpenAIRE

    Tanju KAHRAMAN; Mehmet ÖNDER; H. Hüseyin UGURLU

    2013-01-01

    In this paper, by considering dual geodesic trihedron (dual Darboux frame) we define dual Smarandache curves lying fully on dual unit sphere S^2 and corresponding to ruled surfaces. We obtain the relationships between the elements of curvature of dual spherical curve (ruled surface) x(s) and its dual Smarandache curve (Smarandache ruled surface) x1(s) and we give an example for dual Smarandache curves of a dual spherical curve.

  1. Dynamics of the psychological features and clinical symptoms in mitral valve prolapse patients receiving long-term integrative psychotherapy for anxiety disorders

    Directory of Open Access Journals (Sweden)

    Zinchenko Y.

    2014-09-01

    Full Text Available The purpose of the study was to investigate the dynamics of the psychological features and clinical symptoms in mitral valve prolapse (MVP patients receiving long-term integrative psychotherapy for anxiety disorders (AD and to investigate the psychological factors of their improvement in mental health as a result of psychotherapy. Thirty-two MVP patients with AD attended long-term integrative psychotherapy. Psychological and clinical examinations of the patients were made before and after the therapy courses and in a follow-up study after 2, 5, and 10 years. Data from the study show that 78.1% of the patients who attended psychotherapy sessions demonstrated valid improvements in self-rated psychological well-being and a reduction in their anxiety levels. Analysis of emotion-regulation strategies showed that psychotherapy encouraged the use of strategies effective for solving adaptive tasks. Positive dynamics in the development of personality reflection, the recognition of one’s emotional experiences, improved skills of self-regulation, and growing awareness of actual needs, individual purposes, and personality resources—all were associated with the reduction of MVP clinical symptoms. The psychiatrist who interviewed the patients reported that most of them were in sustained remission.

  2. Diffusion-weighted MRI measures suggest increased white-matter integrity in Internet gaming disorder: Evidence from the comparison with recreational Internet game users.

    Science.gov (United States)

    Dong, Guangheng; Wu, Lingdan; Wang, Ziliang; Wang, Yifan; Du, Xiaoxia; Potenza, Marc N

    2018-06-01

    Several studies have suggested that Internet gaming disorder (IGD) is related to altered brain white matter integrity. However, seeming inconsistencies exist and may reflect comparison groups not matched well for certain gaming characteristics. In order to address this possible concern, we recruited in the present study individuals with recreational Internet game use (RGU) comprised of individuals who spend similar amounts of time as IGD subjects playing online games without developing IGD. Diffusion tensor imaging data were collected from 42 IGD and 44 RGU subjects. Whole-brain comparisons showed that IGD subjects demonstrated increased fractional anisotropy (FA) in the bilateral anterior thalamic radiation, anterior limb of the internal capsule, bilateral corticospinal tract, bilateral inferior fronto-occipital fasciculus, corpus callosum, and bilateral inferior longitudinal fasciculus. In addition, Internet-addiction severity was positively correlated with FA values. Taken together, we conclude that IGD is associated with measures of increased white-matter integrity in tracts linking reward circuitry and sensory and motor control systems. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Dual Coding in Children.

    Science.gov (United States)

    Burton, John K.; Wildman, Terry M.

    The purpose of this study was to test the applicability of the dual coding hypothesis to children's recall performance. The hypothesis predicts that visual interference will have a small effect on the recall of visually presented words or pictures, but that acoustic interference will cause a decline in recall of visually presented words and…

  4. Dual beam vidicon digitizer

    International Nuclear Information System (INIS)

    Evans, T.L.

    1976-01-01

    A vidicon waveform digitizer which can simultaneously digitize two independent signals has been developed. Either transient or repetitive waveforms can be digitized with this system. A dual beam oscilloscope is used as the signal input device. The light from the oscilloscope traces is optically coupled to a television camera, where the signals are temporarily stored prior to digitizing

  5. Dual QCD: A review

    International Nuclear Information System (INIS)

    Baker, M.; Ball, J.S.; Zachariasen, F.

    1991-01-01

    We review the attempts to use dual (electric) vector potentials rather than the standard magnetic vector potentials to describe QCD, particularly in the infrared regime. The use of dual potentials is motivated by the fact that in classical electrodynamics, in a medium with a dielectric constant vanishing at small momenta (as is believed to be the case in QCD), electric potentials provide a far more convenient language than do magnetic potentials. To begin with, we outline attempts to construct the QCD Lagrangian in terms of dual potentials and describe the various possibilities, their shortcomings and advantages, which so far exist. We then proceed to use the most attractive (albeit consistent as a field theory only at the tree level) of these Lagrangians in a number of applications. We show that it describes a non-Abelian dual superconductor (so that it automatically confines color), derive the static quark-antiquark potential, and various temperature dependent effects, such as deconfinement and chiral symmetry breaking. (orig.)

  6. Dual completion method

    Energy Technology Data Exchange (ETDEWEB)

    Mamedov, N Ya; Kadymova, K S; Dzhafarov, Sh T

    1963-10-28

    One type of dual completion method utilizes a single tubing string. Through the use of the proper tubing equipment, the fluid from the low-productive upper formation is lifted by utilizing the surplus energy of a submerged pump, which handles the production from the lower stratum.

  7. Dual ionization chamber

    International Nuclear Information System (INIS)

    Mallory, J.; Turlej, Z.

    1981-01-01

    Dual ionization chambers are provided for use with an electronic smoke detector. The chambers are separated by electrically-conductive partition. A single radiation source extends through the partition into both chambers, ionizing the air in each. The mid-point current of the device may be balanced by adjusting the position of the source

  8. Integration of serious games and wearable haptic interfaces for Neuro Rehabilitation of children with movement disorders: A feasibility study.

    Science.gov (United States)

    Bortone, Ilaria; Leonardis, Daniele; Solazzi, Massimiliano; Procopio, Caterina; Crecchi, Alessandra; Bonfiglio, Luca; Frisoli, Antonio

    2017-07-01

    The past decade has seen the emergence of rehabilitation treatments using virtual reality environments. One of the advantages in using this technology is the potential to create positive motivation, by means of engaging environments and tasks shaped in the form of serious games. In this work, we propose a novel Neuro Rehabilitation System for children with movement disorders, that is based on serious games in immersive virtual reality with haptic feedback. The system design aims to enhance involvement and engagement of patients, to provide congruent multi-sensory afferent feedback during motor exercises, and to benefit from the flexibility of virtual reality in adapting exercises to the patient's needs. We present a feasibility study of the method conducted through an experimental rehabilitation session in a group of 4 children with Cerebral Palsy and Developmental Dyspraxia, 4 Typically Developing children and 4 healthy adults. Subjects and patients were able to accomplish the proposed rehabilitation session and average performance of the motor exercises in patients were lower, although comparable, to healthy subjects. Together with positive comments reported by children after the rehabilitation session, results are encouraging for application of the method in a prolonged rehabilitation treatment.

  9. Duality for discrete integrable systems

    International Nuclear Information System (INIS)

    Quispel, G R W; Capel, H W; Roberts, J A G

    2005-01-01

    A new class of discrete dynamical systems is introduced via a duality relation for discrete dynamical systems with a number of explicitly known integrals. The dual equation can be defined via the difference of an arbitrary linear combination of integrals and its upshifted version. We give an example of an integrable mapping with two parameters and four integrals leading to a (four-dimensional) dual mapping with four parameters and two integrals. We also consider a more general class of higher-dimensional mappings arising via a travelling-wave reduction from the (integrable) MKdV partial-difference equation. By differencing the trace of the monodromy matrix we obtain a class of novel dual mappings which is shown to be integrable as level-set-dependent versions of the original ones

  10. A direct comparison of local-global integration in autism and other developmental disorders: implications for the central coherence hypothesis.

    Science.gov (United States)

    Bernardino, Inês; Mouga, Susana; Almeida, Joana; van Asselen, Marieke; Oliveira, Guiomar; Castelo-Branco, Miguel

    2012-01-01

    The weak central coherence hypothesis represents one of the current explanatory models in Autism Spectrum Disorders (ASD). Several experimental paradigms based on hierarchical figures have been used to test this controversial account. We addressed this hypothesis by testing central coherence in ASD (n = 19 with intellectual disability and n = 20 without intellectual disability), Williams syndrome (WS, n = 18), matched controls with intellectual disability (n = 20) and chronological age-matched controls (n = 20). We predicted that central coherence should be most impaired in ASD for the weak central coherence account to hold true. An alternative account includes dorsal stream dysfunction which dominates in WS. Central coherence was first measured by requiring subjects to perform local/global preference judgments using hierarchical figures under 6 different experimental settings (memory and perception tasks with 3 distinct geometries with and without local/global manipulations). We replicated these experiments under 4 additional conditions (memory/perception*local/global) in which subjects reported the correct local or global configurations. Finally, we used a visuoconstructive task to measure local/global perceptual interference. WS participants were the most impaired in central coherence whereas ASD participants showed a pattern of coherence loss found in other studies only in four task conditions favoring local analysis but it tended to disappear when matching for intellectual disability. We conclude that abnormal central coherence does not provide a comprehensive explanation of ASD deficits and is more prominent in populations, namely WS, characterized by strongly impaired dorsal stream functioning and other phenotypic traits that contrast with the autistic phenotype. Taken together these findings suggest that other mechanisms such as dorsal stream deficits (largest in WS) may underlie impaired central coherence.

  11. A direct comparison of local-global integration in autism and other developmental disorders: implications for the central coherence hypothesis.

    Directory of Open Access Journals (Sweden)

    Inês Bernardino

    Full Text Available The weak central coherence hypothesis represents one of the current explanatory models in Autism Spectrum Disorders (ASD. Several experimental paradigms based on hierarchical figures have been used to test this controversial account. We addressed this hypothesis by testing central coherence in ASD (n = 19 with intellectual disability and n = 20 without intellectual disability, Williams syndrome (WS, n = 18, matched controls with intellectual disability (n = 20 and chronological age-matched controls (n = 20. We predicted that central coherence should be most impaired in ASD for the weak central coherence account to hold true. An alternative account includes dorsal stream dysfunction which dominates in WS. Central coherence was first measured by requiring subjects to perform local/global preference judgments using hierarchical figures under 6 different experimental settings (memory and perception tasks with 3 distinct geometries with and without local/global manipulations. We replicated these experiments under 4 additional conditions (memory/perception*local/global in which subjects reported the correct local or global configurations. Finally, we used a visuoconstructive task to measure local/global perceptual interference. WS participants were the most impaired in central coherence whereas ASD participants showed a pattern of coherence loss found in other studies only in four task conditions favoring local analysis but it tended to disappear when matching for intellectual disability. We conclude that abnormal central coherence does not provide a comprehensive explanation of ASD deficits and is more prominent in populations, namely WS, characterized by strongly impaired dorsal stream functioning and other phenotypic traits that contrast with the autistic phenotype. Taken together these findings suggest that other mechanisms such as dorsal stream deficits (largest in WS may underlie impaired central coherence.

  12. A pilot integrative genomics study of GABA and glutamate neurotransmitter systems in suicide, suicidal behavior, and major depressive disorder.

    Science.gov (United States)

    Yin, Honglei; Pantazatos, Spiro P; Galfalvy, Hanga; Huang, Yung-Yu; Rosoklija, Gorazd B; Dwork, Andrew J; Burke, Ainsley; Arango, Victoria; Oquendo, Maria A; Mann, John J

    2016-04-01

    Gamma-amino butyric acid (GABA) and glutamate are the major inhibitory and excitatory neurotransmitters in the mammalian central nervous system, respectively, and have been associated with suicidal behavior and major depressive disorder (MDD). We examined the relationship between genotype, brain transcriptome, and MDD/suicide for 24 genes involved in GABAergic and glutamatergic signaling. In part 1 of the study, 119 candidate SNPs in 24 genes (4 transporters, 4 enzymes, and 16 receptors) were tested for associations with MDD and suicidal behavior in 276 live participants (86 nonfatal suicide attempters with MDD and 190 non-attempters of whom 70% had MDD) and 209 postmortem cases (121 suicide deaths of whom 62% had MDD and 88 sudden death from other causes of whom 11% had MDD) using logistic regression adjusting for sex and age. In part 2, RNA-seq was used to assay isoform-level expression in dorsolateral prefrontal cortex of 59 postmortem samples (21 with MDD and suicide, 9 MDD without suicide, and 29 sudden death non-suicides and no psychiatric illness) using robust regression adjusting for sex, age, and RIN score. In part 3, SNPs with subthreshold (uncorrected) significance levels below 0.05 for an association with suicidal behavior and/or MDD in part 1 were tested for eQTL effects in prefrontal cortex using the Brain eQTL Almanac (www.braineac.org). No SNPs or transcripts were significant after adjustment for multiple comparisons. However, a protein coding transcript (ENST00000414552) of the GABA A receptor, gamma 2 (GABRG2) had lower brain expression postmortem in suicide (P = 0.01) and evidence for association with suicide death (P = 0.03) in a SNP that may be an eQTL in prefrontal cortex (rs424740, P = 0.02). These preliminary results implicate GABRG2 in suicide and warrant further investigation and replication in larger samples. © 2016 Wiley Periodicals, Inc.

  13. Dual Orlicz geominimal surface area

    Directory of Open Access Journals (Sweden)

    Tongyi Ma

    2016-02-01

    Full Text Available Abstract The L p $L_{p}$ -geominimal surface area was introduced by Lutwak in 1996, which extended the important concept of the geominimal surface area. Recently, Wang and Qi defined the p-dual geominimal surface area, which belongs to the dual Brunn-Minkowski theory. In this paper, based on the concept of the dual Orlicz mixed volume, we extend the dual geominimal surface area to the Orlicz version and give its properties. In addition, the isoperimetric inequality, a Blaschke-Santaló type inequality, and the monotonicity inequality for the dual Orlicz geominimal surface areas are established.

  14. Dual modality densitometry

    International Nuclear Information System (INIS)

    Tjugum, Stein-Arild

    2003-01-01

    Different measurement principles and design issues for gamma-ray densitometry for pipe flow are investigated. The dual modality densitometry (DMD) principle for salinity measurement and flow regime identification by multibeam densitometry are tested and verified. The measurement principles are implemented in a compact instrument design with low energy source and compact detectors. The DMD principle is experimentally verified for 3 inch and 2 inch pipes. These measurements are done on homogenous brine/gas mixtures. Both salinity independent GVF measurements and salinity measurements are obtained. The standard deviation of the salinity measurements are about 2 percent. This measurement inaccuracy is mainly caused by inhomogeneity in the liquid/gas distribution, and measurements are thus sensitive to changes in the flow regime. Models for the generation of scattered radiation are developed, and these have been used in the data-analysis and for producing special sensitivity maps for the generation of scattered radiation. The models are a useful tool for further development of the DMD principle. The work on multibeam gamma-ray densitometry has shown that flow regimes can be identified with as few as two detectors. This is verified in the flow-loop tests. Unambiguous flow regime identification will often require that the multibeam measurements are combined with other flow measurements. With a higher number of detectors more detailed information is found, and from the 9-beam measurements with the University of Bergen (UoB) gamma-ray tomography different flow regimes could clearly be identified from time series plots of the data. A laboratory prototype compact gamma-ray densitometer, the MiniGamma, has been built up and tested. Both the DMD measurement principle and the multibeam arrangement for flow regime identification are implemented in the instrument, and are successfully tested. The detector-types tested are CdZnTe semiconductor detectors, a miniature scintillation

  15. The mean and the individual: Integrating variable-centered and person-centered analyses of cognitive recovery in patients with substance use disorders

    Directory of Open Access Journals (Sweden)

    Marsha E. Bates

    2013-12-01

    Full Text Available Neuropsychological and cognitive deficits are observed in the majority of persons with alcohol and drug use disorders and may interfere with treatment processes and outcomes. Although, on average, the brain and cognition improve with abstinence or markedly reduced substance use, better understanding of the heterogeneity in the time-course and extent of cognitive recovery at the individual level is useful to promote bench-to-bedside translation and inform clinical decision making. This study integrated a variable-centered and a person-centered approach to characterize diversity in cognitive recovery in 197 patients in treatment for a substance use disorder. We assessed executive function, verbal ability, memory, and complex information processing speed at treatment entry, and then 6, 26, and 52 weeks later. Structural equation modeling was used to define underlying ability constructs and determine the mean level of cognitive changes in the sample while minimizing measurement error and practice effects on specific tests. Individual-level empirical growth plots of latent factor scores were used to explore prototypical trajectories of cognitive change. At the level of the mean, small to medium effect size gains in cognitive abilities were observed over one year. At the level of the individual, the mean trajectory of change was also the modal individual recovery trajectory shown by about half the sample. Other prototypical cognitive change trajectories observed in all four cognitive domains included Delayed Gain, Loss of Gain, and Continuous Gain. Together these trajectories encompassed between 86% and 94% of individual growth plots across the four latent abilities. Further research is needed to replicate and predict trajectory membership. Replication of the present findings would have useful implications for targeted treatment planning and the new cognitive interventions being developed to enhance treatment outcomes.

  16. Dual Campus High School

    Directory of Open Access Journals (Sweden)

    Carmen P. Mombourquette

    2013-04-01

    Full Text Available September 2010 witnessed the opening of the first complete dual campus high school in Alberta. Catholic Central High School, which had been in existence since 1967 in one building, now offered courses to students on two campuses. The “dual campus” philosophy was adopted so as to ensure maximum program flexibility for students. The philosophy, however, was destined to affect student engagement and staff efficacy as the change in organizational structure, campus locations, and course availability was dramatic. Changing school organizational structure also had the potential of affecting student achievement. A mixed-methods study utilizing engagement surveys, efficacy scales, and interviews with students and teachers was used to ascertain the degree of impact. The results of the study showed that minimal impact occurred to levels of student engagement, minor negative impact to staff efficacy, and a slight increase to student achievement results.

  17. IAEA's dual function

    International Nuclear Information System (INIS)

    1967-01-01

    'A factor of paramount importance is the dual nature of atomic energy, which is reflected in the dual function of the Agency; not only to promote, but also to safeguard the peaceful uses of atomic energy'. In taking the above statement as a theme in his address to the 1474th Plenary Meeting of the United Nations General Assembly (22nd November), the Director General, Dr. Sigvard Eklund, went on to speak of a few of the many areas in which society was feeling the impact of atomic energy. During the discussion which followed his report on the Agency's work nearly all speakers referred to the importance of the safeguards system as well as to positive achievements in developing nuclear potential for peaceful purposes

  18. Dual double field theory

    Energy Technology Data Exchange (ETDEWEB)

    Bergshoeff, Eric A. [Centre for Theoretical Physics, University of Groningen,Nijenborgh 4, 9747 AG Groningen (Netherlands); Hohm, Olaf [Simons Center for Geometry and Physics, Stony Brook University,Stony Brook, NY 11794-3636 (United States); Penas, Victor A. [Centre for Theoretical Physics, University of Groningen,Nijenborgh 4, 9747 AG Groningen (Netherlands); Riccioni, Fabio [INFN - Sezione di Roma, Dipartimento di Fisica, Università di Roma “La Sapienza”,Piazzale Aldo Moro 2, 00185 Roma (Italy)

    2016-06-06

    We present the dual formulation of double field theory at the linearized level. This is a classically equivalent theory describing the duals of the dilaton, the Kalb-Ramond field and the graviton in a T-duality or O(D,D) covariant way. In agreement with previous proposals, the resulting theory encodes fields in mixed Young-tableau representations, combining them into an antisymmetric 4-tensor under O(D,D). In contrast to previous proposals, the theory also requires an antisymmetric 2-tensor and a singlet, which are not all pure gauge. The need for these additional fields is analogous to a similar phenomenon for “exotic' dualizations, and we clarify this by comparing with the dualizations of the component fields. We close with some speculative remarks on the significance of these observations for the full non-linear theory yet to be constructed.

  19. The effects of residential dual diagnosis treatment on alcohol abuse

    Science.gov (United States)

    Schoenthaler, Stephen J; Blum, Kenneth; Fried, Lyle; Oscar-Berman, Marlene; Giordano, John; Modestino, Edward J.; Badgaiyan, Rajendra

    2017-01-01

    This multi-center study of dual diagnosis (DD) programs involved 804 residential patients with co-occurring alcohol and mental health disorders. The Addiction Severity Index was administered at admission and at one, six, and 12 months after discharge. Repeated measures analysis showed the intoxication rate per month stabilized between months six and 12 with 68% still in remission and an 88% mean reduction from baseline (F = 519, p treatment of both disorders and explained their effectiveness. Co-occurring DSM IV mood disorders such as anxiety and depression as well as drug abuse involving opioids or cocaine fell between 66 and 95% at months one, six, and twelve. PMID:28868159

  20. Dual Vector Spaces and Physical Singularities

    Science.gov (United States)

    Rowlands, Peter

    Though we often refer to 3-D vector space as constructed from points, there is no mechanism from within its definition for doing this. In particular, space, on its own, cannot accommodate the singularities that we call fundamental particles. This requires a commutative combination of space as we know it with another 3-D vector space, which is dual to the first (in a physical sense). The combination of the two spaces generates a nilpotent quantum mechanics/quantum field theory, which incorporates exact supersymmetry and ultimately removes the anomalies due to self-interaction. Among the many natural consequences of the dual space formalism are half-integral spin for fermions, zitterbewegung, Berry phase and a zero norm Berwald-Moor metric for fermionic states.