Efficacy of group psychotherapy for social anxiety disorder: A meta-analysis of randomized-controlled trials

Group psychotherapy for social anxiety disorder (SAD) is an established treatment supported by findings from primary studies and earlier meta-analyses. However, a comprehensive summary of the recent evidence is still pending. This meta-analysis investigates the efficacy of group psychotherapy for adult patients with SAD. A literature search identified 36 randomized-controlled trials examining 2171 patients. Available studies used mainly cognitive-behavioral group therapies (CBGT); therefore, quantitative analyses were done for CBGT. Medium to large positive effects emerged for wait list-controlled trials for specific symptomatology: g = 0.84, 95% CI [0.72; 0.97] and general psychopathology: g = 0.62, 95% CI [0.36; 0.89]. Group psychotherapy was also superior to common factor control conditions in alleviating symptoms of SAD, but not in improving general psychopathology. No differences appeared for direct comparisons of group psychotherapy and individual psychotherapy or pharmacotherapy. Hence, group psychotherapy for SAD is an efficacious treatment, equivalent to other treatment formats.     

液化气扩散火焰的分形结构特征

基于图像处理方法和分型理论研究了液化气扩散火焰边缘分形结构特征。沿火焰轴向将火焰均分为5个区域,研究火焰边缘分形维数沿火焰轴向的变化,通过改变中心通道氧气速度,研究火焰长度、分形维数与过氧系数的关系。研究结果表明：随着过氧系数的增大,火焰长度逐渐缩短;火焰波动范围也减小,从喷嘴到火焰末端分形维数先减小后增大,并且变化范围不大。     

他克莫司制剂临床换用的安全性考虑

他克莫司是一种强效的免疫抑制剂,但治疗指数窄,个体变异大,剂量或者浓度的微小改变就有可能导致不良反应甚至治疗失败。目前,生物等效性研究的常规可接受范围、研究人群及考察指标等并不完全适用于他克莫司等治疗指数狭窄药物,导致批准上市的他克莫司仿制药与原研药可能不具有临床上的治疗等效性。因此临床治疗中随意换用他克莫司制剂存在一定的风险,需要临床医生谨慎决策。     

An evaluation of the measurement equivalence of the Childhood Trauma Questionnaire--Short Form across gender and race in a sample of drug-abusing adults

OBJECTIVE: A number of practice guidelines and recommendations call for an assessment of childhood abuse history among adult medical patients. The cultural sensitivity of screening instruments, however, has not been examined. High rates of childhood abuse history have been reported among adults who abuse substances. The objective of this study was to investigate the measurement invariance of the Childhood Trauma Questionnaire--Short Form (CTQ-SF) across groups defined by gender and race in a sample of substance-abusing adults. METHODS: This study performed a cross-sectional survey of 693 active intravenous drug abusers from San Antonio, TX. Structural equation modeling methods were used to evaluate the measurement invariance of the CTQ-SF between male and female subjects and between Black and Hispanic subjects. RESULTS: Evidence was found for the invariance of the five-factor structure of the CTQ-SF across groups and for a partial invariance model at the item level. Consistent with study hypotheses, two items that referred to "abuse," using the actual word, were more likely to be endorsed by women than by men, even after controlling for responses on similar items. In addition, compared to Hispanics, Blacks tended to report having been "punished with hard objects" at higher rates than expected from their responses on other items related to physical abuse. CONCLUSION: The amount of bias from nonmeasurement invariance in the CTQ-SF across groups was minimal at the total scale score level. Clinically, however, individual questions that use broad labeling terms are more likely to identify women as having a history of abuse, and individual questions that blend the constructs of physical discipline and physical abuse may overidentify Black Americans as having a history of abuse.     

Negative affectivity and social inhibition in cardiovascular disease: evaluating type-D personality and its assessment using item response theory

OBJECTIVE: Individuals with increased levels of both negative affectivity (NA) and social inhibition (SI)-referred to as type-D personality-are at increased risk of adverse cardiac events. We used item response theory (IRT) to evaluate NA, SI, and type-D personality as measured by the DS14. The objectives of this study were (a) to evaluate the relative contribution of individual items to the measurement precision at the cutoff to distinguish type-D from non-type-D personality and (b) to investigate the comparability of NA, SI, and type-D constructs across the general population and clinical populations. METHODS: Data from representative samples including 1316 respondents from the general population, 427 respondents diagnosed with coronary heart disease, and 732 persons suffering from hypertension were analyzed using the graded response IRT model. RESULTS: In Study 1, the information functions obtained in the IRT analysis showed that (a) all items had highest measurement precision around the cutoff and (b) items are most informative at the higher end of the scale. In Study 2, the IRT analysis showed that measurements were fairly comparable across the general population and clinical populations. CONCLUSIONS: The DS14 adequately measures NA and SI, with highest reliability in the trait range around the cutoff. The DS14 is a valid instrument to assess and compare type-D personality across clinical groups.     

Development of a monoclonal antibody binding okadaic acid and dinophysistoxins-1, -2 in proportion to their toxicity equivalence factors

Okadaic acid (OA) and structurally related toxins dinophysistoxin-1 (DTX-1), and DTX-2, are lipophilic marine biotoxins. The current reference method for the analysis of these toxins is the mouse bioassay (MBA). This method is under increasing criticism both from an ethical point of view and because of its limited sensitivity and specificity. Alternative replacement methods must be rapid, robust, cost effective, specific and sensitive. Although published immuno-based detection techniques have good sensitivities, they are restricted in their use because of their inability to: (i) detect all of the OA toxins that contribute to contamination; and (ii) factor in the relative toxicities of each contaminant. Monoclonal antibodies (MAbs) were produced to OA and an automated biosensor screening assay developed and compared with ELISA techniques. The screening assay was designed to increase the probability of identifying a MAb capable of detecting all OA toxins. The result was the generation of a unique MAb which not only cross-reacted with both DTX-1 and DTX-2 but had a cross-reactivity profile in buffer that reflected exactly the intrinsic toxic potency of the OA group of toxins. Preliminary matrix studies reflected these results. This antibody is an excellent candidate for the development of a range of functional immunochemical-based detection assays for this group of toxins.     

IL15 gene variants are not associated with asthma and atopy

Background:  Interleukin 15 (IL15) promotes activation and proliferation of CD8+ T cells and enhances the differentiation into Th2 cells. A previous study described five polymorphisms in the IL15 gene to be associated with asthma in a haplotype analysis.
Aim:  We selected HapMap tagging single nucleotide polymorphisms (SNPs) from IL15 to systematically investigate these IL15 associations in a large population-based sample.
Methods:  Genotyping of seven IL15 SNPs was performed using MALDI-TOF MS in a cross-sectional study population of 3099 children from Dresden or Munich (age 9–11 years). All children were phenotyped by standardized and validated protocols for atopic phenotypes. Effects of single SNPs and haplotypes were studied using sas 9.1.3 and haploview . Equivalence tests were performed to prove the significance of negative results.
Results:  Neither single IL15 polymorphisms nor haplotype analyses showed associations with asthma or atopy after correction for multiple testing.
Conclusion:  These results do not confirm previous case–control studies and suggest that IL15 gene variants do not play an important role in the development for asthma or other atopic disorders.     

The Cerebellum Is Involved in Reward-based Reversal Learning

The cerebellum has recently been discussed in terms of a possible involvement in reward-based associative learning. To clarify the cerebellar contribution, eight patients with focal vascular lesions of the cerebellum and a group of 24 healthy subjects matched for age and IQ were compared on a range of different probabilistic outcome-based associative learning tasks, assessing acquisition, reversal, cognitive transfer, and generalization as well as the effect of reward magnitude. Cerebellar patients showed intact acquisition of stimulus contingencies, while reward-based reversal learning was significantly impaired. In addition, the patients showed slower acquisition of new stimulus contingencies in a second reward-based learning task, which might reflect reduced carry-over effects. Reward magnitude affected learning only during initial acquisition, with better learning on trials with high rewards in patients and control subjects. Overall, the findings suggest that the cerebellum is implicated in reversal learning as a dissociable component of reward-based learning.     

Biological activity of two botulinum toxin type A complexes (Dysport® and Botox®) in volunteers

Despite extensive clinical experience and published data regarding botulinum toxin, questions remain about the clinical substitution of one botulinum toxin formulation for another. In the case of Dysport and Botox, dose-equivalence ratios ranging from 1:1 to 6:1 (Dysport:Botox) have been advocated. This dose-ranging, electroneurographic study investigated the dose equivalence, diffusion characteristics (spread) and safety of these two type-A toxins in 79 volunteers. Dysport and Botox caused significant and similar reductions in compound muscle action potential (CMAP) amplitude in the target muscle (extensor digitorum brevis, EDB) 2 weeks after injection, with effects persisting to the 12-week timepoint. For both products, the reduction in amplitude was increased with increasing doses and with increasing concentration. The effects of toxin on neighbouring muscles were much smaller and of a shorter duration than those on the target muscle, implying a modest spread of toxin. Unlike the target muscle, the effects were greater with the higher volume, suggesting this volume led to greater diffusion from the EDB. No adverse events were reported. Statistical modelling with CMAP amplitude data from the target muscle gave a bioequivalence of 1.57 units of Dysport:1 unit of Botox (95 % CI: 0.77-3.20 units). The data indicate that a dose-equivalence ratio of 3:1 was within the statistical error limits, but ratios over 3:1 are too high.     

Solvent/detergent treatment does not alter the tolerance or uptake of human normal immunoglobulin for intramuscular injection

BACKGROUND AND OBJECTIVES: The tolerability and pharmacokinetics of a solvent/detergent-treated intramuscular immunoglobulin were compared with those of the standard product. MATERIALS AND METHODS: Single, 750-mg intramuscular (i.m.) injections were administered to a total of 36 healthy individuals: 23 in a double-blind trial and 13 in an open trial. Changes in specific serum hepatitis A and hepatitis B antibodies were monitored for a period of up to 3 months postinjection. RESULTS: No serious adverse reactions were reported, and the bioavailability of the solvent/detergent-treated preparation was equivalent to that of the standard i.m. immunoglobulin. CONCLUSION: There is no evidence that solvent/detergent treatment alters the pharmacokinetics or tolerance of human normal immunoglobulin, but it offers additional assurance against potential virus transmission.