Archaeosomes facilitate storage and oral delivery of cannabidiol.

Cannabidiol (CBD) has received great scientific interest due to its numerous therapeutic applications. Degradation in the gastrointestinal (GI) tract, first-pass metabolism, and low water solubility restrain bioavailability of CBD to only 6% in current oral administration. Lipid-based nanocarriers are delivery systems that may enhance accessibility and solubility of hydrophobic payloads, such as CBD. Conventional lecithin-derived liposomes, however, have limitations regarding stability in the GI tract and long-term storage. Ether lipid-based archaeosomes may have the potential to overcome these problems due to chemical and structural uniqueness. In this study, we compared lecithin-derived liposomes with archaeosomes in their applicability as an oral delivery system of CBD. We evaluated drug load, storage stability, stability in a simulated GI tract, and in vitro particle uptake in Caco-2 cells. Loading capacity was 6-fold higher in archaeosomes than conventional liposomes while providing a stable formulation over six months after lyophilization. In a simulated GI tract, CBD recovery in archaeosomes was 57 ± 3% compared to only 34 ± 1% in conventional liposomes and particle uptake in Caco-2 cells was enhanced up to 6-fold. Our results demonstrate that archaeosomes present an interesting solution to tackle current issues of oral CBD formulations due to improved stability and endocytosis.

Traumatized German soldiers with moral injury - value-based cognitive-behavioral group therapy to treat war-related shame.

Introduction: During deployment, soldiers are confronted with potentially morally injurious events. In many cases, these events violate their personal values and belief systems, resulting in feelings of anger, alienation, guilt, and shame. The psychological distress caused by such transgressions is defined as moral injury. It remains unclear to date, which therapeutic interventions are most appropriate for addressing this specific psychological condition. This study examines the effectiveness of value-based cognitive-behavioral group therapy combining elements of cognitive-behavioral therapy, acceptance and commitment therapy, spiritual care, and adaptive disclosure therapy. Materials and methods: This controlled study uses the Compass of Shame Scale to assess symptom severity among participants both before and after a three-week inpatient group therapy regimen for moral injury. An intervention group (n = 45) was compared to a waiting-list control group (n = 40). A one-way between subjects ANOVA was conducted to determine the differences between the two measurement points in the intervention group compared to the control group. A positive ethics vote from the Humboldt University Berlin (Charité) was available (No.EA1/092/15). Results: A significant difference was found on the shame-associated maladaptive strategies subscales of attack self (F (1, 83) = 5.942, p = 0.017, Cohen's f = 0,27), withdrawal (F (1, 83) = 8.263, p = 0.005, Cohen's f = 0,32), and attack others (F (1, 83) = 10.552, p = 0.002, Cohen's f = 0,36) of the Compass of Shame Scale between the intervention group and the control group at the p < 0.05 level in the pre- and post-treatment (t1-t2) comparison. Conclusion: This study suggests that the special therapeutic focus in cognitive-behavioral group therapy can alter shame-based maladaptive coping behaviors in response to war-related moral injury. This study provides further evidence that therapeutic approaches - through fostering a reconciliatory, compassionate, and forgiving approach toward oneself and others - target the underlying mechanisms of moral injury. Therefore, value-based cognitive-behavioral interventions should be considered as a standard element of trauma care in a military setting. Future studies should further examine such interventions in randomized control trials. It would also be particularly valuable for future studies to include a follow-up time point.

Personality traits and alcohol consumption: Secondary analysis of the Self-Match Study.

BACKGROUND: This secondary analysis of the Self-Match Study explores whether personality traits affect the treatment outcome for alcohol use disorders (AUD). We designed the Self-Match Study to investigate whether clients choosing between treatment options improves treatment outcomes. The primary outcome report revealed no difference in the outcome, whether treatment allocation was based on clinician matching or self-matching. Because willingness to choose, choice of treatment method, and compliance with treatment may be related to personality, this exploratory sub-study investigated the influence of personality traits on treatment outcome. METHOD: We enrolled 402 consecutive clients (female 46.7%, mean age 47.4) seeking treatment at the outpatient alcohol treatment center in Odense, Denmark. Clients were randomized to treatment by expert-match or self-matching. Data on alcohol consumption (Timeline Follow Back), personality traits (NEO-FFI-3), and retention in care were collected at baseline and 6-month follow-up. Outcomes were compliance, sensible drinking (alcohol intake below National Recommendations), and the number of heavy drinking days at follow-up. RESULTS: A high neuroticism score was negatively associated with treatment completion. Further, clients with a high score on neuroticism, openness, and extraversion, or a low score on conscientiousness were less likely to reduce their drinking to a sensible level at follow-up. We also found that low scores on conscientiousness were associated with having more heavy drinking days at follow-up. The personality traits neuroticism and openness were associated with treatment preferences. CONCLUSIONS: Personality traits influence 6 months drinking outcomes for people receiving AUD treatment.

Equine-assisted psychotherapy with traumatized couples-Improvement of relationship quality and psychological symptoms.

Many traumatised individuals suffering from deployment related PTSD report severe problems in their relationships. Up until now, the therapeutic interventions used by the German Armed Forces have rarely targeted these problems through the integration of partners. For this reason, a Program designed specifically for couples was developed. In this prospective study equine-assisted psychotherapy was applied to soldiers and their spouses. The study population consisted of n = 36 couples, divided in n = 20 therapy group with a inpatient equine-assisted intervention and a 16-couples control group. After the intervention, numerous significant improvements occurred in the therapy group in the areas of current, somatic and communication problems, depressive symptoms and partnership quality but not in the control group. PTSD was reduced significantly on the sub-scale associated with negative thoughts. These results show that the intervention is an effective way to improve partnership quality and reduce the stressors that the partners of afflicted service members face.

The impact of LuxF on light intensity in bacterial bioluminescence.

The enzymes involved in bacterial bioluminescence are encoded in the lux operon with a conserved gene order of luxCDABEG. Some photobacterial strains carry an additional gene, termed luxF, which produces the LuxF protein, whose function and influence on bacterial bioluminescence is still uncertain. The LuxF protein binds the flavin derivative 6-(3'-(R)-myristyl)-flavin mononucleotide (myrFMN), which is generated as a side product in the luciferase-catalyzed reaction. This study utilized an Escherichia coli (E. coli) based lux operon expression system where the lux operons of Photobacterium leiognathi subsp. mandapamensis 27561 or of Photobacterium leiognathi subsp. leiognathi 25521, namely luxCDAB(F)EG, were cloned into a single expression vector. Exclusion of luxF gene from the lux operon enabled novel insights into the role of LuxF protein in light emission. E. coli cultures harboring and expressing the genes of the lux operon including luxF gene emit more light than without luxF gene. Furthermore, isolation of the tightly bound flavin derivative revealed the presence of at least three different flavin derivatives. Analysis by UV/Vis absorption and NMR spectroscopy as well as mass spectrometry showed that the flavin derivatives bear fatty acids of various chain lengths. This distribution of FMN derivatives is vastly different to what was found in bioluminescent bacteria and indicates that the luciferase is supplied with a range of aldehyde substrates in E. coli.

Effectiveness of Eye Movement Desensitization and Reprocessing in German Armed Forces Soldiers With Post-Traumatic Stress Disorder Under Routine Inpatient Care Conditions.

BACKGROUND: Post-traumatic stress disorder (PTSD) is one of the more commonly occurring mental disorders following potentially traumatizing events soldiers may encounter when deployed abroad. One of the first-line recommended treatment options is eye movement desensitization and reprocessing (EMDR). The number of studies assessing the effectiveness of EMDR in German soldiers under routine conditions is currently almost nil. METHODS: A retrospective, quasi-experimental effectiveness study on EMDR in an inpatient setting is presented using a prepost design. The study compares symptom reduction in soldiers (N = 78) with a wait-list (N = 18). Effect sizes of EMDR were measured for PTSD, symptoms of depression, and general mental health. RESULTS: Effect size for EMDR treatment of PTSD was d = 0.77; 95% confidence interval (CI): 0.51 to 1.36, for symptoms of depression d = 0.99; 95% CI: 0.31 to 1.36, and for general psychiatric symptoms d = 0.53; 95% CI: 0.17 to 1.21. The effects resulting from EMDR treatment were somewhat weaker than those reported in comparable studies in civilians. CONCLUSION: EMDR therapy is an effective treatment to reduce symptoms of PTSD and depression. However, in the military context it needs to be complemented by treatment options that specifically address further conditions perpetuating the disorders.

All-or-nothing thinking: The processing of emotional expressions in traumatized post-deployment soldiers.

The exposure to trauma is a dramatic life event with complex consequences among those like changes in information processing. Dysfunctional cognitions like a negative interpretation of information are a risk factor for the development of trauma-related disorders. The aim of the present study was to test whether post-deployment soldiers with trauma differ in their interpretation of emotional expressions from member of a control group. Interpretation of emotional expressions was assessed in a sample of 106 males (n=53 soldiers, n=53 controls) with the Similarity Rating Task (simtask) and analyzed with a multidimensional scaling (MDS) approach. The findings suggest that individuals with war-related trauma tend to show a negative interpretation bias. Furthermore, traumatized individuals did not discriminate between different intensities of emotional expressions the way controls did. The findings are discussed in terms of the role of dysfunctional cognitions in the development and treatment of mental disorders.

Guilt, Shame and Compassionate Imagery in War: Traumatized German Soldiers with PTSD, a Pilot Study.

BACKGROUND: The consideration of specific trauma-associated emotions poses a challenge for the differential treatment planning in trauma therapy. Soldiers experiencing deployment-related posttraumatic stress disorder often struggle with emotions of guilt and shame as a central component of their PTSD. OBJECTIVE: The purpose of this study was to examine the extent to which soldiers' PTSD symptoms and their trauma-related guilt and shame may be affected as a function of their ability to develop compassionate imagery between their CURRENT SELF (today) and their TRAUMATIZED SELF (back then). METHOD: The sample comprised 24 male German soldiers diagnosed with PTSD who were examined on the Posttraumatic Diagnostic Scale (PDS) and two additional measures: the Emotional Distress Inventory (EIBE) and the Quality of Interaction between the CURRENT SELF and the TRAUMATIZED SELF (QUI-HD: Qualität der Interaktion zwischen HEUTIGEN ICH und DAMALIGEN ICH) at pre- and post-treatment and again at follow-up. The treatment used was imagery rescripting and reprocessing therapy (IRRT). RESULTS: Eighteen of the 24 soldiers showed significant improvement in their PTSD symptoms at post-treatment and at follow-up (on their reliable change index). A significant change in trauma-associated guilt and shame emerged when compassionate imagery was developed towards one's TRAUMATIZED SELF. The degree and intensity of the guilt and shame felt at the beginning of treatment and the degree of compassionate imagery developed toward the TRAUMATIZED SELF were predictors for change on the PDS scores. CONCLUSIONS: For soldiers suffering from specific war-related trauma involving PTSD, the use of self-nurturing, compassionate imagery that fosters reconciling with the traumatized part of the self can effectively diminish trauma-related symptoms, especially when guilt and shame are central emotions.

[Mental disorders in German soldiers after deployment - impact of personal values and resilience]. / Zusammenhänge zwischen Psychischer Symptomatik und Persönlichen Werten bei Bundeswehrsoldaten nach einem Auslandseinsatz.

OBJECTIVE: Soldiers are at increased risk of developing mental health disorders after military deployment. The impact of personal values on psychological symptomatology based on an empirical working model has not yet been studied in a military environment. METHODS: 117 German Armed Forces soldiers completed the Portrait-Values-Questionnaire (PVQ), the Patient-Health-Questionnaire (PHQ) and the Resilience-Scale (RS-11) after their deployment to Afghanistan. RESULTS: In the regression analyses the values hedonism, benevolence, tradition, self-direction and universalism had a differential significant impact on depression, anxiety and somatoform symptoms of the PHQ. The RS-11 sum scale values were negatively correlated with symptomatology. CONCLUSION: Personal values and resilience seem to be associated with psychological symptomatology in soldiers after military deployment. The results can contribute to the further development of both preventive and therapeutic approaches.

Treatment of avoidant personality traits in a German armed forces inpatient psychiatric setting.

Military duty places high demands on the soldiers' social adaptability and competences. Avoidant personality traits can lead to interpersonal conflicts and at least to mental disorders. 192 German Armed Forces soldiers were treated in a multimodal inpatient psychiatric treatment setting at a Bundeswehr hospital between 2007 and 2010. 129 of these patients received a social skills group training (group training of social competence [GSC]) as part of this setting. A comparison group (n=63) did not participate but got unspecific treatment elements instead. The Symptom Checklist 90-Revised (SCL-90-R) and the Inventory on Competence and Control Beliefs (Fragebogen zu Kompetenz- und Kontrollüberzeugungen [FKK]) were applied. Symptom severity in the SCL-Global Severity Index, sum scale of the SCL-90-R and the four primary scales of the FKK showed significant improvements both immediately after treatment and at follow-up. No significant influence of the form of treatment (with/without GSC), age, gender, diagnosis, and deployments on the treatment result was established in the analysis of covariance. The data suggest that an inpatient psychiatric treatment setting focused on avoidant personality traits has a favorable effect on psychiatric symptom severity in military personnel. Social skills group training as a treatment component does not seem to be significantly superior to the standard setting.

Ureteral stents: coil strength and durometer.

OBJECTIVES: To evaluate the coil strength before and after urine exposure and the stiffness of commercially available double-J ureteral stents because both properties may affect stent performance and patient comfort. METHODS: Twelve commercially available 6F ureteral stents were tested for coil strength before and after 30 days of urine exposure. The proximal end of each stent was inserted through a 2-mm hole in bologna, allowed to recoil, and then pulled using a handheld force gauge. Ten different commercially available ureteral stent models were tested for tensile strength using an MTS MicroBionix Testing System and Testworks II software and a 5 N load cell. RESULTS: The Cook Black Silicone and Cook C-Flex stents had the strongest coil strengths before urine exposure at 0.480 +/- 0.0 lb (P < or = 0.0006) and were also the stents that had the greatest decrease in coil strength after urine exposure. After urine exposure, the weakest stent was the Applied Vertex stent at 0.088 +/- 0.008 lb (P < or = 0.02) and the strongest was the Cook Endo-Sof AQ at 0.223 +/- 0.014 lb (P < or = 0.03). Calculating the Young's modulus, E, the Cook C-Flex stent was the stiffest (E = 1472 +/- 196 KPa) and the Cook Black Silicone was the least stiff (E = 122 +/- 18 KPa). The stent models that demonstrated consistent E values across different lot numbers were the Circon Double J stent and Bard InLay. CONCLUSIONS: Ureteral stents can be differentiated according to their coil strength and stiffness. The impact of these properties on stent performance and patient comfort deserve additional evaluation. The significant variability found in stent stiffness among stents from different lot numbers suggests poor quality assurance in biomaterials or stent processing and increases the complexity of cross-stent comparisons.

In vitro evaluation of ureteral stent compression.

OBJECTIVES: To evaluate the force required to radially compress ureteral stents and the impact of compression on stent performance across a broad range of stent sizes and manufacturers. METHODS: Fourteen ureteral stents ranging in size from 6F to 10.3F were evaluated for radial compression using an MTS Micro Bionix Testing System using Testworks II software, 5N load cell, vibration isolation table, and socket set screws with rounded caps. Radial compression was exerted in 0.2-mm increments. Cycles of compression and a 100-second hold time were repeated for each stent to maximal compression. Three trials were completed for each stent. The Young's Modulus, E, was calculated from each trial using the engineering stress. Simultaneous flow data using normal saline were collected for the Amplatz stent. RESULTS: The Cook C-Flex (E = 30,355 +/- 910 Pa), Microvasive Percuflex Plus 6F (E = 28,973 +/- 250 Pa), Cook EndoSof (E = 28,403 +/- 471 Pa), and Fossa Open Lumen (E = 28,627 +/- 5,338) were the most resistant to compression and the Cook Amplatz 10.2F (E = 11,922 +/- 220 Pa) and Microvasive Percuflex Plus 10.3F (E = 8,247 +/- 286 Pa) were the least resistant to compression. Stress relaxation occurred similarly in all stents. Flow through the Cook Amplatz stent decreased at a rate of 5 mL/s/mm of compression linearly (R2 = 0.95). CONCLUSIONS: Stents resistant to radial compression are critical for function in the face of extrinsic ureteral obstruction. The Cook C-Flex ureteral stent resisted extrinsic compressive forces best. Although large-lumen stents are often used in this clinical situation, they were the most susceptible to compressive forces.