Transdiagnostic internet-delivered CBT and mindfulness-based treatment for depression and anxiety: A randomised controlled trial.

AIM: To examine the efficacy of transdiagnostic internet-delivered cognitive behavioural therapy (iCBT), mindfulness-enhanced iCBT, and stand-alone online mindfulness training compared with a usual care control group (TAU) for clinical anxiety and depression. METHOD: Individuals (N = 158) with a DSM-5 diagnosis of a depressive and/or anxiety disorder were randomised to one of the three clinician-guided online interventions, or TAU over a 14-week intervention period. The primary outcomes were self-reported depression (PHQ-9) and anxiety (GAD-7) severity at post-treatment. Secondary outcomes included adherence rates, functional impairment (WHODAS-II), general distress (K-10), and diagnostic status at the 3-month follow-up (intervention groups). RESULTS: All three programs achieved significant and large reductions in symptoms of depression (g = 0.89-1.53), anxiety (g = 1.04-1.40), and distress (g = 1.25-1.76); and medium to large reductions in functional impairment (g = 0.53-0.98) from baseline to post-treatment and 3-month follow-up. Intention-to-treat linear mixed models showed that all three online programs were superior to usual care at reducing symptoms of depression (g = 0.89-1.18) and anxiety (g = 1.00-1.23). CONCLUSION: Transdiagnostic iCBT, mindfulness-enhanced iCBT and online mindfulness training are more efficacious for treating depression and anxiety disorders than usual care, and represent an accessible treatment option for these disorders.

Magnetically retrievable Ce-doped Fe3O4 nanoparticles as scaffolds for the removal of azo dyes.

Considering the significant impact of magnetically retrievable nanostructures, herein, Fe3O4 and Ce-doped Fe3O4 nanoparticles were employed as scaffolds for the removal of the Reactive Black 5 (RB5) azo dye. We synthesized the Ce-doped Fe3O4 nanoparticles via hydrothermal treatment at 120 °C for 10 h with varying cerium concentrations (1.5-3.5%) and characterized them using basic techniques such as FTIR and UV-visible spectroscopy, and XRD analysis. The retention of their magnetic behaviors even after cerium amalgamation was demonstrated and confirmed by the VSM results. FESEM and EDX were used for the morphological and purity analysis of the synthesized nanoabsorbents. XPS was carried out to determine the electronic configuration of the synthesized samples. The porosity of the magnetic nanoparticles was investigated by BET analysis, and subsequently, the most porous sample was further used in the adsorption studies for the cleanup of RB5 from wastewater. The dye adsorption studies were probed via UV-visible spectroscopy, which indicated the removal efficiency of 87%. The prepared Ce-doped Fe3O4 nanoabsorbent showed the high adsorption capacity of 84.58 mg g-1 towards RB5 in 40 min. This is attributed to the electrostatic interactions between the nanoabsorbent and the dye molecules and high porosity of the prepared sample. The adsorption mechanism was also analyzed. The kinetic data well-fitted the pseudo-first-order model, and the adsorption capability at different equilibrium concentrations of the dye solution indicated monolayer formation and chemisorption phenomena. Furthermore, the magnetic absorbent could be rapidly separated from the wastewater using an external magnetic field after adsorption.

Anti-proliferate and apoptosis triggering potential of methotrexate-transferrin conjugate encapsulated PLGA nanoparticles with enhanced cellular uptake by high-affinity folate receptors.

The objective of the present study is to enhance the permeation of bioactive molecules across highly lipophilic insurmountable blood brain barrier (BBB) using folic acid (FA) functionalized poly(lactic-co-glycolic acid) (PLGA) nanoparticles (FA-PNPs) coated with non-ionic surfactant, Polysorbate 80 (P80). The developed Mtx-Tf loaded folic acid anchored PNPs formulation depicted particle size, zeta potential and entrapment efficiency of 109 ± 2.3 nm, -9.38 ± 0.9 mV and 71.0 ± 0.6%, respectively. In vitro release showed biphasic release pattern with initial >35% release in 8 h followed by sustained release, up to 65% by the end of 168 h. SRB cyto-toxicity assay depicted P80-Mtx-Tf-FA-PNPs possessing better cellular cyto-toxicity (C6 Glioma) as compared to counter test formulations, i.e. 100 µM nano-encapsulated drug-conjugate concentration incubated for 72 h resulted in apoptosis of ∼100% of the cellular population. Qualitatively, ∼85% of P80-FITC-FA-PNPs have been found to be internalized by C6 glioma cells post 5 h of incubation. Quantitative cellular uptake assay demonstrated a collinear dependence on drug-conjugate concentration. In vivo administration of P80-Mtx-Tf-FA-PNPs depicted significant decrease, i.e. 73.6% in the tumour spheroid volume. Serum analysis data pointed towards the significant relevance of P80-coated FA-PNPs in lowering the drug diffusion rate by 88.4% (after 30 min) and three-fold enhanced retention time of drug in systemic circulation, thereby felicitating an effective prognostic treatment. This study clearly demonstrated reduced systemic toxicity, enhanced biocompatibility and anti-tumour efficacy of formulated NPs.

Chitosan nanoparticles as a biocompatible and efficient nanowagon for benzyl isothiocyanate.

A plethora of evidences support the health benefits of a sulfur containing compound called Benzyl Isothiocyanate. However, its therapeutic application is limited due to its low solubility, poor stability and inadequate bioavailability. The problem has been worked upon and resolved by the synthesis of biodegradable nanoparticles using chitosan as the controlled delivery nanowagon. The prepared nanoparticles have been characterized using UV-visible absorption spectroscopy, IR spectroscopy, XRD, TGA, TEM and FE-SEM. Results reveal that loading of benzyl isothiocyanate into chitosan nanoparticles increases its solubility and stability. The maximum encapsulation efficiency was obtained to be 64.68±4.7% with slow and sustained release of 77.78% in 144h at pH5.5. Clear enhancement in the stability of benzyl isothiocyanate that is sensitive to ultraviolet light has been showcased after its encompassment in the cationic polymer. Further the biosafety of the fabricated system has been demonstrated by haemolysis and its interaction with biomolecules. The antimicrobial activity connotes that the prepared nanoparticles can act as a useful and safe carrier for the loading of benzyl isothiocyanate making it a promising formulation for biological applications in future.

Internet-based cognitive behavioral therapy versus psychoeducation control for illness anxiety disorder and somatic symptom disorder: A randomized controlled trial.

OBJECTIVE: To examine the efficacy of an Internet-delivered cognitive-behavioral therapy (iCBT) program for health anxiety compared to an active psychoeducation control group. METHOD: Individuals (N = 86, mean age: 30 years, 87% female) with a Diagnostic and Statistical Manual of Mental Disorders (5th ed.) diagnosis of illness anxiety disorder or somatic symptom disorder with health anxiety were randomized to either a 6-lesson clinician-guided iCBT program for health anxiety (n = 45) or an active control group who received anxiety psychoeducation, clinical support, and monitoring (control, n = 41) over a 12-week period. RESULTS: Both groups experienced significant improvements between baseline and posttreatment on self-report measures of health anxiety, depression, general anxiety, and functional impairment. Intention-to-treat analyses indicated that the iCBT group experienced greater improvements in health anxiety on the Short Health Anxiety Inventory (SHAI) compared to controls (between-groups effect size = 1.39, 95% confidence interval [0.87, 1.93]), and a greater proportion of the iCBT group showed clinically reliable change on the SHAI (84% vs. 34% in the control group). Similarly, the iCBT group outperformed the control group on secondary measures of depression, generalized anxiety, functional impairment, maladaptive cognitions, body hypervigilance, safety behaviors and avoidance, and intolerance of uncertainty. Gains were maintained at 3-month follow-up in the iCBT group. CONCLUSION: iCBT for health anxiety is more effective than psychoeducation, clinical support, and monitoring, and presents an efficacious and accessible treatment option for people with health anxiety. (PsycINFO Database Record

Encompassment of Benzyl Isothiocyanate in cyclodextrin using ultrasonication methodology to enhance its stability for biological applications.

The use of methodical and innovative sonication method has been explored for the fabrication of inclusion complex of Benzyl Isothiocyanate, a potential anticancer and -antimicrobial agent. The advancement involved investigation of inclusion behaviour, characterisation and an in-depth study of thermal and UV stability of Benzyl Isothiocyanate with cyclodextrins; ß-CD and hp-ß-CD. The sonication driven encompassment in cyclodextrins helped to overcome the hindrance of low solubility and high volatility. Investigations of physical and thermodynamic parameters using UV-visible spectroscopy, FTIR, XRD, TGA etc confirmed stability of inclusion complexes. Both ß-CD and hp-ß-CD based inclusion complexes retained the antimicrobial property of the free Benzyl Isothiocyanate, indicating their potential utility as antimicrobial agents. Haematological safety and cellular uptake data gives direction to in-depth analysis for its exploitation of anti-tumour activity.

Ultrasound processed nanoemulsion: A comparative approach between resveratrol and resveratrol cyclodextrin inclusion complex to study its binding interactions, antioxidant activity and UV light stability.

Resveratrol is a naturally occurring therapeutic molecule used for treatment of diseases caused by oxidative stress. This investigation elucidates the advantages of fabrication of size controlled resveratrol inclusion complex. This has been done by encapsulating resveratrol-cyclodextrin inclusion complex in a phospholipid stabilized nanoemulsion formulated by ultrasonication emulsification method. The prepared nanoemulsion has been compared with resveratrol encapsulated nanoemulsion system. The morphology of the resveratrol nanoemulsion and inclusion complex nanoemulsion have been observed using transmission electron microscopy with average size 20.41±3.41 and 24.48±5.70nm respectively. The nanoemulsion showed good loading and release efficiency. The radical diminishing potential of resveratrol and its inclusion complex has been compared in nanoemulsion. The effect of UV irradiation (365nm) on resveratrol in different solvent systems (ethanol, water and nanoemulsion) indicated that nanoemulsion prevents degradation of resveratrol. Efforts have also been made to explore the interactions between bovine serum albumin and resveratrol in nanoemulsion.

Physiochemical and cytotoxicity study of TPGS stabilized nanoemulsion designed by ultrasonication method.

The main aim of the present work was to prepare TPGS stabilized D-α-Tocopherol, lemon oil, tween-80, and water nanoemulsion by low cost and highly effective sonication method. The prepared nanoemulsion showed good stability for 60days at variable temperature conditions i.e. 4, 25 and 37°C. The tolerance of the prepared nanoemulsion to salt (50mM-500mM) and pH (pH 2-pH 7.4) was also studied. The morphology and droplet size of pure and quinine loaded nanoemulsion was characterized with transmission electron microscopy. The prepared formulation was transparent and the obtained average particle size ranged between 25nm and 35nm. The nanoemulsion was found to be non toxic. The cell viability study of pure nanoemulsion carried out on Hep G2 cells revealed that the cell viability was 100%. The formulation further exhibited high quinine loading and release capacity with cumulative release up to 76±2% and 65±2% at pH 7.4 and pH 5.5 respectively. The interaction between quinine and vitamins (riboflavin, thiamine and biotin) was also carried out (aqueous medium). The study revealed that riboflavin had strong interaction with quinine and vitamins vis-à-vis thiamine and biotin.

Pilot trial of a therapist-supported internet-delivered cognitive behavioural therapy program for health anxiety.

Cognitive behavioural therapy (CBT) is an effective treatment for health anxiety, but more research is needed to evaluate accessible, low cost ways of delivering CBT. Internet CBT may be effective, but there are no iCBT programs available outside of Sweden. We developed the first English-language clinician-guided iCBT program for health anxiety and conducted an open pilot trial (n = 16) to examine its acceptability, and impact on health anxiety and comorbidity, disability, and the cognitive and behavioural factors thought to maintain the disorder (e.g., catastrophising, hypervigilance). 13/16 participants completed the program (81% adherence). We found large and significant reductions in health anxiety, depression, distress, anxiety and disability (g's > 1.0), dysfunctional cognitions, behaviours and body vigilance between pre- and post-treatment, which were maintained at 3-month follow-up. The results provide preliminary support for the use of iCBT for health anxiety. Randomised controlled efficacy trials are now needed to evaluate this program.

Barriers to transfer of collaborative recovery training into Australian mental health services: implications for the development of evidence-based services.

RATIONALE: Transfer of training (ToT) is defined as the application of competencies acquired during training into the workplace. Poor ToT to clinical practice in mental health settings has negative implications for evidence-based service provision. AIMS AND OBJECTIVES: This study aimed to explore the variables influencing differences in ToT across mental health settings. Variables of interest included organization type, caseload and several variables related to the opportunity to use training. METHOD: One hundred and seventy-three mental health clinicians from community-based governmental and non-governmental mental health services in eastern Australia were trained in recovery-oriented interventions. Measures of ToT included time taken until implementation of intervention protocols, assessed using a clinical audit and a questionnaire survey completed by clinicians to identify barriers to implementation 6 months after training. RESULTS: Approximately 37% of the trained clinicians participating in the study were found to be implementing training protocols in clinical practice. In addition, the average time taken to implement the protocols was 5.6 months following training. The most frequently cited barriers were institutional constraints. Higher caseloads and more frequent client contact were related to a higher level of ToT. CONCLUSION: ToT can be difficult to achieve in clinical practice. Greater facilitation of ToT may be achieved through better integration of the new ideology and protocols, regular monitoring of progress, staff incentives and examination of external attributions by clinicians of their responsibility to transfer training.