[Histological changes in intraperitoneal onlay mesh (IPOM) with synthetic and biological meshes. Results of the chronic experiment]. / Gistologicheskie izmeneniya pri intraperitoneal'noi plastike (IPOM) sinteticheskimi i biologicheskimi endoprotezami. Rezul'taty khronicheskogo eksperimenta.

OBJECTIVE: The objective of the study was to analyze histological changes in the site of the meshes FTOREX, FTOREX coated with carboxymethylcellulose, Ventralight ST, Symbotex, REPEREN-16-2 and decellularized porcine peritoneum on the parietal peritoneum of the pig. MATERIAL AND METHODS: At laparoscopy, 6 different meshes were placed intraperitoneally in each of the 3 pigs. After 90 days, the animals were taken out of the experiment. After staining with hematoxylin and eosin, quantitative morphometry and counting the number of vessels and cells in the interstitium in the areas of the mesh and peritoneum were performed. An immunohistochemical study with an antibody to pancytokeratins assessed the state of the initial peritoneum and neoperitoneum. RESULTS: According to morphological characteristics, the meshes were divided into 3 groups: 1) with fluoropolymer coating FTOREX, 2) Ventralight ST and Symbotex, 3) REPEREN and decellularized peritoneum. In group 1, the surface area of the mesh threads was optimal in terms of the arrangement and arrangement of the threads relative to each other. This contributed to the formation of a relatively dense fibrous framework and a place to preserve the underlying peritoneum involved in the formation of the neoperitoneum. Despite the smallest surface area of the threads, in group 3, the greatest fibroblastic reaction was noted. Inflammatory changes were the least pronounced in group 1. They were the greatest in group 3, where there was a pronounced leukocyte reaction, combined with the processes of metaplasia, the development of fibrinoid necrosis, and the progression of the secondary inflammatory process. In group 1, the optimal ratio of newly formed vessels was noted, in group 2 - veins prevailed over arteries, in group 3 - the number of vessels was minimal. Immunohistochemical study showed that in group 1, mesothelial cells covered almost the entire surface of the implant, and there were also areas of preserved basic peritoneum. In group 2, mesothelium also covered most of the surface of the meshes, but the underlying peritoneum was absent. In group 3, on the contrary, a significant number of extended areas not covered with mesothelium were revealed. CONCLUSION: The conducted morphological and morphometric study showed that the most balanced ratio of the components of the newly formed fibrous tissue and blood vessels is observed when using implants with a fluoropolymer coating FTOREX. At the same time, the remaining basic peritoneum actively participated in the formation of the neoperitoneum. The Ventralight ST and Symbotex meshes also contributed to the formation of a full-fledged fibrous tissue and adequate vascular proliferation, however, they prevented the preservation of the underlying peritoneum, which practically excluded its participation in the formation of the neoperitoneum. The REPEREN mesh and decellularized porcine peritoneum led to the least balanced cell and vascular proliferation and the greatest fibroplastic reaction, which could further negatively affect the state of the formed scar.

Sleep disorders and vascular responsiveness in patients with rheumatoid arthritis.

BACKGROUND: Rheumatoid arthritis (RA) is the most common systemic autoimmune disease characterized by chronic systemic inflammation. Half of the deaths of patients with RA are due to cardiovascular diseases (CVD), considered to be 1.5 to -2.0-fold that in the general population. Patients with RA also experience poor sleep, which by itself is associated with endothelial dysfunction, CVD events and sudden death. Our aim was to study the mechanistic pathways and the correlations between sleep efficiency and vascular reactivity of patients with RA. METHODS AND RESULTS: A prospective study that evaluated quality of sleep using ACTi Graphs, vascular inflammation and endothelial function of 18 patients with RA. Inflammation was studied by levels of E-selectin, intercellular adhesion molecule 1 (ICAM-1) and NO in serum. Endothelial function was studied using the brachial artery plethysmography method. Eighteen RA patients (aged 57.56 ± 13.55 years; 16 women) with a long-standing active RA: Eight patients had impaired sleep efficiency and 10 had a good sleep efficiency. Those who had an impaired sleep had larger baseline diameters of the brachial artery (0.39 ± 0.08 cm vs. 0.32 ± 0.04 cm; P = 0.02). Negative correlations were found between baseline brachial artery diameter and sleep efficiency (P = 0.01), and with NO level (P = 0.04). Stepwise regression found that brachial artery diameter at baseline and NO level could predict sleep efficiency (r2  = 0.543, P = 0.01). CONCLUSION: Vascular reactivity could predict quality of sleep in patients with RA. Quality of sleep may serve as an independent CVD risk factor in patients with RA.

[Applying HIFU for the obliteration of the veins in the experiment ].

The effect of high-intensity focused ultrasound (HIFU) on venous wall structure was studied in the rabbit model. Special setup was developed for ultrasound generation and vessel targeting. Methods. The essential part of the setup is spherical focusing power irradiator with following characteristics: power supply voltage of 25 V, frequency of 1.9 MHz, ultrasound intensity in the focal spot ~8.7 kW/cm2. Results. Single 15-s exposure of the femoral vein to HIFU resulted in partial desquamation of the endothelium, vacuolization of myocyte cytoplasm, misarrangement and coagulation of collagen fibers. Pulsed HIFU (5 pulses for 5 s each) caused protein coagulation in all layers of venous wall (v. cava posterior) as well as the appearance of the areas of fibrinoid necrosis, severe endothelial desquamation, and intimal detachment. HIFU-induced collagen structural changes in media and adventitia of the vein suggest that HIFU exposure resulted in local temperature increase up to ~60°Ð¡. In some experiments, adjacent to the vein muscles were also exposed to HIFU. In this case, edema of the interstitium and muscle fibers was registered, as well as fragmentation and coagulation of some fibers, altered staining patterns and neutrophil infiltration. These changes could be attributed to the development of acute muscle injury (acute fasciitis). Perivascular adipose tissue also demonstrated edema and lipolysis, red blood cell diapedesis, and leukocyte infiltration. Conclusion. The observations on structural changes in the venous wall after HIFU exposure could lay the ground for future experiments on HIFU - mediated obliteration.

Measuring the Economic Impacts of a Circular Economy: an Evaluation of Indicators.

A circular economy (CE) is often seen as a promising way to address pressing environmental challenges, such as climate change, biodiversity loss, and resource depletion. However, the CE concept remains contested, and the implementation of circular strategies (CS) does not automatically improve all dimensions of sustainability. However, assessing the economic impacts of CS implementation is crucial to making the transition from linear to circular value chains. Despite the broad literature on CE indicators, a critical evaluation of economic CE indicators (eCEis) that conduct assessments on a value-chain level is still missing. This study addresses this gap by critically evaluating how capable eCEis are of measuring the economic impacts of implementing CS at the value-chain level. We first identify existing meso eCEis through a literature review, deriving a sample of 13 meso eCEis. We then qualitatively evaluate the eCEis based on criteria synthesised from requirements for CE indicators proposed in the literature. We find that existing meso eCEis only partly fulfil these criteria and consequently have limited capabilities for measuring the economic impacts of the implementation of CS at a value-chain level. The indicators largely satisfy the specific criteria diagnostic and useful, moderately satisfy the criterion practical, and barely satisfy the criteria systemic and transparent. We therefore recommend that future studies on eCEis place a stronger focus on adopting a systemic perspective, discuss their limitations and uncertainties in more detail, and consider combining meso eCEis with the indicators of other dimensions (environmental, social) and levels (micro, macro). Supplementary Information: The online version contains supplementary material available at 10.1007/s43615-022-00190-w.

Predictors of response to Systems Training for Emotional Predictability and Problem Solving (STEPPS) for borderline personality disorder: an exploratory study.

OBJECTIVE: Few predictors of treatment outcome or early discontinuation have been identified in persons with borderline personality disorder (BPD). AIM: The aim of the study was to examine the relationship between baseline clinical variables and treatment response and early discontinuation in a randomized controlled trial of System Training for Emotional Predictability and Problem Solving, a new cognitive group treatment. METHOD: Improvement was rated using the Zanarini Rating Scale for BPD, the Clinical Global Impression Scale, the Global Assessment Scale and the Beck Depression Inventory. Subjects were assessed during the 20 week trial and a 1-year follow-up. RESULTS: Higher baseline severity was associated with greater improvement in global functioning and BPD-related symptoms. Higher impulsivity was predictive of early discontinuation. Optimal improvement was associated with attending > or = 15 sessions. CONCLUSION: Subjects likely to improve have the more severe BPD symptoms at baseline, while high levels of impulsivity are associated with early discontinuation.

Counterfeit and substandard antimalarial drugs in Cambodia.

Counterfeit and substandard antimalarial drugs can cause death and contribute to the growing malaria drug resistance problem, particularly in Southeast Asia. Since 2003 in Cambodia the quality of antimalarial drugs both in the public and private health sector is regularly monitored in sentinel sites. We surveyed 34% of all 498 known facilities and drug outlets in four provinces. We collected 451 drug samples; 79% of these were not registered at the Cambodia Department of Drugs and Food (DDF). Twenty-seven percent of the samples failed the thin layer chromatography and disintegration tests; all of them were unregistered products. Immediate action against counterfeit drugs was taken by the National Malaria Control Program (NMCP) and the DDF. They communicated with the Provincial Health Department about the presence of counterfeit antimalarial drugs through alert letters, a manual, annual malaria conferencing and other training occasions. Television campaigns to alert the population about counterfeit drugs were conducted. Moreover, the NMCP has been promoting the use of good quality antimalarial drugs of a blister co-packaged combination of artesunate and mefloquine in public and private sectors. Appropriate strategies need to be developed and implemented by relevant government agencies and stakeholders to strengthen drug quality assurance and control systems in the country.

A family study of obsessive-compulsive disorder.

First-degree relatives of probands with obsessive-compulsive disorder (OCD) (n = 32) and psychiatrically normal controls (n = 33) were blindly interviewed with the use of the Diagnostic Interview Schedule. The morbidity risk for anxiety disorders was increased among the relatives of obsessional subjects compared with that for the relatives of controls, but the risk for OCD was not. Risk for a more broadly defined OCD (including relatives with obsessions and compulsions not meeting criteria for OCD) was increased among the parents of obsessional subjects but not among the parents of controls (16% vs 3%). The findings suggest that an anxiety disorder diathesis is transmitted in families with OCD, but that its expression within these families is variable. The findings also support the current practice of classifying OCD as an anxiety disorder.

A test of the tridimensional personality theory: association with diagnosis and platelet imipramine binding in obsessive-compulsive disorder.

We administered the Tridimensional Personality Questionnaire (TPQ) to a sample of 25 individuals with obsessive-compulsive disorder (OCD) and 35 normal controls. As predicted, OCD cases scored much higher on the harm avoidance dimension than normal controls. Findings for the novelty seeking and reward dependence dimensions were less dramatic, although compatible with the underlying theory. Despite a theoretical link between the harm avoidance dimension and serotonin-mediated neuropathways, we failed to find an association between this dimension and platelet imipramine binding in either OCD cases or controls.

Personality disorder in obsessive-compulsive volunteers, well comparison subjects, and their first-degree relatives.

OBJECTIVE: The authors sought to determine the frequency of DSM-III personality disorders in subjects with obsessive-compulsive disorder, well comparison subjects, and their first-degree relatives. METHOD: Thirty-two subjects with obsessive-compulsive disorder and 33 age-(within 5 years) and gender-matched well comparison subjects were assessed with the Structured Interview for DSM-III Personality Disorder and several self-report instruments. Their first-degree relatives were assessed in a blind manner with the same instruments. RESULTS: Subjects with obsessive-compulsive disorder were more likely than well comparison subjects to have a personality disorder, but compulsive personality was not the most frequent. No significant differences were found in the prevalence of personality disorders among first-degree relatives, including compulsive personality, or in obsessional, hysterical, or oral character traits. CONCLUSIONS: Personality disorders are highly prevalent among patients with obsessive-compulsive disorder, but the data do not support a relationship between obsessive-compulsive disorder and compulsive personality.

Disciplining young children: the role of verbal instructions and reasoning.

Pediatricians are often asked to advise parents who are having difficulty managing the oppositional behaviors of their toddlers and preschool-age children. A large number of articles provide advice to pediatricians and parents on effective disciplinary strategies. However, despite the fact that verbal explanations, reasoning, and instructions are commonly used by parents, few articles directly address the use of these strategies to affect children's behavior. In this paper, we review studies that explicitly investigate the ability of adults' verbal explanations or instructions to alter the behavior of young children. These studies suggest that under most circumstances, verbal explanations and instructions are not effective in changing young children's problem behaviors. We then discuss how theories in developmental and behavioral psychology help explain the limitations of using verbal reasoning and instructions to change young children's problem behaviors. Finally, we provide some recommendations for parents on the use of verbal explanations and instructions in disciplining young children.

Hoarding and treatment response in 38 nondepressed subjects with obsessive-compulsive disorder.

OBJECTIVE: The authors studied factors associated with short-term treatment response in 38 nondepressed subjects with DSM-III-R obsessive-compulsive disorder (OCD). METHOD: The subjects completed 12 weeks of treatment with paroxetine (N = 20), placebo (N = 8), or cognitive-behavioral therapy (N = 10). Clinician and self-rated measures were gathered at baseline, during treatment, and after treatment. RESULTS: Seventeen (45%) subjects had "much" or "very much" improvement and achieved at least a 40% decrease in their total Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score. Responders had lower obsessive-compulsive scores on the Symptom Checklist 90-Revised, had a lower checking score on the Maudsley Obsessive-Compulsive Inventory, were less likely to have had prior drug therapy, and in general suffered more obsessive-compulsive symptoms. They were significantly less likely to have hoarding obsessions and corresponding compulsions. The latter finding was confirmed using multiple regression analysis. CONCLUSION: Hoarding is an important symptom that predicts poor treatment response in patients with OCD.

Investigating thought disorder in schizophrenia with the lexical decision task.

Prior work has found evidence of hyperpriming in schizophrenics, which has been related to a persistence of associational activation in thought disorder. We extended this work by administering a lateralized version of the lexical decision task to 10 thought-disordered schizophrenics (TD), 10 non-thought-disordered schizophrenics (NTD), and 11 control subjects to localize the patterns of priming. All subjects were right-handed males. Associated, unassociated, and neutral prime-target pairs were displayed across seven stimulus location combinations: prime and target both presented to the center, left visual field (LVF), or right visual field (RVF); prime presented to the center with target presented to the LVF or RVF; and prime and target presented contralaterally. TD schizophrenics exhibited priming effects comparable to those of the other subject groups, suggesting intact semantic memory structures and memory processes that may be unimpaired under the conditions studied. It is believed that the associative process mediating priming effects found in schizophrenia are later in the sequence than those examined in this study.

Psychiatric disorders in relatives of probands with obsessive-compulsive disorder and co-morbid major depression or generalized anxiety.

The authors report findings from a blind, controlled study of obsessive-compulsive disorder (OCD). Prevalence rates of generalized anxiety disorder (GAD) and major depressive disorder (MDD) were compared among first-degree relatives of probands with OCD and co-morbid GAD or MDD, respectively. Rates of MDD were not increased in relatives of probands with OCD and MDD; neither were rates of GAD increased in relatives of probands with OCD and GAD, although rates of GAD were increased among relatives of probands with OCD compared to relatives of healthy controls. The authors explore the implications of the findings.

The bedtime pass: an approach to bedtime crying and leaving the room.

OBJECTIVE: To evaluate a novel intervention for bedtime problems. DESIGN: We used an ABAB withdrawal-type experimental design. SETTING: The intervention was prescribed in an outpatient primary health care context and evaluated in the home setting. PARTICIPANTS: Two normally developing boys aged 3 and 10 years were the primary participants. Twenty parents and 23 practicing pediatricians rated the acceptability of the intervention. INTERVENTION: A bedtime pass, exchangeable for 1 excused departure from the bedroom after bedtime. MAIN OUTCOME MEASURES: For both primary participants, instances of crying and/or coming out from the bedroom after bedtime; for the 20 parents and 23 pediatricians, comparative ratings of acceptability for the pass and 2 other commonly used approaches to bedtime problems (ignoring crying and letting children sleep with their parents). RESULTS: Crying and coming out from the bedroom reduced to zero rates in both children. Pediatricians rated using the pass as significantly more acceptable than letting children sleep with parents and equivalent to ignoring. Parents rated the pass as more acceptable than either alternative. CONCLUSION: The bedtime pass provides pediatricians with a readily usable, potentially effective, and highly acceptable novel intervention for bedtime problems, one of the most common complaints in outpatient pediatrics.

Case study: audio feedforward treatment of selective mutism.

Selective mutism is a relatively rare and difficult-to-treat disorder. Audio feedforward is a potential intervention that involves having the individual with selective mutism listen to audiotapes edited to depict him or her speaking in situations in which he or she is not currently speaking. The successful use of this intervention for three children with selective mutism is reported. The intervention was used in both school and community settings. This intervention has not always proved successful, sometimes because children refused to make the audiotapes.

Depression and other mental disorders in the relatives of morbidly obese patients.

The authors systematically interviewed 88 bariatric clinic patients presenting for vertical banded gastroplasty. The typical subject was middle-aged, female and of low socioeconomic status as indicated by his or her method of payment. Morbidly obese subjects were more likely than a comparison group to have first-degree relatives with a history of depression, bipolar disorder, antisocial personality, and other psychiatric disorders. These data indicate that relatives of morbidly obese subjects are frequently emotionally disturbed. Reasons for the findings are discussed.

Preliminary confirmation of the proposed link between reward-dependence traits and norepinephrine.

The tridimensional theory of personality posits that traits belonging to a personality spectrum called 'reward dependence' are determined in part by the neurotransmitter norepinephrine (NE). We hypothesized that urinary levels of the NE metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG) would be significantly correlated to the reward dependence score on the Tridimensional Personality Questionnaire (TPQ). Twenty-seven never psychiatrically ill subjects collected urine for MHPG measurements and completed the TPQ. There was a significant correlation between the reward dependence score and the level of MHPG. MHPG levels was not associated with the other two personality dimensions, novelty seeking and harm avoidance. This preliminary study supports the hypothesis that reward-dependence traits are in part determined by NE.

Multisite microprobes for neural recordings.

Multisite, passive microprobes have been developed to allow simultaneous recording of action potential activity from multiple neurons at different locations in the brain. The microprobes were fabricated using standard integrated circuit techniques. The probe is a planar structure that consists of gold electrodes sandwiched between two polyimide dielectric layers and bonded to a molybdenum structural support. Windows in the top dielectric layer expose the electrode sites and bonding pads. In two distinct versions of the probe four or six recordings sites, respectively, of approximately 25 microns 2 are arranged on a dagger-shaped structure which can penetrate the pia. The bonding pads and interconnect wires at the probe head are entirely encapsulated in a tubular fixture that is packed with silicone RTV and sealed with epoxy to protect the interconnections from contact with body fluids. The site impedances at 1 kHz are typically between 2 and 4 M omega. Probe lifetimes for continuous immersion in physiological saline solution, as measured by impedance, have exceeded 750 h. The failure mechanism is believed to be due to moisture and ion absorption in the top dielectric layer. In acute neurophysiological experiments using the four site probes, action potential activity was recorded from physiologically identified neurons in the dorsal column nuclei of anesthetized rat.

Differential response of operant self-injury to pharmacologic versus behavioral treatment.

The purpose of this study was to investigate the hypothesis that self-injurious behavior (SIB) maintained by environmental factors will be more effectively treated by behavioral treatments than by haloperidol. Fifteen subjects were enrolled in this study. The efficacy of both haloperidol and a behavioral treatment was assessed. At the onset of treatment, subjects were randomized to receive either haloperidol or a placebo. During each day of treatment, data were collected during sessions with a behavioral treatment and sessions without a behavioral treatment. Behavioral treatment resulted in a statistically significant decrease in SIB, but haloperidol did not. Eighty-three percent of subjects were classified as responders to the behavioral treatment whereas only 25% of the subjects were responders to haloperidol (p = .019). We conclude that individuals with operant SIB are more likely to respond to behavioral treatments than to haloperidol.

Separate and combined effects of methylphenidate and a behavioral intervention on disruptive behavior in children with mental retardation.

We investigated the separate and combined effects of a behavioral intervention and methylphenidate (Ritalin) on disruptive behavior and task engagement in 3 children with severe to profound mental retardation. The behavioral intervention involved differential reinforcement of appropriate behavior and guided compliance. All 3 children demonstrated decreased disruptive behavior and improved task engagement in response to the response to the behavioral intervention. Two of the 3 children demonstrated similar improvement in response to methylphenidate. Although both interventions were highly effective for these 2 participants, the relative efficacy of the interventions varied between the 2 children. There was no evidence of an additive or synergistic effect of the two interventions, but the high efficacy of each intervention alone limited our ability to detect such effects.