The effectiveness of cognitive enhancement therapy in a community-based program

The following paper is the result of a semester-long program evaluation course at Spalding University, located in Louisville, Kentucky. During the course, the students were connected to Bridgehaven, a community based psychiatric rehabilitation and recovery program, also located in Louisville, Kentucky. The researchers of this project studied the long-term effectiveness of its Cognitive Enhancement Therapy (CET) program. Based on the data, the results did not yield significant results. However, this is potentially due to the low sample size and incomplete data set. In lieu of this, the researchers offered some recommendations to improve the collection of client information and possible future research.

Re-examining the effect of carbon emission trading policy on improving the green innovation of China's enterprises

China's carbon emission trading (CET) policy guides enterprises to carry out green innovation and address the growing environmental challenges through market-based instruments. However, can CET policy effectively promote enterprises' green innovation? It has become a hot issue. Whether it can play the "Porter effect" is also controversial. We have little research on the effectiveness and heterogeneity of CET policy in China. We obtained the following conclusions from the empirical results: (1) CET policy has clearly promoted green innovation in enterprises, the proportion of green innovation of enterprises increased by 13.43%, and the "weak Porter hypothesis" was tenable. And the results of the research have been tested to be robust and reliable. (2) CET policy plays an obvious role in enhancing the enterprises' green innovation with high-stock enterprise, large-scale enterprise, and state-owned enterprises. (3) Carbon quota auction does not motivate enterprises to improve green innovation; the CET policy under the ex-post allowance allocation of government can better inspire enterprises to undertake green innovation events. (4) The pilot policy of carbon emission trading can increase the introduction of scientific research talents, increase the expenditure of scientific research and development, and improve the net profit margin of enterprise assets, thus directly or indirectly promoting the development of green innovation of enterprises. Overall, the research in this article provides theoretical policy and empirical research for implementing carbon emission trading policy in developing countries and provides theoretical support for how to realize the "double dividend" of environmental protection and enterprises' green innovation competitiveness. Meanwhile, it also provides reference for the national CET to be officially run, and it is instructive to establish a flexible market-based instruments.

Extreme sleep state misperception: From psychopathology to objective-subjective sleep measures

STUDY OBJECTIVES

We tested the hypothesis that patients with extreme sleep state misperception display higher levels of psychopathology and reduced quantitative estimation abilities compared to other patients with insomnia. Secondary aims included the evaluation of group differences in subjective self-reported quality of life and sleep quality and objective sleep parameters.

METHODS

In this cross-sectional, observational study, 249 patients with insomnia underwent a video-polysomnography with a subsequent morning interview to assess self-reported sleep estimates and filled in a large battery of questionnaires. Patients were classified into High Misperception (HM) and Moderate Misperception (MM) groups, according to the complement of the ratio between self-reported total sleep time and objective total sleep time (Misperception Index).

RESULTS

No significant differences emerged in any of the psychopathological measures considered between the HM and the MM group. Similarly, no effect was observed in quantitative estimation abilities. HM patients displayed a significantly increased number of awakenings per hour of sleep and a reduced dream recall rate. Their overall sleep quality and quality of life was significantly impaired.

CONCLUSIONS

Future research on sleep misperception should focus on factors other than the level of psychopathology and estimation abilities, in particular sleep microstructure and quantitative EEG studies in both REM and NREM sleep.

Cryo-Electron Tomography and Automatic Segmentation of Cultured Hippocampal Neurons

Cryo-electron tomography is fast becoming a preferred method for studying intracellular environments at the molecular scale. Increases in data collection throughput means that large numbers of tomograms can be generated at rates too fast for humans to easily explore quantitatively. Currently, there is a large effort to make data collection and segmentation tools more automated. Here, we describe a workflow for preparing cultured neurons on electron microscopy grids, batch tomographic data collection, reconstruction and automatic segmentation using freely and commercially available software.

Continuing professional development requirements for UK health professionals: a scoping review

OBJECTIVES

This paper sets out to establish the numbers and titles of regulated healthcare professionals in the UK and uses a review of how continuing professional development (CPD) for health professionals is described internationally to characterise the postqualification training required of UK professions by their regulators. It compares these standards across the professions and considers them against the best practice evidence and current definitions of CPD.

DESIGN

A scoping review.

SEARCH STRATEGY

We conducted a search of UK health and social care regulators' websites to establish a list of regulated professional titles, obtain numbers of registrants and identify documents detailing CPD policy. We searched Applied Social Sciences Index and Abstracs (ASSIA), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, EMCare and Scopus Life Sciences, Health Sciences, Physical Sciences and Social Sciences & Humanities databases to identify a list of common features used to describe CPD systems internationally and these were used to organise the review of CPD requirements for each profession.

RESULTS

CPD is now mandatory for the approximately 1.5 million individuals registered to work under 32 regulated titles in the UK. Eight of the nine regulators do not mandate modes of CPD and there is little requirement to conduct interprofessional CPD. Overall 81% of those registered are required to engage in some form of reflection on their learning but only 35% are required to use a personal development plan while 26% have no requirement to engage in peer-to-peer learning.

CONCLUSIONS

Our review highlights the wide variation in the required characteristics of CPD being undertaken by UK health professionals and raises the possibility that CPD schemes are not fully incorporating the best practice.

High-efficiency lysis of cervical cancer by allogeneic NK cells derived from umbilical cord progenitors is independent of HLA status

Down-regulation of HLA in tumor cells, low numbers and dysfunctionality of NK cells are commonly observed in patients with end-stage cervical cancer. Adoptive transfer of high numbers of cytotoxic NK cells might be a promising treatment approach in this setting. Here, we explored the cytotoxic efficacy on ten cervical cancer cell lines of activated allogeneic NK cells from two sources, i.e., peripheral blood (PBNK) with and without cetuximab (CET), a tumor-specific monoclonal antibody directed against EGFR, or derived from umbilical cord blood (UCB-NK). Whereas CET monotherapy was ineffective against the panel of cervical cancer cell lines, irrespective of their EGFR expression levels and despite their RAS^wt status, it significantly enhanced the in vitro cytotoxic efficacy of activated PBNK (P = 0.002). Equally superior cytotoxicity over activated PBNK alone was achieved by UCB-NK (P < 0.001). Both PBNK- and UCB-NK-mediated cytotoxic activity was dependent on the NK-activating receptors natural killer group 2, member D receptor (NKG2D) and DNAX accessory molecule-1 (DNAM-1) (P < 0.05) and unrelated to expression levels of the inhibitory receptors HLA-E and/or HLA-G. Most strikingly, whereas the PBNK’s cytotoxic activity was inversely correlated with HLA-ABC levels (P = 0.036), PBNK + CET and UCB-NK cytotoxicity were entirely independent of HLA-ABC expression. In conclusion, this study provides a rationale to initiate a clinical trial for cervical cancer with adoptively transferred allogeneic NK cells, employing either UCB-NK or PBNK + CET for EGFR-expressing tumors. Adoptive transfer of UCB-NK might serve as a generally applicable treatment for cervical cancer, enabled by HLA-, histology- and HPV-independent killing mechanisms.

Photosynthesis Control: An underrated short-term regulatory mechanism essential for plant viability

Regulation of photosynthetic electron transport provides efficient performance of oxygenic photosynthesis in plants. During the last 15 years, the molecular bases of various photosynthesis short-term regulatory processes have been elucidated, however the wild type-like phenotypes of mutants lacking of State Transitions, Non Photochemical Quenching, or Cyclic Electron Transport, when grown under constant light conditions, have also raised doubts about the acclimatory significance of these short-regulatory mechanisms on plant performance. Interestingly, recent studies performed by growing wild type and mutant plants under field conditions revealed a prominent role of State Transitions and Non Photochemical Quenching on plant fitness, with almost no effect on vegetative plant growth. Conversely, the analysis of plants lacking the regulation of electron transport by the cytochrome b6f complex, also known as Photosynthesis Control, revealed the fundamental role of this regulatory mechanism in the survival of young, developing seedlings under fluctuating light conditions.

Clinical evaluation of contrast-enhanced digital mammography and contrast enhanced tomosynthesis--Comparison to contrast-enhanced breast MRI

PURPOSE

To compare the diagnostic accuracy of contrast-enhanced digital mammography (CEDM) and contrast-enhanced tomosynthesis (CET) to dynamic contrast enhanced breast MRI (DCE-MRI) using a multireader-multicase study.

METHODS

Institutional review board approval and informed consents were obtained. Total 185 patients (mean age 51.3) with BI-RADS 4 or 5 lesions were evaluated before biopsy with mammography, tomosynthesis, CEDM, CET and DCE-MRI. Mediolateral-oblique and cranio-caudal views of the target breast CEDM and CET were acquired at 2 and 4 min after contrast agent injection. A mediolateral-oblique view of the non-target breast was taken at 6 min. Each lesion was scored with forced BI-RADS categories by three readers. Each reader interpreted lesions in the following order: mammography, tomosynthesis, CEDM, CET, and DCE-MRI during a single reading session.

RESULTS

Histology showed 81 cancers and 144 benign lesions in the study. Of the 81 malignant lesions, 44% (36/81) were invasive and 56% (45/81) were non-invasive. Areas under the ROC curve, averaged for the 3 readers, were as follows: 0.897 for DCE-MRI, 0.892 for CET, 0.878 for CEDM, 0.784 for tomosynthesis and 0.740 for mammography. Significant differences in AUC were found between the group of contrast enhanced modalities (CEDM, CET, DCE-MRI) and the unenhanced modalities (all p<0.05). No significant differences were found in AUC between DCE-MRI, CET and CEDM (all p>0.05).

CONCLUSION

CET and CEDM may be considered as an alternative modality to MRI for following up women with abnormal mammography. All three contrast modalities were superior in accuracy to conventional digital mammography with or without tomosynthesis.

Low-voltage operation of ZrO2-gated n-type thin-film transistors based on a channel formed by hybrid phases of SnO and SnO2

With SnO typically regarded as a p-type oxide semiconductor, an oxide semiconductor formed by hybrid phases of mainly SnO and a small amount of SnO2 with an average [O]/[Sn] ratio of 1.1 was investigated as a channel material for n-type thin-film transistors (TFTs). Furthermore, an appropriate number of oxygen vacancies were introduced into the oxide during annealing at 400 °C in ambient N2, making both SnO and SnO2 favorable for current conduction. By using high-κ ZrO2 with a capacitance equivalent thickness of 13.5 nm as the gate dielectric, the TFTs processed at 400 °C demonstrated a steep subthreshold swing (SS) of 0.21 V/dec, and this can be ascribed to the large gate capacitance along with a low interface trap density (Dit) value of 5.16 × 10(11) cm(-2) eV(-1). In addition, the TFTs exhibit a relatively high electron mobility of 7.84 cm(2)/V·s, high ON/OFF current ratios of up to 2.5 × 10(5), and a low gate leakage current at a low operation voltage of 3 V. The TFTs also prove its high reliability performance by showing negligible degradation of SS and threshold voltage (VT) against high field stress (-10 MV/cm). When 3% oxygen annealing is combined with a thinner channel thickness, TFTs with even higher ION/IOFF ratios exceeding 10(7) can also be obtained. With these promising characteristics, the overall performance of the TFTs displays competitive advantages compared with other n-type TFTs formed on binary or even some multicomponent oxide semiconductors and paves a promising and economic avenue to implement an n-type oxide semiconductor without doping for production-worthy TFT technology. Most importantly, when combined with the typical SnO-based p-type oxide semiconductor, it would usher in a new era in achieving high-performance complementary metal oxide semiconductor circuits by using the same SnO-based oxide semiconductor.

Analysis of macrosegregation formation and columnar-to-equiaxed transition during solidification of Al-4 wt.%Cu ingot using a 5-phase model

A 5-phase mixed columnar-equiaxed solidification model was recently introduced to predict the as-cast structure, and a series of laboratory experiments were performed previously to verify the model. The focus of the current work is to analyze the formation of macrosegregation, which accompanies the formation of the as-cast structure including the columnar-to-equiaxed transition (CET). The as-cast structure and macrosegregation map of a cylindrical Al-4 wt.% Cu ingot poured at 800 °C are used as a reference to validate the calculations. Good agreement between the calculations and the experiment regarding both the macrosegregation and CET is achieved. Thermal-solutal convection and equiaxed crystal sedimentation in such ingot are verified to be key mechanisms governing the formation of macrosegregation. The competitive equiaxed/columnar growth, the soft and hard blocking mechanisms predominate the CET. The numerical study of grid sensitivity indicates that the global segregation pattern and CET are not significantly affected by grid size; however, some fine details of the segregation map which are predicted by fine grid (~0.5 mm) are smeared or locally averaged by the coarse grid (~2 mm). Such details were also not resolved in the measurement. Future investigations are demanding.

Peri-conceptional obesogenic exposure induces sex-specific programming of disease susceptibilities in adult mouse offspring

Vulnerability of the fetus upon maternal obesity can potentially occur during all developmental phases. We aimed at elaborating longer-term health outcomes of fetal overnutrition during the earliest stages of development. We utilized Naval Medical Research Institute (NMRI) mice to induce pre-conceptional and gestational obesity and followed offspring outcomes in the absence of any postnatal obesogenic influences. Male adult offspring developed overweight, insulin resistance, hyperleptinemia, hyperuricemia and hepatic steatosis; all these features were not observed in females. Instead, they showed impaired fasting glucose and a reduced fat mass and adipocyte size. Influences of the interaction of maternal diet∗sex concerned offspring genes involved in fatty liver disease, lipid droplet size regulation and fat mass expansion. These data suggest that a peri-conceptional obesogenic exposure is sufficient to shape offspring gene expression patterns and health outcomes in a sex- and organ-specific manner, indicating varying developmental vulnerabilities between sexes towards metabolic disease in response to maternal overnutrition.

Peri-conceptional obesogenic exposure induces sex-specific programming of disease susceptibilities in adult mouse offspring

Vulnerability of the fetus upon maternal obesity can potentially occur during all developmental phases. We aimed at elaborating longer-term health outcomes of fetal overnutrition during the earliest stages of development. We utilized Naval Medical Research Institute (NMRI) mice to induce pre-conceptional and gestational obesity and followed offspring outcomes in the absence of any postnatal obesogenic influences. Male adult offspring developed overweight, insulin resistance, hyperleptinemia, hyperuricemia and hepatic steatosis; all these features were not observed in females. Instead, they showed impaired fasting glucose and a reduced fat mass and adipocyte size. Influences of the interaction of maternal diet∗sex concerned offspring genes involved in fatty liver disease, lipid droplet size regulation and fat mass expansion. These data suggest that a peri-conceptional obesogenic exposure is sufficient to shape offspring gene expression patterns and health outcomes in a sex- and organ-specific manner, indicating varying developmental vulnerabilities between sexes towards metabolic disease in response to maternal overnutrition.

Classification of methods in transcranial electrical stimulation (tES) and evolving strategy from historical approaches to contemporary innovations

Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES.