Danube University Krems

About: Danube University Krems is a education organization based out in Krems, Niederösterreich, Austria. It is known for research contribution in the topics: Stroke & Population. The organization has 498 authors who have published 1572 publications receiving 68797 citations.

Changes in Therapeutic Alliance and in Social Inhibition as Mediators of the Effect of the Cognitive Behavioral Analysis System of Psychotherapy: A Secondary Analysis from a Randomized Clinical Trial.

Abstract: adult outpatients with early-onset PDD, CBASP leads to greater improvements in depression at the end of treatment [3] and 1 year later (but not beyond that) [4]. We conducted a sequential mediation analysis testing the hypothesis that the treatment effect (CBASP vs. SP) on outcome is mediated by a sequential indirect effect of treatment-specific improvements in the therapeutic relationship and a subsequent decrease in social inhibition. The inclusion and exclusion criteria of this RCT are described elsewhere [3]. Briefly, the acute-phase treatment consisted of 24 sessions of CBASP or SP over 20 weeks. In the continuation phase, 8 further sessions were administered between week 20 and 48. In CBASP, the therapeutic relationship is explicitly targeted using techniques that are collectively labeled disciplined personal involvement. For example, positive in-session experiences with the therapist are contrasted with hurtful reactions from significant others to promote safety in the therapeutic dyad (interpersonal discrimination exercise). SP calls for a far less structured approach to the therapeutic relationship and relies on the broader common factors of psychotherapy. Our analysis was performed in a modified intention-to-treat population that included all randomized patients for whom data were available for the mediating variables for at least 1 of the assessments (256 out of 268 patients, 95.5%). These mediating variables were the Helping Alliance Questionnaire (HAQ) and the Inventory of Interpersonal Problems (IIP). Outcome was measured using the clinician-rated Hamilton Rating Scale for Depression (HRSD-24). Out of the subsample analyzed in the current report, 130 patients (50.8%) were randomized to CBASP and 126 patients (49.2%) to SP. The mean age of the patients was 45.05 years (SD 11.8), 64.8% were female (n = 166). We imputed missing values for the HAQ, the IIP, and the HRSD-24 by using the mean of the posterior distribution from the fully conditional specification method obtained by the iterative Markov Chain Monte Carlo estimation. We examined sequential mediation via an ordinary leastsquares path analysis using a bootstrapping approach facilitated by the PROCESS macro version 2.16. The independent variable was group allocation (CBASP vs. SP), the dependent variable was the total score of the HRSD at week 48 (end of treatment), and the putative mediating variables were change of the HAQ between week 1 and the end of the acute treatment phase at week 20 (M1) and subsequent change in the social inhibition subscale of the IIP during the continuation phase from week 20 to 48 (M2). These time points were chosen to establish a temporal sequence of treatmentinduced changes in the therapeutic relationship followed by improvement in interpersonal functioning. For further details of the analysis, see Figure 1. This analysis revealed that a significant part of the association between treatment and outcome is mediated through the sequential indirect effect of improvement in HAQ (M1) and reduction in the IIP social inhibition subscale (M2). The results are summarized in Figure 1 and imply that the superior efficacy of CBASP compared to SP might be explained by a greater effect of CBASP on the therPersistent depressive disorder (PDD) is very common and debilitating, but only few therapeutic options exist that target this form of depression. Guidelines recommend treating PDD with the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) [1]. The effectiveness of CBASP has been demonstrated in numerous randomized controlled trials (RCTs) [1]. But very few of these trials have specifically examined mediators of treatment effect that are specific to the CBASP model. This model states that a novel relational experience in the therapeutic alliance is necessary for interpersonal change to occur and that this interpersonal change in turn leads to improvement of depression. To date, only one CBASP study supports this model [2]. It found an indirect effect of the alliance on outcome through patients’ reduction in hostile submissiveness. These findings are consistent with the CBASP theory but cannot be directly attributed to CBASP because of the lack of a comparison group. In this paper, we therefore present a secondary analysis based on data of a multicenter RCT comparing CBASP to Supportive Psychotherapy (SP). This RCT demonstrated that, in unmedicated Received: July 3, 2019 Accepted after revision: January 21, 2020 Published online: February 19, 2020

Hyaluronan thiomer gel/matrix mediated healing of articular cartilage defects in New Zealand White rabbits—a pilot study

Abstract: Articular cartilage defects are limited to their regenerative potential in human adults. Our current study evaluates tissue regeneration in a surgically induced empty defect site with hyaluronan thiomer as a provisional scaffold in a gel/matrix combination without cells on rabbit models to restore tissue formation. An osteochondral defect of 4 mm in diameter and 5 mm in depth was induced by mechanical drilling in the femoral center of the trochlea in 18 New Zealand White rabbits. Previously evaluated from an in vitro study hyaluronan thiomer matrix, and a hyaluronan thiomer gel was used to treat the defect. As a control, the defect was left untreated. During the whole study, rabbits were clinically examined and after 4 (n = 3) or 12 (n = 3) weeks, the rabbits were sacrificed. Joints were evaluated macroscopically (Brittberg score) and by histology (O’Driscoll score). Synovial cells from the synovial fluid smear were histopathologically evaluated. The healing of the defects varied intra-group wise at the first observation period. After 12 weeks the results concerning the cartilage repair score were inhomogeneous within each group, while the macroscopic analysis was more homogenous. In the synovial fluid smear, the mean score of infiltrated synovial and non-synovial cells was slightly increased after 4 weeks and slightly decreased after 12 weeks in both the treatment groups in comparison to the untreated control. Taken together with results from the in vivo study indicated that implantation of hyaluronan thiomer as a combination of gel and matrix might enhance articular cartilage regeneration in an empty defect. Despite their benefits, the intrinsic healing capacity of New Zealand rabbits is a limitation for comparative test subject in pre-clinical models of cartilage defects.

Thermal lens spectrometry applied for a sensitive detection of silver-stained protein bands in polyacrylamide gels

Abstract: Proteins separated by gel electrophoresis are commonly quantified by colorimetric analysis of the protein band stain intensity. For the most sensitive stain (silver), the minimal protein amount, needed for the optical visualization of the band, is around 1 ng. This study investigates the use of thermal lens (TL) spectrometry for the quantification of subnanogram protein amounts. The developed dual laser TL sensor is set up in collinear geometry; it includes a HeNe probe beam, a 450 nm diode laser pump beam, and a gel holder. After silver staining, the polyacrylamide gel is scanned by the sensor while kept soaked in water, and in 50% (v/v) methanol/water. During scanning, the TL signal of each band is recorded in function of its position. The TL sensor can detect protein amounts as low as 0.1 ng in water, and 0.05 ng in 50% methanol/water. The limit of detection ranges from 8 to 50 pg, depending on the soaking medium and the staining strength. The theoretical results, predicting the sensitivity enhancement in methanol/water, are in agreement with the results. In conclusion, thermal lens spectrometry proves to be a valid method for the detection of subnanogram protein amounts in polyacrylamide gels, and its application can be extended to other soft gel matrices.