The Association Between Service Connection and Treatment Outcome in Veterans Undergoing Residential PTSD Treatment.

The Department of Veterans Affairs has invested significant time and resources into the treatment of posttraumatic stress disorder (PTSD). Despite concerted efforts, a significant portion of patients do not respond optimally to trauma-focused treatment. One of the factors that has been hypothesized to be associated with treatment response is participation in the Veterans Benefits Administration service-connected disability process. This factor may be particularly relevant in the residential treatment setting, where most participants are engaged in the compensation seeking process. We conducted a retrospective chart review of 105 veterans who completed Cognitive Processing Therapy (CPT) in a residential rehabilitation program. ANCOVAs that adjusted for baseline PTSD severity compared symptom change between those who were and were non-compensation seeking at the time of treatment. Compensation seeking status was associated with significantly less symptom improvement over the course of CPT after adjusting for baseline PTSD severity (F(1, 102) = 4.29, p < .001, η2 = .03). Sensitivity analyses did not detect a similar effect during a prior coping skills phase of treatment. During CPT, clinically significant change was met by 66.7% of non-compensation seeking veterans (M = -15, SD = 14.56) and by 40.1% of the compensation seeking group (M = -7.1, SD = 12.24). Compensation-seeking may be associated with reduced response to trauma-focused treatment in certain settings. Future research is needed to better understand the mechanisms underlying this effect.

Osteogenic and bactericidal surfaces from hydrothermal titania nanowires on titanium substrates.

Nanotopographical cues on Ti have been shown to elicit different cell responses such as cell differentiation and selective growth. Bone remodelling is a constant process requiring specific cues for optimal bone growth and implant fixation. Moreover, biofilm formation and the resulting infection on surgical implants is a major issue. Our aim is to identify nanopatterns on Ti surfaces that would be optimal for both bone remodelling and for reducing risk of bacterial infection. Primary human osteoblast/osteoclast co-cultures were seeded onto Ti substrates with TiO2 nanowires grown under alkaline conditions at 240 °C for different times (2, 2.5 or 3 h). Cell growth and behaviour was assessed by scanning electron microscopy (SEM), immunofluorescence microscopy, histochemistry and quantitative RT-PCR methods. Bacterial colonisation of the nanowire surfaces was also assessed by confocal microscopy and SEM. From the three surfaces tested the 2 h nanowire surface supported osteoblast and to a lesser extent osteoclast growth and differentiation. At the same time bacterial viability was reduced. Hence the 2 h surface provided optimal bone remodeling in vitro conditions while reducing infection risk, making it a favourable candidate for future implant surfaces.

Evidence that a polymorphism within the 3'UTR of glutathione peroxidase 4 is functional and is associated with susceptibility to colorectal cancer.

Low selenium (Se) status has been associated with increased risk of colorectal cancer (CRC). Se is present as the amino acid selenocysteine in selenoproteins, such as the glutathione peroxidases. Se incorporation requires specific RNA structures in the 3' untranslated region (3'UTR) of the selenoprotein mRNAs. A single nucleotide polymorphism (SNP) occurs at nucleotide 718 (within the 3'UTR) in the glutathione peroxidase 4 gene. In the present study, Caco-2 cells were transfected with constructs in which type 1 iodothyronine deiodinase coding region was linked to the GPx4 3'UTR with either C or T variant at position 718. Higher reporter activity was observed in cells expressing the C variant compared to those expressing the T variant, under either Se-adequate or Se-deficient conditions. In addition, a disease association study was carried out in cohorts of patients with either adenomatous polyps, colorectal adenocarcinomas and in healthy controls. A higher proportion of individuals with CC genotype at the GPx4 T/C 718 SNP was present in the cancer group, but not in the polyp group, compared with the control group (P < 0.05). The present data demonstrate the functionality of the GPx4 T/C 718 SNP and suggest that T genotype is associated with lower risk of CRC.

Serum immunoglobulin G concentrations in calves fed fresh and frozen colostrum.

OBJECTIVE: To determine whether serum IgG concentrations in neonatal calves are adversely affected by short-term frozen storage of colostrum. DESIGN: Prospective study. SAMPLE POPULATION: Experiment 1 consisted of 10 pairs of Holstein calves (n = 20) fed matched aliquots of either fresh (n = 10) or frozen and thawed (10) colostrum. In experiment 2, 26 Holstein calves were fed either fresh (n = 13) or frozen and thawed (n = 13) colostrum. PROCEDURE: Experiment 1 consisted of calves resulting from observed parturitions; calves were randomly assigned to treatment groups (fresh or frozen and thawed colostrum) in pairs. Calves were fed 4 L aliquots of colostrum via oroesophageal intubation at 3 hours of age. Serum IgG concentrations at 2 days of age were compared between the 2 groups by use of a paired t-test. Experiment 2 consisted of calves resulting from observed parturitions; calves were randomly assigned to treatment groups (fresh or frozen and thawed colostrum). Calves were fed 4 L aliquots of colostrum via oroesophageal intubation at 3 hours of age. Regression analysis was used to determine whether calf serum IgG concentration was a function of colostral IgG concentration and colostrum storage group. RESULTS: Significant differences were not observed between the 2 groups in experiment 1. No significant relationship was observed between colostrum storage group and serum IgG concentration in experiment 2. The model that best predicted serum IgG concentrations accounted for 20% of the variability in serum IgG concentration. CONCLUSION AND CLINICAL RELEVANCE: Frozen colostrum is an adequate source of IgG for calves.

The RN-BSN student: developing a model of empowerment.

Nursing practice is being redefined. Today's graduating nurse is practicing in a tomorrow full of unknowns. The relevancy of traditional nursing education is being questioned in today's health care climate of crisis. In an attempt to prepare the graduating RN-BSN student to cope with these changes, nurse educators developed a process of empowerment. The framework for this effort was derived from the curriculum revolution, adult learning theory and empowerment research. The faculty defined empowerment as both an interpersonal process and an outcome. A graphic model has been created consisting of the four elements of empowerment: collegiality, communication, autonomy and accountability. Learning experiences are selected based upon these four elements. Teaching strategies are identified. Positive changes in student behavior have been reported anecdotally. The faculty are beginning the next phase: designing a research project to investigate behavior changes related to this empowerment model.

Alloproliferative responses of purified CD4+ and CD8+ T cells to endothelial cells in the absence of contaminating accessory cells.

Human capillary endothelial cells (EC), unlike rodent, constitutively express MHC class II antigens, raising the question of whether they can cause direct stimulation of resting T cells. Although previous reports have demonstrated an alloproliferative response between cultured human EC and resting T lymphocytes, they have not stringently proven the absence of contaminating leukocytes in both stimulator and responder populations. Here, we have quantitated the number of contaminating leukocytes in serially passaged human umbilical vein endothelial cells (HUVEC) and have examined the ability of HUVEC and an EC line (EAhy.926) to cause allostimulation of positively selected CD4+ and CD8+ T cells. Contaminating CD45+ leukocytes were found in primary cultures at a mean level of 0.43 +/- 0.49%; by passages 3 and 4 there were less than 1/10,000 cells. CD4+ and CD8+ T cells were purified by positive selection on antibody-coated Dynabeads and residual DR+ cells were removed by complement-dependent lysis. They were shown to be depleted of monocytes by their failure to proliferate in response to OKT3 and PHA. Nevertheless, the same cells gave an unequivocal response to cytokine-treated, serially passaged HUVEC or EAhy.926 cells. The response of CD4+ but not CD8+ T cells was dependent upon pretreatment of HUVEC or EAhy.926 with human rIFN-gamma. Neither CD4+ nor CD8+ T cells responded to MHC class II-bearing fibroblasts or epithelial cells. The CD8+ T cells that recognized EC did not respond to spleen cells in an MLR. The results confirm that EC, unlike other non-bone-marrow-derived cells, have the ability to provide all the signals necessary for direct stimulation of resting allogeneic T cells.

Effects of some nonsteroidal anti-inflammatory agents on experimental radiation pneumonitis.

Corticosteroids have previously been found to be protective against the mortality of radiation pneumonitis in mice, even when given well after lethal lung irradiation. We explored the possibility that this effect was due to their well-known anti-inflammatory actions by giving various nonsteroidal inhibitors of arachidonate metabolism to groups of mice that had received 19 Gy to the thorax (bilaterally). Treatments of four cyclooxygenase inhibitors, one lipoxygenase inhibitor, and one leukotriene receptor antagonist, given by various routes in various doses, were commenced 10 weeks after irradiation or sham irradiation and continued throughout the period when death from radiation pneumonitis occurs, 11-26 weeks after irradiation. Each of the treatments had the appropriate effect on arachidonate metabolism in the lungs as assessed by LTB4 and PGE2 levels in lung lavage fluid. The principal end point was mortality. The 5-lipoxygenase inhibitor diethylcarbamazine and the LTD4/LTE4 receptor antagonist LY 171883 markedly reduced mortality in dose-response fashion. The effects of cyclooxygenase inhibitors were divergent; piroxicam and ibuprofen were marginally protective, indomethacin in all doses accelerated mortality, and aspirin reduced mortality in a dose-response fashion. These results suggest that the protective effect of corticosteroids in radiation pneumonitis can be tentatively attributed to their anti-inflammatory actions, and that nonsteroidal anti-inflammatory agents, particularly those that affect lipoxygenase products, may offer equal or better protection than corticosteroids against mortality due to radiation pneumonitis.