Coping with Transitions: A Promising Intensive Outpatient DBT Program for Emerging Adults and Their Families.

Emerging adulthood is a period of significant exploration, transformation, variability, and growth. Simultaneously, this developmental period presents unique challenges as emerging adults work to achieve developmental milestones including self-identity formation, the establishment of long-term intimate relationships, career advancement, and independence from parents. For those who are vulnerable, this period is also marked by the development of significant mental health problems and associated impairment, which prevents individuals from successfully reaching these developmental milestones. To address the various challenges unique to this developmental period, we created and implemented a multifaceted DBT treatment protocol to specifically address emotional dysregulation within emerging adults. The current study presents an evaluation of a novel, intensive, outpatient DBT program called System for Adult Growth and Emergence-Foundations (SAGE-F). We aim to first introduce the SAGE-F treatment protocol, and then to assess both its short and long-term therapeutic value. Participants enrolled in SAGE-F were administered a testing battery assessing symptom severity, functioning capacities, and coping strategies at intake, upon completion of the program 6-weeks later, and at 3-month follow-up. It was found participants who completed SAGE-F reported significant reductions in depression and anxiety symptoms, as well as non-suicidal self-injurious behaviors. Simultaneously, participants also reported improvements in their daily functioning and coping capacities. Follow-up assessments indicated therapeutic progress remained.

Acidogenic Potential of Packaged Fruit Juices and its Effect on Plaque and Salivary pH.

AIM: The aim of this study was to analyze the acidogenic potential of the various commercially available fruit juices and to evaluate the salivary and plaque pH changes before and after consumption of the fruit juices that were kept at various temperatures. MATERIALS AND METHODS: Baseline plaque and salivary pH were measured for 30 volunteers, and the test was conducted for 4 consecutive days on which juices with a known pH was consumed, which were kept at varying temperatures. The resulting changes in the plaque and salivary pH were measured after 1, 5, 15, and 30 minutes of the consumption of the fruit juices using a portable standard digital pH meter. RESULTS: Among the three juices compared, grape juice was found to be more acidic compared to the orange juice and pineapple juice. The pH fall was maximum after consumption of grape juice followed by orange and pineapple juice, respectively. The consumption of ice candy caused a greater fall in pH followed by the refrigerated juice and the juices that were kept at room temperature, respectively. CONCLUSION: Parents are unaware of the harmful effects of endogenous acids in the fruit juices and their effect on the teeth. We, as primary dental care providers, should take initiatives to provide adequate knowledge and information regarding this new trend of consuming frozen fruit juices and must strongly discourage this form of consumption as a frequent habit. CLINICAL SIGNIFICANCE: Though many presume that the readily available fruit juices are healthy, frequent consumption of these fruit juices causes acid dissolution of enamel as most of these juices have a pH below the critical level. Hence the present study was conducted to evaluate the erosive potential of the various commercial fruit juices. As with increased awareness by both the dentists and the parents, the problem of fruit-juice-induced tooth loss may be reduced. HOW TO CITE THIS ARTICLE: Mehta LK, Hegde A, et al. Acidogenic Potential of Packaged Fruit Juices and its Effect on Plaque and Salivary pH. Int J Clin Pediatr Dent 2019;12(4):312-317.

Feasibility and impact of a guided symptom exposure augmented cognitive behavior therapy protocol to prevent symptoms of pharmacologically induced depression: A pilot study.

Depression is the leading cause of disability and a major cause of morbidity worldwide, with societal costs now upwards of 1 trillion dollars across the globe. Hence, extending current efforts to augment prevention outcomes is consistent with global public health interests. Although many prevention programs have been developed and have demonstrated efficacy, studies have yet to demonstrate that CBT is effective in preventing symptoms in populations at risk for developing depression induced by pharmacological substances. Using a randomized, controlled design, this pilot study reports on the feasibility and preliminary effects of a novel, guided symptom exposure augmented cognitive behavioral prevention intervention (GSE-CBT) in a sample diagnosed with Hepatitis C at risk for developing medication induced depression. Results demonstrated that the guided symptom exposure augmented CBT (GSE-CBT) was feasible in this population and was delivered with high integrity. Although not statistically different, we observed a pattern of lower depression levels in the GSE-CBT group versus those in the control group throughout. This pilot study demonstrates that a psychosocial prevention intervention is feasible for use in patients at risk for developing pharmacologically induced depression and that a guided symptom exposure augmented CBT protocol has the potential to prevent symptoms of depression that develop as a side effect to taking these medications. Results are preliminary and future studies should use larger samples and test the intervention in other populations.

Evaluation of Predictability of Suitable Implant Lengths as related to Accurate Treatment Planning using Recent Roentgenographic Measures: A Key to Success.

BACKGROUND AND AIM: Selection of suitable length of dental implants is very subjective and largely depends on clinical evidences and operator's expertise. The present study was aimed to assess the role of cone beam computed tomography (CBCT) and cephalograms as far as the selection of right implant length is concerned. MATERIALS AND METHODS: The study includes 220 patients for whom radiographic and follow-up records were obtained. There were 105 males and 115 females in the age range of 22 to 58 years. A total of 98 implant sites in different edentulous areas were studied. Length of implant was predicted at treatment planning and compared with finally placed implant at surgical stages. It also includes the in-depth exploration of (1) number of implants placed per patient, (2) implant per edentulous areas, (3) implant location, and (4) implant region. For prediction of implant lengths, CBCT results were obtained and compared with cephalometric findings. Accuracies of implant lengths as planned by CBCT and cephalometric images were also studied at treatment planning and surgical stages. Statistical analysis and results: Upon statistical comparisons, we found that larger implant lengths chosen at treatment planning stage did not change in 65.5% of patients. In addition, the smaller length implants were just about the same as that with larger dimensions. The CBCT results were satisfactory (up to 98.5%). Cephalometry was performed well in this prediction, especially in posterior mandible (87.9%). However, its performance in anterior maxillary region was not satisfactory (69.6%). Intergroup comparisons of CBCT and cephalometric results at different regions were significant (p < 0.001). CONCLUSION: Our study results show insignificant changes in the length of implants that was exactly planned using CBCT scans. Therefore, accurate prediction of implant lengths can be done using CBCT scans as they have superior and advanced tools that facilitate presurgical decision-making. Lateral cephalometric evaluation has been shown as an imperative radiographic tool for determining implant lengths as it confirmed the significance bone resorption on the selection of implant length at different sites. CLINICAL SIGNIFICANCE: The CBCT and lateral cephalogram offer excellent anatomical details that can be judiciously applied for treatment planning and other clinical decision-making, including selection of correct implant length. Our study advocates thorough cephalometric evaluations of mandible wherein implants are to be placed for implant-supported overdentures.

Half of obsessive-compulsive disorder cases misdiagnosed: vignette-based survey of primary care physicians.

OBJECTIVE: Medical settings are the primary mode of care for mental health problems; physicians' abilities with regard to psychiatric diagnosis and treatment recommendations are therefore essential. While misdiagnosis can occur across all psychiatric conditions, the heterogeneous nature of obsessive-compulsive disorder (OCD) may make this condition at an elevated risk for misidentification. The study's aim was to assess primary care physicians' ability to identify OCD. METHOD: The study was cross-sectional in design. An online, vignette-based survey was emailed to 1,172 physicians from 5 major medical hospitals in the Greater New York Area. The email included a link to the survey, which consisted of 1 of 8 randomized OCD vignettes; each vignette focused on one of the following common manifestations of OCD: obsessions regarding aggression, contamination, fear of saying things, homosexuality, pedophilia, religion, somatic concerns, or symmetry. Participants provided diagnostic impressions and treatment recommendations for the individual described in the vignette. Data collection took place from December 10, 2012, through January 18, 2013. RESULTS: Two hundred eight physicians completed the survey. The overall misidentification rate was 50.5%. Vignette type was the strongest predictor of a correct OCD response (Wald χ(2)7 = 40.58; P <.0001). Misidentification rates by vignette were homosexuality (84.6%), aggression (80.0%), saying certain things (73.9%), pedophilia (70.8%), somatic concerns (40.0%), religion (37.5%), contamination (32.3%), and symmetry (3.70%). Participants who misidentified the OCD vignette were less likely to recommend a first-line empirically supported treatment (cognitive-behavioral therapy [CBT] = 46.7%, selective serotonin reuptake inhibitor [SSRI] = 8.6%) compared to participants who correctly identified the OCD vignette (CBT = 66.0%, SSRI = 35.0%). Antipsychotic recommendation rates were elevated among incorrect versus correct responders (12.4% vs 1.9%). CONCLUSIONS: Elevated OCD misdiagnosis rates and the impact of incorrect diagnoses on treatment recommendations highlight the need for greater training regarding OCD symptomatology and empirically supported treatments.

Lessons learned in looking back: perspectives from trailblazers.

Although this is in many ways a good era for women, many things have yet to improve. Women continue to lag behind men with regard to salaries, are under-represented in position of leadership, and still take on greater responsibility for child rearing and family responsibilities. Careers dominated by women tend to be associated with lower salaries and lower prominence and by the same token, women tend to dominate leadership positions when the field becomes less prestigious. Although women now outnumber men in graduating classes, the feminization of clinical psychology brings new challenges. This special series comes out of the 2009 trailblazer panel held at the ABCT convention in New York City, which explored the experiences faced by pioneering women in behavior therapy and discussed ways to help women overcome the glass ceiling. This introductory paper summarizes the lessons learned by these trailblazers with a view toward helping women in academia today.

Inspiration from role models and advice for moving forward.

This Behavior Therapy series on overcoming the glass ceiling followed from a highly attended panel at ABCT on the same topic. The current paper summarizes the common themes across the various papers in this series with respect to obstacles prominent women have faced, and how we can learn from their stories to help inform the future. These themes include the importance of role models, messages from a supportive environment, difficulties balancing careers with children, coordinating careers with family, importance of taking charge of one's career, moving forward despite negative internal and external messages, and questions about whether things have changed substantially. In addition, this paper contains a summary of the helpful advice from accomplished women in academia for navigating the academic waters. It is our aspiration that going forward this series will stimulate other conversations as well as increase thought, behavior, solidarity, and awareness about this topic so that we can continue to work toward a future when things will continue to improve for women.

Hepatitis C treatment completion in individuals with psychiatric comorbidity and depression.

Hepatitis C virus is a common bloodborne pathogen. Patient, provider, and health care system factors combine to constrain access to treatment and have led to low rates of treatment initiation and continuation among medically eligible individuals. Behavioral health comorbidity, which is common in the patient population, has historically been an exclusion criterion and is one such barrier to care. We implemented an interdisciplinary nurse-managed primary care-based hepatitis C evaluation and treatment program to address behavioral health needs concurrently in an effort to increase treatment initiation and continuation rates among comorbid individuals. We found no association between having a psychiatric or substance use history and treatment discontinuation in our patient cohort. Likewise, there was no association in our cohort between becoming depressed or anxious while undergoing treatment and treatment discontinuation. The results of our study concur with others that have shown that addressing behavioral health comorbidities concurrently with hepatitis C evaluation and treatment may improve treatment continuation rates among comorbid patients, thereby helping to remove barriers to treatment of chronic hepatitis C.

Effect of zero energy cool chamber and post-harvest treatments on shelf-life of fruits under semi-arid environment of Western India. Part 1. Ber fruits.

Effect of zero energy cool chamber (ZECC) along with post-harvest treatments (including CaCl2, mustard oil and K2SO4 separately) on shelf-life and fruit quality attributes of ber (Zizyphus mauritiana Lamk.) cv 'Gola' during storage under semi-arid ecosystem of Gujarat was studied. Increase in physiological loss in weight (PLW), spoilage loss, total soluble solids, total sugars, reducing sugar and reduction in titratable acidity, and ascorbic acid during storage were observed in all treatments. Fruits treated with CaCl2 1.5% and stored in ZECC recorded least PLW (17.1%), spoilage loss (20%), respiratory activity (0.25 mg CO2/kg/h) and exhibited 7 days of shelf-life, followed by CaCl2 1% + ZECC, while untreated fruits had 3 days of economic shelf-life. Fruits stored in ZECC recorded 6 days shelf-life. Highest respiration rate was in control (0.45 mg CO2 /kg/h) on 9(th) day of storage. Data on fruit quality attributes indicated that ZECC + CaCl2 1.5% or ZECC alone might be an ideal on-farm storage facility for maintaining the quality of ber fruits under semi-arid environment of Western India.

History of child abuse and severity of adult depression: the mediating role of cognitive schema.

The link between childhood abuse, adult depression, and anxiety has been well studied, but few studies have empirically explored the mechanism of that link. Using a clinical sample of women, this study examined the relationship between retrospectively measured childhood abuse and neglect and current adult symptoms of anxiety and depression, via the mediating effects of cognitive style. This study found that women who reported a positive abuse history were significantly more depressed and exhibited more maladaptive schemas than women who did not report a history of abuse. Specifically, it would appear that cognitive styles marked by interpersonal disconnection and rejection are particularly pathogenic. These findings contribute to the growing literature by providing support for the role of cognitions in mediating the link between childhood abuse and psychopathology.

Increased personality disorders and Axis I comorbidity in atypical depression.

OBJECTIVE: Comparison of patients with and without atypical depression on comorbid Axis I and I disorders to determine whether atypical depression is associated with a higher comorbidity. METHOD: Twenty-nine major depressive disorder patients with and without atypical depression were compared on clinical measures using multiple regression analyses. RESULTS: Atypical depression predicted the presence of comorbid Axis I (100% vs 33%), Axis II (90% vs 35%), and both Axis I and II (65% vs 8.14%) disorders. Personality disorders did not mediate the relationship between atypical depression and Axis I comorbidity. CONCLUSIONS: The high prevalence of Axis I and II comorbidity in major depression may be explained, at least in part, by the presence of atypical depression. Our findings also suggest that the increased Axis I comorbidity observed in atypical depression is independent of the effects of personality disorders and is probably a direct effect of atypical depression subtype. Future research should confirm whether clinical findings associated with atypical depression are independent of their association with personality disorders in a larger sample of depressed patients and also examine treatment implications in atypical depression other than a preferential monoamine oxidase inhibitor responsivity.

Treating chronic hepatitis C in the primary care setting.

The National Institutes of Health and other institutions have emphasized the need to expand access to treatment of chronic hepatitis C virus infection to a larger and more diverse patient population. To begin to address this need, the divisions of General Internal Medicine and Liver Diseases of the Mount Sinai Medical Center created a program to identify patients who might benefit from hepatitis C treatment, to treat uncomplicated patients in the primary care setting, and to refer appropriate patients to liver disease specialists. Preliminary data from this program suggest that primary care-based treatment of chronic hepatitis C may offer unique advantages. The primary care setting allows special needs to be addressed and allows comprehensive services to be provided. Patients are guided through the complex pretreatment evaluation process, and non-liver-related comorbidities are managed. Our program may provide a useful model for increasing hepatitis C literacy among primary care providers and for extending treatment to a broader population of patients with hepatitis C.

A novel process using enhanced acidification and a UASB reactor for biomethanation of vegetable market waste.

The processing of solid vegetable market waste was attempted in a two-stage digester. Initially, for the hydrolysis and acidification of waste, enhanced extraction process was carried out by continuous sprinkling of water over the bed of waste in a mild steel 100 1 solid bed digester. The leachate obtained after completion of acidification phase was further treated in 24.6 1 UASB reactor for biogas production. The effect of waste-liquid ratio, dilution and sprinkling rate on the digestion of waste were studied. A high strength leachate, with a COD of 25,298 mg l(-1) and total volatile fatty acids concentration of 11.3 g l(-1), was obtained as a result of hydrolysis and acidification in a very short retention time of 40 h. The COD reduction of 94% was achieved during UASB reactor operation at organic loading rate of 19.6 kg COD m day(-3). A minimum hydraulic retention time of 16 h was achieved.

Three-dimensional reconstruction of the Escherichia coli 30 S ribosomal subunit in ice.

Three-dimensional (3D) reconstructions of both the heat-activated and non-activated 30 S subunit of the Escherichia coli 70 S ribosome were obtained from a frozen hydrated specimen preparation at 1/37 A-1 resolution. Well-characterized features that can be identified in both reconstructions are the head, the base, the platform and the cleft formed between the head and the platform. Comparisons between the 3D maps of 30 S subunits at 0 degree C, heat-activated at 37 degrees C, and the 30 S subunit portion identified in the cryo-3D map of 70 S ribosome reveal conformational changes the subunit probably undergoes during inactive-active transition and upon association with the 50 S subunit. These comparisons also allow us to localize the sites of association of 30 S and 50 S subunits.

Automatic particle picking from electron micrographs.

A computer program for automatic particle picking based on textural methods is proposed. The technique relies on the evaluation of certain textural parameters for data windows containing single particles, and those containing undesirable material. These parameters are manipulated by a discriminant analysis routine for determining the rules of classification between the different categories. The effectiveness of the method was demonstrated by application to electron micrographs of 70S Escherichia coli ribosomes.

A simple screening procedure for detection of infraclinical cases of multiple myeloma.

Agarose Gel Serum Electrophoresis is a simple, rapid and sensitive technique routinely used for diagnosis of Multiple Myeloma. Its effectiveness as a screening tool for detecting infraclinical cases of Multiple Myeloma is brought out in this study. 29 out of the 219 patients presenting with unexplained osteoporosis and pain are found to be positive for M proteins. These patients were earlier adjudged organic disease free after preliminary investigation and examination.

Efficacy of lignocaine in the suppression of the intra-ocular pressure response to suxamethonium and tracheal intubation.

The effect of lignocaine pretreatment on the intra-ocular pressure response to suxamethonium and tracheal intubation was studied in 80 adult patients, divided randomly into four groups of 20 each. These groups received respectively normal saline (10 ml), lignocaine 1 mg/kg, 1.5 mg/kg and 2 mg/kg as pretreatment, in a double blind manner, one minute before anaesthetic induction with thiopentone and suxamethonium 1.5 mg/kg. Lignocaine pretreatment caused a significant decrease in intra-ocular pressure. Suxamethonium caused a significant increase, but lignocaine pretreatment in doses of 1.5 mg/kg and 2 mg/kg effectively kept the postsuxamethonium pressure below control values. Tracheal intubation further aggravated the postsuxamethonium increase in intra-ocular pressure. Lignocaine, in doses of 1.5 mg/g and 2 mg/kg also effectively kept the postintubation pressure values below control levels. Lignocaine, in dose of 1 mg/kg, only partially attenuated the postsuxamethonium and postintubation increase in intra-ocular pressure. In conclusion, lignocaine pretreatment, in a dose of 1.5 mg/kg, offers protection against suxamethonium- and tracheal-intubation initiated increases in intra-ocular pressure, without causing any significant decrease in arterial pressure.

Skeletal muscle metabolism in mice bearing adenocarcinoma. I. Histochemical alterations in glycogenolytic, glycolytic, lipolytic and oxidative metabolism.

Metabolism of triceps, pectoralis (in the vicinity of tumor) and gastrocnemius (away from the tumor) muscles in Swiss albino mice bearing adenocarcinoma has been studied histochemically with regard to content of glycogen, lipids, phosphorylase, aldolase, lipase, succinate dehydrogenase and cytochrome oxidase in the constituent fibres. At 9-10 weeks after transplantation of adenocarcinoma, a negligible glycogen content and decreased phosphorylase and aldolase activities are observed in the white, intermediate and red fibre types in the three muscles. Hypertrophy of fibres and occurrence of targetoid fibres is distinct in the muscles of tumor-bearing mice. The red fibres demonstrate a general loss of lipids, lipase, succinate dehydrogenase and cytochrome oxidase whereas the hypertrophied fibres reveal intense localization of these parameters in their central zones. The results indicate that a decline in glycogenolysis, glycolysis, lipolysis and oxidative metabolism in the various fibre types may contribute to the muscle weakness and muscle wasting in the adenocarcinoma-bearing mice.