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Body image disturbance (BID) is a core symptom of anorexia nervosa (AN), but as yet distinctive features of BID are unknown. The present study aimed at disentangling perceptual and attitudinal components of BID in AN.
We investigated n = 24 women with AN and n = 24 controls. Based on a three-dimensional (3D) body scan, we created realistic virtual 3D bodies (avatars) for each participant that were varied through a range of ±20% of the participants’ weights. Avatars were presented in a virtual reality mirror scenario. Using different psychophysical tasks, participants identified and adjusted their actual and their desired body weight. To test for general perceptual biases in estimating body weight, a second experiment investigated perception of weight and shape matched avatars with another identity.
Women with AN and controls underestimated their weight, with a trend that women with AN underestimated more. The average desired body of controls had normal weight while the average desired weight of women with AN corresponded to extreme AN (DSM-5). Correlation analyses revealed that desired body weight, but not accuracy of weight estimation, was associated with eating disorder symptoms. In the second experiment, both groups estimated accurately while the most attractive body was similar to Experiment 1.
Our results contradict the widespread assumption that patients with AN overestimate their body weight due to visual distortions. Rather, they illustrate that BID might be driven by distorted attitudes with regard to the desired body. Clinical interventions should aim at helping patients with AN to change their desired weight.
To evaluate the agreement between the current National Healthcare Safety Network (NHSN) definition for ventriculitis and others found in the literature among patients with an external ventricular drain (EVD)
Retrospective cohort study from January 2009 to December 2014
Neurology and neurosurgery intensive care unit of a large tertiary-care center
Patients with an EVD were included. Patients with an infection prior to EVD placement or a permanent ventricular shunt were excluded.
We reviewed the charts of patients with positive cerebrospinal fluid (CSF) cultures and/or abnormal CSF results while they had an EVD in place and applied various ventriculitis definitions.
We identified 48 patients with a total of 52 cases of ventriculitis (41 CSF culture-positive cases and 11 cases based on abnormal CSF test results) using the NHSN definition. The most common organisms causing ventriculitis were gram-positive commensals (79.2%); however, 45% showed growth of only 1 colony on 1 piece of media. Approximately 60% of the ventriculitis cases by the NHSN definition met the Honda criteria, approximately 56% met the Gozal criteria, and 23% met Citerio’s definition. Cases defined using Honda versus Gozal definitions had a moderate agreement (κ=0.528; P<.05) whereas comparisons of Honda versus Citerio definitions (κ=0.338; P<.05) and Citerio versus Gozal definitions (κ=0.384; P<.05) had only fair agreements.
The agreement between published ventriculostomy-associated infection (VAI) definitions in this cohort was moderate to fair. A VAI surveillance definition that better defines contaminants is needed for more homogenous application of surveillance definitions between institutions and better comparison of rates.
Anorexia nervosa (AN) is a serious illness leading to substantial morbidity and mortality. The treatment of AN very often is protracted; repeated hospitalizations and lost productivity generate substantial economic costs in the health care system. Therefore, this study aimed to determine the differential cost-effectiveness of out-patient focal psychodynamic psychotherapy (FPT), enhanced cognitive–behavioural therapy (CBT-E), and optimized treatment as usual (TAU-O) in the treatment of adult women with AN.
The analysis was conducted alongside the randomized controlled Anorexia Nervosa Treatment of OutPatients (ANTOP) study. Cost-effectiveness was determined using direct costs per recovery at 22 months post-randomization (n = 156). Unadjusted incremental cost-effectiveness ratios (ICERs) were calculated. To derive cost-effectiveness acceptability curves (CEACs) adjusted net-benefit regressions were applied assuming different values for the maximum willingness to pay (WTP) per additional recovery. Cost–utility and assumptions underlying the base case were investigated in exploratory analyses.
Costs of in-patient treatment and the percentage of patients who required in-patient treatment were considerably lower in both intervention groups. The unadjusted ICERs indicated FPT and CBT-E to be dominant compared with TAU-O. Moreover, FPT was dominant compared with CBT-E. CEACs showed that the probability for cost-effectiveness of FTP compared with TAU-O and CBT-E was ⩾95% if the WTP per recovery was ⩾€9825 and ⩾€24 550, respectively. Comparing CBT-E with TAU-O, the probability of being cost-effective remained <90% for all WTPs. The exploratory analyses showed similar but less pronounced trends.
Depending on the WTP, FPT proved cost-effective in the treatment of adult AN.
Elemental Composition: Orbital and in situ Surface Measurements
J. Brückner, Geochemistry Department, Max Planck Institut für Chemie, PO Box 3060, Mainz D-55020, Germany,
G. Dreibus, Cosmochemistry Deparment, Max Planck Institut für Chemie, PO Box 3060, Mainz D-55020, Germany,
R. Gellert, Department of Physics, University of Guelph Guelph, ON N1G 2W1, Canada,
S. W. Squyres, Department of Astronomy, Cornell University, 428 Space Sciences Building, Ithaca, NY 14853, USA,
H. Wänke, Abteilung Kosmochemie Max Planck Institut für Chemie, PO Box 3060, Mainz D-55020, Germany,
A. Yen, JPL/Caltech 4800 Oak Grove Road M/S 183-501 Pasadena, CA 91109-8099, USA,
J. Zipfel, Forschungsinstitut und Naturmuseum Senckenberg Frankfurt/Main, D-60325, Germany
The Alpha Particle X-Ray Spectrometers (APXSs) on board the Mars Exploration Rovers (MERs) determine the elemental compositions of Martian samples. Improvements to the version of the instrument flown on the Mars Pathfinder (MPF) mission allow, for the first time, in situ detection and quantification of trace elements such as nickel, zinc, and bromine. The APXS measurements are performed by placing the sensor head against or immediately above the sample surface. A wealth of compositional diversity has been discovered at the two MER landing sites. At Gusev crater, fresh rock surfaces in the plains resemble primitive basalts, while rocks in the Columbia Hills are significantly weathered and enriched in mobile elements such as phosphorus, sulfur, chlorine, and bromine. Sandstones cemented by sulfates as well as evidence for clay formation have also been found in the Columbia Hills. At Meridiani Planum, the layered sedimentary rocks were found to consist primarily of sulfates mixed with siliciclastic debris. Iron-rich spherules and their fragments, confirmed to be hematitic by the Mössbauer spectrometer (MB), are found armoring the soil bedforms as well as embedded in the outcrop rocks. A variety of unusual objects, including an iron-nickel meteorite and a likely ejecta fragment similar to a Martian meteorite, have also been discovered. The elemental compositions of soils analyzed at both sites are remarkably similar, indicative of global-scale homogenization or the similarity of the soil precursors.
Tinnitus produced by repetitive contraction of the middle-ear muscles is a rare condition. We present an interesting case of bilateral middle-ear myoclonus causing incapacitating tinnitus in a patient with multiple sclerosis. Otological examination demonstrated rhythmic involuntary movement of the tympanic membrane. These movements correlated with a rhythmic ‘rushing wind’ noise perceived by the patient. Oropharyngeal examination showed no evidence of palatal myoclonus. Impedance audiometry confirmed rhythmic change in the middle-ear volume. Medical management was unsuccessful. The patient’s tinnitus was subsequently cured with bilateral sectioning of the tensor tympani and stapedial tendons.
The deposition of a-Si:H films on crystalline silicon substrates was monitored in situ by transient photoconductivity measurements in the microwave frequency range. At the start of the deposition a drastic increase of the interface recombination velocity was observed, followed by a rapid decrease. The implications of these results for the structure of the interface are discussed. Changes of the interface after deposition were detected without a change of the temperature, even at 250'C: The long relaxation time of the structure of the interface will be discussed. Ex situ results on the samples produced will be compared to the in situ results in view of the passivation properties of a-Si:H films on c-Si substrates.
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