scholarly journals Reduction of Fear: Towards a Unifying Theory

1973 ◽  
Vol 18 (1) ◽  
pp. 9-12 ◽  
Author(s):  
Isaac M. Marks
Keyword(s):  
Prolonged Exposure ◽  
Real Life ◽  
Current Evidence ◽  
Therapeutic Principle ◽  
Phobic Disorders ◽  
Short Acting ◽  
New Methods ◽  
Avoidance Responses

In recent years many new methods which alleviate phobic disorders have been introduced. These include desensitization, operant shaping, flooding (implosion), prolonged exposure, paradoxical intention, modelling, cognitive rehearsal and intravenous short-acting sedatives. Different theories have been invoked to explain the action of these procedures, and these are often contradictory. Current evidence suggests that the same therapeutic principle is responsible for the efficacy of most of these methods, this being the continued exposure to the phobic situation until anxiety and avoidance responses are extinguished. This exposure is greatly facilitated when carried out in real life rather than in phantasy. The conditions for successful exposure are explored and other possible therapeutic elements are discussed.

The development of a cognitive rehabilitation and psycho-social group programme for teenage and young adult survivors of brain tumours: A feasibility study

2021 ◽  
pp. 135910452110555
Author(s):  
Daniel Glazer ◽  
Xeni Daniilidi ◽  
Charlotte Valentino
Keyword(s):  
Young Adult ◽  
Feasibility Study ◽  
Social Group ◽  
Brain Tumours ◽  
Cognitive Rehabilitation ◽  
Real Life ◽  
Adult Survivors ◽  
Strategy Training ◽  
Current Evidence ◽  
Current Evidence Base

Introduction and aims Treatment for childhood and adolescent brain tumours is often intensive, with significant neurocognitive and psycho-social late effects ( Zeltzer et al., 2009 ). This feasibility Study aimed to inform the development of a cognitive rehabilitation and psycho-social group intervention for Teenage and Young Adult (TYA) survivors of brain tumours. Methods A group-based intervention incorporated ideas from the current evidence base, including psychoeducation and compensatory strategy training, with a focus on real-life goals and improving quality of life. Participants ( N = 19, 13–24 years) were recruited from the University College London Hospital TYA Oncology Service. Participants had received treatment for a malignant brain tumour and had completed their treatment at least 1 year prior to participation. Four group-based, whole-day interventions ran every 3 months throughout a year. Feasibility criteria were established to answer questions about acceptability of the intervention and recruitment. Results Qualitative and quantitative feedback from all four groups demonstrated acceptability and suitability of the intervention with regards to the content, structure and delivery. Recruitment presented more of a challenge with 35% fewer referrals than expected. Discussion and conclusion Feedback suggests that the intervention is suitable and acceptable, whilst limitations include numbers of referrals and referral pathways. Future directions are discussed.

scholarly journals P282 Outcome for PsA biologic switchers following primary inefficacy of TNFi therapy in a secondary care cohort: sequential TNFi versus switching mode of action

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Meena Naja ◽  
Liliana R Santos ◽  
Muhammad Shipa ◽  
Greenwood Mandy ◽  
Madhura Castelino
Keyword(s):  
Mode Of Action ◽  
Real Life ◽  
Initial Therapy ◽  
Current Evidence ◽  
First Line ◽  
Test Analysis ◽  
Drug Survival ◽  
Clinical Biomarkers ◽  
Switching Mode ◽  
Drop Outs

Abstract Background TNFi are the most used first line of biologic disease modifying anti-rheumatic drugs (bDMARDs) in PsA. In primary loss of response (PLR) to TNFi, there is no current evidence that directs the choice of second line bDMARDs. Our aim in this work was to compare drug survival for those who switched to a second TNFi versus alternative agents in real life. Methods Data was analysed retrospectively from a cohort of 400 PsA patients followed through from 2002-2019. Statistical analysis was carried out with descriptive statistics and t-test analysis using SPSS version 22. Results Out of 400 patients, 220 (55.0%) were started on bDMARD treatment. Of these 220, 212 (96.5%) were started on TNFi as initial therapy. PLR was seen in 42 of these patients (19.8%). The median drug survival of initial TNFi therapy was 7.1 months (interquartile range [IQR] 3.6 - 53.4 months). Of the 42 patients with PLR: 32 (76.2%) were switched to a second TNFi; 6 (14.3%) were switched to ustekinumab and 4 (9.5%) were switched to secukinumab. 21 of the 32 patients switched to a second TNFi were subsequently switched onto a third biologic due to treatment failure (65.6%). The median drug survival of the second TNFi in this group was 7.7 months (IQR 3.0 - 26.3 months). 3 out of the 6 (50%) patients who were switched to ustekinumab were then subsequently switched, this was due to primary inefficacy in 66.7% and adverse events in 33.3%. The median drug survival of ustekinumab in this group was 10.0 months (IQR 0.0 - 16.0 months). All 4 patients switched to secukinumab continue on this treatment with no drop outs, giving a median drug survival 12.3 months (IQR 6.5 - 19.5 months). Conclusion Our data suggests that patients with PLR to TNFi in PsA who switched mode of action to IL-17 inhibitor appeared to have better drug survival than subsequent TNFi or IL-12/23 inhibitors. Exploring the clinical biomarkers for those with successful switch to non-TNFi bDMARD in a larger cohort would help with targeting the most appropriate individuals and early disease control. Disclosures M. Naja None. L. R. Santos None. M. Shipa None. G. Mandy None. M. Castelino None.

scholarly journals Two Weighted Fuzzy Goal Programming Methods to Solve Multiobjective Goal Programming Problem

2012 ◽  
Vol 2012 ◽  
pp. 1-20 ◽  
Author(s):  
Mousumi Gupta ◽  
Debasish Bhattacharjee
Keyword(s):  
Goal Programming ◽  
Real Life ◽  
Fuzzy Goal Programming ◽  
Relative Importance ◽  
Objective Functions ◽  
Weighting Method ◽  
Fuzzy Operator ◽  
New Methods ◽  
Aspiration Levels ◽  
Fuzzy Goal

We propose two new methods to find the solution of fuzzy goal programming (FGP) problem by weighting method. Here, the relative weights represent the relative importance of the objective functions. The proposed methods involve one additional goal constraint by introducing only underdeviation variables to the fuzzy operatorλ(resp., 1-λ), which is more efficient than some well-known existing methods such as those proposed by Zimmermann, Hannan, Tiwari, and Mohamed. Mohamed proposed that every fuzzy linear program has an equivalent weighted linear goal program where the weights are restricted as the reciprocals of the admissible violation constants. But the above proposition of Mohamed is not always true. Furthermore, the proposed methods are easy to apply in real-life situations which give better solution in the sense that the objective values are sufficiently closer to their aspiration levels. Finally, for illustration, two real examples are used to demonstrate the correctness and usefulness of the proposed methods.

Oxford Case Histories in General Surgery

2018 ◽  
Keyword(s):  
General Surgery ◽  
Real Life ◽  
Surgical Care ◽  
Diagnostic Information ◽  
Current Evidence ◽  
Evidence Based ◽  
Case Histories ◽  
The Core ◽  
Discussion Format ◽  
Case Based

Oxford Case Histories in General Surgery aims to bring the different subspecialties of general surgery to life for its readers by adopting a case-based discussion format around real-life cases. It is most relevant to those who are just starting out in general surgery, including medical students, surgical care practitioners, foundation doctors, and those entering core surgical training. Each case presents a clinical vignette comprising focussed and relevant clinical and diagnostic information followed by a cases-based discussion that covers relevant clinical material pertinent to the core surgical element of the Intercollegiate Surgical Curriculum. The case-based discussion format is an important learning tool, as it allows focussed application of textbook knowledge to clinical practice and incorporates that with current evidence-based approaches to clinical and surgical management.

scholarly journals Switching to riociguat: a potential treatment strategy for the management of CTEPH and PAH

2020 ◽  
Vol 10 (1) ◽  
pp. 204589401983784
Author(s):  
Raymond L. Benza ◽  
Paul A. Corris ◽  
Hossein-Ardeschir Ghofrani ◽  
Manreet Kanwar ◽  
Vallerie V. McLaughlin ◽  
...  
Keyword(s):  
Life Experience ◽  
Soluble Guanylate Cyclase ◽  
Real Life ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Cyclic Guanosine Monophosphate ◽  
Initial Therapy ◽  
Guanosine Monophosphate ◽  
Current Evidence ◽  
Off Label ◽  
Insufficient Response

Currently, five classes of drug are approved for the treatment of pulmonary arterial hypertension (PAH): phosphodiesterase 5 inhibitors (PDE5i); endothelin receptor antagonists; prostacyclin analogs; the IP receptor agonist selexipag; and the soluble guanylate cyclase (sGC) stimulator riociguat. For patients with inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH), riociguat is currently the only approved pharmacotherapy. Despite the development of evidence-based guidelines on appropriate use of specific drugs, in clinical practice patients are often prescribed PAH-targeted therapies off label or at inadequate doses. PDE5i are the most often prescribed class of drugs as initial therapy, either alone or in combination with other drug classes. However, a proportion of patients receiving PAH therapies do not reach or maintain treatment goals. As PDE5i and riociguat target different molecules in the nitric oxide-sGC-cyclic guanosine monophosphate (NO-sGC-cGMP) signaling pathway, for patients with PAH without an initial or sustained response to PDE5i, there is a biological rationale for switching to riociguat. However, robust data from randomized controlled trials on the safety and efficacy of switching are lacking, as is formal guidance for clinicians. Here we review studies of sequential combination therapy, and trial data and case studies that have investigated switching between PAH-approved therapies, particularly from PDE5i to riociguat in patients with PAH with an insufficient response to PDE5i, and in patients with CTEPH who were receiving off-label treatment. These studies summarize the current evidence and practical real-life experience on the concept of switching treatments.

Emotional Objectivity: Neural Representations of Emotions and Their Interaction with Cognition

2020 ◽  
Vol 71 (1) ◽  
pp. 25-48 ◽  
Author(s):  
Rebecca M. Todd ◽  
Vladimir Miskovic ◽  
Junichi Chikazoe ◽  
Adam K. Anderson
Keyword(s):  
Human Brain ◽  
Learning And Memory ◽  
Current Evidence ◽  
Fundamental Feature ◽  
New Methods ◽  
Neural Representations ◽  
Emotional Outcomes ◽  
Multiple Levels ◽  
Psychological Events ◽  
Emotional Representations

Recent advances in our understanding of information states in the human brain have opened a new window into the brain's representation of emotion. While emotion was once thought to constitute a separate domain from cognition, current evidence suggests that all events are filtered through the lens of whether they are good or bad for us. Focusing on new methods of decoding information states from brain activation, we review growing evidence that emotion is represented at multiple levels of our sensory systems and infuses perception, attention, learning, and memory. We provide evidence that the primary function of emotional representations is to produce unified emotion, perception, and thought (e.g., “That is a good thing”) rather than discrete and isolated psychological events (e.g., “That is a thing. I feel good”). The emergent view suggests ways in which emotion operates as a fundamental feature of cognition, by design ensuring that emotional outcomes are the central object of perception, thought, and action.

scholarly journals Explicit Integrator of Runge-Kutta Type for Direct Solution of u(4)=f(x,u,u′,u′′)

Symmetry ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 246 ◽  
Author(s):  
Nizam Ghawadri ◽  
Norazak Senu ◽  
Firas Fawzi ◽  
Fudziah Ismail ◽  
Zarina Ibrahim
Keyword(s):  
Real Life ◽  
Order Ordinary Differential Equation ◽  
New Techniques ◽  
First Order ◽  
New Methods ◽  
Life Problems ◽  
Algebraic Order ◽  
Runge Kutta ◽  
Order Four ◽  
Primary Contribution

The primary contribution of this work is to develop direct processes of explicit Runge-Kutta type (RKT) as solutions for any fourth-order ordinary differential equation (ODEs) of the structure u ( 4 ) = f ( x , u , u ′ , u ′ ′ ) and denoted as RKTF method. We presented the associated B-series and quad-colored tree theory with the aim of deriving the prerequisites of the said order. Depending on the order conditions, the method with algebraic order four with a three-stage and order five with a four-stage denoted as RKTF4 and RKTF5 are discussed, respectively. Numerical outcomes are offered to interpret the accuracy and efficacy of the new techniques via comparisons with various currently available RK techniques after converting the problems into a system of first-order ODE systems. Application of the new methods in real-life problems in ship dynamics is discussed.

A New Intelligent Jigsaw Puzzle Algorithm Base on Mixed Similarity and Symbol Matrix

2017 ◽  
Vol 32 (02) ◽  
pp. 1859001 ◽  
Author(s):  
Lifang Chen ◽  
Dai Cao ◽  
Yuan Liu
Keyword(s):  
Error Rate ◽  
Real Life ◽  
Image Editing ◽  
Jigsaw Puzzle ◽  
Practical Application ◽  
New Methods ◽  
Crime Scene Reconstruction ◽  
Two Measures ◽  
Low Efficiency ◽  
Algorithm Base

Jigsaw puzzle algorithm is important as it can be applied to many areas such as biology, image editing, archaeology and incomplete crime-scene reconstruction. But, still, some problems exist in the process of practical application, for example, when there are a large number of similar objects in the puzzle fragments, the error rate will reach 30%–50%. When some fragments are missing, most algorithms fail to restore the images accurately. When the number of fragments of the jigsaw puzzle is large, efficiency is reduced. During the intelligent puzzle, mainly the Sum of Squared Distance Scoring (SSD), Mahalanobis Gradient Compatibility (MGC) and other metrics are used to calculate the similarity between the fragments. On the basis of these two measures, we put forward some new methods: 1. MGC is one of the most effective measures, but using MGC to reassemble the puzzle can cause an error image every 30 or 50 times, so we combine the Jaccard and MGC metric measure to compute the similarity between the image fragments, and reassemble the puzzle with a greedy algorithm. This algorithm not only reduces the error rate, but can also maintain a high accuracy in the case of a large number of fragments of similar objects. 2. For the lack of fragmentation and low efficiency, this paper uses a new method of SSD measurement and mark matrix, it is general in the sense that it can handle puzzles of unknown size, with fragments of unknown orientation, and even puzzles with missing fragments. The algorithm does not require any preset conditions and is more practical in real life. Finally, experiments show that the algorithm proposed in this paper improves not only the accuracy but also the efficiency of the operation.

scholarly journals An Approach to Prevent Air Pollution and Generate Electricity Using Nanostructured Carbon Materials

2021 ◽  
Vol 6 (1) ◽  
pp. 1-8
Author(s):  
Samrat Mondal ◽  
Avishek Bhadra ◽  
Souvik Chakraborty ◽  
Suraj Prasad ◽  
Shouvik Chakraborty
Keyword(s):  
Air Pollution ◽  
Large Scale ◽  
Fossil Fuels ◽  
Carbon Materials ◽  
Real Life ◽  
Energy Resource ◽  
Nanostructured Carbon ◽  
New Methods ◽  
Living Organisms ◽  
Different Sources

Pollution is one of the major threats for the environment as well as society. It causes severe problems for the living organisms and can gives birth of various unknown issues. Different sources like cars, industrial belts, fossil fuels etc. are the major causes of air pollution. Different researchers are working to develop new methods to combat air pollution. In this work, a new solution is proposed to fight against air pollution. The proposed solution is based on nanotechnology which not only fight against the air pollution but, it can generate electricity using the nanostructured carbon materials. The proposed solution can be deployed in real life scenario to reduce the air pollution and produce electricity in a large scale to provide an alternate energy resource to the society.

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