Working Alliance Inventory-Short Revised (WAI-SR): psychometric properties in outpatients and inpatients

The Working Alliance Inventory-Short Revised (WAI-SR) is a recently refined measure of the therapeutic alliance that assesses three key aspects of the therapeutic alliance: (a) agreement on the tasks of therapy, (b) agreement on the goals of therapy and (c) development of an affective bond. The WAI-SR demonstrated good psychometric properties in an initial validation in psychotherapy outpatients in the USA. The generalizability of these findings is limited because in some countries a substantial portion of individual psychotherapy is delivered in inpatient settings. This study investigated and compared the psychometric properties of the WAI-SR in German outpatients (N = 88) and inpatients (N = 243). In both samples reliability (alpha > 0.80) and convergent validity with the Helping Alliance Questionnaire were good (r > 0.64). Confirmatory factor analysis showed acceptable to good model fit for the proposed Bond-Task-Goal model in both samples. Multi-group analysis demonstrated that the same constructs were measured across settings. Alliance ratings of outpatients and inpatients differed regarding the overlap of alliance components and the magnitude of the alliance ratings: The differentiation of the alliance components was poorer in inpatients and they reported lower alliances. Unique aspects of the alliance in inpatient treatment are discussed and a need for further research on the alliance in inpatient settings is pointed out. Overall, the WAI-SR can be recommended for alliance assessment in both settings.

Three-dimensional electroanatomic entrainment map in atypical atrial flutter late after heart transplantation

Atrial flutter in the donor part of orthotopic heart transplants has been reported and successfully treated by radiofrequency ablation of the cavotricuspid isthmus, but mapping and ablation of atypical flutter circuits may be challenging.(1) Entrainment mapping has been used in combination with activation mapping to define the mechanism of atypical atrial flutter. Here, we report a case where colour-coded three-dimensional (3D) entrainment mapping allowed us to accurately determine and visualize the 3D location of the reentrant circuit and to plan the ablation of a left atrial flutter without the need for activation mapping.

Cardiac rehabilitation in Europe: results from the European Cardiac Rehabilitation Inventory Survey

Cardiac rehabilitation (CR) programmes support patients to achieve professionally recommended cardiovascular prevention targets and thus good clinical status and improved quality of life and prognosis. Information on CR service delivery in Europe is sketchy.

Speech Enhancement With Inventory Style Speech Resynthesis

We present a new method for the enhancement of speech. The method is designed for scenarios in which targeted speaker enrollment as well as system training within the typical noise environment are feasible. The proposed procedure is fundamentally different from most conventional and state-of-the-art denoising approaches. Instead of filtering a distorted signal we are resynthesizing a new “clean” signal based on its likely characteristics. These characteristics are estimated from the distorted signal. A successful implementation of the proposed method is presented. Experiments were performed in a scenario with roughly one hour of clean speech training data. Our results show that the proposed method compares very favorably to other state-of-the-art systems in both objective and subjective speech quality assessments. Potential applications for the proposed method include jet cockpit communication systems and offline methods for the restoration of audio recordings.

Development of the Heat and Energy Concept Inventory: Preliminary Results on the Prevalence and Persistence of Engineering Students' Misconceptions

BACKGROUND Students frequently hold a number of misconceptions related to temperature, heat and energy. There is not currently a concept inventory with sufficiently high internal reliability to assess these concept areas for research purposes. Consequently, there is little data on the prevalence of these misconceptions amongst undergraduate engineering students. PURPOSE (HYPOTHESIS) This work presents the Heat and Energy Concept Inventory (HECI) to assess prevalent misconceptions related to: (1) Temperature vs. Energy, (2) Temperature vs. Perceptions of Hot and Cold, (3) Factors that affect the Rate vs. Amount of Heat Transfer and (4) Thermal Radiation. The HECI is also used to document the prevalence of misconceptions amongst undergraduate engineering students. DESIGN/METHOD Item analysis, guided by classical test theory, was used to refine individual questions on the HECI. The HECI was used in a one group, pre-test-post-test design to assess the prevalence and persistence of targeted misconceptions amongst a population of undergraduate engineering students at diverse institutions. RESULTS Internal consistency reliability was assessed using Kuder-Richardson Formula 20; values were 0.85 for the entire instrument and ranged from 0.59 to 0.76 for the four subcategories of the HECI. Student performance on the HECI went from 49.2% to 54.5% after instruction. Gains on each of the individual subscales of the HECI, while generally statistically significant, were similarly modest. CONCLUSIONS The HECI provides sufficiently high estimates of internal consistency reliability to be used as a research tool to assess students' understanding of the targeted concepts. Use of the instrument demonstrates that student misconceptions are both prevalent and resistant to change through standard instruction.

MAP kinase kinase 1 (MKK1) is essential for transmission of Trypanosoma brucei by Glossina morsitans

MAP kinase kinase 1 (MKK1) is encoded by a single copy gene in Trypanosoma brucei. It has been shown recently that MKK1 is not essential for bloodstream forms [14]. To investigate the requirement for MKK1 in other life-cycle stages we generated null mutants in procyclic forms of a fly-transmissible strain. These grew normally in culture and were able to establish midgut infections in tsetse at normal rates and intensities, but were incapable of colonising the salivary glands. Transformation of null mutants with an ectopic copy of MKK1 enabled parasites to complete the life cycle in tsetse and infect mice. This is the first example of a gene that is indispensable for transmission of T. brucei. It also raises the possibility that activating the MKK1 signalling cascade in vitro might trigger the differentiation and proliferation of life-cycle stages of T. brucei that are currently refractory to culture.

Metabolomics reveals the metabolic map of procainamide in humans and mice

Procainamide, a type I antiarrhythmic agent, is used to treat a variety of atrial and ventricular dysrhythmias. It was reported that long-term therapy with procainamide may cause lupus erythematosus in 25-30% of patients. Interestingly, procainamide does not induce lupus erythematosus in mouse models. To explore the differences in this side-effect of procainamide between humans and mouse models, metabolomic analysis using ultra-performance liquid chromatography coupled with electrospray ionization quadrupole time-of-flight mass spectrometry (UPLC-ESI-QTOFMS) was conducted on urine samples from procainamide-treated humans, CYP2D6-humanized mice, and wild-type mice. Thirteen urinary procainamide metabolites, including nine novel metabolites, derived from P450-dependent, FMO-dependent oxidations and acylation reactions, were identified and structurally elucidated. In vivo metabolism of procainamide in CYP2D6-humanized mice as well as in vitro incubations with microsomes and recombinant P450s suggested that human CYP2D6 plays a major role in procainamide metabolism. Significant differences in N-acylation and N-oxidation of the drug between humans and mice largely account for the interspecies differences in procainamide metabolism. Significant levels of the novel N-oxide metabolites produced by FMO1 and FMO3 in humans might be associated with the development of procainamide-induced systemic lupus erythematosus. Observations based on this metabolomic study offer clues to understanding procainamide-induced lupus in humans and the effect of P450s and FMOs on procainamide N-oxidation.