Global ETD Search

11	Traditional Chinese medicine: evidence and challenges in fatigue clinical research Adams, Denise 06 1900 (has links) The increasing popularity of traditional Chinese medicine (TCM) therapies as health care options warrants thorough examination of the efficacy and safety evidence around these therapies. This thesis explores the intersection of TCM and fatigue using two rigorous methodologies: systematic reviews (SRs) and a randomized controlled clinical trial (RCT). In order to inform the development of an RCT of acupuncture for infectious mononucleosis (mono), a common condition with no known cure, characterized by profound fatigue, we examined the literature on TCM treatment of mono as well as another fatigue condition, idiopathic chronic fatigue (ICF). Additionally, we investigated the literature on the safety of pediatric acupuncture. SRs of TCM efficacy in mono and ICF determined that although clinical trials exist, methodological flaws compromised their validity. In particular, studies published as RCTs were found to lack proper randomization. Inclusion of these studies in the SRs would have been inappropriate and demonstrates the importance of verifying RCT methods. We also present the results of the first known SR of pediatric acupuncture safety. This review was comprehensive, including a large number of databases and publications in any language. Synthesis of the results from those studies that included a denominator produced mild adverse event estimates of 16.3/100 (95% CI 11.221.5) per patient, for RCTs, and 6.3/100 (95% CI 4.97.7) per patient, for cohort studies, with a combined estimate of 7.8/100 (95% CI 6.49.2) per patient. We developed and conducted an RCT of acupuncture for mono, although limitations to recruitment resulted in the enrolment of only three participants. The primary result of the small sample size was to restrict the determination of treatment effect, however, successful implementation of other elements is informative to further research in this area. In addition, we determined the local 5-year Monospot positive incidence rate to be 1.11/1000 (95% CI 0.953.2) for all ages and 5.46/1000 (95% CI 0.8910.0) for the 15-25 year old group. This dissertation examined the evidence around TCM and fatigue and provides recommendations that are aimed at increasing the value of research and the safety and efficacy of practice in this area. traditional Chinese medicine clinical research systematic review randomized controlled trial infectious mononucleosis chronic fatigue fatigue bias adverse events
12	Traditional Chinese medicine: evidence and challenges in fatigue clinical research Adams, Denise Unknown Date No description available. traditional Chinese medicine clinical research systematic review randomized controlled trial infectious mononucleosis chronic fatigue fatigue bias adverse events
13	EBV-Specific CD4+ T Cell Responses in Acute Infectious Mononucleosis: a Dissertation Precopio, Melissa Lynn 01 April 2004 (has links) Epstein-Barr virus (EBV) is a ubiquitous herpesvirus that establishes a life-long latent infection of B cells. It is usually asymptomatic in healthy individuals; however, individuals with compromised immunity often develop EBV-induced lymphoma. EBV also encodes potential oncogenes that can contribute to tumorigenesis. Therefore, vaccine and immunotherapeutic strategies targeting EBV are desirable. Recent studies have shown that infusion of EBV-specific CD8+T cells can elicit remission of lymphomas arising after administration of immunosuppressive drugs during transplantation, suggesting an important role for T cells in the prevention of EBV-induced malignancy. A better understanding of the cellular immune components involved in the control of EBV will aid in the development of methods to prevent infection and/or treat EBV-associated disease. While EBV infection is usually acquired asymptomatically during childhood, primary infection of adolescents and young adults can result in an illness termed acute infectious mononucleosis (AIM). Because of the characteristic symptoms of the illness, individuals with AIM can be readily identified and diagnosed with acute EBV infection. Thus, primary CD4+ and CD8+ T cell responses against the virus can be evaluated. It has been previously found that there is a marked expansion of lytic EBV protein-specific CD8+ T cells early during AIM, with delayed detection of lower frequencies of latent EBV protein-specific CD8+ T cells. The magnitude and specificity of CD4+T cell responses during AIM has been less well characterized. This thesis dissertation presents data from both functional assays and direct staining experiments documenting the timing, magnitude, and antigen-specificity of CD4+ T cells over the course of primary EBV infection. Lytic and latent protein-specific CD4+ T cells were readily detected by intracellular IFN-γ production at presentation with AIM and declined rapidly thereafter. Blood EBV load was also quantitated and found to decrease over time following AIM. By contrast, CD8+T cell IFN-y responses remained high for several weeks following presentation with AIM. Direct staining of lytic epitope-specific CD4+ T cells during AIM revealed high frequencies of virus-specific cells with low proliferative and IFN-γ-producing potential. Blood EBV load in these patients was persistently high through 6 wk following AIM. These data suggest a relationship between high EBV load during acute infection and impaired EBV-specific CD4+ T cell responses, which are compatible with impaired CD4+ T cell responses reported during high viremia associated with other viral infections. This may represent a mechanism by which persistent viruses, such as EBV, are able to establish a life-long infection in their hosts. CD4-Positive T-Lymphocytes Epstein-Barr Virus Infections Herpesvirus 4 Human Infectious Mononucleosis Cells Environmental Public Health Hemic and Immune Systems Hemic and Lymphatic Diseases Immune System Diseases Investigative Techniques Neoplasms Pharmaceutical Preparations Therapeutics Virus Diseases
14	Conserved Features of the T Cell Receptor Repertoire Contribute to the Persistence of EBV-Specific CD8 T Cells Kamga, Larisa 14 June 2019 (has links) Epstein-Barr Virus (EBV) is a ubiquitous human virus linked to several diseases, including cancers. CD8 T cells are important for controlling EBV replication. Generation and maintenance of virus-specific CD8 T cells is dependent on specific interaction between MHC-peptide complexes on the infected cell and the CD8 T cell receptor (TCR). Several lines of evidence suggest that the TCR repertoire is an essential component of the CD8 T-cell immune response. The current work focuses on delineating the features of the TCR repertoire that drive the selection of EBV-specific CD8 T cells into the memory phase. We used bulk and single-cell TCRαβ sequencing to analyze the TCR repertoire of human CD8 T cells specific for two immunodominant HLA-A02:01-restricted EBV-derived epitopes: BRLF1109-117 (YVLDHLIVV) and BMLF1280-288 (GLCTLVAML) during the acute and memory phases of primary EBV infection in humans. We showed that persistent EBV-specific clonotypes accounted for only 9% of unique clonotypes but were highly expanded in acute EBV infection and more commonly expressed identifiable features than non-persistent clonotypes. The other 91% of highly diverse unique clonotypes disappeared and were replaced in convalescence by equally diverse “de-novo” clonotypes. We provide evidence suggesting that recognition of BRLF1109-117may be driven by the TCRα. We identified a highly dominant and degenerate BRLF1109-117-specific TCRα sequence, AV8.1-CAVKDTDKLIF-AJ34, that was shared by all donors studied and identified conserved residues within this sequence that were important for antigen recognition. These findings are relevant to current efforts to develop or optimize the efficacy of T cell based therapies or vaccines. Epstein-Barr virus EBV acute infectious mononucleosis T-cell receptor TCR T cell CD8 T cell CDR3 TCR repertoire TCR sequencing BRLF1 BMLF1 Bioinformatics Immunology and Infectious Disease Molecular Biology
15	Action in Chronic Fatigue Syndrome: an Enactive Psycho-phenomenological and Semiotic Analysis of Thirty New Zealand Women's Experiences of Suffering and Recovery Hart, M J Alexandra January 2010 (has links) This research into Chronic Fatigue Syndrome (CFS) presents the results of 60 first-person psycho-phenomenological interviews with 30 New Zealand women. The participants were recruited from the Canterbury and Wellington regions, 10 had recovered. Taking a non-dual, non-reductive embodied approach, the phenomenological data was analysed semiotically, using a graph-theoretical cluster analysis to elucidate the large number of resulting categories, and interpreted through the enactive approach to cognitive science. The initial result of the analysis is a comprehensive exploration of the experience of CFS which develops subject-specific categories of experience and explores the relation of the illness to universal categories of experience, including self, ‘energy’, action, and being-able-to-do. Transformations of the self surrounding being-able-to-do and not-being-able-to-do were shown to elucidate the illness process. It is proposed that the concept ‘energy’ in the participants’ discourse is equivalent to the Mahayana Buddhist concept of ‘contact’. This characterises CFS as a breakdown of contact. Narrative content from the recovered interviewees reflects a reestablishment of contact. The hypothesis that CFS is a disorder of action is investigated in detail. A general model for the phenomenology and functional architecture of action is proposed. This model is a recursive loop involving felt meaning, contact, action, and perception and appears to be phenomenologically supported. It is proposed that the CFS illness process is a dynamical decompensation of the subject’s action loop caused by a breakdown in the process of contact. On this basis, a new interpretation of neurological findings in relation to CFS becomes possible. A neurological phenomenon that correlates with the illness and involves a brain region that has a similar structure to the action model’s recursive loop is identified in previous research results and compared with the action model and the results of this research. This correspondence may identify the brain regions involved in the illness process, which may provide an objective diagnostic test for the condition and approaches to treatment. The implications of this model for cognitive science and CFS should be investigated through neurophenomenological research since the model stands to shed considerable light on the nature of consciousness, contact and agency. Phenomenologically based treatments are proposed, along with suggestions for future research on CFS. The research may clarify the diagnostic criteria for CFS and guide management and treatment programmes, particularly multidimensional and interdisciplinary approaches. Category theory is proposed as a foundation for a mathematisation of phenomenology. action Chronic Fatigue Syndrome Myalgic Encephalomyelitis Chronic Immune Deficiency Syndrome enaction social enaction social enactivism enactive psycho-phenomenological psychophenomenological vipassana groundlessness mind-body korper leib co-generative Focusing co-creative environment Antonio Damasio reciprocal constraints Pierre Vermersch Claire Petitmengin Antione Lutz narrative discourse phenomenal invariants Evan Thompson Merleau-Ponty Algirdis Julien Greimas Husserl first-person Fransisco Varela modelling invariants Natalie Depraz isotope John Boyd OODA loop Jonathan Shear Shaun Gallagher Arthur Kleinman Humberto Maturana second-person Alva Noe Dan Zahavi stages Embodied Mind Canterbury Wellington New Zealand non-dual non-reductive embodied phenomenological third-person graph-theoretical cluster analysis cognitive science experience solution subject-specific categories universal categories universal categories self energy illness process intersubjectivity Mahayana Buddhism contact narrative recovered making sense recursive loop perception dynamical decompensation neurology diagnosis empathy treatment management neurophenomenological neurophenomenology consciousness veracity agency multidimensional interdisciplinary category theory enculturation mathematisation of phenomenology interview nomenclature diagnostic criteria incidence prevalence coping strategy etiology epidemiology psychosomatic medicine meaning women girl female anthropology sociology cognitive behavioral therapy exercise therapy recovery mindful awareness suffering symbolisation Prasangika no-self aggregates wheel of karma cognition basic element analysis mental factors operational closure stereotypes enactive ontologically fragile self grief process-knowledge epoche phenomenal invariants textual invariants compound meaning saturation formalisation cluster analysis inter-session review inter-individual validation explicitation interview intricacy confidence psychophenomenology self-esteem sanction self dis-integration permanence continuity ego-self emotion surrender semiotic square meditation empathy semiotic compassion existential feelings goal obstruction movement transformation change somatic Giovanna Colombetti agoraphobia panic anxiety psychotherapy sleep rest pain weakness strength stamina Diego Cosmelli heaviness food chemicals allergy recovering despair frustration helplessness fear efference valence afference as-if-body-loop consciousness representation attention recovery intention sustainable sustainability neurasthenia existential feelings asthenia hysteria mononucleosis samatha-vispasnya prajna vijnana Eugene Gendlin Abhidharma dukkha shamatha interdependence vipashyana

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