No description available.

Paclitaxel (PTX) is among the most commonly used first-line drugs for cancer chemotherapy. However, its poor water solubility and indiscriminate distribution in normal tissues remain clinical challenges. Here we designed and synthesized a highly water-soluble nucleolin aptamer-paclitaxel conjugate (NucA-PTX) that selectively delivers PTX to the tumor site. By connecting a tumor-targeting nucleolin aptamer (NucA) to the active hydroxyl group at 2' position of PTX via a cathepsin B sensitive dipeptide bond, NucA-PTX could remain stable and inactive in the circulation. The tumor-recognition component NucA facilitates the uptake of the conjugated PTX specifically in tumor cells. Once inside cells, the dipeptide bond linker of NucA-PTX will be cleaved by cathepsin B and then the conjugated PTX will be released for action. The stability of NucA-PTX in human serum and the cathepsin-B dependent release of the conjugated PTX in tumor cells were verified by monitoring the fluorescence resonance energy transfer (FRET) of a dual fluorescence-labeled conjugate FAM-NucA-PTX-Rd. In addition, the PTX conjugation did not considerably affect the binding affinity between NucA and its target protein nucleolin, which was supported by both molecular dynamic simulation and isothermal titration calorimetry (ITC). The NucA modification was shown to facilitate the uptake of the conjugated PTX in ovarian cancer cells mainly by macropinocytosis in a nucleolin expression-dependent manner. Moreover, the NucA modification increased the in vitro cytotoxicity and mitosis inhibition of the conjugated PTX in ovarian cancer cell lines. The in vivo data collected from a human xenograft model of ovarian cancer demonstrated that the NucA modification facilitated the selective accumulation of the conjugated PTX in ovarian tumor tissue, and subsequently resulting in notably improved antitumor activity and reduced toxicity.

The aim of this research is to reveal the reality negotiation process for finding hope in people who have Depression. In the traditional, modern and medical models of depression, and biological, psychological, social or even contextual perspectives, it is considered that people who are affected by depression are stigmatized in a sick role with different kinds of dysfunctions or deficiencies. They are not considered to have much hope. Their reality is singular and absolute which prevent the use of personal agency to make choices, take action and narrate preferences and experiences to address their problems. In the school of positive psychology, there is a theory that focuses on pathways to hope which aim at positivity as people have the ability for reality negotiation. The postmodern and humanistic views have allowed people to start to see that even though one may be affected by mental illnesses, one will still have his/her expert knowledge, unique experiences, and strategies through narratives of hope. This research is collaborative narrative research. Twelve individuals, males and females of different ages and backgrounds, have been invited to take part in semi-structured in-depth narrative interviews. They have also been invited to provide feedback and reflections during the interview process. They are given the opportunity to comment on their own verbatim and review the script at a second interview for further storytelling and reflection. When these individuals are given the space and time to narrate their accounts of negotiating depression, the hope that is previously hidden will then emerge. Throughout the conversation, they reconstruct their preferred self by revisiting the negotiation process. They have the agency to perform their preferred life and self-strategies and over techniques to manage life problems and compete with the power of dominant discourses within the mainstream context. It is shown that they have to lead their life with hopeful stories that are applicable to their future life circumstances. A theory is consequently formulated based on the findings of the process of reality negotiation in finding hope. Recommendations are provided in light of the current situation of mental health services in the Hong Kong Chinese cultural context, which include recommendations on the allocation of resources and human resources that are oriented towards the expertise of the persons who are facing depression. It is based on their knowledge and experience found by the everyday stories of the persons through collaboration with them.

IINTRODUCTION: This study’s aims were to: 1) evaluate whether or not there was a treat- ment plan change, if CBCT is used; and 2) evaluate if the use of CBCT as diagnostic tool improves the treatment outcome. We hypothesized that 1. the use of CBCT as diagnostic tool changes the treatment plan; and 2. improves the treatment outcome MATERIALS AND METHODS: This was an IRB approved retrospective study of all the conventional re-treatments and surgical RCT performed at Boston University Post-doctoral clinic from 2009 - 2015. Of 10,836 cases completed, 674 cases had a CBCT on file and 31 had a pre- and post-CBCT treatment plan with at least 3 months follow up. Cases with CBCT were matched (2 to 1) with cases without CBCT based on patients’ sex, age, tooth type, diagnosis, procedure performed, and insurance type. Chart notes and treatments were reviewed to identifytreatment plan changes. The investigator evaluated outcome as either Success/Survive/ Failure. Statistical Analyses tested for differences in treatment plan and Success/Survive/ Failure rates at minimum 3 months. RESULT: 31 cases and 49 controls were evaluated. There were no differences in mean age (46) or insurance between cases and controls. In over half of the cases (54.8%) the treatment plan changed when CBCT was used. Cases with CBCT had 32% success rate, 60% sur- vival rate and 8% failure rate at minimum 3 months whereas cases without CBCT had 22.4% success rate, 53.1% survival rate and 24.5% failure rate, p-value = 0.21. CONCLUSION: The use of CBCT as diagnostic tool affected more than half of the treatment plans. While CBCT appeared to improve the treatment outcomes, the difference in this small sample is not statistically significant. Future research will require larger sample sizes to test whether CBCT improves treatment efficacy in endodontics.

Thesis (M.S.)--Boston University

Thesis (Ph.D.)--Boston University / Since chlorpromazine was first developed it has found widespread use in the treatment of various mental dis orders, particularly schizophrenia. Research to date has suggested that the drug has an adverse effect on some psychological functions and a beneficial effect on others, particularly in the area of clinical symptoms. While some studies have led to the conclusion that the drug reduces the symptoms of psychiatric patients, other studies often do not support that conclusion. In the stuiies where psychiatric patients have been used as subjects for laboratory tasks, it has usually been assumed that the patient's psychiatric state has a detrimental effect on the performance of the task and it has been hypot he sized that chlorpromazine will increase task efficiency. The purpose of this study was to test the effect of chlorpromazine hydrochloride on stress-induced anxiety. There has been little effort to manipulate experimentally the emotional state of the subject and then to test the drug's ability to reduce the emotional state. One study, using normal human subjects, found that the drug did not reduce the detrimental effects of psychological stress. Two animal studies, however, indicated that the drug hastened the extinction of conditioned fear responses. [TRUNCATED]

PURPOSE: This qualitative study explores the perceptions of women diagnosed with Opiate Use Disorder enrolled in Methadone Maintenance Treatment (MMT). The purpose is to gain an understanding of the women’s perceptions of their treatment and recovery. RESEARCH QUESTIONS: Research questions explored: the women’s experiences and perceptions related to recovery on dimensions such as family, social network, sense of identity, motivations for continued recovery, and relapse prevention methods; their belief in their ability to succeed; changes in personal identity from a drug user to a non-drug-user; and the role of the methadone medication in their recovery. SAMPLE: Criteria included women 35-50 years of age with a history of opioid addiction for at least 5 years; regular attendance at the Methadone program; abstinent from alcohol and illicit drugs for 12- 18 months. RESEARCH DESIGN: A convenience sample of thirty-one women was interviewed using semi-structured interviews, conducted by the PI. Open-ended questions were asked to elicit the women’s views. The PI conducted a record review to verify that the women had a history of opioid addiction, were regular attendees of the MMT program, and had maintained the period of abstinence that they reported. Methods included Thematic Analysis. THEORETICAL FRAMEWORKS: Guiding frameworks were the Developmental Model of Recovery (Brown, 1985), describing healthy adaptation following a period of debilitation, and Symbolic Interactionism (Blumer, 1969), describing social interactions as mutually developed exchanges to which individuals bring their own symbolic meanings. FINDINGS: These women had positive perceptions of their recovery and changes in themselves including becoming more responsible, reuniting with their families and developing personal insight. They saw methadone as crucial to their recovery. Although they saw themselves as fairly well along in recovery, they believed they could not be fully recovered until they were off methadone. IMPLICATIONS: Findings help us understand the women’s perception of how MMT and behavioral and personal changes contributed to their recovery. Although these women, who were abstinent and treatment-compliant for at least one year, were able to ignore or reframe their experiences of methadone stigma, the stigma may contribute to treatment drop out for some women, especially early in treatment

No description available.

Background: Lateral elbow pain (LEP) is one of the most common musculoskeletal pains of the upper limbs. There is no substantial evidence of efficacy, particularly in the long-term use, of current conservative treatment options, many of which also carry considerable side effects. Finding a safe and effective treatment for LEP is therefore of high significance. Acupuncture is a popular form of complementary and alternative medicine for treating pain and dysfunction associated with musculoskeletal conditions, including LEP. Multi-center acupuncture randomized controlled trials (RCTs) are still relatively novel. However, they have methodological advantages over single-center RCTs, which lead to an enhanced external validity and generalizability of their results. On the other hand, pattern diagnosis, which is the basis for individualized treatment in Traditional Chinese Medicine (TCM), has been used in the treatment of LEP clinically, but such practice has not been standardized and its basis not understood. Study of pattern diagnosis in LEP may provide a better understanding of the nature of LEP and lead to better treatment outcomes in future clinical trials.;Conclusion: Our findings suggest that acupuncture is effective and safe in the treatment of LEP. Further international multi-center RCTs are suggested to investigate the long-term (3-6 months post-treatment) efficacy as well as the effect of individualized, pattern-based acupuncture (and moxibustion) for LEP. The subtypes of LEP discovered by the combined use of TCM pattern diagnosis and thermal imaging may be important in the understanding of LEP and may also be used to improve individualized treatment approach for this and other musculoskeletal disorders.;Methods: (1) A systematic review of acupuncture for LEP that included Chinese language studies and that used revised STRICTA criteria to appraise acupuncture procedures would first be performed. Based on the findings of the first study we then would (2) conduct an international, collaborative multi-center RCT of acupuncture for LEP; (3) systematically review TCM patterns for LEP; (4) conduct a Delphi study to create a LEP pattern questionnaire; and (5) investigate if distinct temperature profiles were associated with LEP patterns, using the LEP pattern questionnaire developed prior.;Results: The main findings are as follows: (1) results from previous acupuncture RCTs for LEP were inconclusive due to low methodological quality; (2) compared to sham laser, acupuncture showed a medium effect size (d = 0.48) in improvement of functional impairment of the elbow; (3) four major LEP patterns, that had unique features with distinct bio- physiological correlations were identified; (4) an LEP pattern questionnaire to assist and standardize LEP pattern diagnosis was created; and (5) we found for the first time that different TCM patterns had distinct skin temperature profiles, and such profiles might reflect different pathophysiological processes amongst LEP sufferers.;We set out to (1) review the current evidence of efficacy for acupuncture treatment of LEP; (2) to obtain evidence of efficacy for acupuncture treatment of LEP; (3) to review the diagnostic methods of Chinese medicine in the treatment of LEP; (4) to improve the diagnostic methods of Chinese medicine for the treatment of LEP; and (5) to determine if different TCM patterns are each associated with distinct, objective physiological changes in LEP.

Substance abuse treatment non-completion has serious implications for the future success with sobriety of adolescents. In this study, 38 adolescents were given the opportunity to complete a survey with the intent of identifying barriers to participating and successfully completing substance abuse treatment. Directors of substance abuse services at chosen agencies in Southern Illinois were also given the opportunity to complete a survey to identify quality components of effective adolescent substance abuse treatment programs. Collected data were analyzed using multivariate approaches, such as regression and chi-square tests, to identify factors that may contribute to treatment completion. The results provide information about how substance use service providers can address barriers and improve services to meet the needs of adolescents suffering from substance abuse issues.