Miracle-dz/UniFAR-FTUs huggingface dataset:
Goal setting in psychotherapy: The relevance of approach and avoidance goals for treatment outcome

Abstract The present study is the first aimed at investigating the influence of goal definition on treatment outcome in a sample of depressed patients. Data from 657 inpatients admitted to a psychosomatic clinic in Germany being treated in a cognitive–behavioral therapy program were analyzed. Treatment goals were identified as either approach or avoidance, and the sample was classified accordingly. Patients who identified approach goals only were placed in the approach group, and those who identified at least one avoidance goal were placed in the avoidance group. Results showed that framing goals using avoidance terms was associated with less symptomatic improvement but did not affect goal attainment. Findings from this research should be utilized in practice not only for process management such as individual treatment planning but also to control outcome quality. Furthermore, goal definition should be considered as a control variable in research on depression.
Neonatal Outcomes After Late-Gestation Exposure to Selective Serotonin Reuptake Inhibitors

Objective This study aimed to investigate neonatal outcomes after prenatal exposure to selective serotonin reuptake inhibitors (SSRIs) during late-gestation. Methods A retrospective cohort study was conducted using linked records from the Women’s and Children’s Health Network in South Australia, Australia, including the Perinatal Statistics Collection and the Hospital Pharmacy Dispensing Records. Women were eligible to participate if they gave birth to singleton, live-born infants between September 2000 and December 2008 (n = 33,965). Women were excluded if they received a dispensing for antidepressants other than SSRIs (n = 93) or an antipsychotic (n = 81). We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for preterm delivery, low birth weight, small-for-gestational age, neonatal hospitalization and length of hospital admission, adjusting for sociodemographic, lifestyle, and medical factors. Results Two hundred twenty-one women received a dispensing for an SSRI during pregnancy, 1566 had a psychiatric illness but did not receive a dispensing for an SSRI, and 32,004 did not have a psychiatric illness and did not receive a dispensing for an SSRI. Compared to infants of women with a psychiatric illness but no SSRI use, infants of women exposed to SSRIs had an increased risk of preterm delivery (adjusted OR, 2.68; 95% CI, 1.83–3.93), low birth weight (adjusted OR, 2.26; 95% CI, 1.31–3.91), admission to hospital (adjusted OR, 1.92; 95% CI, 1.39–2.65), and length of hospital stay longer than 3 days (adjusted OR, 1.93; 95% CI, 1.11–3.36) but not small-for-gestational age (adjusted OR, 1.13; 95% CI, 0.65–1.94). Psychiatric illness but no SSRI use during pregnancy was only associated with an increased likelihood of neonatal hospital admission (adjusted OR, 1.21; 95% CI, 1.07–1.38). Conclusions These results add to the growing body of evidence of an association between SSRI exposure during pregnancy and a range of adverse neonatal outcomes, but the potential for confounding according to severity of underlying maternal psychiatric illness requires further investigation.
Psychodynamic change in psychotherapy: Cycles of patient–therapist linguistic interactions and interventions

Abstract Psychodynamic change is understood to occur in part through the unique therapeutic relationship developed between therapist and patient, and the subtle cycles of their conversation from relaxed connection to intense experiencing. The Therapeutic Cycles Model (TCM) (Mergenthaler, 1996) and Heidelberg Structural Change Scale (HSCS) (OPD Task Force, 2008) were used to investigate therapist–patient dynamic processes across 16 sessions of psychotherapy. The TCM identified interventions of the therapist instigating change in emotion-abstraction patterns. Structural personality change was higher in TCM cycles, and differed according to emotion-abstraction patterns. The interventions of the therapist promoted dynamic structural change in the patient. The findings demonstrate for the first time the interconnection between specific types of therapist and patient dialogue that promote deep changes.
In vitro biomechanical evaluation and comparison of FiberWire, FiberTape, OrthoFiber, and nylon leader line for potential use during extraarticular stabilization of canine cruciate deficient stifles.

OBJECTIVE To compare biomechanical properties of 3 new generation polyethylene sutures (FiberTape [FT], FiberWire [FW], and OrthoFiber [OF]) with nylon leader line (NL) for use during extraarticular fixation of cranial cruciate deficient stifles. STUDY DESIGN In vitro biomechanical testing of suture loops under monotonic tensile and cyclical loading until failure. SAMPLE POPULATION Constructs of FT, FW, OF, and NL. METHODS Twenty loops of each of 12 combinations of fixation and suture had monotonic tensile and cyclical loading. Two knotting techniques (square knot [SQ], slip knot [SL]) and a crimp clamp (CR) system were evaluated. Elongation, stiffness, and strength of constructs was tested. The main effects of group, loop material, and their interaction were evaluated. RESULTS Knotted FT, FW, and OF had less elongation than knotted NL under monotonic tensile and cyclical loading. Under monotonic tensile loading, knotted FT and OF were stiffer than knotted NL. CR FT, CR FW, and CR OF were stiffer than CR NL and CR FT, CR FW, and CR OF were stiffer than knotted FT, FW, and OF. FW and OF knotted loops were weaker than knotted NL. CR FT was stronger than CR NL. CR FT and CR OF were weaker than knotted FT and OF. CONCLUSIONS Polyethylene sutures are stronger, stiffer and elongate less than nylon leader. Crimping suture alters the biomechanical properties of the loop. CLINICAL RELEVANCE FW, FT, and OF may perform better in reconstructive procedures, where increased strength and stiffness are considered to be beneficial.
Clients' and therapists' perceptions of intrasessional connection: An analogue study of change over time, predictor variables, and level of consensus

Abstract Clients' and therapists' within-session experiences of relational connection were investigated using an analogue design. Eighty “therapist–client” dyads rated, on a minute-by-minute basis, their levels of connection to the other over a 20 minute counselling session. Therapists' and clients' feelings of connection increased over time with a negatively accelerating curve. Clients experienced a greater increase in feelings of connection with therapists that they perceived as less anxious; while older therapists, and therapists who believed they were perceived as more agreeable, experienced a deeper connection. Clients' and therapists' perception of connection were significantly associated, with a median within-dyad correlation of . 76.
Value of low-field magnetic resonance imaging in diagnosing meniscal tears in the canine stifle: a prospective study evaluating sensitivity and specificity in naturally occurring cranial cruciate ligament deficiency with arthroscopy as the gold standard.

OBJECTIVE To evaluate the sensitivity and specificity of low-field magnetic resonance imaging (lfMRI) for detection of meniscal tears in the canine stifle. STUDY DESIGN Double-blinded prospective clinical study. ANIMALS Forty-two consecutive stifles of dogs (>or=20 kg; n=34) with clinical and radiologic signs suspicious for cranial cruciate ligament (CCL) insufficiency. METHODS Each stifle had 7 predefined lfMRI sequences using a 0.5 T magnet with a human knee coil. After lfMRI, diagnostic arthroscopy was performed by 1 surgeon unaware of the MRI findings. After completion of the study MRI images were read by 1 investigator, unaware of the intraoperative findings. RESULTS At arthroscopy, 22 stifles had meniscal tears requiring subtotal meniscectomy. Of these only 14 were identified by lfMRI. Overall sensitivity and specificity of lfMRI for detection of meniscal tears were 0.64 (95% confidence interval [95% CI]=0.43, 0.80) and 0.90 (95% CI=0.70, 0.97), respectively. Positive and negative predictive values were 0.88 (95% CI=0.64, 0.97) and 0.69 (95% CI=0.50, 0.83), respectively. Neither the state of dislocation of vertical longitudinal tears nor the amount of CCL rupture had an influence on lfMRI accuracy (P=1.00). CONCLUSION lfMRI was of low diagnostic accuracy in detecting meniscal tears, when compared with arthroscopy. Especially negative lfMRI findings should be interpreted with caution. CLINICAL RELEVANCE When using lfMRI as a noninvasive preoperative screening tool for the diagnosis of meniscal tears, a high percentage of missed meniscal tears has to be expected.
Morphometric characteristics of the pelvic limb musculature of Labrador Retrievers with and without cranial cruciate ligament deficiency.

OBJECTIVE To identify morphometric characteristics of the pelvic limb musculature associated with the development of cranial cruciate ligament (CCL) deficiency in Labrador Retrievers. STUDY DESIGN Cross-sectional clinical study. ANIMALS Pure-bred female (n=18) and male (n=12) Labrador Retrievers with (n=16) and without (n=14) CCL deficiency. METHODS Muscle conformation of pelvic limbs was evaluated by physical examination, radiography (widths of quadriceps, hamstring, and gastrocnemius were expressed relative to tibial length and to each other), and dual-energy X-ray absorptiometry (DEXA, lean contents of quadriceps, hamstring, and gastrocnemius were expressed relative to tibial length and to each other). Pelvic limbs of dogs without CCL deficiency were classified as normal (n=28 limbs), whereas those with CCL deficiency were considered diseased (n=18 limbs) or sound contralateral to CCL deficiency (n=10 limbs). Variables were compared between groups using mixed models analysis of variance, with P<. 05 considered significant. RESULTS The ratios of quadriceps width to tibial length (P=.008), hamstring width (P=.013), and gastrocnemius width (P=.005) on lateral radiographs were lower in diseased limbs than controls. The mass of hamstring muscles in CCL deficient limbs was similar to that of normal limbs. The ratio of the lean content of gastrocnemius to hamstring muscles was greater in diseased (P=.007) and sound contralateral (P=.013) limbs than in normal limbs. CONCLUSIONS Atrophy associated with CCL deficiency may predominantly affect the quadriceps muscle. Dominance of the gastrocnemius muscle over active restraints to the cranial tibial thrust may be associated with predisposition to CCL deficiency in Labrador Retrievers. CLINICAL RELEVANCE If confirmed, this dynamic imbalance between muscle groups of the rear limbs could serve as a basis for screening programs and preventive rehabilitation.
Fatores associados à asfixia perinatal

PURPOSE: to assess risk factors for low Apgar score. METHODS: this was a cross-sectional study preformed in a random sample of patients admitted to a level III maternity hospital in 2001. The outcome was low Apgar score defined as an Apgar score 1-6 (study group) versus Apgar score 7-10 (control group) in the first minute of life. The first step was the evaluation of the association of each possible risk factor with low Apgar score. The second step was multivariate analysis with the backward stepwise logistic regression model. RESULTS: there were 39 (14%) depressed newborns which were compared to 238 (86%) not depressed babies. The final analysis (multivariate) showed an association between low Apgar score and previous case of stillbirth (OR=52.6), preterm labor threat (OR=33.8), low birth weight, less than 2,500 g body weight (OR=11.2) and previous cesarean section (OR=7.4). Some factors acted as a protection, including birth weight, in grams (OR=0.9), female sex of the newborn (OR=0.1), medical complications (OR=0.4) and prematurity (gestational age < 37 weeks, OR=0.1). CONCLUSION: the study may help in the identification of fetuses at great risk of asphyxia, allowing proper reference within the health system and planning of effective assistance in neonatal intensive care units.
Cognitive behaviour therapy (CBT) for depression by computer vs. therapist: Patient experiences and therapeutic processes

Abstract This case series compares patient experiences and therapeutic processes between two modalities of cognitive behaviour therapy (CBT) for depression: computerized CBT (cCBT) and therapist-delivered CBT (tCBT). In a mixed-methods repeated-measures case series, six participants were offered cCBT and tCBT in sequence, with the order of delivery randomized across participants. Questionnaires about patient experiences were administered after each session and a semi-structured interview was completed with each participant at the end of each therapy modality. Therapy expectations, patient experiences and session impact ratings in this study generally favoured tCBT. Participants typically experienced cCBT sessions as less meaningful, less positive and less helpful compared to tCBT sessions in terms of developing understanding, facilitating problem-solving and building a therapeutic relationship.
Understanding processes of change: How some patients reveal more than others—and some groups of therapists less—about what matters in psychotherapy

Abstract Objective: We identify difficulties researchers encounter in psychotherapy process-outcome investigations, and we describe several limitations of the popular “variance accounted for” approach to understanding the effects of psychotherapy. Methods & Results: Using data simulations, we show how the expected correlation between an excellent measure of therapy quality and outcome would be surprisingly small (approximately .25) under conditions likely to be common in psychotherapy research. Even when we modeled conditions designed to increase the likelihood that strong process-outcome relationships would be observed, we found that the expected correlations were still only in the modest range (.38–.51). Conclusions: We discuss the implications of our analysis for the interpretation of process-outcome findings as well as for design considerations in future investigations.
Investigating the personality disorder psychotherapy process: The roles of symptoms, quality of affects, emotional dysregulation, interpersonal processes, and mentalizing

Abstract Personality Disorders (PDs) can reasonably hope to gain benefit from psychotherapy. Nevertheless many patients do not fully respond. Research therefore has to be done into which variables need to be targeted in psychotherapy, in order to tailor treatment to the needs of the majority of PD patients. These have to date been understudied, in particular where patients have PD other than borderline and where they obtain no or limited benefits from available treatments. Many elements of the therapy process, such as therapy alliance, can be investigated. We outline here some personality pathology core issues and then describe how the authors involved in this special issue investigated the roles of symptoms, emotional experience and regulation, interpersonal patterns and mentalizing in PD psychotherapy.
Patient Attachment to Therapist Rating Scale: Development and psychometric properties

Abstract Objective: To report on the development and initial psychometric properties of a new rating scale for patent-therapist attachment. Method: Seventy interviews from the Young Adult Psychotherapy Project (YAPP) were rated. Results: Excellent internal consistency (Cronbach's α > .90) was observed for all four subscales (Security, Deactivation, Hyperactivation, and Disorganization). Three subscales showed good inter-rater reliability (ICC > .60), while one (Hyperactivation) had poor (ICC < .40). Correlations with measures of alliance, mental representations, and symptom distress support the construct validity of the reliable subscales. Exploratory factor analysis indicated three underlying factors explaining 82% of the variance. Conclusions: The Patient Attachment to Therapist Rating Scale is a promising approach for assessing the quality of attachment to therapist from patient narratives. Future development should focus on improving the discrimination of the insecure subscales.
Effect of tibial tuberosity advancement on the contact mechanics and the alignment of the patellofemoral and femorotibial joints.

OBJECTIVE To evaluate the effect of tibial tuberosity advancement (TTA) on patellofemoral (PF) contact mechanics, and alignment of the PF and femorotibial (FT) joints in cranial cruciate ligament (CrCL)-deficient stifles of dogs. STUDY DESIGN Ex vivo biomechanical study. ANIMALS Unpaired cadaveric hind limbs (n=9). METHODS Digital pressure sensors placed in the PF joint were used to measure contact force, contact area, peak and mean contact pressure, and peak pressure location with the limb under an axial load of 30% body weight and a stifle angle of 135°. The FT and PF poses were obtained using a 2-dimensional computer digitization technique. Each specimen was tested under normal, CrCL-deficient, and TTA-treated conditions. Data was normalized and analyzed, after testing for normality by Wilk-Shapiro, using 1 sample T-test, paired T-test, and ANOVA; P≤. 05 was considered significant. Bonferroni's correction was used when needed. RESULTS A significant cranioproximal tibial displacement and increase in patellar tilt were found in the CrCL-deficient joints. Both FT and PF alignments were restored after TTA. Contact areas and peak pressure did not vary between conditions. Peak pressure location displaced proximally from intact to CrCL-deficient condition and returned to normal after TTA. Total force measured in the CrCL-deficient stifle and TTA conditions were significantly lower than in the control. CONCLUSION TTA restored the normal FT and PF alignment, and reduced the retropatellar force by about 20%.
Plasticity of the Human Tendon to Short- and Long-Term Mechanical Loading

This review examines the effects of short- and long-term static and cyclic mechanical loading on the mechanical properties of tendons. Tendons do not alter their mechanical properties after static and cycling loading that occurs during fatiguing contractions. Adaptations can occur after the application of long-term loading, but the strain magnitude must exceed a given threshold.
Disceratose congênita: relato de caso e revisão da literatura

Dyskeratosis congenita is an inherited disease characterised by the triad of abnormal skin pigmentation, nail dystrophy and mucosal leukoplakia. Non-cutaneous abnormalities (dental, gastrointestinal, genitourinary, neurological, ophthalmic, pulmonary and skeletal) have also been reported. Bone marrow failure is the main cause of early mortality, with an additional predisposition to malignancy. Men are more affected than women and X-linked recessive, autosomal dominant and autosomal recessive forms of the disease are recognised. We report a case of a male child who presented the classic triad of lesions, without familial cases. A review of the literature is also made, emphasizing the importance of a multidisciplinary approach, which is fundamental for an early diagnosis of the complications.
Reported positive and negative outcomes associated with a self-practice/self-reflection cognitive-behavioural therapy exercise for CBT trainees

Abstract Objective: The aim of the current study was to identify outcomes of a self-practice/self-reflection (SP/SR) exercise for trainee clinical psychologists. Method: Thirty-two trainees enrolled in their first year of a UK university doctoral clinical psychology training programme completed an online questionnaire following an eight-week exercise. Results: Findings indicated an endorsement of many previously reported benefits of exercise participation, but also the identification of negative outcomes. Thematic analysis of qualitative data revealed that outcomes could be grouped into two main thematic domains (individual task outcomes and task organization issues) along with several subordinate themes. Conclusion: SP/SR is a useful tool in the development of trainee CBT therapist competences. There has been limited previous recognition of potential negative outcomes from this type of exercise. However, these can provide additional impetus for therapist skill development.
Expressão das citoceratinas em dermatoses infecto- parasitárias associadas à hiperplasia epidérmica

FUNDAMENTOS: As citoceratinas(C) sao as proteinas estruturais mais importantes das celulas epiteliais e exibem a maior heterogeneidade dentre todas as proteinas dos filamentos intermediarios. Seu estudo atraves de imunomarcacao possibilita a analise estrutural do citoesqueleto em varios afeccoes neoplasicas e inflamatorias. OBJETIVOS: Verificar o padrao imuno-histoquimico da expressao das citoceratinas na epiderme de doencas infecto-parasitarias associadas a hiperplasia escamosa. METODOS: Cortes histologicos obtidos de tecidos pre-fixados e incluidos em parafina a partir de lesoes de cromomicose, paracoccidioidomicose, leishmaniose e condiloma acuminado foram marcados com os anticorpos DEK10, LL025, LL002 e AE1 pela tecnica de imunoperoxidase (avidina-biotina). RESULTADOS: A analise de areas com intensidade variavel de hiperplasia epidermica presentes nos fragmentos mostrou exclusivamente e/ou predominantemente nas quatro doencas: ausencia de expressao da C10 nas areas de hiperplasia intensa e retardo da expressao nas areas de hiperplasia moderada e/ou ausente; padrao suprabasal de marcacao para a C16 independentemente do grau de hiperplasia como tambem, liberacao de epitopos suprabasais para os marcadores LL002 (C14) e AE1 (C10,14,16,19). CONCLUSOES: As modificacoes indicam que, independentemente da natureza do agente etiologico e do grau de hiperplasia presente, ocorrem alteracoes na diferenciacao e proliferacao do ceratinocito.
Investigating treatment characteristics and first-session relationship variables as predictors of dropout in the treatment of traumatized youth

Abstract Objective: Attrition is a common problem in youth trauma treatment, but there is currently little knowledge of why so many youths drop out. In this study, treatment variables (caregiver attendance in the first session and exposure vs. non-exposure-based treatment) and first-session process variables (the therapeutic alliance and youths’ perceptions of parental treatment approval) were investigated as predictors of dropout. Method: Participants (N = 156, mean age = 15.1) were randomly assigned to trauma-focused cognitive behavioral therapy or therapy as usual in a community trial. Results: Dropout (n = 39, 25.0%) was predicted by a lack of caregiver attendance, lower rates of youth-perceived parental treatment approval, and weaker therapist-rated youth alliance. Neither type of treatment, youth-rated alliance or caregiver alliance, predicted dropout. Conclusions: The findings indicate that in addition to caregivers’ actual participation in the first session, youths’ perception of their parents’ approval of treatment seems to influence treatment attendance. This finding implies that therapists should engage caregivers in therapy and address possible discordance in treatment goals and tasks. Furthermore, consistent with adult studies, exposure-based treatments do not appear to increase dropout rates.