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Purpose:To assess the feasibility of magnetic particle imaging (MPI) to guide stenting in a phantom model. Materials and Methods:MPI is a new tomographic imaging method based on the background-free magnetic field detection of a tracer agent composed of superparamagnetic iron oxide nanoparticles (SPIOs). All experiments were conducted on a custom-built MPI scanner (field of view: 29-mm diameter, 65-mm length; isotropic spatial resolution 1–1.5-mm). Stenosis phantoms (n=3) consisted of polyvinyl chloride (PVC) tubes (8-mm inner diameter) prepared with centrally aligned cable binders to form a ~50% stenosis. A dedicated image reconstruction algorithm allowed precise tracking of endovascular instruments at 8 frames/s with a latency time of ~115 ms. A custom-made MPI-visible lacquer was used to manually label conventional guidewires, balloon catheters, and stainless steel balloon-expandable stents. Vascular stenoses were visualized by injecting a diluted SPIO tracer (ferucarbotran, 10 mmol iron/L) into the vessel phantoms. Balloon angioplasty and stent placement were performed by inflating balloon catheters and stent delivery balloons with diluted ferucarbotran. Results:After deployment of the stent, the markers on its ends were clearly visible. The applied lacquer markers were thin enough to not relevantly alter gliding properties of the devices while withstanding friction during the experiments. Placing an optimized flexible lacquer formulation on the preexisting radiopaque stent markers provided enough stability to withstand stent expansion. Final MPA confirmed successful stenosis treatment, facilitated by the disappearance of the lacquer markers on the stent due to differences in SPIO concentration. Thus, the in-stent lumen could be visualized without interference by the signal from the markers. Conclusion:Near real-time visualization of MPI-guided stenting of stenoses in a phantom model is feasible. Optimized MPI-visible markers can withstand the expansion process of stents.

There is a lack of knowledge regarding the long-term effect of evidence-based CBT/ ERP treatment for OCD that is delivered in routine clinical care. The aim of this study was to examine the long-term effectiveness of behavioral treatment for OCD in a Norwegian general outpatient clinic. In the current study, 62% (N= 40) of the original patients treated in a previously published study of group ERP for OCD were re-evaluated an average of eight years after completing the original treatment. This is the longest follow-up study that has been conducted for OCD patients treated with group ERP. There was a significant reduction in symptoms from pre- to post-treatment measured with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Spielberger State Anxiety Inventory (STAI-S) and the Beck Depression Inventory (BDI). The gains were in average maintained from post-treatment through extended long-term follow-up. Fifty percent of the participants experienced either a clinically significant improvement (10%) or recovery (40%) in OCD symptoms at extended long-term follow-up. This suggests that many patients receiving general outpatient mental health clinic based group ERP for OCD maintain gains over the long-term.

The metacognitive model of obsessive-compulsive disorder (OCD; Wells, 1997) emphasises the role of metacognitive beliefs about both thoughts and rituals. The current study tested hypotheses that emerge from the model concerning three domains of these metacognitive beliefs: though fusion beliefs, beliefs about rituals, and stop signals, in an OCD sample (N=210). Results showed that each type of metacognitive belief significantly and positively correlated with two different measures of obsessive-compulsive symptoms. Additionally, in hierarchical regressions, with worry, and non-metacognitive beliefs linked to OCD in other theories controlled, each of the metacognitive domains, when entered in their hypothesised order of activation, incrementally predicted each obsessive-compulsive symptom measure. Results provide further support for the role of these three metacognitive belief domains as hypothesised in the metacognitive model.

This study sought to investigate the effectiveness of group treatment for trichotillomania (TTM) in ordinary clinical settings. Treatment consisted of a combination of habit reversal training (HRT) and acceptance and commitment treatment (ACT). Both short- and long-term effects were explored, as well as individual change trajectories.

The Metacognitions Questionnaire-30 (MCQ-30) was developed to measure individual differences in metacognitive beliefs and processes, which are central to the metacognitive model of emotional disorders. Although previous research has supported the role of metacognitive beliefs and processes in obsessive-compulsive disorder (OCD), no studies have examined the psychometric properties and factor structure of the MCQ-30 in OCD patients. The present study overcomes this limitation by exploring the factor structure and convergent validity of the MCQ-30 in a sample of OCD patients before and after psychological treatment.

Today‘s conurbations suffer from inefficiency in transportation systems. Bike sharing systems (BSS) combine the advantages of public and private transportation to better exploit the given transportation infrastructure. They provide bikes for short-term trips at automated rental stations. However, spatio-temporal variation of bike rentals leads to imbalances in the distribution of bikes, causing full or empty stations in the course of the day. Ensuring the reliable provision of bike and free bike racks is crucial for the viability of these systems. On the tactical planning level, target fill levels of bikes at stations are determined to provide reliability in service. On the operational planning level, the BSS operator relocates bikes in vehicles among stations based on target fill levels. A recent approach in tactical service network design (SND) anticipates relocation operations of BSS by means of a dynamic transportation model yielding the required demand of relocation services (RS). A RS is described by pickup and return station, time period, and the number of relocated bikes. RS represent the design decision for implementing a service between two stations in each period for each day of the system operation. The output of the SND model are the time-dependent target fill levels at stations and the set of cost-efficient RS to facilitate these target fill levels. However, the existing approach neglects the sequence of RS into tours, thus leading to a weak anticipation of operational decisions. We extend an existing SND approach by including the concept of service tours (ST). RS are sequenced in ST which start and end at the depot. Experiments shows that the ST obtained by the extended SND yield a stronger anticipation of operational decisions.

In this paper we analyze extensive operational data from bike-sharing systems in order to derive bike activity patterns. A common issue observed in bike-sharing systems is imbalances in the distribution of bikes. We use Data Mining to gain insight into the complex bike activity patterns at stations. Activity patterns reveal imbalances in the distribution of bikes and lead to a better understanding of the system structure. A structured Data Mining process supports planning and operating decisions for the design and management of bike-sharing systems.

Thirty-five outpatients (25 women, 10 men) with a DSM-III-R principal diagnosis of OCD accepted exposure treatment at a psychiatric outpatient clinic. They were randomly assigned to one of two individual treatments for a 6-week exposure therapy treatment based on a treatment manual or to a 6-week waiting list condition. The 12 patients assigned to the waiting list were subsequently randomly assigned to one of the active treatments. Both treatment groups received in vivo or imaginal exposure in each of the 10 twice-weekly treatment sessions held after two assessment sessions. One group (n=16) received cognitive therapy interventions for comorbidity problems or to alter beliefs underlying patients' OCD. The other group (n=19) received relaxation training as an attention placebo control. Both groups received relapse prevention follow-up contacts. Twenty-seven patients completed intensive treatment. Both treatments overall showed satisfactory levels of clinical improvement and large effect sizes. ANCOVAS for treatment completers showed non-significantly lower levels of OCD symptoms, depression and state anxiety in the treatment condition that did not include cognitive interventions. The patients receiving additional cognitive therapy showed significantly lesser dropout than those in the other treatment condition, but there were no significant differences in the intention-to-treat analyses.

PURPOSE: To determine if the lyse and wait (L&W) technique with a 4-mg dose of alteplase (tissue plasminogen activator; tPA) is a safe and effective method of declotting dialysis grafts as compared to use of the Arrow-Trerotola Percutaneous Thrombectomy Device (PTD) or the L&W technique with use of urokinase (UK). MATERIALS AND METHODS: Forty patients were randomized prospectively to undergo L&W declotting with use of 4 mg of tPA or mechanical thrombolysis with the PTD. The time interval to restored graft flow, total procedure time, hemostasis time, and anatomic success, clinical success, complications, and patency rates were analyzed. These were compared with historic results in 20 patients treated with the L&W technique with use of 250,000 U UK. RESULTS: The immediate anatomic success rate was 95% in the tPA L&W and PTD groups. The mean in-room lysis time with restored flow was 10 minutes for L&W with tPA and 19 minutes for PTD (P = .002). The mean in-room procedure time was 39 minutes for L&W and 45 minutes for PTD (P = NS). Mean hemostasis time with use of manual compression was 44 minutes for L&W with tPA and 23 minutes for PTD (P = .057). The historic group of 20 patients who underwent L&W with UK had a 95% anatomic success rate, a mean of 14 minutes of lysis time, a mean of 34 minutes of procedure time, and a mean of 26 minutes of time to hemostasis. No bleeding complications occurred in the PTD group. Seven episodes of bleeding occurred in six patients given tPA; four were delayed 60-90 minutes after the procedure, one necessitated hospitalization, and two required additional therapies. Four of the 20 patients undergoing L&W with UK had minor puncture site bleeding during the procedure. The 3-month primary patency rates were 65%, 65%, and 60% for L&W with tPA, PTD, and L&W with UK, respectively (P = NS). CONCLUSION: The 4-mg dose of tPA is effective but results in more bleeding complications and longer hemostasis times than mechanical thrombolysis with use of the PTD. Unlike in our experience with UK, bleeding complications with tPA were both major and delayed.