This study determined whether self-reported Traumatic Brain Injury (TBI), identified in a community sample and occurring up to 60 years previously, is associated with current psychiatric symptoms, ...suicidality, and psychologic well-being.
Three age cohorts (20–24, 40–44, 60–64) were randomly sampled from the cities of Canberra and Queanbeyan, Australia, yielding a total of 7,485 participants. The samples were administered scales measuring anxiety, depression, suicidality, positive and negative affect, personality traits, and physical health status.
Of the total sample, 5.7% reported history of TBI involving loss of consciousness for at least 15 min, occurring an average of 22 years previously. History of TBI was associated with increased symptoms of depression, anxiety, negative affect, and suicidal ideation.
History of TBI is a risk factor for psychiatric morbidity. The effect is greatest in young adults, and occurs up to several decades subsequent to the occurrence of TBI.
In this data article we describe synthetic and characterisation data for four members of the 5-acyl-6,7-dihydrothieno3,2-cpyridine (termed “RU-SKI”) class of inhibitors of Hedgehog acyltransferase, ...including associated NMR spectra for final compounds. RU-SKI compounds were selected for synthesis based on their published high potencies against the enzyme target. RU-SKI 41 (9a), RU-SKI 43 (9b), RU-SKI 101 (9c), and RU-SKI 201 (9d) were profiled for activity in the related article “Click chemistry armed enzyme linked immunosorbent assay to measure palmitoylation by Hedgehog acyltransferase” (Lanyon-Hogg et al., 2015) 1. 1H NMR spectral data indicate different amide conformational ratios between the RU-SKI inhibitors, as has been observed in other 5-acyl-6,7-dihydrothieno3,2-cpyridines. The synthetic and characterisation data supplied in the current article provide validated access to the class of RU-SKI inhibitors.
Background and Objective
We recently showed that a pharmacist-led information technology-based intervention (PINCER) was significantly more effective in reducing medication errors in general ...practices than providing simple feedback on errors, with cost per error avoided at £79 (US$131). We aimed to estimate cost effectiveness of the PINCER intervention by combining effectiveness in error reduction and intervention costs with the effect of the individual errors on patient outcomes and healthcare costs, to estimate the effect on costs and QALYs.
Methods
We developed Markov models for each of six medication errors targeted by PINCER. Clinical event probability, treatment pathway, resource use and costs were extracted from literature and costing tariffs. A composite probabilistic model combined patient-level error models with practice-level error rates and intervention costs from the trial. Cost per extra QALY and cost-effectiveness acceptability curves were generated from the perspective of NHS England, with a 5-year time horizon.
Results
The PINCER intervention generated £2,679 less cost and 0.81 more QALYs per practice incremental cost-effectiveness ratio (ICER): −£3,037 per QALY in the deterministic analysis. In the probabilistic analysis, PINCER generated 0.001 extra QALYs per practice compared with simple feedback, at £4.20 less per practice. Despite this extremely small set of differences in costs and outcomes, PINCER dominated simple feedback with a mean ICER of −£3,936 (standard error £2,970). At a ceiling ‘willingness-to-pay’ of £20,000/QALY, PINCER reaches 59 % probability of being cost effective.
Conclusions
PINCER produced marginal health gain at slightly reduced overall cost. Results are uncertain due to the poor quality of data to inform the effect of avoiding errors.
Falls are a major cause of morbidity among older people. Multifaceted interventions may be effective in preventing falls and related fractures.
To evaluate the cost-effectiveness alongside the ...REducing Falls with Orthoses and a Multifaceted podiatry intervention (REFORM) trial.
REFORM was a pragmatic multicentre cohort randomised controlled trial in England and Ireland; 1,010 participants (> 65 years) were randomised to receive either a podiatry intervention (n = 493), including foot and ankle strengthening exercises, foot orthoses, new footwear if required, and a falls prevention leaflet, or usual podiatry treatment plus a falls prevention leaflet (n = 517).
incidence of falls per participant in the 12 months following randomisation.
proportion of fallers and quality of life (EQ-5D-3L) which was converted into quality-adjusted life years (QALYs) for each participant. Differences in mean costs and QALYs at 12 months were used to assess the cost-effectiveness of the intervention relative to usual care. Cost-effectiveness analyses were conducted in accordance with National Institute for Health and Clinical Excellence reference case standards, using a regression-based approach with costs expressed in GBP (2015 price). The base case analysis used an intention-to-treat approach on the imputed data set using multiple imputation.
There was a small, non-statistically significant reduction in the incidence rate of falls in the intervention group (adjusted incidence rate ratio 0.88, 95% CI 0.73-1.05, p = 0.16). Participants allocated to the intervention group accumulated on average marginally higher QALYs than the usual care participants (mean difference 0.0129, 95% CI -0.0050 to 0.0314). The intervention costs were on average GBP 252 more per participant compared to the usual care participants (95% CI GBP -69 to GBP 589). Incremental cost-effectiveness ratios ranged between GBP 19,494 and GBP 20,593 per QALY gained, below the conventional National Health Service cost-effectiveness thresholds of GBP 20,000 to GBP 30,000 per additional QALY. The probability that the podiatry intervention is cost-effective at a threshold of GBP 30,000 per QALY gained was 0.65. The results were robust to sensitivity analyses.
The benefits of the intervention justified the moderate cost. The intervention could be a cost-effective option for falls prevention when compared with usual care in the UK.
To assess the public's recognition of mental disorders and their beliefs about the effectiveness of various treatments ("mental health literacy").
A cross-sectional survey, in 1995, with structured ...interviews using vignettes of a person with either depression or schizophrenia.
A representative national sample of 2031 individuals aged 18-74 years; 1010 participants were questioned about the depression vignette and 1021 about the schizophrenia vignette.
Most of the participants recognised the presence of some sort of mental disorder: 72% for the depression vignette (correctly labelled as depression by 39%) and 84% for the schizophrenia vignette (correctly labelled by 27%). When various people were rated as likely to be helpful or harmful for the person described in the vignette for depression, general practitioners (83%) and counsellors (74%) were most often rated as helpful, with psychiatrists (51%) and psychologists (49%) less so. Corresponding data for the schizophrenia vignette were: counsellors (81%), GPs (74%), psychiatrists (71%) and psychologists (62%). Many standard psychiatric treatments (antidepressants, antipsychotics, electroconvulsive therapy, admission to a psychiatric ward) were more often rated as harmful than helpful, and some nonstandard treatments were rated highly (increased physical or social activity, relaxation and stress management, reading about people with similar problems). Vitamins and special diets were more often rated as helpful than were antidepressants and antipsychotics.
If mental disorders are to be recognised early in the community and appropriate intervention sought, the level of mental health literacy needs to be raised. Further, public understanding of psychiatric treatments can be considerably improved.
Aim
To contribute insight into health and social care integration through an exploration of the care experiences of adults with degenerative neuromuscular conditions who use a mechanical ventilator ...at home.
Design
Descriptive qualitative research.
Methods
Seventeen semi‐structured interviews were conducted with patients and family carers living in Scotland during 2015–2016 and thematically analysed.
Results
To achieve a satisfying life, home ventilated participants required help from a variety of health and social care services, as well as care from family. Examples of successful care were identified, but there were also serious failures and conflict with services. Identifying how care fails or succeeds for this patient population and their families requires an understanding of the interdependency of health and social care. This was achieved by examining health and social care provision from the experiential perspective of care‐users to provide insights into how disconnected provision has an impact on users’ lives in numerous, idiosyncratic ways.
Cellular interactions with elastin Rodgers, Ursula R.; Weiss, Anthony S.
Pathologie biologie (Paris),
09/2005, Letnik:
53, Številka:
7
Journal Article
Recenzirano
Elastin is a key structural component of the extracellular matrix. Tropoelastin is the soluble precursor of elastin. In addition to providing elastic recoil to various tissues such as the aorta and ...lung, elastin, tropoelastin and elastin degradation products are able to influence cell function and promote cellular responses. These responses include chemotaxis, proliferation and cell adhesion. The interaction of elastin products with cells has been attributed to the elastin receptor. However, additional cell-surface receptors have also been identified. These include G protein-coupled receptors and integrins. The potential roles of these receptors in cell–elastin interactions, with particular focus on elastin formation are discussed.
L'élastine est un composant essentiel de la matrice extracellulaire. La tropoélastine est le précurseur soluble de l'élastine. Outre leur rôle dans l'élasticité des tissus comme l'aorte et les poumons, la tropoélastine, l'élastine et ses produits de dégradation agissent sur les cellules et déclenchent des réponses cellulaires. Ces réponses comprennent le chimiotactisme, la prolifération et l'adhésion cellulaires. L'interaction des dérivés de l'élastine avec les cellules a été attribuée au récepteur de l'élastine. Cependant, d'autres récepteurs cellulaires ont aussi été identifiés. Ceux-ci comprennent des récepteurs couples à des protéines G et des intégrines. Le rôle potentiel de ces récepteurs dans l'interaction cellules–élastine est discuté et en particulier dans la formation de l'élastine.
A comprehensive study of charge diagnostics is conducted to verify their validity for measuring electron beams produced by laser plasma accelerators (LPAs). First, a scintillating screen (Lanex) was ...extensively studied using subnanosecond electron beams from the Advanced Light Source booster synchrotron, at the Lawrence Berkeley National Laboratory. The Lanex was cross calibrated with an integrating current transformer (ICT) for up to the electron energy of 1.5 GeV, and the linear response of the screen was confirmed for charge density and intensity up to 160pC/mm2 and 0.4pC/(psmm2) , respectively. After the radio-frequency accelerator based cross calibration, a series of measurements was conducted using electron beams from an LPA. Cross calibrations were carried out using an activation-based measurement that is immune to electromagnetic pulse noise, ICT, and Lanex. The diagnostics agreed within ±8% , showing that they all can provide accurate charge measurements for LPAs.
Microvascular abnormalities and impaired gas transfer have been observed in patients with COVID-19. The progression of pulmonary changes in these patients remains unclear.
Do patients hospitalized ...with COVID-19 without evidence of architectural distortion on structural imaging exhibit longitudinal improvements in lung function measured by using
H and
Xe MRI between 6 and 52 weeks following hospitalization?
Patients who were hospitalized with COVID-19 pneumonia underwent a pulmonary
H and
Xe MRI protocol at 6, 12, 25, and 51 weeks following hospital admission in a prospective cohort study between November 2020 and February 2022. The imaging protocol was as follows:
H ultra-short echo time, contrast-enhanced lung perfusion,
Xe ventilation,
Xe diffusion-weighted, and
Xe spectroscopic imaging of gas exchange.
Nine patients were recruited (age 57 ± 14 median ± interquartile range years; six of nine patients were male). Patients underwent MRI at 6 (n = 9), 12 (n = 9), 25 (n = 6), and 51 (n = 8) weeks following hospital admission. Patients with signs of interstitial lung damage were excluded. At 6 weeks, patients exhibited impaired
Xe gas transfer (RBC to membrane fraction), but lung microstructure was not increased (apparent diffusion coefficient and mean acinar airway dimensions). Minor ventilation abnormalities present in four patients were largely resolved in the 6- to 25-week period. At 12 weeks, all patients with lung perfusion data (n = 6) showed an increase in both pulmonary blood volume and flow compared with 6 weeks, although this was not statistically significant. At 12 weeks, significant improvements in
Xe gas transfer were observed compared with 6-week examinations; however,
Xe gas transfer remained abnormally low at weeks 12, 25, and 51.
Xe gas transfer was impaired up to 1 year following hospitalization in patients who were hospitalized with COVID-19 pneumonia, without evidence of architectural distortion on structural imaging, whereas lung ventilation was normal at 52 weeks.
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