A novel Zr‐chain based MOF, namely MIL‐163, was designed and successfully synthesized using a bis‐1,2,3‐trioxobenzene ligand. Endowed with large square‐shaped channels of 12 Å width, it shows ...remarkable water uptake (ca. 0.6 cm3 g−1 at saturating vapor pressure) and a remarkable stability in simulated physiological media, where archetypical Zr carboxylate MOFs readily degrade.
Water‐proof MOF: The reaction of ZrIV with 1,2,3‐trioxobenzene moieties leads to the formation of a robust chain‐like coordination motif. Such a motif is used to rationally build a new metal–organic framework (MOF) which combines a good water sorption capacity with high chemical stability in physiologically relevant conditions, outperforming archetypical ZrIV carboxylate MOFs.
Objective: To describe the characteristics of people attending mental health clinics at shelters for the homeless in inner city Sydney.
Design: Retrospective review of medical records of homeless ...hostel clinic attenders.
Setting: Mental health clinics located in three inner city homeless hostels.
Participants: Consecutive series of clinic attenders, 21 July 2008 – 31 December 2016.
Main outcome measures: Demographic characteristics; social, medical and mental health histories of homeless people.
Results: 2388 individual patients were seen at the clinics during the 8.5‐year study period. Their mean age was 42 years (standard deviation, 13 years), 93% were men, and 56% were receiving disability support pensions. 59% of attenders had been homeless for more than a year, and 34% of all attenders reported sleeping in the open. The most common diagnoses were substance use disorder (66%), psychotic illness (51%), acquired brain injury (14%), and intellectual disability (5%). Most patients had more than one diagnosis. Early life and recent trauma was reported by 42% of patients. Pathways to homelessness included release from prison (28% of the homeless), discharge from a psychiatric hospital (21%), loss of public housing tenancy (21%), and inability to pay rent because of problem gambling.
Conclusions: The high rates of substance use and mental disorder among homeless people in inner Sydney confirms the need for increased access to treatment for these conditions in this setting. Homelessness among those with mental illness might be reduced by developing alternative housing models, and supporting people with multiple problems to retain tenancy.
This volume brings together leading experts on the investigation, litigation and scholarly analysis of innocence cases in America, from legal, political and ethical perspectives. The contributors ...consider the challenges faced by the exoneration movement, causes of wrongful convictions, problems associated with investigating, proving, and defining 'innocence', and theories of reform. These issues are investigated from a multi-disciplinary perspective and with the aim of improving the American criminal justice system when it is faced with its most harrowing sight: an innocent defendant.
•Varenicline, NRT and MI is a feasible, safe, and effective.•Participants held concerns regarding varenicline safety and efficacy.•Counselling and NRT were viewed as acceptable strategies.•Education ...regarding varenicline safety is warranted.
This pilot study aimed to test the feasibility of providing varenicline in combination with nicotine replacement therapy (NRT) and motivational interviewing (MI) to adult male smokers attending a clinic in a hostel for homeless people.
A single group pre- and post-treatment (12 weeks following intervention commencement) design with embedded process evaluation (at weekly counselling and fortnightly safety check-ins). Participants were 20 male smokers attending a health clinic within a homelessness service in Sydney, Australia, between December 2019 and March 2020. Participants set a target quit date 7-days post intervention commencement. Adverse events, self-reported abstinence, cigarettes per day, treatment adherence and acceptability of the study interventions were assessed 12 weeks post intervention commencement. Abstinence was biochemically verified. Results are complete cases.
Retention was 65% at 12-weeks post-intervention commencement (n = 13). No related adverse events were reported. Three participants (15%) reported continuous abstinence. Two participants self-reported 30-day point prevalence abstinence (10%), confirmed by CO level. Participants who did not quit smoking (n = 10), reported a significant reduction in the number of cigarettes smoked per day (19.4 vs 4.7, p < .01). Cravings, withdrawal symptoms, and psychological distress significantly decreased from baseline to 12-week follow-up (all < 0.01). Adherence to the pharmacological interventions was good, most used combination NRT and varenicline. Adherence to the counselling sessions was low, attending three of 12 sessions. Both NRT and MI were rated as highly acceptable. Some participants expressed concerns about the safety of varenicline.
The intervention was feasible and acceptable and associated with short-term smoking cessation and significant reductions in the number of cigarettes smoked-per-day.
People who are homeless have increased hepatitis C virus (HCV) infection risk, and are less likely to access primary healthcare. We aimed to evaluate HCV RNA prevalence, liver disease burden, linkage ...to care and treatment uptake and outcomes among people attending a homelessness service in Sydney. Participants were enrolled in an observational cohort study with recruitment at a homelessness service over eight liver health campaign days. Finger‐stick whole‐blood samples for Xpert® HCV Viral Load and venepuncture blood samples were collected. Participants completed a self‐administered survey and received transient elastography and clinical assessment by a general practitioner or nurse. Clinical follow‐up was recommended 2‐12 weeks after enrolment. For participants initiating direct‐acting antiviral (DAA) therapy, medical records were audited retrospectively and treatment outcome data were collected. Among 202 participants (mean age, 48 years), 82% were male (n = 165), 39% (n = 78) reported ever injecting drugs, of whom 63% (n = 49) injected in the previous month. Overall, 23% (n = 47) had detectable HCV RNA and 6% (n=12) had cirrhosis. HCV RNA prevalence among participants with either injecting or incarceration history was 35% (37/105), compared to 4% (3/73) among participants without these risk factors. Among those with detectable HCV RNA, 23 (49%) commenced therapy, of whom 65% (n = 15) achieved sustained virological response, while the remainder had no available treatment outcome. No participant had documented virological failure. HCV DAA treatment uptake among people attending a homelessness service was encouraging, but innovative models of HCV care are required to improve linkage to care and treatment uptake among this highly marginalized population.
Virtual memory T (T
) cells are antigen-naïve CD8
T cells that exist in a semi-differentiated state and exhibit marked proliferative dysfunction in advanced age. High spare respiratory capacity (SRC) ...has been proposed as a defining metabolic characteristic of antigen-experienced memory T (T
) cells, facilitating rapid functionality and survival. Given the semi-differentiated state of T
cells and their altered functionality with age, here we investigate T
cell metabolism and its association with longevity and functionality. Elevated SRC is a feature of T
, but not T
, cells and it increases with age in both subsets. The elevated SRC observed in aged mouse T
cells and human CD8
T cells from older individuals is associated with a heightened sensitivity to IL-15. We conclude that elevated SRC is a feature of T
, but not T
, cells, is driven by physiological levels of IL-15, and is not indicative of enhanced functionality in CD8
T cells.
Following infection, inflammatory cues upregulate core transcriptional programs to establish pathogen-specific protection. In viral infections, T follicular helper (TFH) cells express the ...prototypical T helper 1 transcription factor T-bet. Several studies have demonstrated essential but conflicting roles for T-bet in TFH biology. Understanding the basis of this controversy is crucial, as modulation of T-bet expression instructs TFH differentiation and ultimately protective antibody responses. Comparing influenza and LCMV viral infections, we demonstrate that the role of T-bet is contingent on the environmental setting of TFH differentiation, IL-2 signaling, and T cell competition. Furthermore, we demonstrate that T-bet expression by either TFH or GC B cells independently drives antibody isotype class switching. Specifically, T cell-specific loss of T-bet promotes IgG1, whereas B cell-specific loss of T-bet inhibits IgG2a/c switching. Combined, this work highlights that the context-dependent induction of T-bet instructs the development of protective, neutralizing antibodies following viral infection or vaccination.
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•In influenza infection, T-bet represses TFH cells to promote TH1 differentiation•T-bet is required for differentiation of both TFH and TH1 cells following LCMV•Distinct IL-2 signaling, T cell competition, and T-bet threshold between infections•T cell- and B cell-specific T-bet together balance IgG1 and IgG2a/c isotype switching
Shiekh et al. show that, in influenza and LCMV infections, the role of the transcription factor T-bet in TFH differentiation is contingent on environmental cues, IL-2 signaling, and T cell competition. Cell-specific T-bet expression independently drives antibody isotype class switching. Therefore T-bet instructs immune protection in a context-dependent manner.
Successful T-dependent humoral responses require the production of antibody-secreting plasmablasts, as well as the formation of germinal centers which eventually form high-affinity B cell memory. The ...ability of B cells to differentiate into germinal center and plasma cells, as well as the ability to tailor responses to different pathogens, is driven by transcription factors. In T cells, the T-box transcription factors T-bet and Eomesodermin (Eomes) regulate effector and memory T cell differentiation, respectively. While T-bet has a critical role in regulating anti-viral B cell responses, a role for Eomes in B cells has yet to be described. We therefore investigated whether Eomes was required for B cell differentiation during either Th1 or Th2 cell-biased immune responses. Here, we demonstrate that deletion of Eomes specifically in B cells did not affect B cell differentiation in response to vaccination, as well as following viral or helminth infection. In contrast to its established role in CD8+ T cells, Eomes did not influence memory B cell differentiation. Finally, the use of an Eomes reporter mouse confirmed the lack of Eomes expression during immune responses. Thus, germinal center and plasma cell differentiation and the formation of isotype-switched memory B cells in response to infection are independent of Eomes expression.
Results of a metabolic health clinic at a hostel for homeless men Nielssen, Olav; Chudleigh, Alan; Chen, Mia ...
Australasian psychiatry : bulletin of the Royal Australian and New Zealand College of Psychiatrists,
06/2017, Letnik:
25, Številka:
3
Journal Article
Recenzirano
Objectives:
People who are homeless have high mortality and morbidity, including from metabolic disorder. The aim of this study was to report on the characteristics and progress of the metabolic ...health of people attending a metabolic clinic at a homeless men’s shelter.
Methods:
Homeless men attending the clinic were assessed by measuring their weight, height, body mass index (BMI), waist circumference, blood pressure, blood lipids, fasting blood glucose and, if indicated, HbA1c. The sample characteristics of people who attended once (one-off clients) were compared to those who attended on more than one occasion (returning clients). Changes in health status were examined among returning clients by comparing baseline results to those at their last clinic visit.
Results:
Baseline data were recorded on a total of 136 men, of whom 126 had a consultation with a general practitioner and at least one blood test. The 136 clients had a median BMI of 27.4 kg/m2. Forty-three were obese (BMI ≥30 kg/m2), 18 had class II obesity (BMI >35 kg/m2) and seven were underweight (BMI <20 kg/m2). Sixty-five had an intervention for either a newly diagnosed condition or a change to existing medical treatment. Seventy-six returning clients were seen on an average of 2.3 further occasions. Returning clients had significant improvements in measures of metabolic health.
Conclusions:
Homeless people in Sydney appear to be at a high risk of metabolic disease. The feasibility of a metabolic health clinic was demonstrated, and an encouraging improvement in some health indicators was found.
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