A randomized controlled multicenter trial of post-suicide attempt case management for the prevention of further attempts in Japan (ACTION-J)

<p>Abstract</p> <p>Background</p> <p>A previous suicide attempt is a potent risk factor for suicide later on. Crisis intervention, psychiatric and psychosocial evaluation at emergency medical facilities, and follow-up care for suicide attempters are considered important components for suicide prevention. The Japanese Multimodal Intervention Trials for Suicide Prevention (J-MISP) includes a randomized, controlled, multicenter trial of post-suicide attempt case management for the prevention of further attempts (ACTION-J) to address the continuing increase in suicides in Japan. The primary aim of ACTION-J is to examine the effectiveness of an extensive intervention for suicide attempters in prevention of recurrent suicidal behavior, as compared with standard intervention. This paper describes the rationale and protocol of the ACTION-J trial.</p> <p>Methods/Design</p> <p>In this clinical trial, case management intervention will be provided at 19 emergency medical facilities in Japan. After crisis intervention including psychiatric evaluation, psychosocial assessment, and psychological education, subjects will be randomly assigned to either a group receiving continuous case management or a control group receiving standard care. Suicidal ideation, depressive symptoms, and general health condition will be evaluated as secondary measures. The intervention was initiated in July 2006. By December, 2009, 842 subjects will be randomized. Subject follow-up will continue for 1.5 to 5 years.</p> <p>Discussion</p> <p>Suicide is a complex phenomenon that encompasses multiple factors. Case management by multi-sector collaboration is needed. ACTION-J may provide valuable information on suicide attempters and may develop effective case management to reduce future risk for suicide attempters.</p> <p>Trial registration</p> <p>UMIN Clinical Trials Registry number, UMIN000000444. ClinicalTrials.gov number, NCT00736918.</p

Different Requirement for Wnt/β-Catenin Signaling in Limb Regeneration of Larval and Adult Xenopus

BACKGROUND:In limb regeneration of amphibians, the early steps leading to blastema formation are critical for the success of regeneration, and the initiation of regeneration in an adult limb requires the presence of nerves. Xenopus laevis tadpoles can completely regenerate an amputated limb at the early limb bud stage, and the metamorphosed young adult also regenerates a limb by a nerve-dependent process that results in a spike-like structure. Blockage of Wnt/β-catenin signaling inhibits the initiation of tadpole limb regeneration, but it remains unclear whether limb regeneration in young adults also requires Wnt/β-catenin signaling. METHODOLOGY/PRINCIPAL FINDINGS:We expressed heat-shock-inducible (hs) Dkk1, a Wnt antagonist, in transgenic Xenopus to block Wnt/β-catenin signaling during forelimb regeneration in young adults. hsDkk1 did not inhibit limb regeneration in any of the young adult frogs, though it suppressed Wnt-dependent expression of genes (fgf-8 and cyclin D1). When nerve supply to the limbs was partially removed, however, hsDkk1 expression blocked limb regeneration in young adult frogs. Conversely, activation of Wnt/β-catenin signaling by a GSK-3 inhibitor rescued failure of limb-spike regeneration in young adult frogs after total removal of nerve supply. CONCLUSIONS/SIGNIFICANCE:In contrast to its essential role in tadpole limb regeneration, our results suggest that Wnt/β-catenin signaling is not absolutely essential for limb regeneration in young adults. The different requirement for Wnt/β-catenin signaling in tadpoles and young adults appears to be due to the projection of nerve axons into the limb field. Our observations suggest that nerve-derived signals and Wnt/β-catenin signaling have redundant roles in the initiation of limb regeneration. Our results demonstrate for the first time the different mechanisms of limb regeneration initiation in limb buds (tadpoles) and developed limbs (young adults) with reference to nerve-derived signals and Wnt/β-catenin signaling

Spin-polarized semiconductor surface states localized in subsurface layers

A pair of different surface-state and surface-resonance bands has been identified on Bi/Ge(111)-(√3×√3)R30° by a combined experimental and computational study. The wave functions of the states have negligible amplitude at Bi atoms and are extended over more than 20 subsurface layers. These bands exhibit characteristic spin structure, which is ascribed to the combined Rashba and atomic spin-orbit interaction (SOI). Unlike previously known surface Rashba systems, the spin polarization is induced by SOI of a light element (Ge) with negligible contribution of a heavier one (Bi)

The Examination of Location Information Communication System to Develop a Forestry Vehicle Management System

本論文ではまず林業機械走行管理システムの概要をハーベスタ・フォワーダシステムを例にとって説明し，作業効率や環境負荷を考慮した集材計画について議論した。次にシステムの構築に向けて森林における位置情報の精度と位置情報通信システムの利用可能性について検討した。位置情報の精度についてはGPS単独測位の精度について四等三角点と作業道において実験を行い，相対測位の精度については既往の文献に基づいて議論したが，林業機械走行管理システムに用いるにはGPS測位だけでは精度的に問題があった。今後，他のセンサーとの併用により精度を上げる必要がある。通信システムについては無線と携帯電話を用いたシステムについて，国道と林道でGPSデータの通信実験を行った。携帯電話を用いたシステムではリアルタイムで長距離のGPSデータの通信が可能であったので，林業機械走行管理システムへの利用が可能であるが，森林地域における携帯電話の通話エリアは限られるため，今後は衛星通信の利用などを検討する必要がある。The paper describes first the forestry vehicle management system for a harvester and forwarder system, and discusses a logging operation taking into account operational efficiency and environmental impacts. Then the paper discusses the precision of location information and the availability of the communication system in the forest to the forestry vehicle management system. According to the precision of location information, the precision of point positioning was examined at a fourth graded triangulation point and on a strip road, and the precision of DGPS was discussed on the basis of other researches. The precision of point positioning or DGPS is not accurate enough to develop the forestry vehicle management system. Therefore, the precision of location information must be improved using both GPS and other sensors. According to the availability of the communication system, transferring GPS data by radio system and cellular phones were examined on national roads and forest roads. Using cellular phones will enable the development of a vehicle management system because the real-time and long-distance transmission test of GPS data using cellular phones succeeded. But cellular phones cannot always be used in the forest. Therefore, utilization of the satellite communication system must also be discussed