Models of collaboration between general practice and mental health services in Italy.

Background and objectives: Anxiety and Depressive disorders represent an important public health problem, which involves not only the mental health services, but the General Practice as well. This paper examines models of Collaboration between General Practice and Community Mental Health Services developed in Italy. Methods: Different Consultation -Liaison activities are presented. For every Collaboration model advantages and disadvantage are discussed. Results: The structured Consultation Liaison Service is based on supplying diagnostic consultation and therapeutic interventions in support of General Practitioners (GPs). The service could be based in either a Community Mental Health Centre (CMHC) or externally. Diagnostic evaluation can be followed by brief and focal therapeutic interventions, in support of the GP's therapeutic plan. The spontaneous collaboration in small centres are frequent in rural areas where the contained dimensions of the services and the direct acquaintance between psychiatrists and GPs encourage the personalization of the collaboration. The model of Liaison and Group-Training focuses on direct contact between consultant and GPs. In the course of regular meetings, the consultant gives the GPs supervision and education, and they can discuss the therapeutic plans for patients requiring specialist intervention. Conclusion: The empiric classification presented should be considered an attempt to represent a complex reality. Every service, in fact, carries out activities that are necessarily wider than abstract typologies and that overlap with other models' activities

Geometry of General Hypersurfaces in Spacetime: Junction Conditions

We study imbedded hypersurfaces in spacetime whose causal character is allowed to change from point to point. Inherited geometrical structures on these hypersurfaces are defined by two methods: first, the standard rigged connection induced by a rigging vector (a vector not tangent to the hypersurface anywhere); and a second, more physically adapted, where each observer in spacetime induces a new type of connection that we call the rigged metric connection. The generalisation of the Gauss and Codazzi equations are also given. With the above machinery, we attack the problem of matching two spacetimes across a general hypersurface. It is seen that the preliminary junction conditions allowing for the correct definition of Einstein's equations in the distributional sense reduce to the requirement that the first fundamental form of the hypersurface be continuous. The Bianchi identities are then proven to hold in the distributional sense. Next, we find the proper junction conditions which forbid the appearance of singular parts in the curvature. Finally, we derive the physical implications of the junction conditions: only six independent discontinuities of the Riemann tensor are allowed. These are six matter discontinuities at non-null points of the hypersurface. For null points, the existence of two arbitrary discontinuities of the Weyl tensor (together with four in the matter tensor) are also allowed.Comment: Latex, no figure

Bogoliubov modes of a dipolar condensate in a cylindrical trap

The calculation of properties of Bose-Einstein condensates with dipolar interactions has proven a computationally intensive problem due to the long range nature of the interactions, limiting the scope of applications. In particular, the lowest lying Bogoliubov excitations in three dimensional harmonic trap with cylindrical symmetry were so far computed in an indirect way, by Fourier analysis of time dependent perturbations, or by approximate variational methods. We have developed a very fast and accurate numerical algorithm based on the Hankel transform for calculating properties of dipolar Bose-Einstein condensates in cylindrically symmetric traps. As an application, we are able to compute many excitation modes by directly solving the Bogoliubov-De Gennes equations. We explore the behavior of the excited modes in different trap geometries. We use these results to calculate the quantum depletion of the condensate by a combination of a computation of the exact modes and the use of a local density approximation

Early Response to the Plant Toxin Stenodactylin in Acute Myeloid Leukemia Cells Involves Inflammatory and Apoptotic Signaling

Stenodactylin, a highly toxic type 2 ribosome-inactivating protein purified from the caudex of Adenia stenodactyla Harms, is a potential anticancer drug candidate. Previous studies demonstrated that stenodactylin induces apoptosis and necroptosis in treated cells, involving the production of reactive oxygen species. We analyzed the effect of stenodactylin on Raji and Ramos (Human Burkitt’s lymphoma cells) and MOLM-13 (acute myeloid leukemia cells). Moreover, we focused on the early events in MOLM-13 cells that characterize the cellular response to the toxin by whole-genome microarray analysis of gene expression. Treatment with stenodactylin induced the depurination of 28S rRNA within 4 h and increased the phosphorylation of p38 and JNK. A time-dependent activation of caspase 1, 2, 8, 9, 3/7 was also observed. Genome-wide gene expression microarray analysis revealed early changes in the expression of genes involved in the regulation of cell death, inflammation and stress response. After 4 h, a significant increase of transcript level was detectable for ATF3, BTG2, DUSP1, EGR1, and JUN. Increased upstream JUN signaling was also confirmed at protein level. The early response to stenodactylin treatment involves inflammatory and apoptotic signaling compatible with the activation of multiple cell death pathways. Because of the above described properties toward acute myeloid leukemia cells, stenodactylin may be a promising candidate for the design of new immunoconjugates for experimental cancer treatment

Comprehensive Evaluation of Plasma 7-Ketocholesterol and Cholestan-3β,5α,6β-Triol in an Italian Cohort of Patients Affected by Niemann-Pick Disease due to NPC1 and SMPD1 Mutations

: Niemann-Pick C disease (NPCD) is a rare autosomal recessive neurovisceral disorder with a heterogeneous clinical presentation. Cholestan-3β,5α,6β-triol and 7-ketocholesterol have been proposed as biomarkers for the screening of NPCD. In this work, we assessed oxysterols levels in a cohort of Italian patients affected by NPCD and analyzed the obtained results in the context of the clinical, biochemical and molecular data. In addition, a group of patients affected by Niemann-Pick B disease (NPBD) were also analyzed. NPC patients presented levels of both oxysterols way above the cut off value, except for 5 siblings presenting the variant biochemical phenotype who displayed levels of 3β,5α,6β-triol below or just above the cut-off value; 2 of them presented also normal levels of 7-KC. Both oxysterols were extremely high in a patient presenting the neonatal systemic lethal phenotype. All NPB patients showed increased oxysterols levels. In conclusion, the reported LC-MS/MS assay provides a robust non-invasive screening tool for NPCD. However, false negative results can be obtained in patients expressing the variant biochemical phenotype. These data strengthen the concept that the results should always be interpreted in the context of the patients' clinical picture and filipin staining and/or genetic studies might still be undertaken in patients with normal levels of oxysterols if symptoms are highly suggestive of NPCD. Both oxysterols are significantly elevated in NPB patients; thus a differential diagnosis should always be performed in patients presenting isolated hepatosplenomegaly, a common clinical sign of both NPCD and NPBD

Kinetics of trifurcated electron flow in the decaheme bacterial proteins MtrC and MtrF

The bacterium Shewanella oneidensis has evolved a sophisticated electron transfer (ET) machinery to export electrons from the cytosol to extracellular space during extracellular respiration. At the heart of this process are decaheme proteins of the Mtr pathway, MtrC and MtrF, located at the external face of the outer bacterial membrane. Crystal structures have revealed that these proteins bind 10 c-type hemes arranged in the peculiar shape of a staggered cross that trifurcates the electron flow, presumably to reduce extracellular substrates while directing electrons to neighboring multiheme cytochromes at either side along the membrane. Especially intriguing is the design of the heme junctions trifurcating the electron flow: they are made of coplanar and T-shaped heme pair motifs with relatively large and seemingly unfavorable tunneling distances. Here, we use electronic structure calculations and molecular simulations to show that the side chains of the heme rings, in particular the cysteine linkages inserting in the space between coplanar and T-shaped heme pairs, strongly enhance electronic coupling in these two motifs. This results in an [Formula: see text]-fold speedup of ET steps at heme junctions that would otherwise be rate limiting. The predicted maximum electron flux through the solvated proteins is remarkably similar for all possible flow directions, suggesting that MtrC and MtrF shuttle electrons with similar efficiency and reversibly in directions parallel and orthogonal to the outer membrane. No major differences in the ET properties of MtrC and MtrF are found, implying that the different expression levels of the two proteins during extracellular respiration are not related to redox function

Ecological and social factors influence interspecific pathogens occurrence among bees

The interspecific transmission of pathogens can occur frequently in the environment. Among wild bees, the main spillover cases are caused by pathogens associated with Apis mellifera, whose colonies can act as reservoirs. Due to the limited availability of data in Italy, it is challenging to accurately assess the impact and implications of this phenomenon on the wild bee populations. In this study, a total of 3372 bees were sampled from 11 Italian regions within the BeeNet project, evaluating the prevalence and the abundance of the major honey bee pathogens (DWV, BQCV, ABPV, CBPV, KBV, Nosema ceranae, Ascosphaera apis, Crithidia mellificae, Lotmaria passim, Crithidia bombi). The 68.4% of samples were positive for at least one pathogen. DWV, BQCV, N. ceranae and CBPV showed the highest prevalence and abundance values, confirming them as the most prevalent pathogens spread in the environment. For these pathogens, Andrena, Bombus, Eucera and Seladonia showed the highest mean prevalence and abundance values. Generally, time trends showed a prevalence and abundance decrease from April to July. In order to predict the risk of infection among wild bees, statistical models were developed. A low influence of apiary density on pathogen occurrence was observed, while meteorological conditions and agricultural management showed a greater impact on pathogen persistence in the environment. Social and biological traits of wild bees also contributed to defining a higher risk of infection for bivoltine, communal, mining and oligolectic bees. Out of all the samples tested, 40.5% were co-infected with two or more pathogens. In some cases, individuals were simultaneously infected with up to five different pathogens. It is essential to increase knowledge about the transmission of pathogens among wild bees to understand dynamics, impact and effects on pollinator populations. Implementing concrete plans for the conservation of wild bee species is important to ensure the health of wild and human-managed bees within a One-Health perspective

Spin torque resonant vortex core expulsion for an efficient radio-frequency detection scheme

Spin-polarised radio-frequency currents, whose frequency is equal to that of the gyrotropic mode, will cause an excitation of the core of a magnetic vortex confined in a magnetic tunnel junction. When the excitation radius of the vortex core is greater than that of the junction radius, vortex core expulsion is observed, leading to a large change in resistance, as the layer enters a predominantly uniform magnetisation state. Unlike the conventional spin-torque diode effect, this highly tunable resonant effect will generate a voltage which does not decrease as a function of rf power, and has the potential to form the basis of a new generation of tunable nanoscale radio-frequency detectors