Energy Release During Slow Long Duration Flares Observed by RHESSI

Slow Long Duration Events (SLDEs) are flares characterized by long duration of rising phase. In many such cases impulsive phase is weak with lack of typical short-lasting pulses. Instead of that smooth, long-lasting Hard X-ray (HXR) emission is observed. We analysed hard X-ray emission and morphology of six selected SLDEs. In our analysis we utilized data from RHESSI and GOES satellites. Physical parameters of HXR sources were obtained from imaging spectroscopy and were used for the energy balance analysis. Characteristic time of heating rate decrease, after reaching its maximum value, is very long, which explains long rising phase of these flares.Comment: Accepted for publication in Solar Physic

AURKB-mediated effects on chromatin regulate binding versus release of XIST RNA to the inactive chromosome

How XIST RNA strictly localizes across the inactive X chromosome is unknown; however, prophase release of human XIST RNA provides a clue. Tests of inhibitors that mimic mitotic chromatin modifications implicated an indirect role of PP1 (protein phosphatase 1), potentially via its interphase repression of Aurora B kinase (AURKB), which phosphorylates H3 and chromosomal proteins at prophase. RNA interference to AURKB causes mitotic retention of XIST RNA, unlike other mitotic or broad kinase inhibitors. Thus, AURKB plays an unexpected role in regulating RNA binding to heterochromatin, independent of mechanics of mitosis. H3 phosphorylation (H3ph) was shown to precede XIST RNA release, whereas results exclude H1ph involvement. Of numerous Xi chromatin (chromosomal protein) hallmarks, ubiquitination closely follows XIST RNA retention or release. Surprisingly, H3S10ph staining (but not H3S28ph) is excluded from Xi and is potentially linked to ubiquitination. Results suggest a model of multiple distinct anchor points for XIST RNA. This study advances understanding of RNA chromosome binding and the roles of AURKB and demonstrates a novel approach to manipulate and study XIST RNA

Perceived stigma and social support in treatment for pharmaceutical opioid dependence

Introduction and Aims: The dramatic increase in pharmaceutical opioid (PO) use in high-income countries is a growing public health concern. Stigma and social support are important as they may influence treatment uptake and outcomes, yet few studies exist regarding perceived stigma and social support among people with PO dependence. The aims of the study are to: (i) compare characteristics of those with PO dependence from iatrogenic and non-iatrogenic causes; (ii) document perceived stigma and its correlates in people in treatment for PO dependence; and (iii) examine correlates of social support in people in treatment for PO dependence. Design and Methods: This prospective cohort study included (n = 108) PO-dependent people referred from treatment services. Telephone interviews were conducted at baseline, 3, 12 and 24 months. Multivariate linear regression was used to examine correlations. Results: Mean age was 41 (SD = 10.5). Half (n = 56, 52%) were female. Two in five met the criteria for iatrogenic dependence (n = 41, 38%), with iatrogenic dependence associated with chronic pain, and no history of injection or heroin use. One quarter of study subjects reported past month unsanctioned opioid use (n = 25, 23%). Being married/de facto or female was associated with higher levels of perceived stigma. Unsanctioned opioid use, iatrogenic dependence and mental health conditions were associated with lower social support. Discussion and Conclusions: Stigma affects all people in treatment. Those who are married/de facto and female may benefit from interventions to address stigma. The association of low social support with poorer mental health and ongoing substance use indicate that treatment could focus more on this area

Exercise Capacity and Acute Effect of Exercise on Affect in a Substance Use Disorder Population

ABSTRACT Background It is known that exercise is beneficial to people with substance use disorder, however little evidence exists regarding their exercise capacity. This pilot study investigates the exercise capacity of patients with substance use disorder and effects of an acute bout of exercise on affect. Methods Twenty-nine participants admitted to a withdrawal management facility were recruited to complete a health and exercise assessment (18 females, 11 males; 41 ± 11 years old). Mood was measured before and after exercise assessments using the subjective experience to exercise scale. Data was grouped by sex, and descriptive analyses were performed against age-matched normative data. Within group, before and after subjective experience to exercise scale measures were analyzed using 2-way ANOVA with sex as a between subject factor. Results Participants ranged from having 2 to 6 modifiable cardiovascular risk factors. Participants performed below average compared to age-matched and sex-matched normative data for the 6-minute walk test (females: 539 ± 54 m, males: 606 ± 89 m); and push-up test (females: 22% good, males: 36% good). Of the 29 participants, 29% failed to achieve the average range for sex-matched norms in the sit-to-stand test. However, all participants achieved above average for curl-ups, and 72% achieved an average or above score in the step-up test. Exercise significantly increased wellbeing (P &amp;lt; 0.001, effect size = 1.12) and decreased psychological distress (P = 0.045, effect size = 1.03) and fatigue (P &amp;lt; 0.001, effect size = 1.32). Conclusion Exercise is both feasible and beneficial in a withdrawal management setting. Capacity to perform exercise was generally poor with high individual variance. Design of future interventions will need tailored prescription for patients in this population. </jats:sec

The assessment of frailty in older people in acute care

Aim: Develop a measure of frailty for older acute inpatients to be performed by non-geriatricians. Method: The Reported Edmonton Frail Scale (REFS) was adapted from the Edmonton Frail Scale for use with Australian acute inpatients. With acute patients aged over 70 years admitted to an Australian teaching hospital, we validated REFS against the Geriatrician's Clinical Impression of Frailty (GCIF), measures of cognition, comorbidity and function, and assessed inter-rater reliability. Results: REFS was moderately correlated with GCIF (n = 105, R = 0.61, P < 0.01), Mini-Mental State Examination impairment (n = 61, R = 0.49, P < 0.001), Charlson Comorbidity Index (n = 59, R = 0.51, P < 0.001) and Katz Daily Living Scale (n = 59, R = 0.51, P < 0.001). Inter-rater reliability of REFS administered by two researchers without medical training was excellent (kappa = 0.84, n = 31). Conclusion: In this cohort of older acute inpatients, REFS is a valid, reliable test of frailty, and may be a valuable research tool to assess the impact of frailty on prognosis and response to therapy. © 2009 ACOTA

Treating codeine dependence with buprenorphine: Dose requirements and induction outcomes from a retrospective case series in New South Wales, Australia

Introduction and Aims: Codeine dependence is an emerging public health concern, yet no studies have specifically examined the treatment of codeine dependence. Given the lower potency of codeine it cannot be assumed that buprenorphine dose requirements for heroin dependence will generalise to codeine. This is the first study to examine buprenorphine treatment for codeine dependence.Design and Methods: Retrospective case series of 19 codeine-dependent treatment entrants who received sublingual buprenorphine maintenance treatment through six specialist inpatient and outpatient treatment centres. Baseline codeine doses and buprenorphine dose at days 7 and 28 were collected, in addition to details on general demographics, pain and mental health, substance use and outcomes after 28 days of buprenorphine treatment.Results: A significant linear relationship was found between initial codeine dose and dose of buprenorphine given at days 7 and 28 for the codeine dose range of 50-960 mg day-1 (mean: 564 mg; 95% confidence interval 431-696 mg). Median buprenorphine dose was 12.0 mg (interquartile range 9.5 mg, range 4-32 mg) at day 7 and 16.0 mg (interquartile range 13.5 mg, range 4-32 mg) at day 28. Buprenorphine doses received were markedly higher than estimated codeine doses based on standard dose conversion tables.Discussion and Conclusions: With increasing presentations relating to codeine dependence, these findings provide important guidance to clinicians. Buprenorphine doses were consistently higher than doses estimated based on the dose of codeine consumed, and were comparable with doses used in the treatment of dependence with heroin and more potent prescription opioids. [Nielsen S, Bruno R, Murnion B, Dunlop A, Degenhardt L, Demirkol A, Muhleisen P, Lintzeris N. Treating codeine dependence with buprenorphine: Dose requirements and induction outcomes from a retrospective case series in New South Wales, Australia. Drug Alcohol Rev 2015]