Implementing measurement-based care (iMBC) for depression in community mental health: a dynamic cluster randomized trial study protocol

BACKGROUND: Measurement-based care is an evidence-based practice for depression that efficiently identifies treatment non-responders and those who might otherwise deteriorate [1]. However, measurement-based care is underutilized in community mental health with data suggesting fewer than 20 % of behavioral health providers using this practice to inform treatment. It remains unclear whether standardized or tailored approaches to implementation are needed to optimize measurement-based care fidelity and penetration. Moreover, there is some suggestion that prospectively tailored interventions that are designed to fit the dynamic context may optimize public health impact, though no randomized trials have yet tested this notion [2]. This study will address the following three aims: (1) To compare the effect of standardized versus tailored MBC implementation on clinician-level and client-level outcomes; (2) To identify contextual mediators of MBC fidelity; and (3) To explore the impact of MBC fidelity on client outcomes. METHODS/DESIGN: This study is a dynamic cluster randomized trial of standardized versus tailored measurement-based care implementation in Centerstone, the largest provider of community-based mental health services in the USA. This prospective, mixed methods implementation-effectiveness hybrid design allows for evaluation of the two conditions on both clinician-level (e.g., MBC fidelity) and client-level (depression symptom change) outcomes. Central to this investigation is the focus on identifying contextual factors (e.g., attitudes, resources, process, etc.) that mediate MBC fidelity and optimize client outcomes. DISCUSSION: This study will contribute generalizable and practical strategies for implementing systematic symptom monitoring to inform and enhance behavioral healthcare. TRIAL REGISTRATION: Clinicaltrials.gov NCT02266134

Goα Regulates Volatile Anesthetic Action in Caenorhabditis elegans

To identify genes controlling volatile anesthetic (VA) action, we have screened through existing Caenorhabditis elegans mutants and found that strains with a reduction in Go signaling are VA resistant. Loss-of-function mutants of the gene goa-1, which codes for the α-subunit of Go, have EC_(50)s for the VA isoflurane of 1.7- to 2.4-fold that of wild type. Strains overexpressing egl-10, which codes for an RGS protein negatively regulating goa-1, are also isoflurane resistant. However, sensitivity to halothane, a structurally distinct VA, is differentially affected by Go pathway mutants. The RGS overexpressing strains, a goa-1 missense mutant found to carry a novel mutation near the GTP-binding domain, and eat-16(rf) mutants, which suppress goa-1(gf) mutations, are all halothane resistant; goa-1(null) mutants have wild-type sensitivities. Double mutant strains carrying mutations in both goa-1 and unc-64, which codes for a neuronal syntaxin previously found to regulate VA sensitivity, show that the syntaxin mutant phenotypes depend in part on goa-1 expression. Pharmacological assays using the cholinesterase inhibitor aldicarb suggest that VAs and GOA-1 similarly downregulate cholinergic neurotransmitter release in C. elegans. Thus, the mechanism of action of VAs in C. elegans is regulated by Goα, and presynaptic Goα-effectors are candidate VA molecular targets

Large Tree Level CP Violation in e+e−→ttˉH0e^+e^-\to t\bar{t}H^0 in The Two Higgs Doublet Model

We find a large CP violation effect within the Two-Higgs-Doublet-Model for the reaction $e^+e^-\to t\bar{t}H^0$ at future linear colliders. The CP-asymmetry arises already at the tree level as a result of interference between diagrams with $H^0$ emission from $t$ (and $\bar{t}$) and its emission from a $Z^0$ and can be about 10--20\%. In the best case one needs a few hundred $t\bar{t}H^0$ events to observe CP violation at the 3$\sigma$ level.Comment: UU encoded tar compressed tex file with postscript figure

An automated system for measuring parameters of nematode sinusoidal movement

BACKGROUND: Nematode sinusoidal movement has been used as a phenotype in many studies of C. elegans development, behavior and physiology. A thorough understanding of the ways in which genes control these aspects of biology depends, in part, on the accuracy of phenotypic analysis. While worms that move poorly are relatively easy to describe, description of hyperactive movement and movement modulation presents more of a challenge. An enhanced capability to analyze all the complexities of nematode movement will thus help our understanding of how genes control behavior. RESULTS: We have developed a user-friendly system to analyze nematode movement in an automated and quantitative manner. In this system nematodes are automatically recognized and a computer-controlled microscope stage ensures that the nematode is kept within the camera field of view while video images from the camera are stored on videotape. In a second step, the images from the videotapes are processed to recognize the worm and to extract its changing position and posture over time. From this information, a variety of movement parameters are calculated. These parameters include the velocity of the worm's centroid, the velocity of the worm along its track, the extent and frequency of body bending, the amplitude and wavelength of the sinusoidal movement, and the propagation of the contraction wave along the body. The length of the worm is also determined and used to normalize the amplitude and wavelength measurements. To demonstrate the utility of this system, we report here a comparison of movement parameters for a small set of mutants affecting the Go/Gq mediated signaling network that controls acetylcholine release at the neuromuscular junction. The system allows comparison of distinct genotypes that affect movement similarly (activation of Gq-alpha versus loss of Go-alpha function), as well as of different mutant alleles at a single locus (null and dominant negative alleles of the goa-1 gene, which encodes Go-alpha). We also demonstrate the use of this system for analyzing the effects of toxic agents. Concentration-response curves for the toxicants arsenite and aldicarb, both of which affect motility, were determined for wild-type and several mutant strains, identifying P-glycoprotein mutants as not significantly more sensitive to either compound, while cat-4 mutants are more sensitive to arsenite but not aldicarb. CONCLUSIONS: Automated analysis of nematode movement facilitates a broad spectrum of experiments. Detailed genetic analysis of multiple alleles and of distinct genes in a regulatory network is now possible. These studies will facilitate quantitative modeling of C. elegans movement, as well as a comparison of gene function. Concentration-response curves will allow rigorous analysis of toxic agents as well as of pharmacological agents. This type of system thus represents a powerful analytical tool that can be readily coupled with the molecular genetics of nematodes

Flux-tubes in three-dimensional lattice gauge theories

Flux-tubes in different representations of SU(2) and U(1) lattice gauge theories in three dimensions are measured. Wilson loops generate heavy ``quark-antiquark'' pairs in fundamental ($j=1/2$), adjoint ($j=1$), and quartet ($j=3/2$) representations of SU(2). The first direct lattice measurements of the flux-tube cross-section ${\cal A}_j$ as a function of representation are made. It is found that ${\cal A}_j \approx {\rm constant}$, to about 10\%. Results are consistent with a connection between the string tension $\sigma_j$ and ${\cal A}_j$ suggested by a simplified flux-tube model, $\sigma_j = g^2 j(j+1) / (2 {\cal A}_j)$ [$g$ is the gauge coupling], given that $\sigma_j$ scales like the Casimir $j(j+1)$, as observed in previous lattice studies in both three and four dimensions. The results can discriminate among phenomenological models of the physics underlying confinement. Flux-tubes for singly- and doubly-charged Wilson loops in compact QED$_3$ are also measured. It is found that the string tension scales as the squared-charge and the flux-tube cross-section is independent of charge to good approximation. These SU(2) and U(1) simulations lend some support, albeit indirectly, to a conjecture that the dual superconductor mechanism underlies confinement in compact gauge theories in both three and four dimensions.Comment: 15 pages (REVTEX 2.1). Figures: 11, not included (available by request from [email protected] by regular mail, postscript files, or one self-unpacking uuencoded file

Scalars from Top-condensation Models at Hadron Colliders

We study the production and decay of neutral scalars and pseudo-scalars at hadron colliders, in theories where the top-quark mass is the result of a $t\bar t$ condensate. We show that the dominant decay channel for masses below the $t\bar t$ threshold is the flavor changing mode $tc$. This is a consequence of the non-universal nature of the underlying interactions in all top-condensation models and provides a model-independent signature of these scenarios. We show that an upgraded Tevatron is sensitive to a sizeable region of the interesting parameter space and that the LHC will highly constrain these models through this flavor violating channel.Comment: 4 pages, 4 figures. Minor changes in figures for readibility. final version to appear in PR

The Gene Ontology Resource: 20 years and still GOing strong

The Gene Ontology resource (GO; http://geneontology.org) provides structured, computable knowledge regarding the functions of genes and gene products. Founded in 1998, GO has become widely adopted in the life sciences, and its contents are under continual improvement, both in quantity and in quality. Here, we report the major developments of the GO resource during the past two years. Each monthly release of the GO resource is now packaged and given a unique identifier (DOI), enabling GO-based analyses on a specific release to be reproduced in the future. The molecular function ontology has been refactored to better represent the overall activities of gene products, with a focus on transcription regulator activities. Quality assurance efforts have been ramped up to address potentially out-of-date or inaccurate annotations. New evidence codes for high-throughput experiments now enable users to filter out annotations obtained from these sources. GO-CAM, a new framework for representing gene function that is more expressive than standard GO annotations, has been released, and users can now explore the growing repository of these models. We also provide the ‘GO ribbon’ widget for visualizing GO annotations to a gene; the widget can be easily embedded in any web page

Recovering 3D structural properties of galaxies from SDSS-like photometry

Because of the 3D nature of galaxies, an algorithm for constructing spatial density distribution models of galaxies on the basis of galaxy images has many advantages over surface density distribution approximations. We present a method for deriving spatial structure and overall parameters of galaxies from images and estimate its accuracy and derived parameter degeneracies on a sample of idealised model galaxies. The test galaxies consist of a disc-like component and a spheroidal component with varying proportions and properties. Both components are assumed to be axially symmetric and coplanar. We simulate these test galaxies as if observed in the SDSS project through ugriz filters, thus gaining a set of realistically imperfect images of galaxies with known intrinsic properties. These artificial SDSS galaxies were thereafter remodelled by approximating the surface brightness distribution with a 2D projection of a bulge+disc spatial distribution model and the restored parameters were compared to the initial ones. Down to the r-band limiting magnitude 18, errors of the restored integral luminosities and colour indices remain within 0.05 mag and errors of the luminosities of individual components within 0.2 mag. Accuracy of the restored bulge-to-disc ratios (B/D) is within 40% in most cases, and becomes worse for galaxies with low B/D, but the general balance between bulges and discs is not shifted systematically. Assuming that the intrinsic disc axial ratio is < 0.3, the inclination angles can be estimated with errors < 5deg for most of the galaxies with B/D < 2 and with errors < 15deg up to B/D = 6. Errors of the recovered sizes of the galactic components are below 10% in most cases. In general, models of disc components are more accurate than models of spheroidal components for geometrical reasons.Comment: 15 pages, 13 figures, accepted for publication in RA