Discharge to the Community from an Inpatient Psychiatric Hospital: Factors to Consider

Nationally, inpatient psychiatric settings average a 5% readmission rate for their patients, within one month of discharge. A search for articles published within the past 20 years, uncovered critical themes and led to recommendations for practice from 15 articles. Impacting an individual’s readmission are 1) length of stay at the facility, 2) employment opportunities and support after discharge, 3) social and family support, impacting feelings of exclusion/inclusion (stigma), 4) the extent to which the individual embraces the AA recovery philosophy, 5) the specific characteristics of the immediate geographical location of housing, 6) adherence to medical plans, and 7) the availability of continuity of care. Successful discharge is multifaceted for the co-occurring mental health and substance abuse population. Findings suggest that occupational therapy should consider shifting its focus from skill level development to including more adaptation of the social environment and community development to find solutions to exclusion, urban planning, and economic concerns due to unemployment. Needed is more attention to the complexity of managing fragmented health and social systems, which a multidisciplinary team approach of continuity of care could help untangle and as a result reduce barriers to successful transition to community living

Multiple breast cancer risk variants are associated with differential transcript isoform expression in tumors.

Genome-wide association studies have identified over 70 single-nucleotide polymorphisms (SNPs) associated with breast cancer. A subset of these SNPs are associated with quantitative expression of nearby genes, but the functional effects of the majority remain unknown. We hypothesized that some risk SNPs may regulate alternative splicing. Using RNA-sequencing data from breast tumors and germline genotypes from The Cancer Genome Atlas, we tested the association between each risk SNP genotype and exon-, exon-exon junction- or transcript-specific expression of nearby genes. Six SNPs were associated with differential transcript expression of seven nearby genes at FDR < 0.05 (BABAM1, DCLRE1B/PHTF1, PEX14, RAD51L1, SRGAP2D and STXBP4). We next developed a Bayesian approach to evaluate, for each SNP, the overlap between the signal of association with breast cancer and the signal of association with alternative splicing. At one locus (SRGAP2D), this method eliminated the possibility that the breast cancer risk and the alternate splicing event were due to the same causal SNP. Lastly, at two loci, we identified the likely causal SNP for the alternative splicing event, and at one, functionally validated the effect of that SNP on alternative splicing using a minigene reporter assay. Our results suggest that the regulation of differential transcript isoform expression is the functional mechanism of some breast cancer risk SNPs and that we can use these associations to identify causal SNPs, target genes and the specific transcripts that may mediate breast cancer risk

Regulation of D-galacturonate metabolism in Caulobacter crescentus by HumR, a LacI-family transcriptional repressor

The oligotrophic freshwater bacterium Caulobacter crescentus encodes a cluster of genes (CC_1487 to CC_1495) shown here to be necessary for metabolism of D-galacturonate, the primary constituent of pectin, a major plant polymer. Sequence analysis suggests that these genes encode a version of the bacterial hexuronate isomerase pathway. A conserved 14 bp sequence motif is associated with promoter regions of three operons within this cluster, and is conserved in homologous gene clusters in related alpha-Proteobacteria. Embedded in the hexuronate gene cluster is a gene (CC_1489) encoding a member of the LacI family of bacterial transcription factors. This gene product, designated here as HumR (hexuronate metabolism regulator), represses expression of the uxaA and uxaC operon promoters by binding to the conserved operator sequence. Repression is relieved in the presence of galacturonate or, to a lesser extent, by glucuronate. Other genes potentially involved in pectin degradation and hexuronate transport are also under the control of HumR. Adoption of a LacI-type repressor to control hexuronate metabolism parallels the regulation of xylose, glucose, and maltose utilization in C. crescentus, but is distinct from the use of GntR-type repressors to control pectin and hexuronate utilization in gamma-Proteobacteria such as Escherichia coli

Effects of 7.5% Carbon Dioxide and Nicotine Administration on Latent Inhibition.

Stratified medicine approaches have potential to improve the efficacy of drug development for schizophrenia and other psychiatric conditions, as they have for oncology. Latent inhibition is a candidate biomarker as it demonstrates differential sensitivity to key symptoms and neurobiological abnormalities associated with schizophrenia. The aims of this research were to evaluate whether a novel latent inhibition task that is not confounded by alternative learning effects such as learned irrelevance, is sensitive to (1) an in-direct model relevant to psychosis [using 7.5% carbon dioxide (CO2) inhalations to induce dopamine release via somatic anxiety] and (2) a pro-cognitive pharmacological manipulation (via nicotine administration) for the treatment of cognitive impairment associated with schizophrenia. Experiment 1 used a 7.5% CO2 challenge as a model of anxiety-induced dopamine release to evaluate the sensitivity of latent inhibition during CO2 gas inhalation, compared to the inhalation of medical air. Experiment 2 examined the effect of 2 mg nicotine administration vs. placebo on latent inhibition to evaluate its sensitivity to a potential pro-cognitive drug treatment. Inhalation of 7.5% CO2 raised self-report and physiological measures of anxiety and impaired latent inhibition, relative to a medical air control; whereas administration of 2 mg nicotine, demonstrated increased latent inhibition relative to placebo control. Here, two complementary experimental studies suggest latent inhibition is modified by manipulations that are relevant to the detection and treatment of schizophrenia. These results suggest that this latent inhibition task merits further investigation in the context of neurobiological sub-groups suitable for novel treatment strategies

G28.17+0.05: An unusual giant HI cloud in the inner Galaxy

New 21 cm HI observations have revealed a giant HI cloud in the Galactic plane that has unusual properties. It is quite well defined, about 150 pc in diameter at a distance of 5 kpc, and contains as much as 100,000 Solar Masses of atomic hydrogen. The outer parts of the cloud appear in HI emission above the HI background, while the central regions show HI self-absorption. Models which reproduce the observations have a core with a temperature <40 K and an outer envelope as much as an order of magnitude hotter. The cold core is elongated along the Galactic plane, whereas the overall outline of the cloud is approximately spherical. The warm and cold parts of the HI cloud have a similar, and relatively large, line width of approximately 7 km/s. The cloud core is a source of weak, anomalously-excited 1720 MHz OH emission, also with a relatively large line width, which delineates the region of HI self-absorption but is slightly blue-shifted in velocity. The intensity of the 1720 MHz OH emission is correlated with N(H) derived from models of the cold core. There is 12CO emission associated with the cloud core. Most of the cloud mass is in molecules, and the total mass is > 200,000 Solar Masses. In the cold core the HI mass fraction may be 10 percent. The cloud has only a few sites of current star formation. There may be about 100 more objects like this in the inner Galaxy; every line of sight through the Galactic plane within 50 degrees of the Galactic center probably intersects at least one. We suggest that G28.17+0.05 is a cloud being observed as it enters a spiral arm and that it is in the transition from the atomic to the molecular state.Comment: 35 pages, inludes 12 figure

α5β1 integrin recycling promotes Arp2/3-independent cancer cell invasion via the formin FHOD3

Invasive migration in 3D extracellular matrix (ECM) is crucial to cancer metastasis, yet little is known of the molecular mechanisms that drive reorganization of the cytoskeleton as cancer cells disseminate in vivo. 2D Rac-driven lamellipodial migration is well understood, but how these features apply to 3D migration is not clear. We find that lamellipodia-like protrusions and retrograde actin flow are indeed observed in cells moving in 3D ECM. However, Rab-coupling protein (RCP)-driven endocytic recycling of α5β1 integrin enhances invasive migration of cancer cells into fibronectin-rich 3D ECM, driven by RhoA and filopodial spike-based protrusions, not lamellipodia. Furthermore, we show that actin spike protrusions are Arp2/3-independent. Dynamic actin spike assembly in cells invading in vitro and in vivo is regulated by Formin homology-2 domain containing 3 (FHOD3), which is activated by RhoA/ROCK, establishing a novel mechanism through which the RCP–α5β1 pathway reprograms the actin cytoskeleton to promote invasive migration and local invasion in vivo

Information Competencies for Students in Design Disciplines

Information Competencies for Students in Design Disciplines, for the first time, compiles a list of core information literacy skills for students. Divided into basic, intermediate, and advanced skills in each design discipline, this set of competencies is an invaluable aid to librarians as they strive to define and delimit information literacy skills for students in design disciplines. These competencies are intended to facilitate a systematic means of integrating information literacy skills into the core curriculum of design students, as well as to open lines of communication with faculty as to how competencies can be integrated into specific course goals. The authors developed Information Competencies for Students in Design Disciplines with previously established information literacy standards at its foundation. The ACRL Information Literacy Competency Standards for Higher Education as well as specific standards in other disciplines such as Information Literacy Standards for Science and Engineering/Technology were consulted in the creation of these standards

Auricular Point Acupressure Smartphone Application to Manage Chronic Musculoskeletal Pain: A Longitudinal, One-Group, Open Pilot Trial

Background: Chronic musculoskeletal pain (CMP) is the most common self-reported chronic pain condition. Current treatment for CMP is limited. Methods: This was a two-phase study. In Phase 1, three auricular point acupressure (APA)-naïve participants were recruited to explore their experiences of APA and a smartphone app was developed based on their feedback. In Phase 2, a prospective longitudinal study was used to examine the effectiveness of the smartphone app to self-manage CMP. Results: Phase 1 resulted in the successful development of the APA smartphone app. In Phase 2, after four weeks of APA, participants reported reduced pain intensity (30%), pain interference (35%), and disability (40%), as well as improved physical function (47%). The mean score for the participants’ perception of treatment efficacy was 4.94 (SD = 2.08, scale of 0–7) indicating that approximately 70% of participants rated global improvements with noticeable changes. The majority (88%, n = 22) of the participants were satisfied with the treatment: 32% [8] were very satisfied and 56% [n = 14] were somewhat satisfied. The average frequency of pressing APA seeds per day was 2.93 times (SD = 2.27, range 0–10) and 1.60 minutes per time (SD = 2.64, range 0–10); the participants were able to adhere to the suggested pressing time per day, although they only pressed the ear points about 53% of the suggested time. Conclusion: It is feasible for individuals to learn APA from the smartphone app and successfully self-administer APA to manage their pain. Participants found the app useful and were satisfied with the information provided through the app