Systematic monitoring of needs for care and global outcomes in patients with severe mental illness

<p>Abstract</p> <p>Background</p> <p>It was hypothesised that the introduction of tools that allow clinicians to assess patients' needs and to negotiate treatment (Cumulative Needs for Care Monitor; CNCM), would be associated with global outcome improvements in patients diagnosed with severe mental illness.</p> <p>Methods</p> <p>The CNCM was introduced in one region in South Limburg (the Netherlands) in 1998 (REGION-1998) and in the rest of South Limburg in 2004 (REGION-2004). By comparing these two regions, changes after the introduction of the CNCM could be assessed (between-region comparison). In addition, a pre-post within-patient comparison was conducted in both regions.</p> <p>Results</p> <p>The within-patient comparison revealed that global outcomes of psychopathology and impairment improved in the first 3-5 years after the introduction of the CNCM. The between-region comparison revealed an improvement in global psychopathology but not in global impairment in REGION-2004 after 2004, while there was no such improvement in REGION-1998.</p> <p>Conclusion</p> <p>Systematic clinical monitoring of individual severe mental illness patients, in combination with provision of feedback, is associated with global improvement in psychopathology. More research is needed to determine the degree to which this association reflects a causal effect.</p

A real-life observational study of the effectiveness of FACT in a Dutch mental health region

<p>Abstract</p> <p>Background</p> <p>ACT is an effective community treatment but causes discontinuity of care between acutely ill and currently stable patient groups. The Dutch variant of ACT, FACT, combines both intensive ACT treatment and care for patients requiring less intensive care at one time point yet likely to need ACT in the future. It may be hypothesised that this case mix is not beneficial for patients requiring intensive care, as other patient groups may "dilute" care provision. The effectiveness of FACT was compared with standard care, with a particular focus on possible moderating effects of patient characteristics within the case mix in FACT.</p> <p>Methods</p> <p>In 2002, three FACT teams were implemented in a Dutch region in which a cumulative routine outcome measurement system was in place. Patients receiving FACT were compared with patients receiving standard treatment, matched on "baseline" symptom severity and age, using propensity score matching. Outcome was the probability of being in symptomatic remission of psychotic symptoms.</p> <p>Results</p> <p>The probability of symptomatic remission was higher for SMI patients receiving FACT than for controls receiving standard treatment, but only when there was an unmet need for care with respect to psychotic symptoms (OR = 6.70, p = 0.002; 95% CI = 1.97 – 22.7).</p> <p>Conclusion</p> <p>Compared to standard care, FACT was more rather than less effective, but only when a need for care with respect to psychotic symptoms is present. This suggests that there is no adverse effect of using broader patient mixes in providing continuity of care for all patients with severe mental illness in a defined geographical area.</p

COSMOS-Europe : a European network of cosmic-ray neutron soil moisture sensors

We thank TERENO (Terrestrial Environmental Observatories), funded by the Helmholtz-Gemeinschaft for the financing and maintenance of CRNS stations. We acknowledge financial support by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) of the research unit FOR 2694 Cosmic Sense (grant no. 357874777) and by the German Federal Ministry of Education of the Research BioökonomieREVIER, Digitales Geosystem – Rheinisches Revier project (grant no. 031B0918A). COSMOS-UK has been supported financially by the UK’s Natural Environment Research Council (grant no. NE/R016429/1). The Olocau experimental watershed is partially supported by the Spanish Ministry of Science and Innovation through the research project TETISCHANGE (grant no. RTI2018-093717-BI00). The Calderona experimental site is partially supported by the Spanish Ministry of Science and Innovation through the research projects CEHYRFO-MED (grant no. CGL2017-86839- C3-2-R) and SILVADAPT.NET (grant no. RED2018-102719-T) and the LIFE project RESILIENT FORESTS (grant no. LIFE17 CCA/ES/000063). The University of Bristol’s Sheepdrove sites have been supported by the UK’s Natural Environment Research Council through a number of projects (grant nos. NE/M003086/1, NE/R004897/1, and NE/T005645/1) and by the International Atomic Energy Agency of the United Nations (grant no. CRP D12014). Acknowledgements. We thank Peter Strauss and Gerhab Rab from the Institute for Land and Water Management Research, Federal Agency for Water Management Austria, Petzenkirchen, Austria. We thank Trenton Franz from the School of Natural Resources, University of Nebraska–Lincoln, Lincoln, NE, United States. We also thank Carmen Zengerle, Mandy Kasner, Felix Pohl, and Solveig Landmark, UFZ Leipzig, for supporting field calibration, lab analysis, and data processing. We furthermore thank Daniel Dolfus, Marius Schmidt, Ansgar Weuthen, and Bernd Schilling, Forschungszentrum Jülich, Germany. The COSMOS-UK project team is thanked for making its data available to COSMOS-Europe. Luca Stevanato is thanked for the technical details about the Finapp sensor. The stations at Cunnersdorf, Lindenberg, and Harzgerode have been supported by Falk Böttcher, Frank Beyrich, and Petra Fude, German Weather Service (DWD). The Zerbst site has been supported by Getec Green Energy GmbH and Jörg Kachelmann (Meteologix AG). The CESBIO sites have been supported by the CNES TOSCA program. The ERA5-Land data are provided by ECMWF (Muñoz Sabater, 2021). The Jena dataset was retrieved at the site of The Jena Experiment, operated by DFG research unit FOR 1451.Peer reviewedPublisher PD

Preclinical characterization and target validation of the antimalarial pantothenamide MMV693183.

Drug resistance and a dire lack of transmission-blocking antimalarials hamper malaria elimination. Here, we present the pantothenamide MMV693183 as a first-in-class acetyl-CoA synthetase (AcAS) inhibitor to enter preclinical development. Our studies demonstrate attractive drug-like properties and in vivo efficacy in a humanized mouse model of Plasmodium falciparum infection. The compound shows single digit nanomolar in vitro activity against P. falciparum and P. vivax clinical isolates, and potently blocks P. falciparum transmission to Anopheles mosquitoes. Genetic and biochemical studies identify AcAS as the target of the MMV693183-derived antimetabolite, CoA-MMV693183. Pharmacokinetic-pharmacodynamic modelling predict that a single 30 mg oral dose is sufficient to cure a malaria infection in humans. Toxicology studies in rats indicate a \u3e 30-fold safety margin in relation to the predicted human efficacious exposure. In conclusion, MMV693183 represents a promising candidate for further (pre)clinical development with a novel mode of action for treatment of malaria and blocking transmission

Whole-epigenome analysis in multiple myeloma reveals DNA hypermethylation of B cell-specific enhancers

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