The Interactive Effect of Major Depression and Nonsuicidal Self-Injury On Current Suicide Risk and Lifetime Suicide Attempts

Objectives: This study examined the main and interactive effects of MDD and lifetime nonsuicidal self-injury (NSSI) on current suicide risk and past suicide attempts. We predicted that individuals with a history of NSSI and current MDD would be at greater suicide risk than those with either risk factor alone. An interaction between lifetime MDD and NSSI was hypothesized for past suicide attempts. Methods: 204 substance dependent inpatients completed self-report measures and a diagnostic interview. Results: Patients with both a history of NSSI and current MDD, relative to all other groups, had the greatest suicide risk. No support was found for the lifetime MDD by NSSI interaction. Conclusion: Findings suggest the relevance of both NSSI and MDD in suicide risk

Ischemia and Infarction in STEMI Patients With Multivessel Disease : Insights From the CvLPRIT Nuclear Substudy

The CvLPRIT (Complete versus Lesion-only PRimary PCI Trial) trial was undertaken in 7 UK centers (1,2). Patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary stenoses were randomized to primary percutaneous coronary intervention (PPCI) to the infarct-related artery (IRA) only, or complete revascularization. At 12-month follow-up, the rate of the combined primary endpoint (all-cause mortality, recurrent MI, heart failure, ischemia-driven revascularization) was lower after complete revascularization. All surviving patients were asked to undergo myocardial perfusion scintigraphy (MPS) 6 to 8 weeks post-admission. It was expected that this a priori nuclear substudy would provide mechanistic insights into the outcome of the main trial, and help to define the clinical role of MPS in the PPCI era

Towards detection of structurally-diverse glycated epitopes in native proteins : single-chain antibody directed to non-A1c epitope in human haemoglobin

Over 500 million people worldwide are affected by diabetes mellitus, a chronic disease that leads to high blood glucose levels and causes severe side effects. The predominant biological marker for diagnosis of diabetes is glycated haemoglobin (GHb). In human blood the predominant reducing sugar, glucose, irreversibly conjugates onto accessible amine groups within Hb. Most methods for diagnosis and monitoring of diabetes selectively detect N-terminal glycation at Val-1 on the β-globin chain, but not glycation at other sites. Detection of other glycated epitopes of GHb has the potential to provide new information on the extent, duration and timing of elevated glucose, facilitating personalised diagnosis and intelligent diabetic control. In this work, a new anti-GHb Fab antibody (Fab-1) specific for haemoglobin A1c (HbA1c) with nanomolar affinity was discovered via epitope-directed immunisation and phage display. A single chain variable fragment (scFv) antibody derived from Fab-1 retained affinity and specificity for HbA1c, and affinity was enhanced tenfold upon addition of an enhanced green fluorescent protein tag. Both the scFv and Fab-1 recognised an epitope within HbA1c that was distinct from β-Val-1, and our data suggest that this epitope may include glycation at Lys-66 in the β-globin chain. To our knowledge, this is the first report of an scFv/Fab anti-glycated epitope antibody that recognises a non-A1c epitope in GHb, and confirms that fructosamine attached to different, discrete glycation sites within the same protein can be resolved from one another by immunoassay. [Abstract copyright: Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

Natural Inflation: Particle Physics Models, Power Law Spectra for Large Scale Structure, and Constraints from COBE

A pseudo-Nambu-Goldstone boson, with a potential of the form $V(\phi) = \Lambda^4[1 \pm \cos(\phi/f)], naturally gives rise to inflation if$f \sim M_{Pl}$and$\Lambda \sim M_{GUT}$. We show how this can arise in technicolor-like and superstring models, and work out an explicit string example in the context of multiple gaugino condensation models. We study the cosmology of this model in detail, and find that sufficient reheating to ensure that baryogenesis can take place requires$f > 0.3 M_{Pl}$. The primordial density fluctuation spectrum generated is a non-scale-invariant power law,$P(k) \propto k^{n_s}$, with$n_s \simeq 1 - (M^2_{Pl}/8\pi f^2)$, leading to more power on large length scales than the$n_s = 1$Harrison-Zeldovich spectrum. The standard CDM model with$0 \la n_s \la 0.6-0.7$could in principle explain the large-scale clustering observed in the APM and IRAS galaxy surveys as well as large-scale flows, but the COBE microwave anisotropy implies such low amplitudes (or high bias factors,$b>2$) for these CDM models that galaxy formation occurs too late to be viable; combining COBE with sufficiently early galaxy formation or the large-scale flows leads to$n_s >0.6$, or$f > 0.3 M_{Pl}$as well. For extended and power law inflation models, this constraint is even tighter,$n_s > 0.7$; combined with other bounds on large bubbles in extended inflation, this leaves little room for most extended models.Comment: 42 pages, (12 figures not included but available from the authors

Genetic risk and a primary role for cell-mediated immune mechanisms in multiple sclerosis.

Multiple sclerosis is a common disease of the central nervous system in which the interplay between inflammatory and neurodegenerative processes typically results in intermittent neurological disturbance followed by progressive accumulation of disability. Epidemiological studies have shown that genetic factors are primarily responsible for the substantially increased frequency of the disease seen in the relatives of affected individuals, and systematic attempts to identify linkage in multiplex families have confirmed that variation within the major histocompatibility complex (MHC) exerts the greatest individual effect on risk. Modestly powered genome-wide association studies (GWAS) have enabled more than 20 additional risk loci to be identified and have shown that multiple variants exerting modest individual effects have a key role in disease susceptibility. Most of the genetic architecture underlying susceptibility to the disease remains to be defined and is anticipated to require the analysis of sample sizes that are beyond the numbers currently available to individual research groups. In a collaborative GWAS involving 9,772 cases of European descent collected by 23 research groups working in 15 different countries, we have replicated almost all of the previously suggested associations and identified at least a further 29 novel susceptibility loci. Within the MHC we have refined the identity of the HLA-DRB1 risk alleles and confirmed that variation in the HLA-A gene underlies the independent protective effect attributable to the class I region. Immunologically relevant genes are significantly overrepresented among those mapping close to the identified loci and particularly implicate T-helper-cell differentiation in the pathogenesis of multiple sclerosis

Baryogenesis During Reheating in Natural Inflation and Comments on Spontaneous Baryogenesis

We calculate the baryon asymmetry created by the decay of a pseudo Nambu-Goldstone boson whose interactions violate baryon number conservation. Our results are in disagreement with previous results in the original spontaneous baryogenesis models for the asymmetry produced by the decay of an oscillating scalar field with B number violating derivative couplings; we find that the net baryon number density is proportional to $\th_i^3$, where $\th_i$ is the amplitude of the PNGB-field in natural inflation at the onset of reheating. We also discuss our disagreement with the interpretation of $\dot\theta$ as an effective chemical potential for baryon number in spontaneous baryogenesis models. While our calculation of the asymmetry is carried out in the context of natural inflation our approach is generally valid for baryogenesis models using decaying classical fields. In the Appendices, we include a complete derivation of the number density of particles produced by the decay of a classical scalar field; this number density is proportional to the integral over momenta of the one pair production amplitude.Comment: 22 pages, TeX, no figures. Submitted to Physical Review

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy