Facilitating access to voluntary and community services for patients with psychosocial problems: a before-after evaluation

Background: Patients with psychosocial problems may benefit from a variety of community, educational, recreational and voluntary sector resources, but GPs often under-refer to these through lack of knowledge and time. This study evaluated the acceptability and effectiveness of graduate primary care mental health workers (GPCMHWs) facilitating access to voluntary and community sector services for patients with psychosocial problems. Methods: Patients with psychosocial problems from 13 general practices in London were referred to a GPCMHW Community Link scheme providing information and support to access voluntary and community resources. Patient satisfaction, mental health and social outcomes, and use of primary care resources, were evaluated. Results: 108 patients consented to take part in the study. At three-month follow-up, 63 (58%) had made contact with a community service identified as suitable for their needs. Most were satisfied with the help provided by the GPCMHW in identifying and supporting access to a suitable service. There was a reduction in the number of patients with a probable mental health problem on the GHQ-12 from 83% to 52% (difference 31% (95% CI, 17% – 44%). Social adjustment improved and frequencies of primary care consultations and of prescription of psychotropic medications were reduced. Conclusion: Graduates with limited training in mental health and no prior knowledge of local community resources can help patients with psychosocial problems access voluntary and community services, and patients value such a scheme. There was some evidence of effectiveness in reducing psychosocial and mental health problems

The RET/PTC3 oncogene activates classical NF-κB by stabilizing NIK.

The oncogenic fusion protein RET/PTC3 (RP3) that is expressed in papillary thyroid carcinoma (PTC) and thyroid epithelia in Hashimoto\u27s thyroiditis activates nuclear factor-kappa B (NF-κB) and induces pro-inflammatory gene expression; however, the mechanism of this activation is unknown. To address this, we expressed RP3 in murine embryonic fibroblasts (MEFs) lacking key classical and noncanonical NF-κB signaling components. In wild-type MEFs, RP3 upregulated CCL2, CXCL1, granulocyte-macrophage colony-stimulating factor and tumor necrosis factor expression and activated classical but not noncanonical NF-κB. RP3-activated NF-κB in IκB kinase (IKK)β(-/-) MEFs but not IKKα- or NF-κB essential modulator (NEMO)-deficient cells and activation was inhibited by a peptide that blocks NEMO binding to the IKKs. RP3 increased the levels of NF-κB-inducing kinase (NIK) and did not activate NF-κB in NIK-deficient MEFs. Notably, NIK stabilization was not accompanied by TRAF3 degradation demonstrating that RP3 disrupts normal basal NIK regulation. Dominant-negative NIK blocked RP3-induced NF-κB activation and an RP3 signaling mutant (RP3(Y588F)) did not stabilize NIK. Finally, examination of PTC specimens revealed strong positive staining for NIK. We therefore conclude that RP3 activates classical NF-κB via NIK, NEMO and IKKα. Importantly, our findings reveal a novel mechanism for oncogene-induced NF-κB activation via stabilization of NIK

The 69 ms Radio Pulsar Near the Supernova Remnant RCW 103

We report the detection of the radio pulsar counterpart to the 69 ms X-ray pulsar discovered near the supernova remnant RCW 103 (G332.4-0.4). Our detection confirms that the pulsations arise from a rotation-powered neutron star, which we name PSR J1617-5055. The observed barycentric period derivative confirms that the pulsar has a characteristic age of only 8 kyr, the sixth smallest of all known pulsars. The unusual apparent youth of the pulsar and its proximity to a young remnant requires that an association be considered. Although the respective ages and distances are consistent within substantial uncertainties, the large inferred pulsar transverse velocity is difficult to explain given the observed pulsar velocity distribution, the absence of evidence for a pulsar wind nebula, and the symmetry of the remnant. Rather, we argue that the objects are likely superposed on the sky; this is reasonable given the complex area. Without an association, the question of where is the supernova remnant left behind following the birth of PSR J1617-5055 remains open. We also discuss a possible association between PSR J1617-5055 and the gamma-ray source 2CG 333+01. Though an association is energetically plausible, it is unlikely given that EGRET did not detect 2CG 333+01.Comment: 18 pages, 2 encapsulated Postscript figures, uses AAS LaTeX style files. Accepted for publication in The Astrophysical Journal Letter

Null Geodesics in Five Dimensional Manifolds

We analyze a class of 5D non-compact warped-product spaces characterized by metrics that depend on the extra coordinate via a conformal factor. Our model is closely related to the so-called canonical coordinate gauge of Mashhoon et al. We confirm that if the 5D manifold in our model is Ricci-flat, then there is an induced cosmological constant in the 4D sub-manifold. We derive the general form of the 5D Killing vectors and relate them to the 4D Killing vectors of the embedded spacetime. We then study the 5D null geodesic paths and show that the 4D part of the motion can be timelike -- that is, massless particles in 5D can be massive in 4D. We find that if the null trajectories are affinely parameterized in 5D, then the particle is subject to an anomalous acceleration or fifth force. However, this force may be removed by reparameterization, which brings the correct definition of the proper time into question. Physical properties of the geodesics -- such as rest mass variations induced by a variable cosmological ``constant'', constants of the motion and 5D time-dilation effects -- are discussed and are shown to be open to experimental or observational investigation.Comment: 19 pages, REVTeX, in press in Gen. Rel. Gra

Typical equilibrium state of an embedded quantum system

We consider an arbitrary quantum system coupled non perturbatively to a large arbitrary and fully quantum environment. In [G. Ithier and F. Benaych-Georges, Phys. Rev. A 96, 012108 (2017)] the typicality of the dynamics of such an embedded quantum system was established for several classes of random interactions. In other words, the time evolution of its quantum state does not depend on the microscopic details of the interaction. Focusing at the long time regime, we use this property to calculate analytically a new partition function characterizing the stationary state and involving the overlaps between eigenvectors of a bare and a dressed Hamiltonian. This partition function provides a new thermodynamical ensemble which includes the microcanonical and canonical ensembles as particular cases. We check our predictions with numerical simulations.Comment: 1 figure, 5 pages. This article supersedes the part on the equilibrium state in arXiv:1510.0435

Identification of the Mass Donor Star's Spectrum in SS 433

We present spectroscopy of the microquasar SS 433 obtained near primary eclipse and disk precessional phase Psi = 0.0, when the accretion disk is expected to be most ``face-on''. The likelihood of observing the spectrum of the mass donor is maximized at this combination of orbital and precessional phases since the donor is in the foreground and above the extended disk believed to be present in the system. The spectra were obtained over four different runs centered on these special phases. The blue spectra show clear evidence of absorption features consistent with a classification of A3-7 I. The behavior of the observed lines indicates an origin in the mass donor. The observed radial velocity variations are in anti-phase to the disk, the absorption lines strengthen at mid-eclipse when the donor star is expected to contribute its maximum percentage of the total flux, and the line widths are consistent with lines created in an A supergiant photosphere. We discuss and cast doubt on the possibility that these lines represent a shell spectrum rather than the mass donor itself. We re-evaluate the mass ratio of the system and derive masses of 10.9 +/- 3.1 Msun and 2.9 +/- 0.7 Msun for the mass donor and compact object plus disk, respectively. We suggest that the compact object is a low mass black hole. In addition, we review the behavior of the observed emission lines from both the disk/wind and high velocity jets.Comment: submitted to ApJ, 24 pages, 7 figure

Formation of a disk-structure and jets in the symbiotic prototype Z And during its 2006-2010 active phase

We present an analysis of spectrophotometric observations of the latest cycle of activity of the symbiotic binary Z And from 2006 to 2010. We estimate the temperature of the hot component of Z And to be \approx 150000 - 170000 K at minimum brightness, decreasing to \approx 90000 K at the brightness maximum. Our estimate of the electron density in the gaseous nebula is N_{e}=10^{10}-10^{12} cm^{-3} in the region of formation of lines of neutral helium and 10^6-10^7 cm^{-3} in the region of formation of the [OIII] and [NeIII] nebular lines. A trend for the gas density derived from helium lines to increase and the gas density derived from [OIII] and [NeIII] lines to simultaneously decrease with increasing brightness of the system was observed. Our estimates show that the ratios of the theoretical and observed fluxes in the [OIII] and [NeIII] lines agree best when the O/Ne ratio is similar to its value for planetary nebulae. The model spectral energy distribution showed that, in addition to a cool component and gaseous nebula, a relatively cool pseudophotosphere (5250-11 500 K) is present in the system. The simultaneous presence of a relatively cool pseudophotosphere and high-ionization spectral lines is probably related to a disk-like structure of the pseudophotosphere. The pseudophotosphere formed very rapidly, over several weeks, during a period of increasing brightness of Z And. We infer that in 2009, as in 2006, the activity of the system was accompanied by a collimated bipolar ejection of matter. In contrast to the situation in 2006, the jets were detected even before the system reached its maximum brightness. Moreover, components with velocities close to 1200 km/s disappeared at the maximum, while those with velocities close to 1800 km/s appeared.Comment: 18 pages, 19 figures, Accepted for publication in Astronomy Report

Pattern of Disease after Murine Hepatitis Virus Strain 3 Infection Correlates with Macrophage Activation and Not Viral Replication

Murine hepatitis virus strain (MHV-3) produces a strain-dependent pattern of disease which has been used as a model for fulminant viral hepatitis. This study was undertaken to examine whether there was a correlation between macrophage activation and susceptibility or resistance to MHV-3 infection. Peritoneal macrophages were isolated from resistant A/J and susceptible BALB/cJ mice and, following stimulation with MHV-3 or lipopolysaccharide (LPS), analyzed for transcription of mRNA and production of interleukin-1 (IL-1), tumor necrosis factor alpha (TNF-alpha), transforming growth factor beta (TGF-beta), mouse fibrinogen-like protein (musfiblp), tissue factor (TF), leukotriene B4, and prostaglandin E2 (PGE2). Macrophages from BALB/cJ mice produced greater amounts of IL-1, TNF-alpha, TGF-beta, leukotriene B4, and musfiblp following MHV-3 infection than macrophages from resistant A/J mice, whereas in response to LPS, equivalent amounts of IL-1, TNF-alpha, TGF-beta, and TF were produced by macrophages from both strains of mice. Levels of mRNA of IL-1, TNF-alpha, and musfiblp were greater and more persistent in BALB/cJ than in A/J macrophages, whereas the levels and kinetics of IL-1, TNF-alpha, and TF mRNA following LPS stimulation were identical in macrophages from both strains of mice. Levels of production of PGE2 by MHV-3-stimulated macrophages from resistant and susceptible mice were equivalent; however, the time course for induction of PGE2, differed, but the total quantity of PGE2 produced was insufficient to inhibit induction of musfiblp, a procoagulant known to correlate with development of fulminant hepatic necrosis in susceptible mice. These results demonstrate marked differences in production of inflammatory mediators to MHV-3 infection in macrophages from resistant A/J and susceptible BALB/cJ mice, which may explain the marked hepatic necrosis and fibrin deposition and account for the lethality of MHV-3 in susceptible mice

Corrosion of structural materials by lead-based reactor coolants.

Advanced nuclear reactor design has, in recent years, focused increasingly on the use of heavy-liquid-metal coolants, such as lead and lead-bismuth eutectic. Similarly, programs on accelerator-based transmutation systems have also considered the use of such coolants. Russian experience with heavy-metal coolants for nuclear reactors has lent credence to the validity of this approach. Of significant concern is the compatibility of structural materials with these coolants. We have used a thermal convection-based test method to allow exposure of candidate materials to molten lead and lead-bismuth flowing under a temperature gradient. The gradient was deemed essential in evaluating the behavior of the test materials in that should preferential dissolution of components of the test material occur we would expect dissolution in the hotter regions and deposition in the colder regions, thus promoting material transport. Results from the interactions of a Si-rich mild steel alloy, AISI S5, and a ferritic-martensitic stainless steel, HT-9, with the molten lead-bismuth are presented