Violent victimisation of psychiatric patients: a Swedish case–control study

The intriguing question of how mental disorder and violence relate to each other has become an epic academic debate. During the last decades, there has been a change in direction of the debate on individuals with mental disorder, with a greater focus on violent victimization than violent behaviour towards others. Up until now, no Swedish study has investigated the frequency of violent behaviour among general psychiatric patients undergoing psychiatric treatment. Moreover, no Swedish study so far has investigated the relative risk of victimization in general psychiatric patients, in comparison to the general population. The aim of this dissertation was to investigate these issues and to validate the risk assessment method Classification of Violence Risk (COVR)™. Method: In study I, general psychiatric patients were recruited from two public psychiatric hospitals in Stockholm County (n=390). The control group consisted of gender- and age-matched subjects recruited from an annual national survey of living conditions, (conducted by Statistics Sweden) (n=1170). Studies II-IV consisted of prospective follow-ups on 331 patients. At baseline, clinical and socio-demographic variables were collected and a COVR assessment was conducted. Follow-up included telephone interviews with the patients and collaterals 10 and 20 weeks after baseline. Violent behaviour was self-reported and in addition, data was collected from a national criminal register. Results: Twenty percent of the patients had been victimised during the year preceding inclusion. The relative rate of victimization was six times higher in patients compared to controls. Women appeared to be most vulnerable with a 10-fold risk increase (Study I). The base rate of violent behaviour was 5.7% and a receiver operating curve analysis (ROC) showed that the area under the curve (AUC) for COVR was 0.77. The gender gap concerning violent behaviour among the general population was not replicated, since there was no significant gender difference with respect to violent acts 20 weeks after discharge. The predictive validity of the COVR software was comparable between females and males. There was an overlap between offenders and victims among psychiatric patients (Studies II-IV). Conclusions: The risk of being subjected to violence is high among Swedish psychiatric patients. The findings are most pronounced for female patients. Research, clinicians and social policy should target the problem of victimization. The base rate of violent behaviour towards others is relatively low among general psychiatric patients in Sweden. Therefore, prediction is difficult. Violent behaviour was uncommon in female as well as male patients and there were no gender differences. The COVR software could significantly predict violent behaviour and its validity was comparable to other risk assessment tools. COVR predicted violent behaviour with the same precision in both genders. The overlap between offenders and victims should be taken into account in both research and clinical settings

Evaluation of the in-situ Performance of Neutron Detectors based on EJ-426 Scintillator Screens for Spent Fuel Characterization

The reliable detection of neutrons in a harsh gamma-ray environment is an important aspect of establishing non-destructive methods for the characterization of spent nuclear fuel. In this study, we present results from extended in-situ monitoring of detector systems consisting of commercially available components: EJ-426, a $^6$Li-enriched solid-state scintillator material sensitive to thermal neutrons, and two different types of Hamamatsu photomultiplier tubes (PMT). Over the period of eight months, these detectors were operated in close vicinity to spent nuclear fuel stored at the interim storage facility CLAB, Oskarshamn, Sweden. At the measurement position the detectors were continuously exposed to an estimated neutron flux of approx. 280 n/s $\cdot$ cm$^2$ and a gamma-ray dose rate of approx. 6 Sv/h. Using offline software algorithms, neutron pulses were identified in the data. Over the entire investigated dose range of up to 35 kGr, the detector systems were functioning and were delivering detectable neutron signals. Their performance as measured by the number of identified neutrons degrades down to about 30% of the initial value. Investigations of the irradiated components suggest that this degradation is a result of reduced optical transparency of the involved materials as well as a reduction of PMT gain due to the continuous high currents. Increasing the gain of the PMT through step-ups of the applied high voltage allowed to partially compensate for this loss in detection sensitivity. The integrated neutron fluence during the measurement was experimentally verified to be in the order of $5 \cdot 10^9$ n/cm$^2$. The results were interpreted with the help of MCNP6.2 simulations of the setup and the neutron flux

Predicting functional upstream open reading frames in Saccharomyces cerevisiae

<p>Abstract</p> <p>Background</p> <p>Some upstream open reading frames (uORFs) regulate gene expression (i.e., they are functional) and can play key roles in keeping organisms healthy. However, how uORFs are involved in gene regulation is not yet fully understood. In order to get a complete view of how uORFs are involved in gene regulation, it is expected that a large number of experimentally verified functional uORFs are needed. Unfortunately, wet-experiments to verify that uORFs are functional are expensive.</p> <p>Results</p> <p>In this paper, a new computational approach to predicting functional uORFs in the yeast <it>Saccharomyces cerevisiae </it>is presented. Our approach is based on inductive logic programming and makes use of a novel combination of knowledge about biological conservation, Gene Ontology annotations and genes' responses to different conditions. Our method results in a set of simple and informative hypotheses with an estimated sensitivity of 76%. The hypotheses predict 301 further genes to have 398 novel functional uORFs. Three (<it>RPC11</it>, <it>TPK1</it>, and <it>FOL1</it>) of these 301 genes have been hypothesised, following wet-experiments, by a related study to have functional uORFs. A comparison with another related study suggests that eleven of the predicted functional uORFs from genes <it>LDB17</it>, <it>HEM3</it>, <it>CIN8</it>, <it>BCK2</it>, <it>PMC1</it>, <it>FAS1</it>, <it>APP1</it>, <it>ACC1</it>, <it>CKA2</it>, <it>SUR1</it>, and <it>ATH1 </it>are strong candidates for wet-lab experimental studies.</p> <p>Conclusions</p> <p>Learning based prediction of functional uORFs can be done with a high sensitivity. The predictions made in this study can serve as a list of candidates for subsequent wet-lab verification and might help to elucidate the regulatory roles of uORFs.</p

Access to health care in relation to socioeconomic status in the Amazonian area of Peru

<p>Abstract</p> <p>Background</p> <p>Access to affordable health care is limited in many low and middle income countries and health systems are often inequitable, providing less health services to the poor who need it most. The aim of this study was to investigate health seeking behavior and utilization of drugs in relation to household socioeconomic status for children in two small Amazonian urban communities of Peru; Yurimaguas, Department of Loreto and Moyobamba, Department of San Martin, Peru.</p> <p>Methods</p> <p>Cross-sectional study design included household interviews. Caregivers of 780 children aged 6–72 months in Yurimaguas and 793 children of the same age in Moyobamba were included in the study. Caregivers were interviewed on health care seeking strategies (public/private sectors; formal/informal providers), and medication for their children in relation to reported symptoms and socio-economic status. Self-reported symptoms were classified into illnesses based on the IMCI algorithm (Integrated Management of Childhood Ilness). Wealth was used as a proxy indicator for the economic status. Wealth values were generated by Principal Component Analysis using household assets and characteristics.</p> <p>Results</p> <p>Significantly more caregivers from the least poor stratum consulted health professionals for cough/cold (p < 0.05: OR = 4.30) than the poorest stratum. The poorest stratum used fewer antibiotics for cough/cold and for cough/cold + diarrhoea (16%, 38%, respectively) than the least poor stratum (31%, 52%, respectively). For pneumonia and/or dysentery, the poorest used significantly fewer antibiotics (16%) than the least poor (80%).</p> <p>Conclusion</p> <p>The poorest seek less care from health professionals for non-severe illnesses as well as for severe illnesses; and treatment with antibiotics is lacking for illnesses where it would be indicated. Caregivers frequently paid for health services as well as antibiotics, even though all children in the study qualified for free health care and medicines. The implementation of the Seguro Integral de Salud health insurance must be improved.</p

Pregnancy related back pain, is it related to aerobic fitness? A longitudinal cohort study

<p>Abstract</p> <p>Background</p> <p>Low back pain with onset during pregnancy is common and approximately one out of three women have disabling pain. The pathogenesis of the pain condition is uncertain and there is no information on the role of physical fitness. Whether poorer physical conditioning is a cause or effect of back pain is also disputed and information from prospective studies needed.</p> <p>Methods</p> <p>A cohort of pregnant women, recruited from maternal health care centers in central Sweden, were examined regarding estimated peak oxygen uptake by cycle ergometer test in early pregnancy, reported physical activity prior to pregnancy, basic characteristics, back pain during pregnancy and back pain postpartum.</p> <p>Results</p> <p>Back pain during the current pregnancy was reported by nearly 80% of the women. At the postpartum appointment this prevalence was 40%. No association was displayed between estimated peak oxygen uptake and incidence of back pain during and after pregnancy, adjusted for physical activity, back pain before present pregnancy, previous deliveries, age and weight. A significant inverse association was found between estimated peak oxygen uptake and back pain intensity during pregnancy and a direct association post partum, in a fully adjusted multiple linear regression analysis.</p> <p>Conclusions</p> <p>Estimated peak oxygen uptake and reported physical activity in early pregnancy displayed no influence on the onset of subsequent back pain during or after pregnancy, where the time sequence support the hypothesis that poorer physical deconditioning is not a cause but a consequence of the back pain condition. The mechanism for the attenuating effect of increased oxygen uptake on back pain intensity is uncertain.</p

ERBB3 is a marker of a ganglioneuroblastoma/ganglioneuroma-like expression profile in neuroblastic tumours

Background: Neuroblastoma (NB) tumours are commonly divided into three cytogenetic subgroups. However, by unsupervised principal components analysis of gene expression profiles we recently identified four distinct subgroups, r1-r4. In the current study we characterized these different subgroups in more detail, with a specific focus on the fourth divergent tumour subgroup (r4). Methods: Expression microarray data from four international studies corresponding to 148 neuroblastic tumour cases were subject to division into four expression subgroups using a previously described 6-gene signature. Differentially expressed genes between groups were identified using Significance Analysis of Microarray (SAM). Next, gene expression network modelling was performed to map signalling pathways and cellular processes representing each subgroup. Findings were validated at the protein level by immunohistochemistry and immunoblot analyses. Results: We identified several significantly up-regulated genes in the r4 subgroup of which the tyrosine kinase receptor ERBB3 was most prominent (fold change: 132–240). By gene set enrichment analysis (GSEA) the constructed gene network of ERBB3 (n = 38 network partners) was significantly enriched in the r4 subgroup in all four independent data sets. ERBB3 was also positively correlated to the ErbB family members EGFR and ERBB2 in all data sets, and a concurrent overexpression was seen in the r4 subgroup. Further studies of histopathology categories using a fifth data set of 110 neuroblastic tumours, showed a striking similarity between the expression profile of r4 to ganglioneuroblastoma (GNB) and ganglioneuroma (GN) tumours. In contrast, the NB histopathological subtype was dominated by mitotic regulating genes, characterizing unfavourable NB subgroups in particular. The high ErbB3 expression in GN tumour types was verified at the protein level, and showed mainly expression in the mature ganglion cells. Conclusions: Conclusively, this study demonstrates the importance of performing unsupervised clustering and subtype discovery of data sets prior to analyses to avoid a mixture of tumour subtypes, which may otherwise give distorted results and lead to incorrect conclusions. The current study identifies ERBB3 as a clear-cut marker of a GNB/GN-like expression profile, and we suggest a 7-gene expression signature (including ERBB3) as a complement to histopathology analysis of neuroblastic tumours. Further studies of ErbB3 and other ErbB family members and their role in neuroblastic differentiation and pathogenesis are warranted

A fossil winonaite-like meteorite in Ordovician limestone: A piece of the impactor that broke up the L-chondrite parent body?

AbstractAbout a quarter of all meteorites falling on Earth today originate from the breakup of the L-chondrite parent body ∼470 Ma ago, the largest documented breakup in the asteroid belt in the past ∼3 Ga. A window into the flux of meteorites to Earth shortly after this event comes from the recovery of about 100 fossil L chondrites (1–21 cm in diameter) in a quarry of mid-Ordovician limestone in southern Sweden. Here we report on the first non-L-chondritic meteorite from the quarry, an 8 cm large winonaite-related meteorite of a type not known among present-day meteorite falls and finds. The noble gas data for relict spinels recovered from the meteorite show that it may be a remnant of the body that hit and broke up the L-chondrite parent body, creating one of the major asteroid families in the asteroid belt. After two decades of systematic recovery of fossil meteorites and relict extraterrestrial spinel grains from marine limestone, it appears that the meteorite flux to Earth in the mid-Ordovician was very different from that of today

Families of exact solutions to Vasiliev's 4D equations with spherical, cylindrical and biaxial symmetry

We provide Vasiliev's four-dimensional bosonic higher-spin gravities with six families of exact solutions admitting two commuting Killing vectors. Each family contains a subset of generalized Petrov Type-D solutions in which one of the two so(2) symmetries enhances to either so(3) or so(2,1). In particular, the spherically symmetric solutions are static and we expect one of them to be gauge-equivalent to the extremal Didenko-Vasiliev solution given in arXiv:0906.3898. The solutions activate all spins and can be characterized either via generalized electric and magnetic charges defined asymptotically in weak-field regions or via the values of fully higher-spin gauge-invariant observables given by on-shell closed zero-forms. The solutions are obtained by combining the gauge-function method with separation of variables in twistor space via expansion of the Weyl zero-form in Di-Rac supersingleton projectors times deformation parameters in a fashion that is suggestive of a generalized electromagnetic duality.Comment: v1: 77 pages; 3 tables; 23 pages of appendices. v2: 5 additional pages of clarifications, typos correcte