59 research outputs found

    Toward the development of guidelines for the conduct of forensic psychiatric examinations

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    Guidelines for conducting forensic psychiatric consultations and evaluations have not been clearly established. The authors offer and discuss such guidelines, which are based upon the boundary guidelines in general psychiatric practice, ethics principles in general psychiatry, ethics principles in forensic psychiatry, and the relevant case and statutory law. These guidelines are intended to assist the psychiatrist in appropriately conducting forensic evaluations whether in litigation-or administraiive proceedings

    The early proximal αβ TCR signalosome specifies thymic selection outcome through a quantitative protein interaction network

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    During αβ T cell development, T cell antigen receptor (TCR) engagement transduces biochemical signals through a protein-protein interaction (PPI) network that dictates dichotomous cell fate decisions. It remains unclear how signal specificity is communicated, instructing either positive selection to advance cell differentiation or death by negative selection. Early signal discrimination might occur by PPI signatures differing qualitatively (customized, unique PPI combinations for each signal), quantitatively (graded amounts of a single PPI series), or kinetically (speed of PPI pathway progression). Using a novel PPI network analysis, we found that early TCR-proximal signals distinguishing positive from negative selection appeared to be primarily quantitative in nature. Furthermore, the signal intensity of this PPI network was used to find an antigen dose that caused a classic negative selection ligand to induce positive selection of conventional αβ T cells, suggesting that the quantity of TCR triggering was sufficient to program selection outcome. Because previous work had suggested that positive selection might involve a qualitatively unique signal through CD3δ, we reexamined the block in positive selection observed in CD3δ0 mice. We found that CD3δ0 thymocytes were inhibited but capable of signaling positive selection, generating low numbers of MHC-dependent αβ T cells that expressed diverse TCR repertoires and participated in immune responses against infection. We conclude that the major role for CD3δ in positive selection is to quantitatively boost the signal for maximal generation of αβ T cells. Together, these data indicate that a quantitative network signaling mechanism through the early proximal TCR signalosome determines thymic selection outcome

    Use of anticoagulants and antiplatelet agents in stable outpatients with coronary artery disease and atrial fibrillation. International CLARIFY registry

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    A Psychiatric Perspective on Washington\u27s Sexually Violent Predators Statute

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    This Article will critique Washington\u27s Community Protection Act from the perspective of a clinical and forensic psychiatrist. Part II of the Article will address and examine problems with the statute\u27s definitions and consider some of the problems in conducting evaluations of proposed sexual predators. Part III will then discuss some of the many difficulties inherent in providing treatment under the statute. Part IV will review the potential abuses, costs and risks to the participants presented by the statute. Finally, Part V will focus on the ethical issues in providing expert medical testimony pursuant to the statute

    Peer Review to Ensure Quality in Forensic Mental Health Publication

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    Peer reviewers have been called the gatekeepers of science. For journal publications in forensic psychiatry, as well as other disciplines, the purposes of peer review are to assist in the selection of manuscripts to publish, improve the quality of manuscripts before their publication, and promote the fairness of the process. In this article, we examine, in particular, characteristics of high-quality peer reviewers, selection of peer reviewers, recruitment and retention of peer reviewers, desired quality of peer-reviewer ratings, and the value of peer review. We conclude with specific, albeit largely untested, recommendations for improvements in peer review of forensic mental health publications

    Surface protein gradients generated in sealed microchannels using spatially varying helium microplasma

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    Spatially varied surface treatment of a fluorescently labeled Bovine Serum Albumin (BSA) protein, on the walls of a closed (sealed) microchannel is achieved via a well-defined gradient in plasma intensity. The microchips comprised a microchannel positioned in-between two microelectrodes (embedded in the chip) with a variable electrode separation along the length of the channel. The channel and electrodes were 50 μm and 100 μm wide, respectively, 50 μm deep, and adjacent to the channel for a length of 18 mm. The electrode separation distance was varied linearly from 50 μm at one end of the channel to a maximum distance of 150, 300, 500, or 1000 μm to generate a gradient in helium plasma intensity. Plasma ignition was achieved at a helium flow rate of 2.5 ml/min, 8.5 kVpk-pk, and 10 kHz. It is shown that the plasma intensity decreases with increasing electrode separation and is directly related to the residual amount of BSA left after the treatment. The plasma intensity and surface protein gradient, for the different electrode gradients studied, collapse onto master curves when plotted against electrode separation. This precise spatial control is expected to enable the surface protein gradient to be tuned for a range of applications, including high-throughput screening and cell-biomolecule-biomaterial interactions
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