The impact of different liaison psychiatry models on the emergency department: A systematic review of the international evidence

Objective This review aimed to evaluate the current evidence for what impact different Liaison Psychiatry (LP) services are having on Emergency Departments (ED). Mental Health (MH) problems contribute to 12 million annual US ED attendances and 5% in the UK. Methods Databases were searched for articles describing LP services for adult MH patients attending EDs which reported ED care-related outcomes, published since 2000. Articles were screened and relevant articles quality assessed and narratively synthesized. Results 3653 articles were identified and 17 included in the review. Study designs were overall of poor-moderate quality, using retrospective before-and-after study designs. LP services were categorized into four models. Models with MH personnel integrated into the ED team or triage reduced patient waiting time to be seen, may reduce patients leaving without being seen and have high staff satisfaction. Co-located MH space or personnel reduced patient waiting times. Care agreements with existing psychiatry teams don't affect waiting times or ED length of stay. Transferring patients to external services reduces patients' time in the ED. There is insufficient evidence about patient satisfaction, costs, and onward care. Conclusions Waiting times are shortened by MH personnel integrated into the ED and are more satisfactory to staff than other LP models. The involvement of a psychiatrist in the LP team improves the care quality. All models may improve safety for patients but most evaluations are of poor quality and therefore there is still insufficient evidence to recommend one service model over another and further robust research is required

Brain-derived neurotrophic factor association with amygdala response in major depressive disorder

Background: Brain-derived neurotrophic factor (BDNF) has an essential role in synaptic plasticity and neurogenesis. BDNF mediates amygdala-dependent learning for both aversive and appetitive emotional memories. The expression of BDNF in limbic regions is posited to contribute the development of depression, and amygdala responsivity is a potential marker of depressive state. Methods: The present study examined the relationship between platelet BDNF levels and amygdala volume and function in major depressive disorder (MDD). Participants were 23 MDD (mean age 38.9 years) and 23 healthy controls (mean age 38.8 years). All participants were recruited from the community. MDD participants were in a current depressive episode of moderate severity and medication-free. Amygdala responses were acquired during a functional MRI task of implicit emotional processing with sad facial expressions. Results: Significant correlation was observed between platelet BDNF levels and left amygdala responses, but no significant correlations were found with right amygdala responses or with amygdala volumes. Limitations: Interactions with neuroprotective as well as neurotoxic metabolites in the kyneurenine pathway were not examined. Conclusions: Relationship between BDNF levels and amygdala responsivity to emotionally salient stimuli in MDD could reflect the importance of BDNF in amygdala-dependent learning with clinical implications for potential pathways for treatment

Post-exercise Supplementation of Sodium Bicarbonate Improves Acid Base Balance Recovery and Subsequent High-Intensity Boxing Specific Performance

The aim of this study was to assess the effects of post-exercise sodium bicarbonate (NaHCO3) ingestion (0.3 g.kg−1 body mass) on the recovery of acid-base balance (pH, HCO−3, and the SID) and subsequent exercise performance in elite boxers. Seven elite male professional boxers performed an initial bout of exhaustive exercise comprising of a boxing specific high-intensity interval running (HIIR) protocol, followed by a high-intensity run to volitional exhaustion (TLIM1). A 75 min passive recovery then ensued, whereby after 10 min recovery, participants ingested either 0.3 g.kg−1 body mass NaHCO3, or 0.1 g.kg−1 body mass sodium chloride (PLA). Solutions were taste matched and administered double-blind. Participants then completed a boxing specific punch combination protocol, followed by a second high-intensity run to volitional exhaustion (TLIM2). Both initial bouts of TLIM1 were well matched between PLA and NaHCO3 (ICC; r = 0.94, p = 0.002). The change in performance from TLIM1 to TLIM2 was greater following NaHCO3 compared to PLA (+164 ± 90 vs. +73 ± 78 sec; p = 0.02, CI = 45.1, 428.8, g = 1.0). Following ingestion of NaHCO3, pH was greater prior to TLIM2 by 0.11 ± 0.02 units (1.4%) (p < 0.001, CI = 0.09, 0.13, g = 3.4), whilst HCO−3 was greater by 8.8 ± 1.5 mmol.l−1 (26.3%) compared to PLA (p < 0.001, CI = 7.3, 10.2, g = 5.1). The current study suggests that these significant increases in acid base balance during post-exercise recovery facilitated the improvement in the subsequent bout of exercise. Future research should continue to explore the role of NaHCO3 supplementation as a recovery aid in boxing and other combat sports

Core (Polystyrene)−Shell [Poly(glycerol monomethacrylate)] Particles

YesA set of water-swollen core−shell particles was synthesized by emulsion polymerization of a 1,3-dioxolane functional monomer in water. After removal of the 1,3- dioxolane group, the particles’ shells were shown to swell in aqueous media. Upon hydrolysis, the particles increased in size from around 70 to 100−130 nm. A bicinchoninic acid assay and ζ-potential measurements were used to investigate the adsorption of lysozyme, albumin, or fibrinogen. Each of the core−shell particles adsorbed significantly less protein than the noncoated core (polystyrene) particles. Differences were observed as both the amount of difunctional, cross-linking monomer and the amount of shell monomer in the feed were changed. The core−shell particles were shown to be resistant to protein adsorption, and the degree to which the three proteins adsorbed was dependent on the formulation of the shell.EPSRC and MR

Preservation of the High Quality Factor and Accelerating Gradient of Nb3Sn-coated Cavity During Pair Assembly

Two CEBAF 5-cell accelerator cavities have been coated with Nb3Sn film using the vapor diffusion technique. One cavity was coated in the Jefferson Lab Nb3Sn cavity coating system, and the other in the Fermilab Nb3Sn coating system. Both cavities were measured at 4 K and 2 K in the vertical dewar test in each lab and then assembled into a cavity pair at Jefferson Lab. Previous attempts to assemble Nb3Sn cavities into a cavity pair degraded the superconducting properties of Nb3Sn-coated cavities. This contribution discusses the efforts to identify and mitigate the pair assembly challenges and will present the results of the vertical tests before and after pair assembly. Notably, one of the cavities reached the highest gradient above 80 mT in the vertical test after the pair assembly.Comment: 21st Intl Conf Radio Frequency Superconductivity (SRF 2023