Amniotic fluid brain-specific proteins are biomarkers for spinal cord injury in experimental myelomeningocele

Myelomeningocele (MMC), the most severe form of spina bifida (SB), causes neurological deficit. Injury to the spinal cord is thought to begin in utero. We investigated whether brain-specific proteins (BSPs) would enable us to monitor the development of MMC-related tissue damage during pregnancy in an animal model with naturally occurring SB (curly tail/loop tail mouse; n = 256). Amniotic fluid levels of neurofilament heavy chain (NfH), glial acidic fibrillary protein (GFAP) and S100B were measured by standard ELISA techniques. The amniotic fluid levels of all BSPs were similar in SB and control mice on embryonic day (E) 12.5 and 14.5, whereas a significant increase was observed for GFAP in SB mice on E16.5. Levels of all BSPs were significantly increased in SB mice on E18.5. The rapid increase in GFAP, paralleled by a moderate increase in NfH and S100B, suggests that spinal cord damage starts to accelerate around E16.5. The macroscopic size of the MMC was related to NfH level on E16.5 and E18.5, suggesting that axonal degeneration is most severe in large MMC. Amniotic fluid BSP measurements may provide important information for balancing the risks and benefits to mother and child of in utero surgery for MMC

Observational study of suicide in Switzerland: comparison between psychiatric in- and outpatients.

In Switzerland, suicide is a major cause of years of potential life lost. Among people who died by suicide, a significant number suffered from mental illness and were treated by psychiatric care institutions. Psychiatric patients are thus a specific target for suicide prevention. Based on data from a clinical committee reviewing every death by suicide of psychiatric patients in the Canton of Vaud (Switzerland), this observational study aimed to gain knowledge on sociodemographic and clinical characteristics of psychiatric patients who died by suicide by comparing in- and outpatients. Sociodemographic and clinical characteristics of patients who died by suicide in our department from January 2007 to December 2019 were analysed. In- and outpatients were compared. The sample included 153 patients (64.7% males, n = 99). Three quarters (76.4%, n = 81) of the patients had at least one previous suicide attempt. In- and outpatients did not differ significantly in terms of sociodemographics data, psychiatric diagnosis or method of suicide. Almost all (97.2%) of the outpatients had at least one past psychiatric hospitalisation. We found gender disparities for several variables and a lower male/female suicide ratio than in the general Swiss population. Seventy-two percent of the outpatients (n = 49) had a last personal contact with clinicians less than a week before their suicide and 38.8 % of those less than 24 hours (28% of outpatients, n = 19). Patients dying by suicide present most of the time a serious psychiatric history. In- and outpatients seem to have a similar clinical and sociodemographic profile and suicide prevention should thus not be addressed differently in these two groups. The time between death of outpatients and last contact with a therapist was shorter than expected

Suicides in Psychiatric Patients: Identifying Health Care-Related Factors through Clinical Practice Reviews.

The objective of this study was to identify health care-related factors associated with death by suicide in psychiatric patients and to gain insight into clinician views on how to deal with suicidality. The study material derived from a clinician committee in a psychiatric department reviewing every outpatient and inpatient suicide in a standardized way. Reports' conclusions and corresponding plenary discussion minutes regarding 94 suicides were analyzed using inductive thematic content analysis. Health care-related factors were categorized into 4 themes: patient evaluation, patient management, clinician training, and involvement of relevant non-clinical partners. Clinician views on the themes were expressed through statements (i) promoting or restricting an aspect of care (here called recommendations), which mainly followed existing guidelines and were consensual and (ii) without precise indication (here called comments), which departed from mainstream opinions or addressed topics not covered by existing policy. Involvement of non-clinical partners emerged as a new key issue for suicide prevention in psychiatric departments and should be openly discussed with patients. Clinicians preferred balanced conclusions when they reviewed suicide cases

Communication skills training in oncology: a position paper based on a consensus meeting among European experts in 2009

Background: Communication in cancer care has become a major topic of interest. Since there is evidence that ineffective communication affects both patients and oncology clinicians (physicians and nurses), so-called communication skills trainings (CSTs) have been developed over the last decade. While these trainings have been demonstrated to be effective, there is an important heterogeneity with regard to implementation and with regard to evidence of different aspects of CST. Methods: In order to review and discuss the scientific literature on CST in oncology and to formulate recommendations, the Swiss Cancer League has organised a consensus meeting with European opinion leaders and experts in the field of CST, as well as oncology clinicians, representatives of oncology societies and patient organisations. On the basis of a systematic review and a meta-analysis, recommendations have been developed and agreed upon. Results: Recommendations address (i) the setting, objectives and participants of CST, (ii) its content and pedagogic tools, (iii) organisational aspects, (iv) outcome and (v) future directions and research. Conclusion: This consensus meeting, on the basis of European expert opinions and a systematic review and meta-analysis, defines key elements for the current provision and future development and evaluation of CST in oncolog

Reduced quasifission competition in fusion reactions forming neutron-rich heavy elements

Measurements of mass-angle distributions (MADs) for Cr + W reactions, providing a wide range in the neutron-to-proton ratio of the compound system, (N/Z)CN, have allowed for the dependence of quasifission on the (N/Z)CN to be determined in a model-independent way. Previous experimental and theoretical studies had produced conflicting conclusions. The experimental MADs reveal an increase in contact time and mass evolution of the quasifission fragments with increasing (N/Z)CN, which is indicative of an increase in the fusion probability. The experimental results are in agreement with microscopic time-dependent Hartree-Fock calculations of the quasifission process. The experimental and theoretical results favor the use of the most neutron-rich projectiles and targets for the production of heavy and superheavy nuclei.Comment: Accepted to PRC as a Rapid Communicatio

Analytic estimates and topological properties of the weak stability boundary

The weak stability boundary (WSB) is the transition region of the phase space where the change from gravitational escape to ballistic capture occurs. Studies on this complicated region of chaotic motion aim to investigate its unique, fuel saving properties to enlarge the frontiers of low energy transfers. This “fuzzy stability” region is characterized by highly sensitive motion, and any analysis of it has been carried out almost exclusively using numerical methods. On the contrary this paper presents, for the planar circular restricted 3 body problem (PCR3BP), 1) an analytic definition of the WSB which is coherent with the known algorithmic definitions; 2) a precise description of the topology of the WSB; 3) analytic estimates on the “stable region” (nearby the smaller primary) whose boundary is, by definition, the WSB

A Computational Procedure to Detect a New Type of High Dimensional Chaotic Saddle and its Application to the 3-D Hill's Problem

A computational procedure that allows the detection of a new type of high-dimensional chaotic saddle in Hamiltonian systems with three degrees of freedom is presented. The chaotic saddle is associated with a so-called normally hyperbolic invariant manifold (NHIM). The procedure allows to compute appropriate homoclinic orbits to the NHIM from which we can infer the existence a chaotic saddle. NHIMs control the phase space transport across an equilibrium point of saddle-centre-...-centre stability type, which is a fundamental mechanism for chemical reactions, capture and escape, scattering, and, more generally, ``transformation'' in many different areas of physics. Consequently, the presented methods and results are of broad interest. The procedure is illustrated for the spatial Hill's problem which is a well known model in celestial mechanics and which gained much interest e.g. in the study of the formation of binaries in the Kuiper belt.Comment: 12 pages, 6 figures, pdflatex, submitted to JPhys

BMI Course Over 10 Years After Bariatric Surgery and Biopsychosocial Complexity Assessed with the INTERMED: a Retrospective Study.

While bariatric surgery is an effective therapy for patients with severe obesity, not all patients benefit equally. An explanation might be that psychosocial risk factors hamper outcome. The study aimed to evaluate if biopsychosocial case complexity predicts evolution of BMI over 10 years after bariatric surgery. Charts of patients (N = 236) of the Cohort of Obesity Lausanne (COOL) were retrospectively reviewed and rated with the INTERMED, a reliable and validated instrument, which assesses biopsychosocial case complexity and has been proven to predict outcome of medical treatments in different patient populations. The sample was stratified into BMI quartiles, computed from the patients' baseline BMI. For each quartile, BMI evolution was analyzed using individual growth curve analysis. Growth curve analyses showed that in quartiles 1, 2, and 3, none of the INTERMED domain scores significantly predicted the BMI evolution after surgery. However, in the fourth quartile-including patients with the highest pre-surgical BMI-the social domain score of the INTERMED significantly predicted BMI evolution: patients with more social complexity showed higher increase in BMI. Effectiveness of interventions targeted at social complexity, especially when patients suffer from severe obesity, may therefore be evaluated in future studies