The evaluation of a highly specialist inpatient psychologist working with patients with high risk presentations in an acute mental health inpatient setting

Objective: To evaluate the function and impact of a highly specialist psychologist working with high risk patients in an acute mental health inpatient setting. The impact was examined on outcomes such as risk related incidents, re-admission, average length of stay, and use of restrictive practice. / Method: A mixed methods service evaluation of a pilot project was undertaken to examine the impact of the specialist psychologist role on these outcomes over a 17-month period. Demographic and clinical data was collected for 18 patients who were seen by the psychologist. Routinely collected clinical data examining risk incidents, re-admission rates, average length of stay, and use of restrictive practice, were also used to evaluate outcome across the evaluation period (at baseline and six-month follow-up). / Results: The specialist psychologist provided input to patients’ care and undertook a variety of direct and indirect work and training. Examination of descriptive routine clinical data indicated a slight reduction in risk related incidents, readmissions, and average length of stay after the introduction of the psychologist role, however these were not statistically significant. / Conclusion: These initial findings suggest the potential for outcome improvement, but further, more robust research is required to see if such a role can have a significant impact on outcomes

Equivalence problem for the orthogonal webs on the sphere

We solve the equivalence problem for the orthogonally separable webs on the three-sphere under the action of the isometry group. This continues a classical project initiated by Olevsky in which he solved the corresponding canonical forms problem. The solution to the equivalence problem together with the results by Olevsky forms a complete solution to the problem of orthogonal separation of variables to the Hamilton-Jacobi equation defined on the three-sphere via orthogonal separation of variables. It is based on invariant properties of the characteristic Killing two-tensors in addition to properties of the corresponding algebraic curvature tensor and the associated Ricci tensor. The result is illustrated by a non-trivial application to a natural Hamiltonian defined on the three-sphere.Comment: 32 page

Structural and Functional Analysis of Validoxylamine A 7′-phosphate Synthase ValL Involved in Validamycin A Biosynthesis

Validamycin A (Val-A) is an effective antifungal agent widely used in Asian countries as crop protectant. Validoxylamine A, the core structure and intermediate of Val-A, consists of two C7-cyclitol units connected by a rare C-N bond. In the Val-A biosynthetic gene cluster in Streptomyces hygroscopicus 5008, the ORF valL was initially annotated as a validoxylamine A 7′-phosphate(V7P) synthase, whose encoded 497-aa protein shows high similarity with trehalose 6-phosphate(T6P) synthase. Gene inactivation of valL abolished both validoxylamine A and validamycin A productivity, and complementation with a cloned valL recovered 10% production of the wild-type in the mutant, indicating the involvement of ValL in validoxylamine A biosynthesis. Also we determined the structures of ValL and ValL/trehalose complex. The structural data indicates that ValL adopts the typical fold of GT-B protein family, featuring two Rossmann-fold domains and an active site at domain junction. The residues in the active site are arranged in a manner homologous to that of Escherichia coli (E.coli) T6P synthase OtsA. However, a significant discrepancy is found in the active-site loop region. Also noticeable structural variance is found around the active site entrance in the apo ValL structure while the region takes an ordered configuration upon binding of product analog trehalose. Furthermore, the modeling of V7P in the active site of ValL suggests that ValL might have a similar SNi-like mechanism as OtsA

MICB0106 gene polymorphism is associated with ulcerative colitis in central China

Background: The highly polymorphic nonclassical MHC class I chain-related genes A and B (MICA and MICB) encode stress-inducible glycoproteins expressed on various epithelial cells including intestinal epithelial cells. MICA and MICB gene polymorphisms and expressions are associated with autoimmune diseases but not known in ulcerative colitis (UC). Aims: To investigate the association of MICB exon 2-4 polymorphisms and soluble MICA (sMICA) expression with the susceptibility of UC in central China. Materials and methods: Genomic DNA was isolated from peripheral blood. The allele frequencies of MICB exon 2-4 were genotyped in 105 UC patients and 213 healthy controls by PCR single-stranded conformation polymorphism method. Thirty-two patients and 32 controls were selected for determining serum sMICA expression by ELISA. Results: Allele frequency of MICB0106 was significantly higher in UC patients than in healthy controls (19.0% vs. 8.9%, corrected P (Pc)=0.0006), especially in patients with extensive colitis (24.4% vs. 8.9%, Pc=0.0006), moderate and severe disease (24.1% vs. 8.9%, Pc=0.0006), extraintestinal manifestations (20.5% vs. 8.9%, Pc=0.012), male patients (22.1% vs. 8.0%, Pc=0.006), and patients over the age of 40 years (28.8% vs. 8.3%, Pc=0.0006). The sMICA level was significantly higher in UC than in healthy controls (604.41±480.43 pg/ml vs. 175.37±28.31 pg/ml, P=0.0001) but not associated with the MICB0106 genotypes. Conclusions: Overall, MICB0106 allele was positively associated with UC in the Han Chinese in central China. sMICA was highly expressed in UC but not associated with the MICB0106 genotype