Collaborative agencies and quality discharge support for the long-term care inpatients with mental illness

Long-term hospitalization is a problem for psychiatric care in Japan. The purpose of this research was to clarify the demands placed on public health nurses’ (PHN) involved in the discharge of long-term inpatients (LIPs) with mental illness, and their lack of support. A questionnaire was mailed to 516 health centers, and 112 health centers replied. The response rate was 21.7 percent. The mail survey questionnaire was based on original questionnaire developed by the authors. Significant differences were found among collaborative agencies selected as essential for the discharge support project for the LIPs with mental illness. These differences were evident in the following question items on insufficiency of support : “Incompatibility with the policy of the public health center on discharge support” ; “Opposition to discharge of a LIPs with mental illness by hospital staff” ; and “Shortage of PHN in charge of the discharge support project for the LIPs with mental illness”. It was clarified that the discharge support project required not only the involvement of health and medical welfare personnel but also the cooperation of local human resources such as local residents, neighbor associations, social workers, real-estate agencies and others

Perivascular Expression and Potent Vasoconstrictor Effect of Dynorphin A in Cerebral Arteries

BACKGROUND: Numerous literary data indicate that dynorphin A (DYN-A) has a significant impact on cerebral circulation, especially under pathophysiological conditions, but its potential direct influence on the tone of cerebral vessels is obscure. The aim of the present study was threefold: 1) to clarify if DYN-A is present in cerebral vessels, 2) to determine if it exerts any direct effect on cerebrovascular tone, and if so, 3) to analyze the role of κ-opiate receptors in mediating the effect. METHODOLOGY/PRINCIPAL FINDINGS: Immunohistochemical analysis revealed the expression of DYN-A in perivascular nerves of rat pial arteries as well as in both rat and human intraparenchymal vessels of the cerebral cortex. In isolated rat basilar and middle cerebral arteries (BAs and MCAs) DYN-A (1-13) and DYN-A (1-17) but not DYN-A (1-8) or dynorphin B (DYN-B) induced strong vasoconstriction in micromolar concentrations. The maximal effects, compared to a reference contraction induced by 124 mM K(+), were 115±6% and 104±10% in BAs and 113±3% and 125±9% in MCAs for 10 µM of DYN-A (1-13) and DYN-A (1-17), respectively. The vasoconstrictor effects of DYN-A (1-13) could be inhibited but not abolished by both the κ-opiate receptor antagonist nor-Binaltorphimine dihydrochloride (NORBI) and blockade of G(i/o)-protein mediated signaling by pertussis toxin. Finally, des-Tyr(1) DYN-A (2-13), which reportedly fails to activate κ-opiate receptors, induced vasoconstriction of 45±11% in BAs and 50±5% in MCAs at 10 µM, which effects were resistant to NORBI. CONCLUSION/SIGNIFICANCE: DYN-A is present in rat and human cerebral perivascular nerves and induces sustained contraction of rat cerebral arteries. This vasoconstrictor effect is only partly mediated by κ-opiate receptors and heterotrimeric G(i/o)-proteins. To our knowledge our present findings are the first to indicate that DYN-A has a direct cerebral vasoconstrictor effect and that a dynorphin-induced vascular action may be, at least in part, independent of κ-opiate receptors

An adaptive cracking particle method providing explicit and accurate description of 3D crack surfaces

Cracks in 3D have arbitrary shapes and therefore present difficulties for numerical modelling. A novel adaptive cracking particle method with explicit and accurate description of 3D cracks is described in this paper. In this meshless method, crack surfaces are described by a set of discontinuous segments which are associated with particles. This group of particles are assumed all to be “cracked” and split into two sub-particles with modified support domains. Compared to the original method where the spherical supports at particles are equally divided, the proposed method makes use of non-planar segments to account for changes in crack face direction. The orientations of those segments and the angular changes of cracks during crack propagation steps are recorded using triangular meshes. Supports of weight functions are modified according to those changes so that quasi-continuous crack surfaces can be obtained, avoiding the spurious cracking seen in earlier CPMs. An adaptive approach in 3D is then introduced to capture stress gradients around crack fronts. Several 3D crack problems with reference results have been tested to validate the proposed method with good agreement being achieved using the new method, showing it to be potentially a significant advance for 3D fracture predictions problems

Effect of branchings on blood flow in the system of human coronary arteries

In this work, we investigate the behavior of the pulsatile blood flow in the system of human coronary arteries. Blood is modeled as an incompressible non-Newtonian fluid. The transient phenomena of blood flow through the coronary system are simulated by solving the three dimensional unsteady state Navier-Stokes equations and continuity equation. Distributions of velocity, pressure and wall shear stresses are determined in the system under pulsatile conditions on the boundaries. Effect of branching vessel on the flow problem is investigated. The numerical results show that blood pressure in the system with branching vessels of coronary arteries is lower than the one in the system with no branch. The magnitude of wall shear stresses rises at the bifurcation

Sulf1 has ligand-dependent effects on canonical and non-canonical Wnt signalling

Wnt signalling plays essential roles during embryonic development and is known to be mis-regulated in human disease. There are many molecular mechanisms that ensure tight regulation of Wnt activity. One such regulator is the heparan-sulfate-specific 6-O-endosulfatase Sulf1. Sulf1 acts extracellularly to modify the structure of heparan sulfate chains to affect the bio-availability of Wnt ligands. Sulf1 could, therefore, influence the formation of Wnt signalling complexes to modulate the activation of both canonical and non-canonical pathways. In this study, we use well-established assays in Xenopus to investigate the ability of Sulf1 to modify canonical and non-canonical Wnt signalling. In addition, we model the ability of Sulf1 to influence morphogen gradients using fluorescently tagged Wnt ligands in ectodermal explants. We show that Sulf1 overexpression has ligand-specific effects on Wnt signalling: it affects membrane accumulation and extracellular levels of tagged Wnt8a and Wnt11b ligands differently, and inhibits the activity of canonical Wnt8a but enhances the activity of non-canonical Wnt11b

Potential Role of Decoy B7-H4 in the Pathogenesis of Rheumatoid Arthritis: A Mouse Model Informed by Clinical Data

Finding an association between soluble B7-H4 and rheumatoid arthritis severity, Lieping Chen and colleagues use a mouse model to show that the soluble form blocks the inhibitory function of cell-surface B7-H4

Synapse Pathology in Psychiatric and Neurologic Disease

Inhibitory and excitatory synapses play a fundamental role in information processing in the brain. Excitatory synapses usually are situated on dendritic spines, small membrane protrusions that harbor glutamate receptors and postsynaptic density components and help transmit electrical signals. In recent years, it has become evident that spine morphology is intimately linked to synapse function—smaller spines have smaller synapses and support reduced synaptic transmission. The relationship between synaptic signaling, spine shape, and brain function is never more apparent than when the brain becomes dysfunctional. Many psychiatric and neurologic disorders, ranging from mental retardation and autism to Alzheimer’s disease and addiction, are accompanied by alterations in spine morphology and synapse number. In this review, we highlight the structure and molecular organization of synapses and discuss functional effects of synapse pathology in brain disease

Comparative genomic analysis of Vibrio parahaemolyticus: serotype conversion and virulence

<p>Abstract</p> <p>Background</p> <p><it>Vibrio parahaemolyticus </it>is a common cause of foodborne disease. Beginning in 1996, a more virulent strain having serotype O3:K6 caused major outbreaks in India and other parts of the world, resulting in the emergence of a pandemic. Other serovariants of this strain emerged during its dissemination and together with the original O3:K6 were termed strains of the pandemic clone. Two genomes, one of this virulent strain and one pre-pandemic strain have been sequenced. We sequenced four additional genomes of <it>V. parahaemolyticus </it>in this study that were isolated from different geographical regions and time points. Comparative genomic analyses of six strains of <it>V. parahaemolyticus </it>isolated from Asia and Peru were performed in order to advance knowledge concerning the evolution of <it>V. parahaemolyticus</it>; specifically, the genetic changes contributing to serotype conversion and virulence. Two pre-pandemic strains and three pandemic strains, isolated from different geographical regions, were serotype O3:K6 and either toxin profiles (<it>tdh+</it>, <it>trh</it>-) or (<it>tdh-</it>, <it>trh</it>+). The sixth pandemic strain sequenced in this study was serotype O4:K68.</p> <p>Results</p> <p>Genomic analyses revealed that the <it>trh</it>+ and <it>tdh</it>+ strains had different types of pathogenicity islands and mobile elements as well as major structural differences between the <it>tdh </it>pathogenicity islands of the pre-pandemic and pandemic strains. In addition, the results of single nucleotide polymorphism (SNP) analysis showed that 94% of the SNPs between O3:K6 and O4:K68 pandemic isolates were within a 141 kb region surrounding the O- and K-antigen-encoding gene clusters. The "core" genes of <it>V. parahaemolyticus </it>were also compared to those of <it>V. cholerae </it>and <it>V. vulnificus</it>, in order to delineate differences between these three pathogenic species. Approximately one-half (49-59%) of each species' core genes were conserved in all three species, and 14-24% of the core genes were species-specific and in different functional categories.</p> <p>Conclusions</p> <p>Our data support the idea that the pandemic strains are closely related and that recent South American outbreaks of foodborne disease caused by <it>V. parahaemolyticus </it>are closely linked to outbreaks in India. Serotype conversion from O3:K6 to O4:K68 was likely due to a recombination event involving a region much larger than the O-antigen- and K-antigen-encoding gene clusters. Major differences between pathogenicity islands and mobile elements are also likely driving the evolution of <it>V. parahaemolyticus</it>. In addition, our analyses categorized genes that may be useful in differentiating pathogenic Vibrios at the species level.</p

Wnt signalling in human breast cancer: expression of the putative Wnt inhibitor Dickkopf-3 (DKK3) is frequently suppressed by promoter hypermethylation in mammary tumours

INTRODUCTION: Expression of the putative Wnt signalling inhibitor Dickkopf-3 (DKK3) is frequently lost in human cancer tissues because of aberrant 5'-cytosine methylation within the DKK3 gene promoter. Since other Wnt signalling inhibitors have been reported to be targets of epigenetic inactivation in human breast cancer, we questioned if DKK3 expression is also epigenetically silenced during breast carcinogenesis and therefore might contribute to oncogenic Wnt signalling commonly found in this disease. METHODS: DKK3 mRNA expression and DKK3 promoter methylation were determined by RT-PCR, realtime PCR and methylation-specific PCR in breast cell lines (n = 9), normal breast tissues (n = 19) and primary breast carcinomas (n = 150), respectively. In vitro DNA demethylation was performed by incubating breast cell lines with 5-aza-2'-deoxycytidine and trichostatin A. DKK3 protein expression was analysed by immunohistochemistry in breast carcinomas (n = 16) and normal breast tissues (n = 8). Methylation data were statistically correlated with clinical patient characteristics. All statistical evaluations were performed with SPSS 14.0 software. RESULTS: DKK3 mRNA was downregulated in 71% (five of seven) of breast cancer cell lines and in 68% of primary breast carcinomas (27 of 40) compared with benign cell lines and normal breast tissues, respectively. A DNA demethylating treatment of breast cell lines resulted in strong induction of DKK3 mRNA expression. In tumourous breast tissues, DKK3 mRNA downregulation was significantly associated with DKK3 promoter methylation (p < 0.001). Of the breast carcinomas, 61% (92 of 150) revealed a methylated DKK3 promoter, whereas 39% (58 of 150) retained an unmethylated promoter. Loss of DKK3 expression in association with DKK3 promoter methylation (p = 0.001) was also confirmed at the protein level (p < 0.001). In bivariate analysis, DKK3 promoter methylation was not associated with investigated clinicopathological parameters except patient age (p = 0.007). CONCLUSIONS: DKK3 mRNA expression and consequently DKK3 protein expression become frequently downregulated during human breast cancer development due to aberrant methylation of the DKK3 promoter. Since DKK3 is thought to negatively regulate oncogenic Wnt signalling, DKK3 may be a potential tumour suppressor gene in normal breast tissue