Adolescent Healthcare Contacts in the Year Before Suicide: a case control study

Introduction: Suicide rates among adolescents have risen steadily since 2007, creating a dire need to expand prevention protocols. Healthcare systems have been identified as a key avenue for identification and intervention. To date, no comprehensive analysis has been done to understand adolescent-specific characteristics and healthcare utilization prior to suicide death. Methods: A case-control study was conducted using records from eight healthcare systems nationwide. Data from 450 subjects aged 10-24 who died by suicide between the years 2000-2013 was matched with 4500 controls based on health system and time period of membership. We examined past-year health diagnoses and patterns of visit types and frequency. Results: Adolescents who died by suicide were more likely to have at least one mental health disorder (52% vs 16%), as well as each individual disorder. Physical health disorders were also more likely among this group. Close to half (49%) and nearly all (89%) of youth who died by suicide had a health care visit in the month and year prior to their death, respectively. Outpatient visits were most common, with suicide decedents averaging 8 in the year before death. Conclusion: With nearly half (48%) of adolescents who died by suicide lacking a mental health diagnosis in the year prior to their death, it is no longer sufficient to rely on mental health services to capture at-risk youth. High rates of healthcare utilization among those who died by suicide indicate a strong need for improving identification of youth while they are seeking services, thereby preventing future deaths

Hidrocondicionamento, secagem e armazenamento em sementes de Piptadenia moniliformis Benth / Hydropriming, drying and storage in seeds of Piptadenia moniliformis Benth

Piptadenia moniliformis Benth. apresenta germinação lenta e desuniforme devido a dormência das sementes. Desse modo, é fundamental o uso de técnicas que possam melhorar a uniformidade de germinação, seja para produção de mudas ou para semeadura direta. Neste sentido, o hidrocondicionamento consiste na embebição controlada das sementes diretamente na água ou em substratos úmidos, permitindo a ativação dos processos metabólicos da germinação, sem que ocorra emissão da raiz primária, contribuindo para uma germinação mais rápida e uniforme. No entanto, para facilitar o manejo e prolongar a manutenção da viabilidade durante o armazenamento, é necessário realizar a desidratação das sementes após o condicionamento, que pode ser de forma natural ou artificial. Dessa forma, objetivou-se avaliar os efeitos do hidrocondicionamento e tipos de secagem sobre a germinação e o vigor de sementes de P. moniliformis durante o armazenamento. Para isto, foi utilizada uma amostra de sementes de catanduva, cujo grau de umidade inicial foi determinado pelo método da estufa à 105 °C por 24 horas com duas repetições de 25 sementes. Em seguida, realizou-se a curva de embebição, para determinar o tempo do hidrocondicionamento. Para elaboração da curva de embebição e definição do tempo de hidrocondicionamento, duas subamostras de 50 sementes foram colocadas entre duas folhas de papel germitest à 25 °C durante 60 horas e pesadas a cada uma hora, até a emissão da raiz primária em 50% das sementes. Assim, o tempo escolhido para o hidrocondicionamento das sementes foi de 36 horas, quando atingiram 41,6% de umidade. Após o hidrocondicionamento, uma parte das sementes foram submetidas a secagem natural em bancada de laboratório (temperatura média do ambiente 30 °C) e a outra submetida a secagem artificial em estufa com circulação de ar forçado (temperatura média de 40 °C por 24 horas) até atingir o grau de umidade inicial de 11,4%. O delineamento experimental foi o inteiramente casualizado em esquema fatorial 3x3, sendo três tipos de sementes (não-hidrocondicionada, hidrocondicionada + secagem natural e hidrocondicionada + secagem artificial) e três épocas de armazenamento (0, 30 e 60 dias). Posteriormente, as sementes foram submetidas as seguintes avaliações: germinação, envelhecimento acelerado, emergência, índice de velocidade de emergência, comprimento de raiz e da parte aérea, massa seca da raiz e da parte aérea em casa de vegetação. As outras sementes foram armazenadas em sacos plásticos em câmara controlada e as avaliações após 30 e 60 dias de armazenamento. Verificou-se que o hidrocondicionamento seguido de secagem natural ou artificial, favorece o vigor de sementes de catanduva durante 30 dias de armazenamento

An intriguing shift occurs in the novel protein phosphatase 1 binding partner, TCTEX1D4: evidence of positive selection in a pika model

T-complex testis expressed protein 1 domain containing 4 (TCTEX1D4) contains the canonical phosphoprotein phosphatase 1 (PPP1) binding motif, composed by the amino acid sequence RVSF. We identified and validated the binding of TCTEX1D4 to PPP1 and demonstrated that indeed this protein is a novel PPP1 interacting protein. Analyses of twenty-one mammalian species available in public databases and seven Lagomorpha sequences obtained in this work showed that the PPP1 binding motif 90RVSF93 is present in all of them and is flanked by a palindromic sequence, PLGS, except in three species of pikas (Ochotona princeps, O. dauurica and O. pusilla). Furthermore, for the Ochotona species an extra glycosylation site, motif 96NLS98, and the loss of the palindromic sequence were observed. Comparison with other lagomorphs suggests that this event happened before the Ochotona radiation. The dN/dS for the sequence region comprising the PPP1 binding motif and the flanking palindrome highly supports the hypothesis that for Ochotona species this region has been evolving under positive selection. In addition, mutational screening shows that the ability of pikas TCTEX1D4 to bind to PPP1 is maintained, although the PPP1 binding motif is disrupted, and the N- and C-terminal surrounding residues are also abrogated. These observations suggest pika as an ideal model to study novel PPP1 complexes regulatory mechanisms.publishe

Discourse and religion in educational practice

Despite the existence of long-held binaries between secular and sacred, private and public spaces, school and religious literacies in many contemporary societies, the significance of religion and its relationship to education and society more broadly has become increasingly topical. Yet, it is only recently that the investigation of the nexus of discourse and religion in educational practice has started to receive some scholarly attention. In this chapter, religion is understood as a cultural practice, historically situated and embedded in specific local and global contexts. This view of religion stresses the social alongside the subjective or experiential dimensions. It explores how through active participation and apprenticeship in culturally appropriate practices and behaviors often mediated intergenerationally and the mobilisation of linguistic and other semiotic resources but also affective, social and material resources, membership in religious communities is constructed and affirmed. The chapter reviews research strands that have explored different aspects of discourse and religion in educational practice as a growing interdisciplinary field. Research strands have examined the place and purpose of religion in general and evangelical Christianity in particular in English Language Teaching (ELT) programmes and the interplay of religion and teaching and learning in a wide range of religious and increasingly secular educational contexts. They provide useful insights for scholars of discourse studies to issues of identity, socialisation, pedagogy and language policy

Bilirubin as a Determinant for Altered Neurogenesis, Neuritogenesis, and Synaptogenesis

Elevated levels of serum unconjugated bilirubin (UCB) in the first weeks of life may lead to long-term neurologic impairment. We previously reported that an early exposure of developing neurons to UCB, in conditions mimicking moderate to severe neonatal j. - Fundacao para a Ciencia e a Tecnologia (FCT) ; FEDER [POCI/SAU-MMO/55955/2004, PTDC/SAU-NEU/64385/2006, SFRH/BPD/26390/2006, SFRH/BPD/26381/2006]; EU FP6 IP FunGenES [LSHG-CT 2003-503-494]; NINDS [RO1-NS049178]. - Contract grant sponsor: Fundacao para a Ciencia e a Tecnologia (FCT). Lisbon, Portugal and FEDER: contract grant numbers: POCI/SAU-MMO/55955/2004, PTDC/SAU-NEU/64385/2006, SFRH/BPD/26390/2006. and SFRH/BPD/26381/2006. Contract grant sponsor: EU FP6 IP Fu

Reducing Smoking Cessation Disparities: Capacity for a Primary Care- and Technology-Based Approach Among Medicaid Recipients

While cigarette use among U.S adults has recently decreased, vulnerable subgroups continue to smoke at high rates, including individuals receiving Medicaid insurance. These individuals have also experienced treatment access disparities, highlighting the need for approaches that leverage their strong desire to quit. We conducted interviews with 100 adult primary care patients receiving Medicaid who were current tobacco users about their use, openness to technology-based interventions, and readiness to change. Most (92%) reported current cigarette use and readiness to change averaged 6.98 out of 10 (SD = 2.82). Nearly all were open to completing an iPad-based tobacco screening (95%) and brief intervention (90%) at their next appointment, while 91% and 88% were willing to talk with their provider or a cessation counselor, respectively, about the subsequent results. Results persisted across age, sex, and race/ethnicity. Openness to technology-based interventions in this population provides support for future work that may ultimately reduce disparities

HLA Upregulation During Dengue Virus Infection Suppresses the Natural Killer Cell Response.

Dengue virus (DENV) is the most prevalent mosquito-borne virus in the world and a major cause of morbidity in the tropics and subtropics. Upregulation of HLA class I molecules has long been considered a feature of DENV infection, yet this has not been evaluated in the setting of natural infection. Natural killer (NK) cells, an innate immune cell subset critical for mounting an early response to viral infection, are inhibited by self HLA class I, suggesting that upregulation of HLA class I during DENV infection could dampen the NK cell response. Here we addressed whether upregulation of HLA class I molecules occurs during in vivo DENV infection and, if so, whether this suppresses the NK cell response. We found that HLA class I expression was indeed upregulated during acute DENV infection across multiple cell lineages in vivo. To better understand the role of HLA class I upregulation, we infected primary human monocytes, a major target of DENV infection, in vitro. Upregulation of total HLA class I is dependent on active viral replication and is mediated in part by cytokines and other soluble factors induced by infection, while upregulation of HLA-E occurs in the presence of replication-incompetent virus. Importantly, blocking DENV-infected monocytes with a pan-HLA class I Fab nearly doubles the frequency of degranulating NK cells, while blocking HLA-E does not significantly improve the NK cell response. These findings demonstrate that upregulation of HLA class I during DENV infection suppresses the NK cell response, potentially contributing to disease pathogenesis

Optimal effector functions in human natural killer cells rely upon autocrine bone morphogenetic protein signaling

Natural killer (NK) cells are critical for innate tumor immunity due to their specialized ability to recognize and kill neoplastically transformed cells. However, NK cells require a specific set of cytokine-mediated signals to achieve optimal effector function. Th1-associated cytokines promote effector functions that are inhibited by the prototypic Th2 cytokine IL4 and the TGFβ superfamily members TGFβ1 and activin-A. Interestingly, the largest subgroup of the TGFβ superfamily are the bone morphogenetic proteins (BMP), but the effects of BMP signaling on NK cell effector functions have not been evaluated. Here, we demonstrate that blood-circulating NK cells express type I and II BMP receptors, BMP-2 and BMP-6 ligands, and phosphorylated isoforms of Smad-1/-5/-8, which mediate BMP family member signaling. In opposition to the inhibitory effects of TGFβ1 or activin-A, autocrine BMP signaling was supportive to NK cell function. Mechanistic investigations in cytokine and TLR-L–activated NK cells revealed that BMP signaling optimized IFNγ and global cytokine and chemokine production, phenotypic activation and proliferation, and autologous dendritic cell activation and target cytotoxicity. Collectively, our findings identify a novel auto-activatory pathway that is essential for optimal NK cell effector function, one that might be therapeutically manipulated to help eradicate tumors