Developing a Hypothetical Model for Suicide Progression in Older Adults With Universal, Selective, and Indicated Prevention Strategies

Suicide prevention is an increasingly important issue, especially among older people. Recent work on improving its effectiveness has focused on developing a framework aligning interventions with key risk factors and stages of the suicide process. We have developed this further, by integrating psycho-behavioral components associated with suicide, existing guidelines for identifying critical points of intervention, and the previous preventive strategies framework. Our schematic diagram shows the relationship between the suicide process and prevention strategies, combined with initiatives for linking different types of strategies, from universal strategies at population level, through selective strategies focusing on groups at risk, to indicated strategies, aimed at specific high-risk individuals. We tested our framework using previous studies assessing the impact of suicide prevention interventions on suicide rates in older adults. It was possible to place all identified interventions within the framework. Examining effectiveness within the framework suggests that some interventions may be more successful in reducing suicide rates because they developed systematic linkages between universal, selective, and indicated prevention interventions. Other studies, however, show that interventions can be successful without these linkages, so other factors may also be important. The main weakness of our framework is a lack of evidence about critical intervention points within the suicide process, which may limit its practical application. However, the framework may help to improve the linkages between types of interventions, and support practitioners in developing a wide range of strategies across different areas and stages of the suicide process

Performance improvements of an atmospheric radiative transfer model on GPU-based platform using CUDA

Classical applications of Atmospheric Radiative Transfer Model (ARTM) for modelization of absorption coefficient line-by-line on the atmosphere consume large computational time since seconds up to a few minutes depending on the atmospheric characterization chosen. ARTM is used together with Ground- Based or Satellite measurements to retrieve atmospheric parameters such as ozone, water vapour and temperature profiles. Nowadays in the Atmospheric Observatory of Southern Patagonia (OAPA) at the Patagonian City of Río Gallegos have been deployed a Spectral Millimeter Wave Radiometer belonging Nagoya Univ. (Japan) with the aim of retrieve stratospheric ozone profiles between 20-80 Km. Around 2 GBytes of data are recorder by the instrument per day and the ozone profiles are retrieving using one hour integration spectral data, resulting at 24 profiles per day. Actually the data reduction is performed by Laser and Application Research Center (CEILAP) group using the Matlab package ARTS/QPACK2. Using the classical data reduction procedure, the computational time estimated per profile is between 4-5 minutes determined mainly by the computational time of the ARTM and matrix operations. We propose in this work first add a novel scheme to accelerate the processing speed of the ARTM using the powerful multi-threading setup of GPGPU based at Compute Unified Device Architecture (CUDA) and compare it with the existing schemes. Performance of the ARTM has been calculated using various settings applied on a NVIDIA graphic Card GeForce GTX 560 Compute Capability 2.1. Comparison of the execution time between sequential mode, Open-MP and CUDA has been tested in this paper.XV Workshop de Procesamiento Distribuido y Paralelo (WPDP)Red de Universidades con Carreras en Informática (RedUNCI

Performance improvements of an atmospheric radiative transfer model on GPU-based platform using CUDA

Classical applications of Atmospheric Radiative Transfer Model (ARTM) for modelization of absorption coefficient line-by-line on the atmosphere consume large computational time since seconds up to a few minutes depending on the atmospheric characterization chosen. ARTM is used together with Ground- Based or Satellite measurements to retrieve atmospheric parameters such as ozone, water vapour and temperature profiles. Nowadays in the Atmospheric Observatory of Southern Patagonia (OAPA) at the Patagonian City of Río Gallegos have been deployed a Spectral Millimeter Wave Radiometer belonging Nagoya Univ. (Japan) with the aim of retrieve stratospheric ozone profiles between 20-80 Km. Around 2 GBytes of data are recorder by the instrument per day and the ozone profiles are retrieving using one hour integration spectral data, resulting at 24 profiles per day. Actually the data reduction is performed by Laser and Application Research Center (CEILAP) group using the Matlab package ARTS/QPACK2. Using the classical data reduction procedure, the computational time estimated per profile is between 4-5 minutes determined mainly by the computational time of the ARTM and matrix operations. We propose in this work first add a novel scheme to accelerate the processing speed of the ARTM using the powerful multi-threading setup of GPGPU based at Compute Unified Device Architecture (CUDA) and compare it with the existing schemes. Performance of the ARTM has been calculated using various settings applied on a NVIDIA graphic Card GeForce GTX 560 Compute Capability 2.1. Comparison of the execution time between sequential mode, Open-MP and CUDA has been tested in this paper.XV Workshop de Procesamiento Distribuido y Paralelo (WPDP)Red de Universidades con Carreras en Informática (RedUNCI

A community intervention trial of multimodal suicide prevention program in Japan: A Novel multimodal Community Intervention program to prevent suicide and suicide attempt in Japan, NOCOMIT-J

<p>Abstract</p> <p>Background</p> <p>To respond to the rapid surge in the incidence of suicide in Japan, which appears to be an ongoing trend, the Japanese Multimodal Intervention Trials for Suicide Prevention (J-MISP) have launched a multimodal community-based suicide prevention program, NOCOMIT-J. The primary aim of this study is to examine whether NOCOMIT-J is effective in reducing suicidal behavior in the community.</p> <p>Methods/DesignThis study is a community intervention trial involving seven intervention regions with accompanying control regions, all with populations of statistically sufficient size. The program focuses on building social support networks in the public health system for suicide prevention and mental health promotion, intending to reinforce human relationships in the community. The intervention program components includes a primary prevention measures of awareness campaign for the public and key personnel, secondary prevention measures for screening of, and assisting, high-risk individuals, after-care for individuals bereaved by suicide, and other measures. The intervention started in July 2006, and will continue for 3.5 years. Participants are Japanese and foreign residents living in the intervention and control regions (a total of population of 2,120,000 individuals).</p> <p>Discussion</p> <p>The present study is designed to evaluate the effectiveness of the community-based suicide prevention program in the seven participating areas.</p> <p>Trial registration</p> <p>UMIN Clinical Trials Registry (UMIN-CTR) UMIN000000460.</p

Effects of canagliflozin in patients with type 2 diabetes and chronic heart failure : a randomized trial (CANDLE)

Aims Little is known about the impact of sodium glucose co‐transporter 2 (SGLT2) inhibitors on cardiac biomarkers, such as natriuretic peptides, in type 2 diabetes (T2D) patients with concomitant chronic heart failure (CHF). We compared the effect of canagliflozin with glimepiride, based on changes in N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), in that patient population. Methods and results Patients with T2D and stable CHF, randomized to receive canagliflozin 100 mg or glimepiride (starting‐dose: 0.5 mg), were examined using the primary endpoint of non‐inferiority of canagliflozin vs. glimepiride, defined as a margin of 1.1 in the upper limit of the two‐sided 95% confidence interval (CI) for the group ratio of percentage change in NT‐proBNP at 24 weeks. Data analysis of 233 patients showed mean left ventricular ejection fraction (LVEF) at randomization was 57.6 ± 14.6%, with 71% of patients having a preserved LVEF (≥50%). Ratio of NT‐proBNP percentage change was 0.48 (95% CI, −0.13 to 1.59, P = 0.226) and therefore did not meet the prespecified non‐inferiority margin. However, NT‐proBNP levels did show a non‐significant trend lower in the canagliflozin group [adjusted group difference; −74.7 pg/mL (95% CI, −159.3 to 10.9), P = 0.087] and also in the subgroup with preserved LVEF [−58.3 (95% CI, −127.6 to 11.0, P = 0.098]). Conclusions This study did not meet the predefined primary endpoint of changes in NT‐proBNP levels, with 24 weeks of treatment with canagliflozin vs. glimepiride. Further research is warranted to determine whether patients with heart failure with preserved ejection fraction, regardless of diabetes status, could potentially benefit from treatment with SGLT2 inhibitors

Performance improvements of an atmospheric radiative transfer model on GPU-based platform using CUDA

Classical applications of Atmospheric Radiative Transfer Model (ARTM) for modelization of absorption coefficient line-by-line on the atmosphere consume large computational time since seconds up to a few minutes depending on the atmospheric characterization chosen. ARTM is used together with Ground- Based or Satellite measurements to retrieve atmospheric parameters such as ozone, water vapour and temperature profiles. Nowadays in the Atmospheric Observatory of Southern Patagonia (OAPA) at the Patagonian City of Río Gallegos have been deployed a Spectral Millimeter Wave Radiometer belonging Nagoya Univ. (Japan) with the aim of retrieve stratospheric ozone profiles between 20-80 Km. Around 2 GBytes of data are recorder by the instrument per day and the ozone profiles are retrieving using one hour integration spectral data, resulting at 24 profiles per day. Actually the data reduction is performed by Laser and Application Research Center (CEILAP) group using the Matlab package ARTS/QPACK2. Using the classical data reduction procedure, the computational time estimated per profile is between 4-5 minutes determined mainly by the computational time of the ARTM and matrix operations. We propose in this work first add a novel scheme to accelerate the processing speed of the ARTM using the powerful multi-threading setup of GPGPU based at Compute Unified Device Architecture (CUDA) and compare it with the existing schemes. Performance of the ARTM has been calculated using various settings applied on a NVIDIA graphic Card GeForce GTX 560 Compute Capability 2.1. Comparison of the execution time between sequential mode, Open-MP and CUDA has been tested in this paper.XV Workshop de Procesamiento Distribuido y Paralelo (WPDP)Red de Universidades con Carreras en Informática (RedUNCI

Activation of ERK/IER3/PP2A-B56γ-positive feedback loop in lung adenocarcinoma by allelic deletion of B56γ gene

In order to investigate the involvement of the IER3/ PP2A-B56γ/ERK-positive feedback loop, which leads to sustained phosphorylation/activation of ERK in carcinogenesis, we immunohistochemically examined the expression of IER3 and phosphorylated ERK in lung tumor tissues. IER3 was overexpressed in all cases of adenocarcinomas examined, but was not overexpressed in squamous cell carcinomas. Phosphorylated ERK (pERK) was also overexpressed in almost all adenocarcinomas. EGFR and RAS, whose gene product is located upstream of ERK, were sequenced. Activating mutation of EGFR, which is a possible cause of overexpression of IER3 and pERK, was found only in 5 adenocarcinomas (42%). No mutation of RAS was found. We further examined the sequences of all exons of B56γ gene (PPP2R5C) and IER3, but no mutation was found. Using a single nucleotide insertion in intron 1 of PPP2R5C, which was found in the process of sequencing, allelic deletion of PPP2R5C was examined. Eight cases were informative (67%), and the deletion was found in 4 of them (50%). Three cases having deletion of PPP2R5C did not have EGFR mutation. Finally, PPP2R5C deletion or EGFR mutation that could be responsible for IER3/pERK overexpression was found in at least 8 cases (67% or more). This is the first report of a high incidence of deletion of PPP2R5C in human carcinomas.Embargo Period 12 month

Rationale and design of a randomized trial to test the safety and non‑inferiority of canagliflozin in patients with diabetes with chronic heart failure : the CANDLE trial

Background: Because type 2 diabetes mellitus is associated strongly with an increased risk of cardiovascular diseases, the number of patients with diabetes with chronic heart failure is increasing steadily. However, clinical evidence of therapeutic strategies in such patients is still lacking. A recent randomized, placebo-controlled trial in patients with type 2 diabetes with high cardiovascular risk demonstrated that the SGLT2 inhibitor, empagliflozin, reduced the incidence of hospitalization for heart failure. Because SGLT2 inhibitors cause a reduction in body weight and blood pressure in addition to improving glycemic control, they have the potential to exert beneficial effects on the clinical pathophysiology of heart failure. The aim of the ongoing CANDLE trial is to test the safety and non-inferiority of canagliflozin, another SGLT2 inhibitor, compared with glimepiride, a sulfonylurea agent, in patients with type 2 diabetes mellitus and chronic heart failure. Methods: A total of 250 patients with type 2 diabetes who are drug-naïve or taking any anti-diabetic agents and suffering from chronic heart failure with a New York Heart Association classification I to III will be randomized centrally into either canagliflozin or glimepiride groups (1: 1) using the dynamic allocation method stratified by age (<65, ≥65 year), HbA1c level (<6.5, ≥6.5 %), and left ventricular ejection fraction (<40, ≥40 %). After randomization, all the participants will be given the add-on study drug for 24 weeks in addition to their background therapy. The primary endpoint is the percentage change from baseline in NT-proBNP after 24 weeks of treatment. The key secondary endpoints after 24 weeks of treatment are the change from baseline in glycemic control, blood pressure, body weight, lipid profile, quality of life score related to heart failure, and cardiac and renal function. Discussion: The CANDLE trial is the first to assess the safety and non-inferiority of canagliflozin in comparison with glimepiride in patients with type 2 diabetes with chronic heart failure. This trial has the potential to evaluate the clinical safety and efficacy of canagliflozin on heart failure

Clinicopathological Parameters Associated with Surgical Site Infections in Patients who Underwent Pancreatic Resection

Background/Aims: To clarify parameters associated with postoperative surgical site infection (SSI) after pancreatectomy, we examined clinicopathological and surgical records in 186 patients who underwent pancreatectomy at a single academic institute. Methodology: Patient demographics, liver functional parameters, histological findings, surgical records and post-hepatectomy outcomes during hospitalization were compared between the non-SSI and SSI group, in which SSIs included superficial and deep SSIs. Results: The prevalence of SSI (29-35%) has not changed over an 18-year period. With respect to patient demographics and laboratory data, no parameters were associated with postoperative SSI. In surgical records, the operating time in the SSI group tended to be longer in comparison with that in the non-SSI group (618 vs. 553 minutes, respectively) but not significantly different (p=0.070). With respect to postoperative outcomes, time to oral intake in the SSI group was significantly longer than that in the non-SSI group (21.2 vs. 13.7 days, respectively) (p<0.01). Incidences of pancreatic fistula, postoperative bleeding, long-term ascites and re-operation were significantly more frequent in the SSI group in comparison with the non-SSI group (p<0.05). Decrease of body weight after surgery in the SSI group was significantly greater than that in the non-SSI group (-4.1 vs. -2.7kg, respectively) (p<0.05). Period of hospital stay in the SSI group was significantly longer than that in the non-SSI group (37 vs. 25 days) (p<0.05). Multivariate analysis showed that only postoperative pancreatic fistula was significantly associated with SSI (p<0.01). Conclusions: SSI is an important risk factor of longer hospital stay after pancreatectomy and prevention of pancreatic fistula through the future improvement of surgical procedures is necessary to decrease SSI rates

Rationale and design of a multicenter randomized study for evaluating vascular function under uric acid control using the xanthine oxidase inhibitor, febuxostat : the PRIZE study

Background: Xanthine oxidase inhibitors are anti-hyperuricemic drugs that decrease serum uric acid levels by inhibiting its synthesis. Xanthine oxidase is also recognized as a pivotal enzyme in the production of oxidative stress. Excess oxidative stress induces endothelial dysfunction and inflammatory reactions in vascular systems, leading to atherosclerosis. Many experimental studies have suggested that xanthine oxidase inhibitors have anti-atherosclerotic effects by decreasing in vitro and in vivo oxidative stress. However, there is only limited evidence on the clinical implications of xanthine oxidase inhibitors on atherosclerotic cardiovascular disease in patients with hyperuricemia. We designed the PRIZE study to evaluate the effects of febuxostat on a surrogate marker of cardiovascular disease risk, ultrasonography-based intima-media thickness of the carotid artery in patients with hyperuricemia. Methods: The study is a multicenter, prospective, randomized, open-label and blinded-endpoint evaluation (PROBE) design. A total of 500 patients with asymptomatic hyperuricemia (uric acid >7.0 mg/dL) and carotid intima-media thickness ≥1.1 mm will be randomized centrally to receive either febuxostat (10–60 mg/day) or non-pharmacological treatment. Randomization is carried out using the dynamic allocation method stratified according to age (<65, ≥65 year), gender, presence or absence of diabetes mellitus, serum uric acid (<8.0, ≥8.0 mg/dL), and carotid intima-media thickness (<1.3, ≥1.3 mm). In addition to administering the study drug, we will also direct lifestyle modification in all participants, including advice on control of body weight, sleep, exercise and healthy diet. Carotid intima-media thickness will be evaluated using ultrasonography performed by skilled technicians at a central laboratory. Follow-up will be continued for 24 months. The primary endpoint is percentage change in mean intima-media thickness of the common carotid artery 24 months after baseline, measured by carotid ultrasound imaging. Conclusions: PRIZE will be the first study to provide important data on the effects of febuxostat on atherosclerosis in patients with asymptomatic hyperuricemia