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In response to research into the complex needs of women with enduring mental health problems, a Women's Special Interest Group was set up in Nottingham. A group of women and staff now meet regularly at a local cafe. Here, Sara Owen and colleagues evaluate the success of the network from the perspectives of the staff, the cafe owner and group members. [ABSTRACT FROM AUTHOR]

His bundle recordings were performed in 2 patients in whom AV nodal bypass tracts coexisted with intermittent AV conduction disturbances occurring below the site from which the His bundle deflection was recorded. Case 1 had: (a) tachycardia dependent right bundle-branch block, (b) persistent HV prolongation, and (c) bradycardia dependent AV block. Case 2 showed: (a) intra-atrial conduction delay, (b) tachcardia dependent left bundle-branch block with HV prolongation, (c) bradycardia dependent HV conduction disturbance, (d) tachycardia-bradycardia syndrome of an unusual type; the latter presumably resulted, during atrial flutter, from the alternation of rapid AH conduction through the bypass tract with intermittent (complete) distal His bundle block or bilateral bundle-branch block. [ABSTRACT FROM PUBLISHER]

Ventricular ectopic activity occurred only after premature atrial beats in a patient with an acute inferior wall myocardial infarction. The ventricular ectopic activity occurred only when the coupling interval between the premature atrial beats and preceding sinus beat was less than or equal to 0-44 s. The sinus cycle length, however, appeared to influence the form of expression of ventricular ectopic activity independent of coupling intervals, with single premature ventricular contractions occurring at cycle lengths greater than or equal to 0-72 s, couplets at cycle lengths of 0-68 to 0-71 s, and ventricular tachycardia at cycle lengths less than or equal to 0-67 s. [ABSTRACT FROM PUBLISHER]

A quantificação da deposição de serapilheira e o acúmulo de manta orgânica são etapas importantes dos estudos de ciclagem de nutrientes. Com esse fim, objetivou-se quantificar a deposição de serapilheira e o acúmulo de manta orgânica em um povoamento de Sabiá (Mimosa caesalpiniifolia Benth.), no campo experimental pertencente à Empresa Pernambucana de Pesquisa Agropecuária - IPA, Itambé, PE. Para quantificação da serapilheira foram utilizados 20 coletores de madeira de 0,50 x 0,50 x 15 cm, à distância do solo de 30 cm, distribuídos sistematicamente na área. O material depositado foi coletado mensalmente no período de outubro/2000 a setembro/2001. O material colhido em cada coletor foi separado em folhas, galhos, flores, frutos e miscelânea. A manta orgânica não decomposta sobre o solo foi amostrada, ao acaso, nas proximidades da caixa coletora, obtendo-se 20 amostras mensais. De cada amostra foi retirado o material contido numa área de 30 x 30 cm. O material colhido foi separado em folhas, flores, frutos, miscelânea e galhos. As amostras foram levadas à estufa a 60 º C no período de 48 horas até peso constante. A deposição mensal de serapilheira e frações folha e legume ocorreu em outubro, provavelmente devido ao início do período seco. A deposição e o estoque de serapilheira foram estimados em 7830,44 kg.ha-1.ano-1 e 8906.9, kg.ha-1, respectivamente, com a fração folha dominando. A fração folha apresentou os maiores teores de nutrientes.Quantification of litter deposition and organic mantle accumulation are important steps on nutrient cycling studies. This study aimed to quantify litter deposition and organic mantle in a sabiá (Mimosa caesalpiniifolia Benth) woodlot in an experimental farm in the Brazilian northeast region. Twenty 0.50 x 0.50 x 0.15 m wood collectors, to quantify litter deposition, were systematically distributed over the area elevated 30 cm above the soil. Deposited material was collected monthly from October 2000 to September 2001, and separated into leaves, twigs, flowers, pods and mixed portions. Undecomposed organic mantle was randomly sampled nearby collector boxes, to a total of 20 monthly samples, from which a 0.30 x 0.30 m composed sample was collected. The collected material was also hand separated into leaves, twigs, flowers, pods and mixed portions. All collected material was dried at 60°C until constant weight was achieved. Highest monthly litter deposition and leaf and pod fractions occurred in October, probably due to initiation of dry period. Litter deposition and stock were estimated at 7830.44 kg.ha-1.year-1 and 8906.9 kg.ha-1, respectively, with the leaf fraction dominating. Leaf fraction was the richest in nutrient content.

Introduction: Improved outcomes with contemporary medical therapy in patients with advanced heart failure questions the benefit of transplantation (TX) in UNOS status 2 patients. Methods: Between January 1999 and June 2001; 4,255 patients were listed for heart TX as UNOS status 2. Using a competing risk method, probabilities of events on the waiting list were computed. Additionally, a time dependent proportional hazards model was used to determine predictors of death pre and post TX. Results: Demographics of this cohort revealed a mean age of 52.3 years, female gender (23%), ischemic etiology (48%), diabetes (21%), white race (85%), and mean time on the waiting list (398.5 days). Relative risks of death (> 1 indicates an increased risk) compared to patients remaining on the waiting list as status 2 were: upgrade to status 1A; RR 14.9 (95%CI 9.7–22.2), upgrade to status 1B; RR 3.4 (95%CI 2.4–4.7), 0–7 days following TX as status 2; RR 16.7 (95%CI 9.3–30.2) and 7–33 days following TX as status 2; RR 6.5 (95%CI 3.7–11.2). All factor were significant at p<0.0001. The overall relative risk of death following TX (365+ days) for status 2 patients initially listed as status 2 compared to those that continue to wait as status 2 is shown below; RR 0.92 (95%CI 0.5–1.58, p=0.8). Conclusion: After accounting for early perioperative mortality, there appears to be little survival benefit at one year in transplanting UNOS status 2 patients. The point of optimal benefit from TX in UNOS status 2 patients may need to be further defined. [ABSTRACT FROM AUTHOR]

Genetic background has the potential to influence both the tempo and trajectory of adaptive change: Different genotypes of a given species may adopt varied solutions to the same environmental challenge, or they may approach the same solution at different rates. Laboratory selection has been widely used to experimentally examine the evolutionary consequences of variation in genetic background, although largely using genotypes differing by only a few mutations. Here, we leverage natural variation in the bacterium Pseudomonas aeruginosa to investigate whether different adaptive solutions are accessible from distant points of departure on an adaptive landscape. We evolved 17 diverse genotypes in a laboratory medium that partially mimics the lung sputum of cystic fibrosis patients, and we measured changes in 10 phenotypes as well as in fitness. Using phylogenetically informed analyses, we found that genetic background impacted the tempo, but not the trajectory, of phenotypic evolution: Different starting genotypes converged toward similar phenotypes, but at varying rates. Our findings add to a growing body of evidence supporting widespread diminishing return epistasis during adaptation. The importance of genetic background toward the trajectory of adaptation remains inconsistent across experimental systems and conditions., (© The Author(s) 2023. Published by Oxford University Press on behalf of The Society for the Study of Evolution (SSE). All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: The COVID-19 pandemic has resulted in many changes to the lives of children and young people. Our aim is to explore the impact of the pandemic on the mental health of children and young people (ages 5-21)., Methods: The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines was used to report the findings of this rapid review., Results: Children and young people are potentially very vulnerable to the emotional impact of traumatic events that disrupt their daily lives. Key areas of concern include: Death Anxiety and Fear of Infection; lack of social interaction and loss of routine., Conclusions: Despite some early and responsive studies, the evidence base for pandemic impact on children and young people is very limited. Such evidence is urgently needed if adequate and responsive services, that can mitigate the long-term impact of the pandemic for children and young people can be established., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)

WHAT IS KNOWN ABOUT THE SUBJECT?: The practices of mental health nurses in the administration of repetitive transcranial magnetic stimulation (rTMS) treatments for depression in outpatient clinic are crucial for patient outcomes To date, most research has focused directly on procedural aspects of treatment delivery with limited focus on the delivery of holistic care and treatment. There is a lack of best practice guidance based on the experiences of those involved in clinical delivery to inform and improve rTMS practices WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This study provides unique insights into service and personalized non-treatment factors associated with rTMS delivery that may reduce stress and improve the experiences of rTMS patients It reviews and updates understanding of the factors that contribute to the delivery of effective rTMS. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The need to apply findings for the development of best practice guidance Factors to improve practice include (a) rTMS machine demonstrations; (b) constructive, individualized, friendly, and therapeutic conversations; (c) a relaxing, comfortable, 'homely' physical environment; (d) long term supportive management; and (e) careful engagement of nursing and support staff., (© 2021 The Authors. Journal of Psychiatric and Mental Health Nursing published by John Wiley & Sons Ltd.)

Traumatic injuries of the brain and spinal cord are a significant source of mortality and long-term disability. A recent systematic study in a rat model of spinal cord injury (SCI) indicates severe, destructive, and very protracted inflammation as the key mechanism initiated by the massive injury involving the white matter. Although the severe inflammation is localized and counteracted by astrogliosis, it has a damaging effect on the blood vessels in the surrounding spinal cord, leading to persistent vasogenic edema. Evaluation of these injuries with imaging of the brain and spinal cord plays a crucial role in the acute trauma work-up, allowing clinicians to quickly identify abnormalities that require immediate medical or surgical intervention or to exclude them from the workup. Recently, anti-inflammatory agents have been shown to inhibit and accelerate the elimination of post-SCI inflammation in preclinical studies, and an exciting potential has arisen for the use of antiinflammatory drugs in clinical studies to achieve neuroprotection (i.e., inhibition of destruction caused by inflammation) and to inhibit vasogenic edema in SCI, traumatic brain injury, and stroke. In both subacute and chronic settings, imaging can guide therapy and provide important prognostic information. In this review, we discuss the imaging workup and evolving imaging findings of neurotrauma in the acute and chronic setting, including conventional and advanced imaging techniques. As neuroimaging is the primary mode of diagnostic analysis in neurotrauma, it is a critical component in future clinical trials evaluating neuroprotective therapies., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

This paper describes a consultation exercise to explore the acceptability of adapting digital social prescribing (DSP) for suicide bereavement support. Bereavement by suicide increases the risk of suicide and mental health issues. Social prescribing improves connectedness and empowerment and can provide digital outcomes-based reporting to improve the capacity for measuring the effectiveness of interventions. Our aim was to consult on the acceptability and potential value of DSP for addressing the complexities of suicide bereavement support. Our approach was underpinned by implementation science and a co-design ethos. We reviewed the literature and delivered DSP demonstrations as part of our engagement process with commissioners and service providers ( marrying evidence and context ) and identified key roles for stakeholders ( facilitation ). Stakeholders contributed to a co-designed workshop to establish consensus on the challenges of providing postvention support. We present findings on eight priority challenges, as well as roles and outcomes for testing the feasibility of DSP for support after suicide. There was a consensus that DSP could potentially improve access, reach, and monitoring of care and support. Stakeholders also recognised the potential for DSP to contribute substantially to the evidence base for postvention support. In conclusion, the consultation exercise identified challenges to facilitating DSP for support after suicide and parameters for feasibility testing to progress to the evaluation of this innovative approach to postvention.

Aseptic loosening and wear is second to only infection as the most common cause of arthroplasty failure. Degeneration of the polyethylene and metal arthroplasty components can lead to metallosis, which can cause a combination of direct cytotoxic effects and an inflammatory response within the synovial and periarticular tissues. This can result in bone resorption and secondary arthroplasty component loosening as well as a metal containing joint effusion and metal-induced synovitis. Little literature exists as to the ultrasonographic findings of metal-induced synovitis and polyethylene component displacement. As the use of musculoskeletal ultrasound significantly increases, being aware of these findings is important. The most important ultrasonographic findings include differentiating a joint effusion from synovitis utilizing dynamic compression, identifying areas of echogenic shadowing related to metal deposition and visualizing displaced arthroplasty components. The following is a case report that demonstrates the ultrasonographic imaging findings of metallosis, metal-induced synovitis and polyethylene component displacement. We will also demonstrate the ultrasound-guided aspiration findings as well as radiographic and gross pathologic correlations., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Aims: To investigate cases of suicide in which there was no healthcare contact, by looking at history of help-seeking and evidence of previous mental health vulnerability. To identify any life events associated with suicide for which individuals did not seek help., Background: Previous research has suggested that non-consultation is the main barrier to suicide prevention among men. Estimates suggest approximately 22% of men who die by suicide have not consulted their GP in the year before their death. Little is known about the lifetime pattern of engagement with services among these individuals and whether or not this may influence their help-seeking behaviour before death., Methods: Coroner records of suicide deaths in Northern Ireland over 2 years were linked to general practice (GP) records. This identified 63 individuals who had not attended health services in the 12 months before death. Coroner's data were used to categorise life events associated with the male deaths. Lifetime mental health help-seeking at the GP was assessed., Findings: The vast majority of individuals who did not seek help were males (n=60, 15% of all suicide deaths). Lack of consultation in the year before suicide was consistent with behaviour over the lifespan; over two-thirds had no previous consultations for mental health. In Coroner's records, suicides with no prior consultation were primarily linked to relationship breakdown and job loss. These findings highlight the limitations of primary care in suicide prevention as most had never attended GP for mental health issues and there was a high rate of supported consultation among those who had previously sought help. Public health campaigns that promote service use among vulnerable groups at times of crisis might usefully be targeted at those likely to be experiencing financial and relationship issues.

Given the integral role of stimulator of interferon genes (STING, TMEM173 ) in the innate immune response, its loss or impairment in cancer is thought to primarily affect antitumor immunity. Here we demonstrate a role for STING in the maintenance of cellular homeostasis through regulation of the cell cycle. Depletion of STING in human and murine cancer cells and tumors resulted in increased proliferation compared with wild-type controls. Microarray analysis revealed genes involved in cell-cycle regulation are differentially expressed in STINGko compared with WT MEFs. STING-mediated regulation of the cell cycle converged on NFκB- and p53-driven activation of p21. The absence of STING led to premature activation of cyclin-dependent kinase 1 (CDK1), early onset to S-phase and mitosis, and increased chromosome instability, which was enhanced by ionizing radiation. These results suggest a pivotal role for STING in maintaining cellular homeostasis and response to genotoxic stress. SIGNIFICANCE: These findings provide clear mechanistic understanding of the role of STING in cell-cycle regulation, which may be exploited in cancer therapy because most normal cells express STING, while many tumor cells do not. See related commentary by Gius and Zhu, p. 1295 ., (©2018 American Association for Cancer Research.)

High-resolution sonography has a growing role in both the diagnosis and management of traumatic and atraumatic peripheral nerve pathology. Sonography not only affords a cost-effective and time-efficient approach to interrogating long segments of peripheral nerves but also possesses unique advantages in terms of its dynamic, real-time nature with few clinical contraindications and limitations. In this review, we will initially discuss imaging techniques and characteristics of normal neural sonohistology, then address specific features and pitfalls pertaining to the spectrum of post-traumatic peripheral nerve injury. Additionally, we will highlight the more common sonographic applications in the clinical work-up of patients presenting with symptoms of dynamic neural impingement and entrapment. Finally, illustrative and clinical features of the more frequently encountered peripheral neural neoplastic pathologies will be addressed.

Background: Although Primary care is crucial for suicide prevention, clinicians tend to report completed suicides in their care as non-preventable. We aimed to examine systemic inadequacies in suicide prevention from the perspectives of bereaved family members and GPs., Methods: Qualitative study of 72 relatives or close friends bereaved by suicide and 19 General Practitioners who have experienced the suicide of patients., Results: Relatives highlight failures in detecting symptoms and behavioral changes and the inability of GPs to understand the needs of patients and their social contexts. A perceived overreliance on anti-depressant treatment is a major source of criticism by family members. GPs tend to lack confidence in the recognition and management of suicidal patients, and report structural inadequacies in service provision., Conclusions: Mental health and primary care services must find innovative and ethical ways to involve families in the decision-making process for patients at risk of suicide.

After entry into the nucleus, herpes simplex virus (HSV) DNA is coated with repressive proteins and becomes the site of assembly of nuclear domain 10 (ND10) bodies. These small (0.1-1 μM) nuclear structures contain both constant [e.g., promyelocytic leukemia protein (PML), Sp100, death-domain associated protein (Daxx), and so forth] and variable proteins, depending on the function of the cells or the stress to which they are exposed. The amounts of PML and the number of ND10 structures increase in cells exposed to IFN-β. On initiation of HSV-1 gene expression, ICP0, a viral E3 ligase, degrades both PML and Sp100. The earlier report that IFN-β is significantly more effective in blocking viral replication in murine PML(+/+) cells than in sibling PML(-/-) cells, reproduced here with human cells, suggests that PML acts as an effector of antiviral effects of IFN-β. To define more precisely the function of PML in HSV-1 replication, we constructed a PML(-/-) human cell line. We report that in PML(-/-) cells, Sp100 degradation is delayed, possibly because colocalization and merger of ICP0 with nuclear bodies containing Sp100 and Daxx is ineffective, and that HSV-1 replicates equally well in parental HEp-2 and PML(-/-) cells infected at 5 pfu wild-type virus per cell, but poorly in PML(-/-) cells exposed to 0.1 pfu per cell. Finally, ICP0 accumulation is reduced in PML(-/-) infected at low, but not high, multiplicities of infection. In essence, the very mechanism that serves to degrade an antiviral IFN-β effector is exploited by HSV-1 to establish an efficient replication domain in the nucleus.

The gender-based nature of suicide-related behaviour is largely accepted. However, studies that report exclusively on female suicides are rare. Here we demonstrate how female suicide has effectively been 'othered' and appears incidental in studies which compare female and male behaviour. We highlight how recent studies of suicide have tended to be dominated by male-only approaches, which increasingly link issues of masculinity with male death by suicide. Drawing on data collected from the general practitioner and coroner's office, we then apply the sociological autopsy approach to a cohort of 78 deaths recorded as suicides in the UK between 2007 and 2009. By focusing on females in isolation from males, we demonstrate that, as in male-only suicide studies, it is similarly possible to draw out issues associated with the feminine identity, which can be linked to death by suicide. We find that bereavement, sexual violence and motherhood could all be linked to the lives and help-seeking of the females who died. In closing, we suggest that a reorientation towards sociological analytic approaches of female suicide may help to produce further reductions in the rate of female death by suicide. A Virtual Abstract of this paper can be found at: https://www.youtube.com/watch?v=a0w9KKMFdIQ., (© 2016 Foundation for the Sociology of Health & Illness.)

Background: Contact with primary care and psychiatric services prior to suicide may be considerable, presenting opportunities for intervention. However, there is scant knowledge on the frequency, nature and determinants of contact., Method: Retrospective cohort study-an analysis of deaths recorded as suicide by the Northern Ireland Coroner's Office linked with data from General Practice patient records over a 2 year period, Results: Eighty-seven per cent of suicides were in contact with General Practice services in the 12 months before suicide. The frequency of contact with services was considerable, particularly among patients with a common mental disorder or substance misuse problems. A diagnosis of psychiatric problems was absent in 40% of suicides. Excluding suicide attempts, the main predictors of a noted general practitioner concern for patient suicidality are male gender, frequency of consultations, diagnosis of mental illness and substance misuse., Conclusions: Despite widespread and frequent contact, a substantial proportion of suicidal people were undiagnosed and untreated for mental health problems. General Practitioner alertness to suicidality may be too narrowly focused.

Background: Although substance misuse is a key risk factor in suicide, relatively little is known about the relationship between lifetime misuse and misuse at the time of suicide., Aims: To examine the relationship between substance misuse and subsequent suicide., Method: Linkage of coroners' reports to primary care records for 403 suicides occurring over 2 years., Results: With alcohol misuse, 67% of the cohort had previously sought help for alcohol problems and 39% were intoxicated at the time of suicide. Regarding misuse of other substances, 54% of the cohort was tested. Almost one in four (38%) tested positive, defined as an excess of drugs over the prescribed therapeutic dosage and/or detection of illicit substances. Those tested were more likely to be young and have a history of drug misuse., Conclusions: A deeper understanding of the relationship between substance misuse and suicide could contribute to prevention initiatives. Furthermore, standardised toxicology screening processes would avoid diminishing the importance of psychosocial factors involved in suicide as a 'cause of death'., (© The Royal College of Psychiatrists 2016.)