Emergency Crisis Services for Psychiatric Boarder Patients at Central Vermont Hospital ED

Purpose: This project’s aim was to reduce the length of emergency department (ED) stays for psychiatric boarder patients at Central Vermont Medical Center (CVMC) and prevent unnecessary psychiatric inpatient admissions through access to psychiatric crisis stabilization care. Methods: June of 2016, CVMC ED developed a unit called the Transitional Care Area (TCA). TCA staffing consisted of mental health workers and security staff. Training strategies were derived from national evidence-based psychiatric care emergency programs (i.e., Alameda Model), along with pertinent safety actions from The Joint Commission. Training modules focused on community social supports, behavioral crisis stabilization modalities, and development of crisis stabilization treatment plans. TCA committee was developed to promote awareness and willingness for change on TCA unit and address key issues while transitioning the TCA towards a clinical crisis stabilization treatment approach. Results: Periods of 8/1/2016-9/30/2016, and 8/1/2017-9/30/2017, respectfully 147 and 82 patients were admitted to the TCA. Out of these admissions, 44 (2016 period) and 39 (2017 period) patients were referred for intensive psychiatric treatment. The average length of stay (LOS) for these patients was 52.9 hours (2016 period) and 69.9 hours (2017 period). Questionnaire responses identified the need for expansion of the TCA to offer a more therapeutic environment (i.e., fresh air, windows, and therapeutic furniture and electronic technical supports (i.e., Reconnect Media Wall), increased the need for staffing including Peers, and expansion of nurses and APRN role in the TCA. Conclusions: TCA Committee was successful in promoting change and access of increase staffing resources and security were no longer considered direct patient care staff. This project suggests that crisis psychiatric stabilization care with adequate staffing, could be cost-effective, decrease psychiatric ED boarder’s LOS and need for inpatient care. The project also displays the potential of replication in other ED’s in Vermon

Hexadecapole Interaction and the Delta I=4 Staggering Effect in Rotational Bands

A role of the multipole interaction in the description of the $\triangle I$=4 staggering phenomenon is investigated in a model consisting of a single-$j$ shell filled by identical nucleons. Exact diagonalization of the quadrupole-plus-hexadecapole Hamiltonian shows that the hexadecapole-hexadecapole interaction can produce a $\triangle I$=4 periodicity in the yrast sequence.Comment: revised version with technical changes only, to be published in Physica Scripta, latex, 4 pages, 3 PostScript figures available on request from [email protected], preprint No. IFT/18/9

Antisymmetry and channel coupling contributions to the absorption for p + alpha/d + 3He

To understand recently established empirical p + alpha potentials, RGM calculations followed by inversion are made to study contributions of the d + 3He reaction channels and deuteron distortion effects to the p + alpha potential. An equivalent study of the d + 3He potential is also presented. The contributions of exchange non-locality to the absorption are simulated by including an phenomenological imaginary potential in the RGM. These effects alone strongly influence the shape of the imaginary potentials for both p + alpha and d + 3He. The potentials local-equivalent to the fully antisymmetrised-coupled channels calculations have a significant parity-dependence in both real and imaginary components, which for p + alpha is qualitatively similar to that found empirically. The effects on the potentials of the further inclusion of deuteron distortion are also presented. The inclusion of a spin-orbit term in the RGM, adds additional terms to the phase-equivalent potential, most notably the comparatively large imaginary spin-orbit term found empirically.Comment: 17 pages, Latex, 8 postscript figs, submitted to Nucl. Phys.

Interleukin-1α Activity in Necrotic Endothelial Cells Is Controlled by Caspase-1 Cleavage of Interleukin-1 Receptor-2: IMPLICATIONS FOR ALLOGRAFT REJECTION.

Inflammation is a key instigator of the immune responses that drive atherosclerosis and allograft rejection. IL-1α, a powerful cytokine that activates both innate and adaptive immunity, induces vessel inflammation after release from necrotic vascular smooth muscle cells (VSMCs). Similarly, IL-1α released from endothelial cells (ECs) damaged during transplant drives allograft rejection. However, IL-1α requires cleavage for full cytokine activity, and what controls cleavage in necrotic ECs is currently unknown. We find that ECs have very low levels of IL-1α activity upon necrosis. However, TNFα or IL-1 induces significant levels of active IL-1α in EC necrotic lysates without alteration in protein levels. Increased activity requires cleavage of IL-1α by calpain to the more active mature form. Immunofluorescence and proximity ligation assays show that IL-1α associates with interleukin-1 receptor-2, and this association is decreased by TNFα or IL-1 and requires caspase activity. Thus, TNFα or IL-1 treatment of ECs leads to caspase proteolytic activity that cleaves interleukin-1 receptor-2, allowing IL-1α dissociation and subsequent processing by calpain. Importantly, ECs could be primed by IL-1α from adjacent damaged VSMCs, and necrotic ECs could activate neighboring normal ECs and VSMCs, causing them to release inflammatory cytokines and up-regulate adhesion molecules, thus amplifying inflammation. These data unravel the molecular mechanisms and interplay between damaged ECs and VSMCs that lead to activation of IL-1α and, thus, initiation of adaptive responses that cause graft rejection.This study was supported by British Heart Foundation Grants FS/09/005/26845, FS/13/3/30038 and FS/11/77/29327 (MCHC) & RG/13/14/30314 (MRB); the BHF Cambridge CRE; and the NIHR Cambridge BRC.This is the final version of the article. It first appeared from ASBMB via http://dx.doi.org/10.1074/jbc.M115.66791

Generator Coordinate Truncations

We investigate the accuracy of several schemes to calculate ground-state correlation energies using the generator coordinate technique. Our test-bed for the study is the $sd$ interacting boson model, equivalent to a 6-level Lipkin-type model. We find that the simplified projection of a triaxial generator coordinate state using the $S_3$ subgroup of the rotation group is not very accurate in the parameter space of the Hamiltonian of interest. On the other hand, a full rotational projection of an axial generator coordinate state gives remarkable accuracy. We also discuss the validity of the simplified treatment using the extended Gaussian overlap approximation (top-GOA), and show that it works reasonably well when the number of boson is four or larger.Comment: 19 pages, 6 eps figure

Mitochondrial genomes of the key zooplankton copepods Arctic Calanus glacialis and North Atlantic Calanus finmarchicus with the longest crustacean non-coding regions

We determined the nearly complete mitochondrial genomes of the Arctic Calanus glacialis and its North Atlantic sibling Calanus finmarchicus, which are key zooplankton components in marine ecosystems. The sequenced part of C. glacialis mitogenome is 27,342 bp long and consists of two contigs, while for C. finmarchicus it is 29,462 bp and six contigs, what makes them the longest reported copepod mitogenomes. The typical set of metazoan mitochondrial genes is present in these mitogenomes, although the non-coding regions (NCRs) are unusually long and complex. The mitogenomes of the closest species C. glacialis and C. finmarchicus, followed by the North Pacific C. sinicus, are structurally similar and differ from the much more typical of deep-water, Arctic C. hyperboreus. This evolutionary trend for the expansion of NCRs within the Calanus mitogenomes increases mitochondrial DNA density, what resulted in its similar density to the nuclear genome. Given large differences in the length and structure of C. glacialis and C. finmarchicus mitogenomes, we conclude that the species are genetically distinct and thus cannot hybridize. The molecular resources presented here: the mitogenomic and rDNA sequences, and the database of repetitive elements should facilitate the development of genetic markers suitable in pursuing evolutionary research in copepods.Polish Ministry of Science and Higher Education [Iuventus Plus] [IP2014 050573]; FCT-CCMAR Portugal [Multi/04326/2013

Peripheral Nα\alpha Scattering: A Tool For Identifying The Two Pion Exchange Component Of The NN Potential

We study elastic N$\alpha$ scattering and produce a quantitative correlation between the range of the effective potential and the energy of the system. This allows the identification of the waves and energies for which the scattering may be said to be peripheral. We then show that the corresponding phase shifts are sensitive to the tail of the NN potential, which is due to the exchange of two pions. However, the present uncertainties in the experimental phase shifts prevent the use of N$\alpha$ scattering to discriminate the existing models for the NN interaction.Comment: 19 pages, 6 PostScript figures, RevTeX, to be appear in Phys. Rev.