Suicide Prevention by Peers Offering Recovery Tactics (SUPPORT) for US Veterans With Serious Mental Illness: Community Engagement Approach.

BACKGROUND: Peer specialists are hired, trained, and accredited to share their lived experience of psychiatric illness to support other similar individuals through the recovery process. There are limited data on the role of peer specialists in suicide prevention, including their role in intervention development. OBJECTIVE: To better understand peer specialists within the Veterans Health Administration (VHA), we followed partnership community engagement and a formative research approach to intervention development to (1) identify barriers, facilitators, and perceptions of VHA peer specialists delivering a suicide prevention service and (2) develop and refine an intervention curriculum based on an evidence-informed preliminary intervention framework for veterans with serious mental illness (SMI). METHODS: Following the community engagement approach, VHA local and national peer support and mental health leaders, veterans with SMI, and veteran peer specialists met to develop a preliminary intervention framework. Next, VHA peer specialist advisors (n=5) and scientific advisors (n=6) participated in respective advisory boards and met every 2-4 months for more than 18 months via videoconferencing to address study objectives. The process used was a reflexive thematic analysis after each advisory board meeting. RESULTS: The themes discussed included (1) the desire for suicide prevention training for peer specialists, (2) determining the role of VHA peer specialists in suicide prevention, (3) integration of recovery themes in suicide prevention, and (4) difficulties using safety plans during a crisis. There were no discrepancies in thematic content between advisory boards. Advisor input led to the development of Suicide Prevention by Peers Offering Recovery Tactics (SUPPORT). SUPPORT includes training in general suicide prevention and a peer specialist-delivered intervention for veterans with SMI at an increased suicide risk. This training aims to increase the competence and confidence of peer specialists in suicide prevention and the intervention supports veterans with SMI at an increased suicide risk through their recovery process. CONCLUSIONS: This paper intends to document the procedures taken in suicide prevention intervention development, specifically those led by peer specialists, and to be a source for future research developing and evaluating similar interventions. TRIAL REGISTRATION: ClinicalTrials.gov NCT05537376; https://classic.clinicaltrials.gov/ct2/show/NCT05537376.

Analysis of Cytokine Profiles in Pediatric Myocarditis Multicenter Study.

Acute myocarditis (AM) is an inflammatory disease of the heart muscle that can progress to fulminant myocarditis (FM), a severe and life-threatening condition. The cytokine profile of myocarditis in children, especially in relation to fulminant myocarditis, is not well understood. This study aims to evaluate the cytokine profiles of acute and fulminant myocarditis in children. Pediatric patients diagnosed with myocarditis were included in the study. Cytokine levels were measured using a multiplexed fluorescent bead-based immunoassay. Statistical analysis was performed to compare patient characteristics and cytokine levels between FM, AM, and healthy control (HC) groups. Principal component analysis (PCA) was applied to cytokine groups that were independent among the FM, AM, and HC groups. The study included 22 patients with FM and 14 with AM patients. We identified four cytokines that were significantly higher in the FM group compared to the AM group: IL1-RA (p = 0.002), IL-8 (p = 0.005), IL-10 (p = 0.011), and IL-15 (p = 0.005). IL-4 was significantly higher in the AM group compared to FM and HC groups (p = 0.006 and 0.0015). PDGF-AA, and VEGF-A were significantly lower in the FM group than in the AM group (p = 0.013 and <0.001). Similar results were obtained in PCA. Cytokine profiles might be used to differentiate pediatric FM from AM, stratify severity, and predict prognosis. The targeted therapy that works individual cytokines might provide a potential treatment for reducing the onset of the FM and calming the condition, and further studies are needed.

Room Temperature Light Emission from Superatom-like Ge-Core/Si-Shell Quantum Dots.

We have demonstrated the high-density formation of super-atom-like Si quantum dots with Ge-core on ultrathin SiO2 with control of high-selective chemical-vapor deposition and applied them to an active layer of light-emitting diodes (LEDs). Through luminescence measurements, we have reported characteristics carrier confinement and recombination properties in the Ge-core, reflecting the type II energy band discontinuity between the Si-clad and Ge-core. Additionally, under forward bias conditions over a threshold bias for LEDs, electroluminescence becomes observable at room temperature in the near-infrared region and is attributed to radiative recombination between quantized states in the Ge-core with a deep potential well for holes caused by electron/hole simultaneous injection from the gate and substrate, respectively. The results will lead to the development of Si-based light-emitting devices that are highly compatible with Si-ultra-large-scale integration processing, which has been believed to have extreme difficulty in realizing silicon photonics.

[Absence of cortical lesions after the first seizure in a patient with anti-myelin oligodendrocyte glycoprotein-associated cortical encephalitis].

A 31-year-old man developed headache and generalized convulsions. At the time of the first seizure, there was no distinct MRI abnormality. He was admitted to the hospital with repeated seizures, left-sided hemiparesis, and left-sided neglect. He had a slight fever, elevated cerebrospinal fluid (CSF) pressure, and increased CSF cell count with predominance of mononuclear cells. A repeat MRI scan on day 8 after the recurrent seizure showed cortical edema in the right cerebral hemisphere on fluid-attenuated inversion recovery (FLAIR), abnormal high signal on DWI, and decreased apparent diffusion coefficient. The patient was diagnosed with aseptic meningoencephalitis and treated with antiviral drugs and methylprednisolone pulse therapy. Serum anti-myelin oligodendrocyte glycoprotein (MOG) antibody was subsequently detected, and prednisolone was added to treat the FLAIR-hyperintense lesions in anti-MOG antibody associated encephalitis with seizures (FLAMES). It is important to identify the clinical picture and typical images of FLAMES to allow early treatment.

Approaches to the source evaluation of chlorinated polycyclic aromatic hydrocarbons in fine particles.

Chlorinated polycyclic aromatic hydrocarbons (ClPAHs) have been recognized as novel hazardous pollutants; however, the dominant sources remain unclear. This study investigates the occurrences of ClPAHs in five stages of size-segregated particles collected from an urban site and evaluates the sources and factors affecting the concentrations using organic and inorganic source tracers. ClPAHs are the most frequently detected in the finest particle fraction (less than 1.1 µm; PM1.1), similar to polycyclic aromatic hydrocarbons (PAHs), hopanes, and levoglucosan (LEV). The concentrations of total ClPAHs in PM1.1 shows a significant correlation (p < 0.05) with those of total PAHs and specific hopanes but not to LEV and biogenic fatty acids; this suggests that ClPAHs dominantly originate from industrial activities and vehicular emissions. Heatmap analysis, including source tracers, is used to categorize the possible sources of ClPAHs into three types: ClPAH-specific sources, local industrial activities and vehicular emissions, and remote industrial activities. Furthermore, correlation network analysis is used to clarify the relationships between the pollutants.

Stepwise Treatment for Heterotaxy Syndrome and Functional Single Ventricle Complicated by Infra-Cardiac Total Anomalous Pulmonary Venous Connection with Ductus Venosus Stent Placement and Subsequent Occlusion.

Even today, when the surgical outcome of congenital heart disease in the neonatal period has improved, the prognosis for heterotaxy syndrome and functional single ventricle complicated with total anomalous pulmonary venous connection (TAPVC), especially the infra-cardiac type, is catastrophic. We describe a strategy that combines percutaneous ductus venosus (DV) stent placement and occlusion after TAPVC repair to ensure survival from initial surgery to bidirectional cavopulmonary shunt (BCPS) procedure and facilitate subsequent treatment. Three consecutive patients with heterotaxy syndrome and functional single ventricle complicated by infra-cardiac TAPVC treated with our own strategy were retrospectively studied. In two infants, DV stent placement was performed on the day of birth. In one case at 11 days of age. The risk of pulmonary vein obstruction was reduced, and on-pump surgery, including TAPVC repair, was performed on a standby basis. Since the rapid increase in hepatic enzymes occurred on postoperative day 0 to 1 in all cases, percutaneous stent occlusion was performed until postoperative day 3. The procedure improved liver function. One patient died due to severe atrioventricular valve regurgitation, one case underwent BCPS, and one patient was waiting to undergo. DV stent placement can avoid TAPVC repair in the early neonatal period. After TAPVC repair, the portosystemic shunt remained, resulting in hepatic dysfunction, but this could be improved by stent and vertical vein occlusion. A series of stepwise treatments can be useful to help such critically ill infants survive the high-risk neonatal period and achieve good BCPS circulation.

A case of eosinophilic granulomatosis with polyangiitis after prolonged intervals of an anti-interleukin-6 receptor antibody for rheumatoid arthritis.

An 83-year-old woman with a history of asthma complained of left abdominal pain and was admitted to our hospital. She was treated with tocilizumab, an anti-interleukin (IL)-6 receptor antibody, with a prolonged interval for rheumatoid arthritis (RA). Laboratory tests revealed a remarkable increase in eosinophil count and inflammatory markers with negative antineutrophil cytoplasmic antibodies. Echocardiography revealed pericardial fluid retention, and contrast-enhanced computed tomography revealed the thickening of the gastric antrum wall. Upper gastrointestinal endoscopy and biopsy revealed eosinophilic infiltration into the gastric mucosal epithelium. She was diagnosed with eosinophilic granulomatosis with polyangiitis (EGPA) with pericarditis and eosinophilic gastroenteritis. High-dose glucocorticoids with intermittent intravenous cyclophosphamide (IVCY) were initiated, resulting in remission. As IL-6 is involved in the pathogenesis of allergic diseases such as asthma, our case can provide insights into the pathogenic role of IL-6 in EGPA as the development of EGPA in our case may have been triggered by IL-6 signals enhanced with tocilizumab interval prolongation.

Broadband high-energy resolution hard x-ray spectroscopy using transition edge sensors at SPring-8.

We have succeeded in operating a transition-edge sensor (TES) spectrometer and evaluating its performance at the SPring-8 synchrotron x-ray light source. The TES spectrometer consists of a 240 pixel National Institute of Standards and Technology (NIST) TES system, and 220 pixels are operated simultaneously with an energy resolution of 4 eV at 6 keV at a rate of ∼1 c/s pixel-1. The tolerance for high count rates is evaluated in terms of energy resolution and live time fraction, leading to an empirical compromise of ∼2 × 103 c/s (all pixels) with an energy resolution of 5 eV at 6 keV. By utilizing the TES's wideband spectroscopic capability, simultaneous multi-element analysis is demonstrated for a standard sample. We conducted x-ray absorption near-edge structure (XANES) analysis in fluorescence mode using the TES spectrometer. The excellent energy resolution of the TES enabled us to detect weak fluorescence lines from dilute samples and trace elements that have previously been difficult to resolve due to the nearly overlapping emission lines of other dominant elements. The neighboring lines of As Kα and Pb Lα2 of the standard sample were clearly resolved, and the XANES of Pb Lα2 was obtained. Moreover, the x-ray spectrum from the small amount of Fe in aerosols was distinguished from the spectrum of a blank target, which helps us to understand the targets and the environment. These results are the first important step for the application of high resolution TES-based spectroscopy at hard x-ray synchrotron facilities.

Design and Synthesis of Cyclometalated Iridium(III) Complexes-Chromophore Hybrids that Exhibit Long-Emission Lifetimes Based on a Reversible Electronic Energy Transfer Mechanism.

We report on the design and synthesis of triscyclometalated iridium (Ir) complexes that contain aryloxy groups at the end of diamino linkers, which exhibit an extraordinarily long-emission lifetime, and were prepared by regioselective substitution reactions of fac-tris-homoleptic cyclometalated Ir complexes, fac-Ir(tpy)3 (tpy = 2-(4'-tolyl)pyridine). It was found that the Ir(tpy)3 complex, equipped with approximately one to six 6-N,N-dimethylamino-2-naphthoic acid (DMANA) groups through the appropriate alkyl linkers, exhibited remarkably long-emission lifetimes of up to 216 µs in DMSO/H2O at room temperature through a reversible electronic energy transfer effect between the Ir complex core and the organic chromophore moieties; however, under the same conditions, the lifetime of fac-Ir(tpy)3 was 1.4 µs. Regarding the mechanistic aspects, the relationship between the emission lifetimes of the Ir complexes and the structures and numbers of the conjugated chromophores, linker lengths, solvents, positions of the chromophores on the Ir(tpy)3 core, and related items are discussed.

[Clinical Outcome of Radiation Therapy for Solitary Lymph Node Metastasis of Gastric Cancer].

We report the clinical course of 6 gastric cancer patients who received radiation therapy at our hospital for solitary lymph node metastasis. The site of the metastatic lymph node was the clavicle, para-aorta, para-portal vein, common hepatic artery, and diaphragm in 1, 1, 2, 1, and 1 case, respectively. Median irradiation dose was 50[range, 45-50.4]Gy, and combination chemotherapy was administered in 4 cases. The clinical outcome was complete response and partial response in 3 cases each, with no adverse events associated with radiation therapy. The median progression-free survival was 11.3 months. In summary, local treatment by radiation therapy is one of the treatment options for patients with solitary lymph node metastasis of gastric cancer.

Accumulation of halogenated polycyclic aromatic hydrocarbons by different tuna species, determined by high-resolution gas chromatography Orbitrap mass spectrometry.

Halogenated polycyclic aromatic hydrocarbon (HPAH) concentrations in tissues from three tuna species Thunnus albacares (yellowfin tuna), Katsuwonus pelamis (skipjack tuna), and Auxis thazard (frigate tuna) were determined by high-resolution gas chromatography Orbitrap mass spectrometry. The tuna samples were collected from the Indian Ocean. The instrument conditions gave high mass accuracy at 0.9 m/z isolation width of the mass filter and a mass error of <±1.0 ppm for many HPAHs. A total of 29 of the 30 targets chlorinated PAHs (ClPAHs) and 20 of the 21 targets brominated PAHs (BrPAHs) were detected in the tuna muscle samples. The mean total ClPAH, BrPAH and PAH concentrations for tuna were 127.2, 156.6 and 682.8 ng/g lipid weight, respectively. The mean total ClPAH and BrPAH concentrations (ng/g lipid weight) in the tuna were considerably lower than that of PAH concentrations. The mean total ClPAH, BrPAH and PAH concentrations in T. albacares respectively were 185.8, 249.2 and 784.1 ng/g lipid weight, irrespective of the body sizes. The mean total ClPAH, BrPAH and PAH concentrations in K. pelamis respectively were 45.1, 24.8 and 555.6 ng/g lipid weight. The mean total ClPAH, BrPAH and PAH concentrations in A. thazard respectively were 34.09, 4.73 and 433.24 ng/g lipid weight. The total ClPAH concentrations and body weights significantly positively correlated for T. albacares. The mean total ClPAH concentration in white muscles was significantly higher (p < 0.05) for large than for small T. albacares. This suggests ClPAHs could bioaccumulate in T. albacares, possibly because they are poorly metabolized. The chlorinated phenanthrene and pyrene concentrations indicated tuna accumulate these compounds increasingly effectively as the tuna grow. This was the first time large numbers of HPAHs were found in biological samples. HPAHs may adversely affect the health of humans consuming tuna.

gas1 mutation extends chronological lifespan via Pmk1 and Sty1 MAPKs in Schizosaccharomyces pombe.

In the longevity research by using yeasts, chronological lifespan is defined as the survival time after entry into stationary phase. Previously, screening for long lived mutants of Schizosaccharomyces pombe was performed to identify the novel factors involved in longevity. From this screening, one long lived mutant called as No.36 was obtained. In this study, we identified the mutation caused in gas1+, which encodes glucanosyltransferase (gas1-287 mutation) is responsible for the longevity of No.36 mutant. Through the analysis of this mutant, we found that cell wall perturbing agent micafungin also extends chronological lifespan in fission yeast. This lifespan extension depended on both Pmk1 and Sty1 MAP kinases, and longevity caused by the gas1-287 mutation also depended on these kinases. In summary, we propose that the gas1-287 mutation causes longevity as the similar mechanism as cell wall stress depending on Pmk1 and Sty1 MAPK pathways.

Supramolecular chirality transformation driven by monodentate ligand binding to a coordinatively unsaturated self-assembly based on C 3-symmetric ligands.

Monodentate ligand binding is facilitated by supramolecular chirality transformations from propeller-shaped chirality into single-twist chirality by altering the self-assembly of C 3-symmetric chiral ligands. The C 3-symmetric chiral ligands (Im R 3Bz and Im S 3Bz) contain three chiral imidazole side arms (Im R  and Im S ) at the 1,3,5-positions of a central benzene ring. Upon coordination to zinc ions (Zn2+), which have a tetrahedral coordination preference, the C 3-symmetric chiral ligands assemble, in a stepwise manner, into a propeller-shaped assembly with a general formula (Im( R or S ) 3Bz)4(Zn2+)3. In this structure each Zn2+ ion coordinates to the three individual imidazole side arms. The resulting assembly is formally coordinatively unsaturated (coordination number, n = 3) and capable of accepting monodentate co-ligands (imidazole: ImH2) to afford a coordinatively saturated assembly [(ImH2)3(Im R 3Bz)4(Zn2+)3]. The preformed propeller-shaped chirality is preserved during this transformation. However, an excess of the monodentate co-ligand (ImH2/Zn2+ molar ratio of ∼1.7) alters the propeller-shaped assembly into a stacked dimer assembly [(ImH2) m (Im R 3Bz)2(Zn2+)3] (m = 4-6) with single-twist chirality. This switch alters the degree of enhancement and the circular dichroism (CD) pattern, suggesting a structural transition into a chiral object with a different shape. This architectural chirality transformation presents a new approach to forming dynamic coordination-assemblies, which have transformable geometric chiral structures.

Off-off-on chiroptical property switching of a pyrene luminophore by stepwise helicate formation.

Pyrene-based chiral ligands (LR and LS) consisting of two chiral imidazole sidearms at the 1,8-positions first form pyrene-bridged oligomers [(L(R or S))3(Zn2+)n], which are chiroptically inactive, with a low concentration of zinc ions (Zn2+). Upon addition of more Zn2+, chiroptically active coordination helicates ([(L(R or S))3(Zn2+)2]) are formed. The stepwise assembly process successfully facilitated an "off-off-on" chiroptical switching process of a pyrene luminophore controlled by the concentration of Zn2+. The resulting pyrene-bridged helicates exhibit high performance in terms of a dissymmetry factor of circular dichroism (|gCD| = 0.006) and circularly polarized luminescence (|gCPL| = 0.01).

Chiroptical Inversion of Europium(III) Complexes by Changing a Remote Stereogenic Center of a C2-Symmetric Bispyrrolidinoindoline Manifold.

As an effort to integrate natural products chemistry and coordination chemistry, a diastereomeric pair of chiral alkaloidal manifolds composed of a bispyrrolidinoindoline (BPI) framework was designed and synthesized to generate luminescent EuIII complexes with switchable chiroptical properties. The C2-symmetric alkaloidal manifolds were linked with bis(benzimidazolyl)pyridine (BBIPy) as an achiral metal-binding component through substituents installed at the stereogenic 2/2' positions of the BPI manifolds. The resulting diastereomeric pair of ligands, syn-L1 and anti-L2, allow pseudomirror symmetrical presentation of the metal-binding BBIPy units due to the stereogenic centers on the alkaloidal manifold. The ligand syn-L1 induces intramolecular coordination to form the 1:1 complex EuIII( syn-L1) composed of a single stranded metal helicate which exhibits a negative split Cotton effect. In contrast, the ligand anti-L2 led to a supramolecular assembly comprising the 2:2 complex EuIII2( anti-L2)2 consisting of a bimetallic double-stranded helicate which shows a positive split Cotton effect. Thus, the sp3 stereogenic centers in the BPI manifolds play pivotal roles in controlling both metal-ligand equilibria and chirality-switching of luminescent EuIII complexes. This approach, which exploits diastereomeric natural product-based manifolds, provides a relatively unexplored means for diversifying metal coordination modes and for controlling the chiroptical properties of the resultant luminescent lanthanoid complexes.

A Smart Sensing Method for Object Identification Using Circularly Polarized Luminescence from Coordination-Driven Self-Assembly.

The potential use of circularly polarized luminescence for object identification in a sensor application is demonstrated. New luminescence probes using pyrene derivatives as sensor luminophores were developed. (R,R)-Im2 Py and (S,S)-Im2 Py contain two chiral imidazole moieties at 1,6-positions through ethynyl spacers (angle between spacers ca. 180°). The probe molecules spontaneously self-assemble into chiral stacks (P or M helicity) upon coordination to metal ions with tetrahedral coordination (Zn2+ ). The chiral probes display neither circular dichroism (CD) nor circularly polarized luminescence (CPL) without metal ions. However, (R,R)-Im2 Py and (S,S)-Im2 Py exhibit intense chiroptical activity (CD and CPL) upon self-assembly with Zn2+ ions. (R,R)-Im2 Py and (S,S)-Im2 Py with chemical stimuli-responsibility allow sensing using the CPL signal as detection output, enabling us to discriminate between a signal from the target analyte and that from non-target species.

Development of novel and non-invasive diagnostic markers for lower urinary tract symptoms using urothelial cells in voided urine.

OBJECTIVES: We evaluated the association between lower urinary tract symptoms (LUTS) and the expression of connexin (Cx) and transient receptor potential (TRP) channel on urothelial cells non-invasively collected from voided urine in humans. METHODS: A total of 55 patients (36 males and 19 females, median age: 71 years old), who were followed up at University of Yamanashi Hospital, were enrolled in the present study. Urothelial cells were collected from voided urine of patients, and the mRNA expression of each subtype of Cxs and TRP channels was measured using quantitive real-time reverse transcription polymerase chain reaction. We then analyzed the correlation between the expression of Cxs and TRP channels and symptom scores in International Prostate Symptom Scoreand Overactive Bladder Symptom Score, in addition to Interstitial Cystitis Symptom Index (ICSI) from only interstitial cystitis (IC) patients. RESULTS: Non-adjusted statistical procedure using Spearman's rank-correlation showed that there were significant correlations between the following expressions and symptom scores; (positive correlations) Cx26 versus urgency score, Cx40 versus nocturia, TRPM2 versus intermittency, TRPV1 versus urge incontinence, (negative correlation) Cx40 versus intermittency, TRPM7 versus pollakisuria. However, a multiple comparison adjustment using Bonferroni correction showed that only Cx40 had a trend of correlation with nocturia in ICSI. CONCLUSIONS: The expressions of Cxs and TRP channels on urothelial cells in voided urine could be related to LUTS. Further analysis of urothelial cells in voided urine has the potential to reveal the mechanism of the LUTS and develop new markers with non-invasive methods.

Identification of a novel protein kinase that affects the chronological lifespan in fission yeast.

Chronological lifespan is defined by how long a cell can survive in a non-dividing state. In yeast, it is measured by viability after entry into the stationary phase. To understand the regulatory mechanisms of chronological lifespan in Schizosaccharomyces pombe, it is necessary to identify and characterize novel factors involved in the regulation of chronological lifespan. To this end, we have screened for a long-lived mutant and identified that novel gene nnk1+ that encodes an essential protein kinase is the determinant of chronological lifespan. We showed that the expression of major glucose transporter gene, ght5+, is decreased in the isolated nnk1-35 mutant, suggesting that Nnk1 protein is involved in the regulation of ght5+ The consumption of glucose in the growth medium after saturated growth was lower in the nnk1-35 mutant than that in wild-type cell. The isolated ght5 deletion mutant showed long-lived phenotype. Based on these results, we propose that Nnk1 regulates chronological lifespan through the regulation of ght5+ Nnk1 might coordinate glucose availability and lifespan in fission yeast.