The U.S. National Strategy for Suicide Prevention calls for states to identify supportive structures that encourage efficient, effective, and sustainable suicide prevention programming at the state, territorial, tribal, and local levels (HHS & Action Alliance, 2012). To meet this objective, the Suicide Prevention Resource Center (SPRC) completed a literature review and environmental scan, convened an advisory panel of suicide prevention experts, and conducted interviews with suicide prevention and policy experts to identify six essential state‐level infrastructure elements: Authorize—Designate a lead organization for suicide prevention in the state and give it the resources to put a state plan into practice. Lead—Maintain a dedicated leadership and core staff positions in order to enact the plan. Create collaboration within state government. Partner—Ensure a state‐level public‐private partnership with a shared vision for suicide prevention. Examine—Encourage the collection and analysis of high‐quality suicide data. Build—Support a multifaceted lifespan approach to suicide prevention across the state. Guide—Build state and local capacity for prevention. In this commentary, we recommend a framework for organizing an emerging evidence base on the infrastructure and systems that are needed to support an effective, sustainable, public health approach to suicide prevention.
This paper provides a review of engineering applications and computational methods used to analyze the dynamics of heart valve closures in healthy and diseased states. Computational methods are a cost-effective tool that can be used to evaluate the flow parameters of heart valves. Valve repair and replacement have long-term stability and biocompatibility issues, highlighting the need for a more robust method for resolving valvular disease. For example, while fluid–structure interaction analyses are still scarcely utilized to study aortic valves, computational fluid dynamics is used to assess the effect of different aortic valve morphologies on velocity profiles, flow patterns, helicity, wall shear stress, and oscillatory shear index in the thoracic aorta. It has been analyzed that computational flow dynamic analyses can be integrated with other methods to create a superior, more compatible method of understanding risk and compatibility.
Results of a recent experimental study challenge the widely-held belief that modern combat helmets are more effective at protecting soldiers against concussions. The research shows that helmets used during First World War without inner paddings may have an advantage in protecting soldiers’ brains from concussions when relying solely on cerebrospinal fluid. The present study explains this counterintuitive finding by revealing that while cerebrospinal fluid can prevent direct brain-to-skull contact during a single event, its protective capabilities diminish with each subsequent event occurring in quick succession—something conventional padded helmets appear to aggravate. The cerebrospinal fluid requires a certain amount of time to reset after an acceleration/deceleration event, which allows it to effectively provide cushioning for any subsequent events and protect against potential brain damage. However, an immediate occurrence of a subsequent event, when the fluid has no time to settle down, may significantly diminish the effectiveness of the fluid’s ability to provide adequate cushioning, thereby putting individuals at risk of serious injury. This new information may have implications for helmet design in the future and calls into question current assumptions regarding the best way to protect soldiers and athletes from concussions.
Autoimmune hepatitis (AIH) is a condition that affects the liver which, potentially, may render it fibrotic and eventually cirrhotic. This condition has many etiologies ranging from genetic predispositions and immunological defects to medication and environmental side effects. Essentially, we will explore the risks, presentation, diagnosis, and treatment of this condition as it relates to a medication-induced etiology. Here we report a case where a patient developed this condition from taking the antibiotic minocycline. The patient was treated with prednisone therapy and went into complete remission with no reoccurrence of AIH. The purpose of this case report is to highlight the fact that these cases have the potential to occur fairly sooner than expected, in a matter of weeks or months, after the induction of minocycline. Hence, carefully monitoring liver functions more frequently may aide in the prevention of minocycline-induced AIH.
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