The travails of women with severe mental illness and pregnancy.

Women with severe mental illness and pregnancy suffer substantial travails in accessing care for mental and perinatal health. Women with psychotic illnesses such as schizophrenia face higher risks of pregnancy and postnatal complications. Similarly, lack of access to holistic psychiatric care presents particular perils for these women and their children.

Contemporary Outcomes and Patterns of Injury Associated With Parachuting Accidents.

Background: Skydiving is an increasingly popular recreational activity in the United States and worldwide. While it is considered a high-risk sport, the United States Parachute Association reported a fatality of .28 per 100 000 jumps in 2022.

Loss of AID exacerbates the malignant progression of CLL.

Activation-induced cytidine deaminase (AID) has been implicated as both a positive and a negative factor in the progression of B cell chronic lymphocytic leukemia (CLL), but the role that it plays in the development and progression of this disease is still unclear. We generated an AID knockout CLL mouse model, AID/Eμ-TCL1, and found that these mice die significantly earlier than their AID-proficient counterparts. AID-deficient CLL cells exhibit a higher ER stress response compared to Eμ-TCL1 controls, particularly through activation of the IRE1/XBP1s pathway.

Post-cholecystectomy Hepatic Artery Pseudoaneurysm Rupture.

Pseudoaneurysm of the hepatic and/or less frequently the cystic artery is a rare but potentially fatal complication following laparoscopic cholecystectomy. While the procedure is safe with minimal morbidity, complications do occur even in experienced hands. Moreover, patient selection is of utmost importance.

Clinical update on public and private psychiatric practice shared-care partnerships - Can the twain work together?

Objective: We explore the previous research and current context regarding opportunities for shared-care partnerships between public and private psychiatric practice.

Conclusions: Since the early 2000s, when there was impetus for the development of public-private psychiatric shared-care models as part of a previous National Mental Health Strategy, there has been surprisingly little research and policy development. Given an apparent exodus of psychiatrists to private practice due to current challenges facing the public health sector, it is timely to reconsider models of private and public sector shared-care that may improve the quality of public mental healthcare.

Private psychiatry in Australia: reflections on career opportunities, benefits, and challenges.

Objective: To provide reflection on career opportunities, benefits and challenges, with regard to commencing private practice psychiatry in Australia.

Conclusions: There are varied opportunities for a career in private practice psychiatry. Private practice has benefits and challenges, distinct from public sector psychiatry; with moderately greater professional autonomy, facilitating the provision of expert mental healthcare for the community.

Through the looking-glass: private and public practice psychiatry in the RANZCP.

Objective: To provide reflections on the representation of and engagement with private practice psychiatrists by the Royal Australian and New Zealand College of Psychiatrists (RANZCP).

Conclusion: We consider some of the reasons for private psychiatrist disengagement with the RANZCP. We suggest approaches to better engage private psychiatrists in the RANZCP, including: involvement in mental health policy, improved committee representation, specific private practice and business training for Fellowship, broader private practice peer support networks (welfare, clinical research, leadership), tailored professional development, branch-based networks of public and private psychiatrists, and collaboration with specialist medical colleges and the Australian Medical Association.

Diagnosing and managing work-related mental health conditions in general practice: new Australian clinical practice guidelines.

Introduction: In Australia, mental health conditions (MHCs) arising from workplace factors are a leading cause of long term work incapacity and absenteeism. While most patients are treated in general practice, general practitioners report several challenges associated with diagnosing and managing workplace MHCs. This guideline, approved by the National Health and Medical Research Council and endorsed by the Royal Australian College of General Practitioners and the Australian College of Rural and Remote Medicine, is the first internationally to address the clinical complexities associated with diagnosing and managing work-related MHCs in general practice.

Altered X-chromosome inactivation in T cells may promote sex-biased autoimmune diseases.

Systemic lupus erythematosus (SLE) is an autoimmune disorder that predominantly affects women and is driven by autoreactive T cell-mediated inflammation. It is known that individuals with multiple X-chromosomes are at increased risk for developing SLE; however, the mechanisms underlying this genetic basis are unclear. Here, we use single cell imaging to determine the epigenetic features of the inactive X (Xi) in developing thymocytes, mature T cell subsets, and T cells from SLE patients and mice.

Diversity of Epigenetic Features of the Inactive X-Chromosome in NK Cells, Dendritic Cells, and Macrophages.

In females, the long non-coding RNA Xist drives X-chromosome Inactivation (XCI) to equalize X-linked gene dosage between sexes. Unlike other somatic cells, dynamic regulation of Xist RNA and heterochromatin marks on the inactive X (Xi) in female lymphocytes results in biallelic expression of some X-linked genes, including , and , implicated in sex-biased autoimmune diseases. We now find that while Xist RNA is dispersed across the nucleus in NK cells and dendritic cells (DCs) and partially co-localizes with H3K27me3 in bone marrow-derived macrophages, it is virtually absent in plasmacytoid DCs (p-DCs).

Loss of Xist RNA from the inactive X during B cell development is restored in a dynamic YY1-dependent two-step process in activated B cells.

X-chromosome inactivation (XCI) in female lymphocytes is uniquely regulated, as the inactive X (Xi) chromosome lacks localized Xist RNA and heterochromatin modifications. Epigenetic profiling reveals that Xist RNA is lost from the Xi at the pro-B cell stage and that additional heterochromatic modifications are gradually lost during B cell development. Activation of mature B cells restores Xist RNA and heterochromatin to the Xi in a dynamic two-step process that differs in timing and pattern, depending on the method of B cell stimulation.