bluuebunny/crossref_metadata_2025 huggingface dataset:
The Mouse Gene Noto Is Expressed in the Tail Bud and Essential for Its Morphogenesis
Authors: Zizic Mitrecic Marica , Mitrecic Dinko , Pochet Roland , Kostovic-Knezevic Ljiljana , Gajovic Srecko
Published: March 2010

The mouse transcription factor Noto is expressed in the notochord and involved in its development. Noto mouse mutants, Nototc/tc(truncate) and NotoGFP/GFP (Noto null mutant), exhibit a segmental lack of the notochord in the caudal part of the embryo and subsequent tail truncation in adult animals. In order to address the relationship between the tail bud (the undifferentiated mesenchymal cells in the tip of the embryo tail) and the caudal notochord, NotoGFP/GFP, a loss- of-function mutant, was analyzed. Taking advantage of NotoGFP/+ heterozygotes, we could track Noto-GFP-expressing cells from the tail bud over the tail cord to the caudal notochord, and confirm a morphological continuum from the tail bud mesenchyme to the caudal notochord. Loss of Noto affected tail bud morphogenesis: Noto-GFP-expressing cells were scattered in the tail bud mesenchyme. They segregated in the notochord-like structure within the medullary cord instead at the tail cord, which subsequently disappeared. In the tail cord, instead of the notochord, additional lumen of the tail gut was formed. These findings suggest that Noto is involved in both rearrangement and morphogenesis of the tail bud during notochord formation.
From Wellington to Bougainville: Migrating Meanings and the Joys of Approximation in Lloyd Jones’ Mister Pip
Authors: Norridge Zoë
Published: March 2010

First published in 2006, Lloyd Jones’ novel about village life on the Pacific island of Bougainville has been the subject of enthusiastic critical reception by the international media. However, it has rarely been discussed in the academic context of Papua New Guinean literature. This article will examine how the New Zealand-born novelist empathizes with his principle character, a young girl from the island, and what role this gesture of identification plays in the literary response to the Bougainville secession struggle. Highlighting the novel’s colonial and postcolonial context, I argue that Mister Pip is less a narrative about the specifics of life on the island and more a story about other stories and their potential to allow us into the lives of others, even when that invitation is politically complex and fraught with ideological implications.
The Future of Nostalgia: Reclaiming Memory in Tan Pin Pin’s Invisible City and Alfian Sa’at’s A History of Amnesia
Authors: Leow Joanne
Published: March 2010

Ideas of nostalgia in Singaporean writing and art often see classic themes of lost spaces, times and innocence at what sociologist Chua Beng Huat refers to as “the level of the individual biography and of collective memories”. However, contemporary Singaporean artists, who have no connection to the rural past, approach the idea of nostalgia in very different ways from their literary and artistic forebears. By analysing Tan Pin Pin’s film Invisible City and Alfian Sa’at’s poetry collection A History of Amnesia, this paper shows how these artists seek to politicize the idea of nostalgia through their fragmented yet lyrical portraits of Singaporean history, and use their art to critique the lack of memory in the official history of Singapore. Their engagement with this transformed nostalgia for elements of the past that can be salvaged, either non-fictively or fictively, represents an important step in reclaiming the agency of memory for a new generation of Singaporean artists and writers.
Natural History of Concussion in Sport
Authors: Makdissi Michael , Darby David , Maruff Paul , Ugoni Antony , Brukner Peter , McCrory Paul R.
Published: March 2010

Background

Evidence-based clinical data are required for safe return to play after concussion in sport.

Purpose

The objective of this study was to describe the natural history of concussion in sport and identify clinical features associated with more severe concussive injury, using return-to-sport decisions as a surrogate measure of injury severity.

Study Design

Cohort study (prognosis); Level of evidence, 3.

Methods

Male elite senior, elite junior, and community-based Australian Rules football players had preseason baseline cognitive testing (Digit Symbol Substitution Test, Trail-Making Test—Part B, and CogSport computerized test battery). Players were recruited into the study after a concussive injury sustained while playing football. Concussed players were tested serially until all clinical features of their injury had resolved.

Results

Of 1015 players, 88 concussions were observed in 78 players. Concussion-associated symptoms lasted an average of 48.6 hours (95% confidence interval, 39.5-57.7 hours) with delayed return to sport correlated with ≥4 symptoms, headache lasting ≥60 hours, or self-reported “fatigue/fogginess.” Cognitive deficits using the Digit Symbol Substitution Test and Trail-Making Test—part B recovered concomitantly with symptoms, but computerized test results recovered 2 to 3 days later and remained impaired in 35% of concussed players after symptom resolution.

Conclusion

Delayed return to sport was associated with initially greater symptom load, prolonged headache, or subjective concentration deficits. Cognitive testing recovery varied, taking 2 to 3 days longer for computerized tests, suggesting greater sensitivity to impairment. Therefore, symptom assessment alone may be predictive of but may underestimate time to complete recovery, which may be better estimated with computerized cognitive testing.
Is Chemical Incompatibility Responsible for Chondrocyte Death Induced by Local Anesthetics?
Authors: Bogatch Michael T. , Ferachi David G. , Kyle Bart , Popinchalk Sam , Howell Melanie H. , Ge Dongxia , You Zongbing , Savoie Felix H.
Published: March 2010

Background

Chondrolysis associated with intra-articular administration of local anesthetics has been attributed to chondrocyte death induced by the local anesthetics. The mechanism of how the local anesthetics cause chondrocyte death is not clear.

Purpose

This study was conducted to determine whether and how the local anesthetics cause chondrocyte death.

Study Design

Controlled laboratory study.

Methods

Bovine articular chondrocytes in suspension culture were treated for 1 hour with phosphate-buffered saline or phosphate-buffered saline/medium mixture (as controls); 1% lidocaine alone; 0.25% to 0.5% bupivacaine alone; phosphate-buffered saline with pH values of 4.5, 3.8, 3.4, and 2.4; or mixtures of the local anesthetics and cell culture medium or human synovial fluid. Chondrocyte viability was analyzed by flow cytometry using the LIVE/DEAD Viability/Cytotoxicity Kit.

Results

In 1% lidocaine-alone or 0.25% to 0.5% bupivacaine-alone groups, the rate of cell death was 11.8% to 13.3% of bovine articular chondrocytes, whereas the phosphate-buffered saline control had 8.4% of cell death. Increased chondrocyte death was only found when the pH value of phosphate-buffered saline dropped to ≤3.4. In contrast, when bupivacaine was mixed with cell culture medium, needle-like crystals were formed, which was accompanied with 100% death of chondrocytes. Lidocaine did not form visible crystals when it was mixed with culture medium, but the mixtures caused death of over 96% of chondrocytes (P < .001).

Conclusion

Less than 5% of chondrocyte death was attributable to the anesthetics when applied to the cells alone or in phosphate-buffered saline—diluted solution. Acidity (as low as pH 3.8) or epinephrine in the anesthetic solutions could not account for chondrocyte death. However, chemical incompatibility between the local anesthetics and cell culture medium or human synovial fluid may be the cause of chondrocyte death.

Clinical Relevance

Intra-articular administration of lidocaine and bupivacaine is not an indicated usage of either anesthetic, although such a usage has become a common practice. Physicians should be aware of the potential incompatibility of the drug and synovial fluid.
Using Technology to Create Motivating Social Skills Lessons
Authors: Cumming Therese M.
Published: March 2010

Many students with emotional and behavioral disabilities do not receive the social skills training required for success in inclusive school settings or life after graduation. Teachers often cite lack of training and motivation as factors explaining this. This article describes a teaching sequence that enables students to create and utilize their own multimedia social skills training modules. This intervention shows promise for social skills training in increasing student motivation, engagement, and generalization. Step-by-step instructions for teacher and student training and facilitation are included.
Preparing Students With Mild Disabilities for Taking State and District Tests
Authors: Conderman Greg , Pedersen Theresa
Published: March 2010

Recent legislation such as No Child Left Behind and the Individuals with Disabilities Education Improvement Act of 2004 has made significant changes in how all students are assessed. Because scores on state and district tests have important implications for students, parents, and school personnel, teachers and students should approach testing with a serious and positive attitude. This article highlights several ways to prepare students with mild disabilities for taking state and district standardized assessments which can be effective practices for teachers. Readers may wish to choose from these practical suggestions to help their students perform optimally on state and district tests.
Shift in sleep apnoea type in heart failure patients in the CANPAP trial
Authors: Ryan C. M. , Floras J. S. , Logan A. G. , Kimoff R. J. , Series F. , Morrison D. , Ferguson K. A. , Belenkie I. , Pfeifer M. , Fleetham J. , Hanly P. J. , Smilovitch M. , Arzt M. , Bradley T. D.
Published: March 2010

In patients with heart failure (HF), the predominant type of sleep apnoea can change over time in association with alterations in circulation time.

The aim of this study was to determine whether, in some patients with HF, a spontaneous shift from mainly central (>50% central events) to mainly obstructive (>50% obstructive events) sleep apnoea (CSA and OSA, respectively) over time coincides with improvement in left ventricular ejection fraction (LVEF). Therefore, sleep studies and LVEFs of HF patients with CSA from the control arm of the Canadian Continuous Positive Airway Pressure for Patients with Central Sleep Apnea and Heart Failure (CANPAP) trial were examined to determine whether some converted to mainly OSA and, if so, whether this was associated with an increase in LVEF.

Of 98 patients with follow-up sleep studies and LVEFs, 18 converted spontaneously to predominantly OSA. Compared with those in the nonconversion group, those in the conversion group had a significantly greater increase in the LVEF (2.8%versus-0.07%) and a significantly greater fall in the lung-to-ear circulation time (-7.6 sversus0.6 s).

In patients with HF, spontaneous conversion from predominantly CSA to OSA is associated with an improvement in left ventricular systolic function. Future studies will be necessary to further examine this relationship.
Idiopathic pulmonary fibrosis: a disease with similarities and links to cancer biology
Authors: Vancheri C. , Failla M. , Crimi N. , Raghu G.
Published: March 2010

Several clinical trials have recently targeted specific pathways implicated in the pathogenesis of idiopathic pulmonary fibrosis (IPF). However, IPF remains plagued by a median survival of 3 yrs and emphasises the need for further research with new insights and perspectives. The prevailing pathogenic hypotheses assume that either an inflammatory process or an independent epithelial/fibroblastic disorder may propagate the disease process. Based on knowledge developed with considerable scientific evidence, we provide our perspectives with an alternative point of view that IPF be considered as a neoproliferative disorder of the lung. Genetic alterations, response to growth and inhibitory signals, resistance to apoptosis, myofibroblast origin and behaviour, altered cellular communications, and intracellular signalling pathways are all fundamental pathogenic hallmarks of both IPF and cancer. The concept of IPF as a lethal malignant disorder of the lung might extend beyond the pathogenic link between these two diseases and disclose new pathogenic mechanisms leading to novel therapeutic options, adopted from cancer biology. Moreover, this vision might dawn the awareness of the public, political and scientific community of this devastating disease from an angle different from the current perception and provoke new ideas and studies to get a better understanding to control the otherwise relentless progressive disease.
Therapeutic implications of the pathophysiology of COPD
Authors: Macklem P. T.
Published: March 2010

This review examines 18 studies published ≥30 yrs ago. They show that the earliest manifestation of chronic obstructive pulmonary disease (COPD) is an increase in residual volume suggesting that the natural history of COPD is a progressive increase in gas trapping with a decreasing vital capacity (VC). The reduction in VC forces the forced expiratory volume in 1 s to decline with it. This is aggravated by rapid shallow breathing leading to dynamic hyperinflation. The earlier studies show that this is energetically opposite to a minimal work or force pattern and is responsible for dyspnoea and exercise limitation.

This information, available for >30 yrs leads to three virtually untested hypotheses: 1) training patients to breathe slowly and deeply transiently during exercise should decrease the work of breathing, dynamic hyperinflation and improve exercise performance; 2) rapid shallow breathing is caused by alveolar and bronchial inflammation that stimulates non-myelinated vagal C-fibre afferents, which are known to cause this breathing pattern; and 3) if so, therapeutic efforts to block these afferents might restore a slow-deep pattern and be beneficial, particularly in COPD exacerbations.
Heliox, dyspnoea and exercise in COPD
Authors: Hunt T. , Williams M. T. , Frith P. , Schembri D.
Published: March 2010

One of the most important determinants of physical and mental well-being of people with chronic obstructive pulmonary disease (COPD) is participation in physical activity. The ability to alter the sensation of dyspnoea during exercise may improve both exercise duration and intensity. Despite the low density, inert nature, strong safety profile and multiple applications of helium gas, the potential benefit of helium–oxygen gas mixtures as an adjunct therapy to modify disease symptoms and exercise capabilities in obstructive lung diseases has only recently been explored.

This is a systematic review of the available peer-reviewed evidence exploring whether symptom modification (perceived levels of dyspnoea) and exercise performance in COPD (either intensity or duration of work) are modified by inhalation of Heliox. Eight experimental studies met inclusion for this review. A variety of methodologies and outcome variables were used negating meta-analysis and hampering direct comparison between interventions.

Overall, there was high level of evidence with a low risk of bias supporting Heliox's effectiveness in improving the intensity and endurance of exercise when compared to room air for people with COPD. Little conclusive evidence was found to determine whether Heliox altered the sensation of dyspnoea during exercise.
Noninvasive positive pressure ventilation in acute asthmatic attack
Authors: Soroksky A. , Klinowski E. , Ilgyev E. , Mizrachi A. , Miller A. , Ben Yehuda T. M. , Shpirer I. , Leonov Y.
Published: March 2010

Asthma is characterised by reversible airway obstruction. In most patients, control of disease activity is easily achieved. However, in a small minority, asthma may be fatal. Between the two extremes lie patients with severe asthmatic attacks, refractory to standard treatment. These patients are at an increased risk of recurrent severe attacks, with respiratory failure, and mechanical ventilation.

Invasive mechanical ventilation of the asthmatic patient is associated with a higher risk of complications and, therefore, is a measure of last resort.

Noninvasive positive pressure ventilation (NPPV) is another treatment modality that may be beneficial in patients with severe asthmatic attack who are at an increased risk of developing respiratory failure. These patients have the potential to benefit from early respiratory support in the form of NPPV. However, reports of NPPV in asthmatic patients are scarce, and its usage in asthmatic attacks is, therefore, still controversial. Only a few reports of NPPV in asthma have been published over the last decade. These studies mostly involve small numbers of patients and those who have problematic methodology.

In this article we review the available evidence for NPPV in asthma and try to formulate our recommendations for NPPV application in asthma based on the available evidence and reports.
Perspectives on novel therapeutic strategies for right heart failure in pulmonary arterial hypertension: lessons from the left heart
Authors: Handoko M. L. , de Man F. S. , Allaart C. P. , Paulus W. J. , Westerhof N. , Vonk-Noordegraaf A.
Published: March 2010

Right heart function is the main determinant of prognosis in pulmonary arterial hypertension (PAH). At present, no treatments are currently available that directly target the right ventricle, as we will demonstrate in this article.

Meta-analysis of clinical trials in PAH revealed that current PAH medication seems to have limited cardiac-specific effects when analysed by the pump-function graph. Driven by the hypothesis that “left” and right heart failure might share important underlying pathophysiological mechanisms, we evaluated the clinical potential of left heart failure (LHF) therapies for PAH, based on currently available literature.

As in LHF, the sympathetic nervous system and the renin–angiotension–aldosterone system are highly activated in PAH. From LHF we know that intervening in this process,e.g.by angiotensin-converting enzyme inhibition or β-blockade, is beneficial in the long run. Therefore, these medications could be also beneficial in PAH. Furthermore, the incidence of sudden cardiac death in PAH could be reduced by implantable cardioverter-defibrillators. Finally, pilot studies have demonstrated that interventricular dyssynchrony, present at end-stage PAH, responded favourably to cardiac resynchronisation therapy as well.

In conclusion, therapies for LHF might be relevant for PAH. However, before they can be implemented in PAH management, safety and efficacy should be evaluated first in well-designed clinical trials.
Diagnostic testing to guide the management of chronic thromboembolic pulmonary hypertension: state of the art
Authors: Pepke-Zaba J.
Published: March 2010

Chronic thromboembolic pulmonary hypertension (CTEPH) is a life-threatening and debilitating disease affecting up to 5% of survivors of pulmonary embolism. Diagnostic testing is important to distinguish it from other forms of pulmonary hypertension and to assess the feasibility of pulmonary endarterectomy.

This review provides an up-to-date perspective on the diagnosis and assessment of the disease. Patients with CTEPH often have a history of pulmonary embolism, deep-vein thrombosis, thrombophilia, splenectomy, ventriculo-atrial shunt, inflammatory bowel disease or malignancy. Chest radiography may reveal pulmonary infarcts. CTEPH is often diagnosed as a wedge-shaped perfusion defect with normal ventilation scan during ventilation–perfusion scintigraphy, but multi-slice computed tomography angiography may be needed for differential diagnosis.

Right heart catheterisation is required for diagnostic confirmation. Suitability for surgery is assessed by evaluating the number of obstructed vessels which could be disobliterated in the context of the pulmonary vascular resistance. Pulmonary vascular resistance that is out of proportion to evident obstructions is indicative of distal disease. Conventional pulmonary angiography, multi-slice computed tomography angiography and, potentially, magnetic resonance imaging can aid the decision to operate, but risk stratification systems are needed.

In conclusion, CTEPH can be cured surgically, providing that patients are diagnosed and assessed using the appropriate techniques.
Surgical and post-operative treatment of chronic thromboembolic pulmonary hypertension
Authors: Mayer E.
Published: March 2010

Patients with chronic thromboembolic pulmonary hypertension (CTEPH) have fibrous obstructions in their proximal pulmonary arteries, as well as a variable degree of secondary vascular remodelling of distal, surgically inaccessible, small pulmonary vessels.

Pulmonary endarterectomy (PEA) is currently the only potentially curative treatment option for CTEPH, although it is not known whether it has a beneficial effect on established secondary remodelling. Medical pre-treatment with therapies specific for pulmonary hypertension is often used as a bridge to PEA.

The aim of PEA is the mechanical removal of the proximal fibrous pulmonary artery obstruction as completely as possible while avoiding vascular injury within the lung. The challenge is to find and follow the correct pulmonary artery endarterectomy plane in the time allowed during brief periods of circulatory arrest.

Learning the operative technique is a complex process and, thus, early mortality after PEA decreases with increasing levels of surgical training and experience. Most patients experience lasting symptomatic and haemodynamic improvements after PEA, with only 10–20% having persistent or recurrent pulmonary hypertension after surgery.
Investigational therapeutics targeting the IL-4/IL-13/STAT-6 pathway for the treatment of asthma
Authors: Oh C. K. , Geba G. P. , Molfino N.
Published: March 2010

Asthma is a complex, persistent, inflammatory disease characterised by airway hyperresponsiveness in association with airway inflammation. Studies suggest that regular use of high-dose inhaled corticosteroids and long-acting bronchodilators or omalizumab (a humanised monoclonal antibody that binds to immunoglobulin E and is often used as next-step therapy) may not be sufficient to provide asthma control in all patients, highlighting an important unmet need. Interleukin-4, interleukin-13, and the signal transducer and activator of transcription factor-6 are key components in the development of airway inflammation, mucus production, and airway hyperresponsiveness in asthma. Biological compounds targeting these molecules may provide a new therapeutic modality for patients with uncontrolled severe asthma. The purpose of this review is to summarise current studies of compounds targeting the interleukin-4/interleukin-13 pathway and to provide a rationale for the development of such compounds for this use.
The Genomics Education Partnership: Successful Integration of Research into Laboratory Classes at a Diverse Group of Undergraduate Institutions
Authors: Shaffer Christopher D. , Alvarez Consuelo , Bailey Cheryl , Barnard Daron , Bhalla Satish , Chandrasekaran Chitra , Chandrasekaran Vidya , Chung Hui-Min , Dorer Douglas R. , Du Chunguang , Eckdahl Todd T. , Poet Jeff L. , Frohlich Donald , Goodman Anya L. , Gosser Yuying , Hauser Charles , Hoopes Laura L.M. , Johnson Diana , Jones Christopher J. , Kaehler Marian , Kokan Nighat , Kopp Olga R. , Kuleck Gary A. , McNeil Gerard , Moss Robert , Myka Jennifer L. , Nagengast Alexis , Morris Robert , Overvoorde Paul J. , Shoop Elizabeth , Parrish Susan , Reed Kelynne , Regisford E. Gloria , Revie Dennis , Rosenwald Anne G. , Saville Ken , Schroeder Stephanie , Shaw Mary , Skuse Gary , Smith Christopher , Smith Mary , Spana Eric P. , Spratt Mary , Stamm Joyce , Thompson Jeff S. , Wawersik Matthew , Wilson Barbara A. , Youngblom Jim , Leung Wilson , Buhler Jeremy , Mardis Elaine R. , Lopatto David , Elgin Sarah C.R.
Published: March 2010

Genomics is not only essential for students to understand biology but also provides unprecedented opportunities for undergraduate research. The goal of the Genomics Education Partnership (GEP), a collaboration between a growing number of colleges and universities around the country and the Department of Biology and Genome Center of Washington University in St. Louis, is to provide such research opportunities. Using a versatile curriculum that has been adapted to many different class settings, GEP undergraduates undertake projects to bring draft-quality genomic sequence up to high quality and/or participate in the annotation of these sequences. GEP undergraduates have improved more than 2 million bases of draft genomic sequence from several species of Drosophila and have produced hundreds of gene models using evidence-based manual annotation. Students appreciate their ability to make a contribution to ongoing research, and report increased independence and a more active learning approach after participation in GEP projects. They show knowledge gains on pre- and postcourse quizzes about genes and genomes and in bioinformatic analysis. Participating faculty also report professional gains, increased access to genomics-related technology, and an overall positive experience. We have found that using a genomics research project as the core of a laboratory course is rewarding for both faculty and students.
Educational Challenges of Molecular Life Science: Characteristics and Implications for Education and Research
Authors: Tibell Lena A.E. , Rundgren Carl-Johan
Published: March 2010

Molecular life science is one of the fastest-growing fields of scientific and technical innovation, and biotechnology has profound effects on many aspects of daily life—often with deep, ethical dimensions. At the same time, the content is inherently complex, highly abstract, and deeply rooted in diverse disciplines ranging from “pure sciences,” such as math, chemistry, and physics, through “applied sciences,” such as medicine and agriculture, to subjects that are traditionally within the remit of humanities, notably philosophy and ethics. Together, these features pose diverse, important, and exciting challenges for tomorrow's teachers and educational establishments. With backgrounds in molecular life science research and secondary life science teaching, we (Tibell and Rundgren, respectively) bring different experiences, perspectives, concerns, and awareness of these issues. Taking the nature of the discipline as a starting point, we highlight important facets of molecular life science that are both characteristic of the domain and challenging for learning and education. Of these challenges, we focus most detail on content, reasoning difficulties, and communication issues. We also discuss implications for education research and teaching in the molecular life sciences.
The Src/PI3K/Akt pathway may play a key role in the production of IL-17 in obesity
Authors: Chen Jiezhong
Published: March 2010

The Src/PI3K/Akt pathway is activated in obesity by many altered factors (such as insulin, leptin, insulin-like growth factor, IL-6 and TNF-alpha) and it may play a key role in the increased production of IL-17 in response to zymosan stimulation.
‘Living upside down’: being a young carer of a parent with mental illness
Authors: Cooklin Alan
Published: March 2010

Most children and young people who have a parent with mental illness will not think of themselves as carers. They may think of themselves as surviving, as lonely and isolated, and of suffering all the common experiences listed in this article. Many parents with mental illness will not acknowledge that their child has become their carer rather than the converse. So many children and young people may be left vulnerable to sometimes extremely damaging and distressing situations but without a role that recognises their contribution or even commands appropriate respect. There is a danger that simply defining these children and young people as ‘young carers’ may provide a cloak of acceptability for allowing quite intolerable demands to be made on them. However, young carers do have some level of support in the UK in the form of young carers' groups. So, with the above provisos, that is the focus of this article.
Psychoeducation for bipolar disorder
Authors: Smith Daniel , Jones Ian , Simpson Sharon
Published: March 2010

Bipolar disorder is a complex disorder of mood and behaviour that requires a multimodal treatment approach. In the past 10 years there has been growing interest in psychoeducational interventions delivered as adjuncts to conventional management. Several studies have tested the effectiveness of psychoeducational treatments delivered in a variety of formats. In this article we assess the evidence for the efficacy of these interventions and consider the likely future role of structured psychoeducational treatments in clinical practice.
Epileptic, organic and genetic vulnerabilities for timing of the
development of interictal psychosis
Authors: Adachi Naoto , Akanuma Nozomi , Ito Masumi , Kato Masaaki , Hara Tsunekatsu , Oana Yasunori , Matsuura Masato , Okubo Yoshiro , Onuma Teiichi
Published: March 2010

Background

Age at the first psychotic episode and an interval between the onset of
epilepsy and that of psychosis reflect developmental processes of
interictal psychosis. However, factors relating to these indices remain
unknown.

Aims

To identify clinical variables that are associated with the timing of the
development of interictal psychosis.

Method

In 285 adults with epilepsy with interictal psychosis, effects of
epileptic (epilepsy type), organic (intellectual functioning) and genetic
(family history of psychosis) variables on timing of the development of
psychosis were examined.

Results

The mean interval between the onset of epilepsy and that of psychosis was
14.4 years. Some psychosis occurred within a few years of the first
seizure. Generalised epilepsy, normal intellectual function and a
positive family history of psychosis were associated with early onset of
psychosis.

Conclusions

Early development of interictal psychosis in people with epilepsy may
reflect other individual vulnerabilities to psychosis rather than
epilepsy-related damage.
Restricting the means of suicide by charcoal
burning
Authors: Yip Paul S. F. , Law C. K. , Fu King-Wa , Law Y. W. , Wong Paul W. C. , Xu Ying
Published: March 2010

We conducted an exploratory controlled trial to examine the efficacy of
restricting access to charcoal in preventing suicides from carbon monoxide
poisoning by charcoal burning in Hong Kong. All charcoal packs were removed
from the open shelves of major retail outlets in the intervention region for
12 months; in the control region, charcoal packs were displayed as usual.
The suicide rate from charcoal burning was reduced by a statistically
significant margin in the intervention region (P<0.05)
but not in the control region. We observed no significant change in the
suicide rate using other methods in either location.
Efficacy of cognitive–behavioural therapy and other psychological treatments for adult depression: meta-analytic study of publication bias
Authors: Cuijpers Pim , Smit Filip , Bohlmeijer Ernst , Hollon Steven D. , Andersson Gerhard
Published: March 2010

Background

It is not clear whether the effects of cognitive–behavioural therapy and other psychotherapies have been overestimated because of publication bias.

Aims

To examine indicators of publication bias in randomised controlled trials of psychotherapy for adult depression.

Method

We examined effect sizes of 117 trials with 175 comparisons between psychotherapy and control conditions. As indicators of publication bias we examined funnel plots, calculated adjusted effect sizes after publication had been taken into account using Duval & Tweedie's procedure, and tested the symmetry of the funnel plots using the Begg & Mazumdar rank correlation test and Egger's test.

Results

The mean effect size was 0.67, which was reduced after adjustment for publication bias to 0.42 (51 imputed studies). Both Begg & Mazumbar's test and Egger's test were highly significant (P<0.001).

Conclusions

The effects of psychotherapy for adult depression seem to be overestimated considerably because of publication bias.
Bifrontal, bitemporal and right unilateral electrode placement in ECT: randomised trial
Authors: Kellner Charles H. , Knapp Rebecca , Husain Mustafa M. , Rasmussen Keith , Sampson Shirlene , Cullum Munro , McClintock Shawn M. , Tobias Kristen G. , Martino Celena , Mueller Martina , Bailine Samuel H. , Fink Max , Petrides Georgios
Published: March 2010

Background

Electroconvulsive therapy (ECT) is an effective treatment for major depression. Optimising efficacy and minimising cognitive impairment are goals of ongoing technical refinements.

Aims

To compare the efficacy and cognitive effects of a novel electrode placement, bifrontal, with two standard electrode placements, bitemporal and right unilateral in ECT.

Method

This multicentre randomised, double-blind, controlled trial (NCT00069407) was carried out from 2001 to 2006. A total of 230 individuals with major depression, bipolar and unipolar, were randomly assigned to one of three electrode placements during a course of ECT: bifrontal at one and a half times seizure threshold, bitemporal at one and a half times seizure threshold and right unilateral at six times seizure threshold.

Results

All three electrode placements resulted in both clinically and statistically significant antidepressant outcomes. Remission rates were 55% (95% CI 43–66%) with right unilateral, 61% with bifrontal (95% CI 50–71%) and 64% (95% CI 53–75%) with bitemporal. Bitemporal resulted in a more rapid decline in symptom ratings over the early course of treatment. Cognitive data revealed few differences between the electrode placements on a variety of neuropsychological instruments.

Conclusions

Each electrode placement is a very effective antidepressant treatment when given with appropriate electrical dosing. Bitemporal leads to more rapid symptom reduction and should be considered the preferred placement for urgent clinical situations. The cognitive profile of bifrontal is not substantially different from that of bitemporal.
Rapid-cycling bipolar disorder: cross-national community
study
Authors: Lee Sing , Tsang Adley , Kessler Ronald C. , Jin Robert , Sampson Nancy , Andrade Laura , Karam Elie G. , Mora Maria Elena Medina , Merikangas Kathleen , Nakane Yoshibumi , Popovici Daniela Georgeta , Posada-Villa Jose , Sagar Rajesh , Wells J. Elisabeth , Zarkov Zahari , Petukhova Maria
Published: March 2010

Background

The epidemiology of rapid-cycling bipolar disorder in the community is
largely unknown.

Aims

To investigate the epidemiological characteristics of rapid-cycling and
non-rapid-cycling bipolar disorder in a large cross-national community
sample.

Method

The Composite International Diagnostic Interview (CIDI version 3.0) was
used to examine the prevalence, severity, comorbidity, impairment,
suicidality, sociodemographics, childhood adversity and treatment of
rapid-cycling and non-rapid-cycling bipolar disorder in ten countries
(n = 54 257).

Results

The 12-month prevalence of rapid-cycling bipolar disorder was 0.3%.
Roughly a third and two-fifths of participants with lifetime and 12-month
bipolar disorder respectively met criteria for rapid cycling. Compared
with the non-rapid-cycling, rapid-cycling bipolar disorder was associated
with younger age at onset, higher persistence, more severe depressive
symptoms, greater impairment from depressive symptoms, more out-of-role
days from mania/hypomania, more anxiety disorders and an increased
likelihood of using health services. Associations regarding childhood,
family and other sociodemographic correlates were less clear cut.

Conclusions

The community epidemiological profile of rapid-cycling bipolar disorder
confirms most but not all current clinically based knowledge about the
illness.
Repeat self-harm: application of hurdle models
Authors: Bethell Jennifer , Rhodes Anne E. , Bondy Susan J. , Lou W. Y. Wendy , Guttmann Astrid
Published: March 2010

Among those who present to the emergency department for self-harm, many will
repeat. Self-harm repetition is an outcome of interest in both observational
and intervention studies. However, few such studies analyse the number of
repeat self-harm presentations. Here, hurdle models are introduced as a
potentially useful statistical method for these analyses. Emergency
department data from the Province of Ontario, Canada, are used to illustrate
an example of implementing hurdle models and interpreting their results.
Watching internet pharmacies
Authors: Ghodse Hamid
Published: March 2010

The number of illegal internet pharmacies selling prescription-only
medicines without a prescription is increasing. Large quantities of drugs
are dispensed, making drugs of abuse readily available, and further risks
are posed by counterfeit medication. Urgent national and international
action is required to stop further proliferation of illegal pharmacies.
Improving physical health monitoring for out-patients on antipsychotic medication
Authors: Gonzalez Carlos , Ahammed Niyaz , Fisher Robert
Published: March 2010

Aims and method

Mental illness is associated with increased physical morbidity. We aimed to assess and improve the routine blood testing of prescribed antipsychotics in out-patients from a busy London inner city area. Audit findings were presented locally to prescribers, together with educational suggestions to improve physical health assessment.

Results

Initially, the numbers monitored were low in the overall number of 126 patients included in the first audit. Following the intervention, this improved significantly in the second audit (of 106 patients).

Clinical implications

A simple one-page monitoring prompt and an educational intervention could significantly increase the adherence to routine blood-testing guidelines. Better physical screening may help reduce physical morbidity and mortality, and improve the quality of life of individuals with mental illness.
Use of psychotropic medication among psychiatric out-patients with personality disorder
Authors: Baker-Glenn Elena , Steels Mark , Evans Chris
Published: March 2010

Aims and method

This survey was conducted to ascertain the use of psychotropic medication in the treatment of patients with a primary diagnosis of personality disorder within a community mental health team. A sample of 113 patients were identified, their notes were reviewed, and details of current medications and diagnoses recorded.

Results

Four-fifths of patients were prescribed at least one psychotropic medication. The most commonly prescribed medication class was antidepressant, comprising almost half of prescriptions. The total annual cost across 107 patients was £37 000.

Clinical implications

Medication is commonly prescribed to people with personality disorder but more needs to be known about why prescriptions are started and stopped, what the benefits are, and how these are judged by patients and care teams.
A modernised psychotherapy curriculum for a modernised profession
Authors: Denman Chess
Published: March 2010

This paper outlines recent revisions to the psychotherapy elements of the core psychiatric training curriculum of the Royal College of Psychiatrists. The reasons why psychotherapy training is important as part of psychiatry training are developed and objections to the inclusion of this element are countered. The paper sets out the reasoning that led to the revisions in the training required and discusses the obstacles to the implementation of good-quality training in this area and suggests ways in which they can be overcome.
The Debt and Mental Health Evidence Form
Authors: Fitch Chris , Chaplin Robert , Tulloch Simon
Published: March 2010

Aims and method

To develop a standardised clinical information form which helps health professionals provide clear and relevant information about individuals who believe mental disorders affect their ability to repay debt and have consented to creditor organisations or money advisors approaching professionals for evidence. The six-question form was evaluated by three stakeholder groups.

Results

Overall, 35 responses were received from creditors/money advisors, 28 from mental health professionals and 29 from service users/carers. All questions scored acceptable levels of clarity and three questions scored acceptable relevance levels. Qualitative data were used to revise questions on the basis of concerns expressed by stakeholders about sharing diagnostic data, providing prognoses, and the risk of creditor misunderstanding.

Clinical implications

The form is likely to be an acceptable standardised means by which health professionals can elicit information on debt from individuals with mental health problems, for use by creditor organisations or money advisors. The results of a pilot study are awaited.
Thyroid Hormone Receptor α Modulates Lipopolysaccharide-Induced Changes in Peripheral Thyroid Hormone Metabolism
Authors: Kwakkel Joan , Chassande Olivier , van Beeren Hermina C. , Fliers Eric , Wiersinga Wilmar M. , Boelen Anita
Published: March 2010

Acute inflammation is characterized by low serum T3 and T4 levels accompanied by changes in liver type 1 deiodinase (D1), liver D3, muscle D2, and muscle D3 expression. It is unknown at present whether thyroid hormone receptor α (TRα) plays a role in altered peripheral thyroid hormone metabolism during acute illness in vivo. We induced acute illness in TRα-deficient (TRα0/0) mice by administration of a sublethal dose of LPS. Compared with wild-type, TRα0/0 mice have lower basal serum T4 and lower liver D1 activity and muscle D3 mRNA expression, whereas liver D3 activity is higher. These changes are gender specific. The inflammatory response to LPS was similar in WT and TRα0/0 mice. The decrease in serum thyroid hormones and liver D1 was attenuated in TRα0/0 mice, whereas the LPS induced fall in liver D3 mRNA was more pronounced in TRα0/0 mice. Muscle D2 mRNA increased similarly in both strains, whereas muscle D3 mRNA decreased less pronounced in TRα0/0 mice. We conclude that alterations in peripheral thyroid hormone metabolism induced by LPS administration are partly regulated via TRα.
Synthesis of Ag@Cu Core–Shell Nanoparticles in High Yield Using a Polyol Method
Authors: Tsuji Masaharu , Hikino Sachie , Tanabe Ryuichi , Yamaguchi Daiki
Published: March 2010

Ag core–Cu shell nanoparticles, denoted as Ag@Cu, were synthesized in high yield (100%) using a one-pot polyol method under bubbling Ar gas. AgNO3 and Cu(OAc)2·H2O were used as reagents. The formation of Ag@Cu particles and their crystal structures were examined using energy dispersed X-ray spectroscopic (EDS) measurements and selected area electron diffraction (SAED) patterns. The growth mechanism of Ag@Cu is discussed.
ESR Study of Disulfide Neutral Radical of α-Keratin Present in Dried White Human Hair Exposed to Near-UV Radiation
Authors: Yanagi Naoki , Niwa Masanao , Sakurai Yasuhiro , Nakajima Akira , Kanaori Kenji , Tajima Kunihiko
Published: March 2010

ESR spectrum attributed to a α-keratin-derived disulfide neutral radical, which is formulated to be RSSHR• (g1 = 2.060, g2 = 2.026, g3 = 2.000, and A2 = 0.8 mT), is observed for completely dried white human hair exposed to near-UV radiation. It is also observed that the residual water present in the matrix of human hair markedly accelerates the decomposition of disulfide radicals.
C5 palsy after cervical laminoplasty
Authors: Imagama S. , Matsuyama Y. , Yukawa Y. , Kawakami N. , Kamiya M. , Kanemura T. , Ishiguro N.
Published: March 2010

We have reviewed 1858 patients who had undergone a cervical laminoplasty and identified 43 (2.3%) who had developed a C5 palsy with a MMT (MRC) grade of 0 to 2 in the deltoid, with or without involvement of the biceps, but with no loss of muscular strength in any other muscles. The clinical features and radiological findings of patients with (group P; 43 patients) and without (group C; 100 patients) C5 palsy were compared. CT scanning of group P revealed a significant narrowing of the intervertebral foramen of C5 (p < 0.005) and a larger superior articular process (p < 0.05). On MRI, the posterior shift of the spinal cord at C4–5 was significantly greater in group P, than in group C (p < 0.01).

This study is the first to correlate impairment of the C5 nerve root with a C5 palsy. It may be that early foraminotomy in susceptible individuals and the avoidance of tethering of the cord by excessive laminoplasty may prevent a post-operative palsy of the C5 nerve root.
Surgical dislocation of the hip for a locked traumatic posterior dislocation with associated femoral neck and acetabular fractures
Authors: Keel M. J. B. , Bastian J. D. , Büchler L. , Siebenrock K. A.
Published: March 2010

Traumatic posterior dislocation of the hip associated with a fracture of the posterior acetabular wall and of the neck of the femur is a rare injury. A 29-year-old man presented at a level 1 trauma centre with a locked posterior dislocation of the right hip, with fractures of the femoral neck and the posterior wall of the acetabulum after a bicycle accident. An attempted closed reduction had failed. This case report describes in detail the surgical management and the clinical and radiological outcome. Open reduction and fixation with preservation of the intact retinaculum was undertaken within five hours of injury with surgical dislocation of the hip and a trochanteric osteotomy. Two years after operation the function of the injured hip was good. Plain radiographs and MR scans showed early signs of osteoarthritis with some loss of joint space but no evidence of avascular necrosis. The patient had begun skiing and hiking again.

The combination of fractures of the neck of the femur and of the posterior wall of the acetabulum hampers closed reduction of a posterior dislocation of the hip. Surgical dislocation of the hip with trochanteric flip osteotomy allows controlled open reduction of the fractures, with inspection of the hip joint and preservation of the vascular supply.
Long-term follow-up of replacement compared with internal fixation for displaced femoral neck fractures
Authors: Leonardsson O. , Sernbo I. , Carlsson å. , åkesson K. , Rogmark C.
Published: March 2010

In a series of 450 patients over 70 years of age with displaced fractures of the femoral neck sustained between 1995 and 1997 treatment was randomised either to internal fixation or replacement. Depending on age and level of activity the latter was either a total hip replacement or a hemiarthroplasty. Patients who were confused or bed-ridden were excluded, as were those with rheumatoid arthritis. At ten years there were 99 failures (45.6%) after internal fixation compared with 17 (8.8%) after replacement. The rate of mortality was high at 75% at ten years, and was the same in both groups at all times. Patient-reported pain and function were similar in both groups at five and ten years. Those with successfully healed fractures had more hip pain and reduction of mobility at four months compared with patients with an uncomplicated replacement, and they never attained a better outcome than the latter patients regarding pain or function.

Primary replacement gave reliable long-term results in patients with a displaced fracture of the femoral neck.