bluuebunny/crossref_metadata_2025 huggingface dataset:
Assimilation of GPS Radio Occultation Refractivity Data from CHAMP and SAC-C Missions over High Southern Latitudes with MM5 4DVAR
Authors: Wee Tae-Kwon , Kuo Ying-Hwa , Bromwich David H. , Monaghan Andrew J.
Published: August 2008

In this study, the GPS radio occultation (RO) data from the Challenging Minisatellite Payload (CHAMP) and Satellite de Aplicaciones Cientificas-C (SAC-C) missions are assimilated. An updated version of the fifth-generation Pennsylvania State University–National Center for Atmospheric Research Mesoscale Model (MM5) four-dimensional variational data assimilation system (4DVAR) is used to assess the impact of the GPS RO data on analyses and short-range forecasts over the Antarctic. The study was performed during the period of intense cyclonic activity in the Ross Sea, 9–19 December 2001. On average 66 GPS RO soundings were assimilated daily. For the assimilation over a single 12-h period, the impact of GPS RO data was only marginally positive or near neutral, and it varied markedly from one 12-h period to another. The large case-to-case variation was attributed to the low number of GPS RO soundings and a strong dependency of forecast impact on the location of the soundings relative to the rapidly developing cyclone. Despite the moderate general impact, noticeable reduction of temperature error in the upper troposphere and lower stratosphere was found, which demonstrates the value of GPS RO data in better characterizing the tropopause. Significant error reduction was also noted in geopotential height and wind fields in the stratosphere. Those improvements indicate that early detection of the upper-level precursors for storm development is a potential benefit of GPS RO data. When the assimilation period was extended to 48 h, a considerable positive impact of GPS RO data was found. All parameters that were investigated (i.e., temperature, pressure, and specific humidity) showed the positive impact throughout the entire model atmosphere for forecasts extending up to 5 days. The impact increased in proportion to the length of the assimilation period. Although the differences in the analyses as a result of GPS RO assimilation were relatively small initially, the subtle change and subsequent nonlinear growth led to noticeable forecast improvements at longer ranges. Consequently, the positive impact of GPS RO data was more evident in longer-range (e.g., greater than 2 days) forecasts. A correlation coefficient is introduced to quantify the linear relationship between the analysis errors without GPS RO assimilation and the analysis increments induced by GPS RO assimilation. This measure shows that the growth of GPS RO–induced modifications over time is related to the prominent error reduction observed in GPS RO experiments. The measure may also be useful for understanding how cycling analysis accumulates the positive impact of GPS RO data for an extended period of assimilation.
A Reanalysis of Ocean Climate Using Simple Ocean Data Assimilation (SODA)
Authors: Carton James A. , Giese Benjamin S.
Published: August 2008

This paper describes the Simple Ocean Data Assimilation (SODA) reanalysis of ocean climate variability. In the assimilation, a model forecast produced by an ocean general circulation model with an average resolution of 0.25° × 0.4° × 40 levels is continuously corrected by contemporaneous observations with corrections estimated every 10 days. The basic reanalysis, SODA 1.4.2, spans the 44-yr period from 1958 to 2001, which complements the span of the 40-yr European Centre for Medium-Range Weather Forecasts (ECMWF) atmospheric reanalysis (ERA-40). The observation set for this experiment includes the historical archive of hydrographic profiles supplemented by ship intake measurements, moored hydrographic observations, and remotely sensed SST. A parallel run, SODA 1.4.0, is forced with identical surface boundary conditions, but without data assimilation. The new reanalysis represents a significant improvement over a previously published version of the SODA algorithm. In particular, eddy kinetic energy and sea level variability are much larger than in previous versions and are more similar to estimates from independent observations. One issue addressed in this paper is the relative importance of the model forecast versus the observations for the analysis. The results show that at near-annual frequencies the forecast model has a strong influence, whereas at decadal frequencies the observations become increasingly dominant in the analysis. As a consequence, interannual variability in SODA 1.4.2 closely resembles interannual variability in SODA 1.4.0. However, decadal anomalies of the 0–700-m heat content from SODA 1.4.2 more closely resemble heat content anomalies based on observations.
A Multimoment Finite-Volume Shallow-Water Model on the Yin–Yang Overset Spherical Grid
Authors: Li Xingliang , Chen Dehui , Peng Xindong , Takahashi Keiko , Xiao Feng
Published: August 2008

A numerical model for shallow-water equations has been built and tested on the Yin–Yang overset spherical grid. A high-order multimoment finite-volume method is used for the spatial discretization in which two kinds of so-called moments of the physical field [i.e., the volume integrated average (VIA) and the point value (PV)] are treated as the model variables and updated separately in time. In the present model, the PV is computed by the semi-implicit semi-Lagrangian formulation, whereas the VIA is predicted in time via a flux-based finite-volume method and is numerically conserved on each component grid. The concept of including an extra moment (i.e., the volume-integrated value) to enforce the numerical conservativeness provides a general methodology and applies to the existing semi-implicit semi-Lagrangian formulations. Based on both VIA and PV, the high-order interpolation reconstruction can only be done over a single grid cell, which then minimizes the overlapping zone between the Yin and Yang components and effectively reduces the numerical errors introduced in the interpolation required to communicate the data between the two components. The present model completely gets around the singularity and grid convergence in the polar regions of the conventional longitude–latitude grid. Being an issue demanding further investigation, the high-order interpolation across the overlapping region of the Yin–Yang grid in the current model does not rigorously guarantee the numerical conservativeness. Nevertheless, these numerical tests show that the global conservation error in the present model is negligibly small. The model has competitive accuracy and efficiency.
Response of the Summer Marine Layer Flow to an Extreme California Coastal Bend
Authors: Dorman Clive E. , Koračin Darko
Published: August 2008

A summer wind speed maximum extending more than 200 km occurs over water around Point Conception, California, the most extreme bend along the U.S. West Coast. The following several causes were investigated for this wind speed maximum: 1) synoptic conditions, 2) marine layer hydraulic flow effects, 3) diurnal variations, 4) mountain leeside downslope flow, 5) sea surface temperature structure, and 6) island influence. Synoptic conditions set the general wind speed around Point Conception, and these winds are classified as strong, moderate, or weak. The strong wind condition extends about Point Conception, reaching well offshore toward the southwest, and the highest speeds are within 20 km to the south. Moderate wind cases do not extend as far offshore, and they have a moderate maximum wind speed that occurs over a smaller area in the western mouth of the Santa Barbara Channel. The weak wind speed case consists of light and variable winds about Point Conception. Each category occurs about one-third of the time. Atmospheric marine layer hydraulic dynamics dominate the situation after the synoptic condition is set. This includes an expansion fan on the south side of the point and a compression bulge on the north side. The expansion fan significantly increases the wind speeds over a large area that extends to the southwest, south, and east of Point Conception, and the maximum wind speed is increased for the strong and moderate synoptic cases as well. The horizontal sea surface temperature pattern contributes to the sea surface wind maximum through the Froude number, which links the potential temperature difference between the sea surface temperature and the capping inversion temperature with marine layer acceleration in an expansion fan. A greater potential temperature difference across the top of the marine layer also causes more energy to be trapped in the marine layer, instead of escaping upward. The thermally driven flow resulting from differential heating over land in the greater Los Angeles, California, coastal and elevated area to the east is not directly related to the wind speed maximum, either in the Santa Barbara Channel or in the open ocean extending farther offshore. The effects of the thermally driven flow extend only to the east of the Santa Barbara Channel. The downslope flow on the south side of the Santa Ynez Mountains that is generated by winds crossing the Santa Ynez Mountain ridge contributes neither to the high-speed wind maximum in the Santa Barbara channel nor to that extending farther offshore. Fifth-generation Pennsylvania State University–NCAR Mesoscale Model (MM5) simulations do support a weak leeside flow in the upper portions of the Santa Ynez Mountains. The larger Channel Islands have a significant effect on the marine layer flow and the overwater wind structure. One major effect of the Santa Barbara Channel Islands is the extension of the zone of high-speed winds farther to the south than would otherwise be the case.
Getting What You Ask For
Authors: Lambright Kristina Trent
Published: August 2008

This article provides a greater understanding of the contract monitoring process by identifying barriers that prevent contracted providers from using service monitoring tools properly. To evaluate barriers to proper tool use, seven case studies were conducted on early childhood programs in three communities in upstate New York. The case studies specifically focused on the reporting forms that the early childhood programs completed. Data sources included (a) interviews with government agency and contracted provider employees, (b) content analysis of key documents relating to the service monitoring tools, and (c) attendance at meetings between government agencies and contracted providers on the service monitoring tools. This article identifies lack of contracted provider ability and misunderstandings between government and contracted providers as key barriers to proper tool use. This study also finds evidence suggesting a link between the overall strength of technical assistance systems and understanding problems.
Identity Formation and Transnational Discourses
Authors: Friedner Michele
Published: August 2008

This article is an attempt to explore the role, if any, that transnational deaf identity politics plays within the lives of members of the Delhi Foundation of Deaf Women (DFDW). Taking a two-pronged ethnographic and historical approach, I will examine how the DFDW came to exist, situating it within the field of organisations serving the deaf in Delhi, as well as providing an overview of its structure and client profile. I will also examine the terrain of identity politics within the deaf community of the DFDW, and ask questions about what identity, deafness and kinship mean to its members. Most theory coming out of Deaf studies has ignored, until relatively recently, the category of gender. This article seeks to explore how culture and gender modify the constructions and experiences of Deaf identity.
Plasmacytoid dendritic cells efficiently cross-prime naive T cells in vivo after TLR activation
Authors: Mouriès Juliette , Moron Gabriel , Schlecht Géraldine , Escriou Nicolas , Dadaglio Gilles , Leclerc Claude
Published: August 2008

Cross-presentation is a crucial mechanism in tumoral and microbial immunity because it allows internalized cell associated or exogenous antigens (Ags) to be delivered into the major histocompatibility complex I pathway. This pathway is important for the development of CD8+ T-cell responses and for the induction of tolerance. In mice, cross-presentation is considered to be a unique property of CD8α+ conventional dendritic cells (DCs). Here we show that splenic plasmacytoid DCs (pDCs) efficiently capture exogenous Ags in vivo but are not able to cross-present these Ags at steady state. However, in vitro and in vivo stimulation by Toll-like receptor-7, or -9 or viruses licenses pDCs to cross-present soluble or particulate Ags by a transporter associated with antigen processing-dependent mechanism. Induction of cross-presentation confers to pDCs the ability to generate efficient effector CD8+ T-cell responses against exogenous Ags in vivo, showing that pDCs may play a crucial role in induction of adaptive immune responses against pathogens that do not infect tissues of hemopoietic origin. This study provides the first evidence for an in vivo role of splenic pDCs in Ag cross-presentation and T-cell cross-priming and suggests that pDCs may constitute an attractive target to boost the efficacy of vaccines based on cytotoxic T lymphocyte induction.
Rabaptin-5 regulates receptor expression and functional activation in mast cells
Authors: Rios Eon J. , Piliponsky Adrian M. , Ra Chisei , Kalesnikoff Janet , Galli Stephen J.
Published: August 2008

Rab5 is a small GTPase that regulates early endocytic events and is activated by RabGEF1/Rabex-5. Rabaptin-5, a Rab5 interacting protein, was identified as a protein critical for potentiating RabGEF1/Rabex-5's activation of Rab5. Using Rabaptin-5 shRNA knockdown, we show that Rabaptin-5 is dispensable for Rab5-dependent processes in intact mast cells, including high affinity IgE receptor (FcϵRI) internalization and endosome fusion. However, Rabaptin-5 deficiency markedly diminished expression of FcϵRI and β1 integrin on the mast cell surface by diminishing receptor surface stability. This in turn reduced the ability of mast cells to bind IgE and significantly diminished both mast cell sensitivity to antigen (Ag)-induced mediator release and Ag-induced mast cell adhesion and migration. These findings show that, although dispensable for canonical Rab5 processes in mast cells, Rabaptin-5 importantly contributes to mast cell IgE-dependent immunologic function by enhancing mast cell receptor surface stability.
CD11c+ antigen presenting cells from the alveolar space, lung parenchyma and spleen differ in their phenotype and capabilities to activate naïve and antigen-primed T cells
Authors: Kugathasan Kapilan , Roediger Elizabeth K , Small Cherrie-Lee , McCormick Sarah , Yang Pingchang , Xing Zhou
Published: August 2008

Background

The lung is divided into two major compartments: the alveolar space and the parenchyma. The alveolar macrophages are the first line of leukocytes in the lung taking up incoming microbes or microbial antigens whereas the parenchymal dendritic cells (DCs) are believed to be the sole potent antigen presenting cells (APCs) in the lung. Both resting alveolar macrophages and parenchymal DCs express CD11c. Several important questions remain to be elucidated: 1] to which extent the alveolar space and lung parenchymal CD11c+ APCs differ in their phenotype and ability to activate naïve T cells; 2] whether they differ in their ability to activate antigen-experienced or -primed T cells; and 3] whether these lung CD11c+ APC populations differ from the splenic CD11c+ APCs which have been commonly used for understanding APC biology.

Results

CD11c+ APCs from the alveolar space, lung parenchyma, and the spleen display differential co-stimulatory molecule expression and cytokine responsiveness upon stimulation. Alveolar space APCs are weak activators of naïve T cells compared to lung parenchymal and splenic CD11c+ APC populations. However, alveolar space APCs are able to potently activate the in vivo microbial antigen-primed T cells to a similar extent as lung parenchymal and splenic APCs.

Conclusion

Together our findings indicate that alveolar CD11c+ APCs have a specialized T cell-activating function, capable of activating antigen-primed, but not naïve, T cells whereas lung CD11c+ APCs are capable of activating both the naïve and antigen-primed T cell populations.
Evolutional selection of a combinatorial phage library displaying randomly-rearranged various single domains of immunoglobulin (Ig)-binding proteins (IBPs) with four kinds of Ig molecules
Authors: Yang Hua , Cao Jie , Li Lian-Qing , Zhou Xia , Chen Qiu-Li , Liao Wen-Ting , Wen Zong-Mei , Jiang Shao-Hua , Xu Rong , Jia Jian-An , Pan Xin , Qi Zhong-Tian , Pan Wei
Published: August 2008

Background

Protein A, protein G and protein L are three well-defined immunoglobulin (Ig)-binding proteins (IBPs), which show affinity for specific sites on Ig of mammalian hosts. Although the precise functions of these molecules are not fully understood, it is thought that they play an important role in pathogenicity of bacteria. The single domains of protein A, protein G and protein L were all demonstrated to have function to bind to Ig. Whether combinations of Ig-binding domains of various IBPs could exhibit useful novel binding is interesting.

Results

We used a combinatorial phage library which displayed randomly-rearranged various-peptide-linked molecules of D and A domains of protein A, designated PA(D) and PA(A) respectively, B2 domain of protein G (PG) and B3 domain of protein L (PL) for affinity selection with human IgG (hIgG), human IgM (hIgM), human IgA (hIgA) and recombinant hIgG1-Fc as bait respectively. Two kinds of novel combinatorial molecules with characteristic structure of PA(A)-PG and PA(A)-PL were obtained in hIgG (hIgG1-Fc) and hIgM (hIgA) post-selection populations respectively. In addition, the linking peptides among all PA(A)-PG and PA(A)-PL structures was strongly selected, and showed interestingly divergent and convergent distribution. The phage binding assays and competitive inhibition experiments demonstrated that PA(A)-PG and PA(A)-PL combinations possess comparable binding advantages with hIgG/hIgG1-Fc and hIgM/hIgA respectively.

Conclusion

In this work, a combinatorial phage library displaying Ig-binding domains of protein A, protein G, or protein L joined by various random linking peptides was used to conducted evolutional selectionin vitrowith four kinds of Ig molecules. Two kinds of novel combinations of Ig-binding domains, PA(A)-PG and PA(A)-PL, were obtained, and demonstrate the novel Ig binding properties.
Prognostic relevance of Centromere protein H expression in esophageal carcinoma
Authors: Guo Xian-Zhi , Zhang Ge , Wang Jun-Ye , Liu Wan-Li , Wang Fang , Dong Ju-Qin , Xu Li-Hua , Cao Jing-Yan , Song Li-Bing , Zeng Mu-Sheng
Published: August 2008

Background

Many kinetochore proteins have been shown to be associated with human cancers. The aim of the present study was to clarify the expression of Centromere protein H (CENP-H), one of the fundamental components of the human active kinetochore, in esophageal carcinoma and its correlation with clinicopathological features.

Methods

We examined the expression of CENP-H in immortalized esophageal epithelial cells as well as in esophageal carcinoma cells, and in 12 cases of esophageal carcinoma tissues and the paired normal esophageal tissues by RT-PCR and Western blot analysis. In addition, we analyzed CENP-H protein expression in 177 clinicopathologically characterized esophageal carcinoma cases by immunohistochemistry. Statistical analyses were applied to test for prognostic and diagnostic associations.

Results

The level of CENP-H mRNA and protein were higher in the immortalized cells, cancer cell lines and most cancer tissues than in normal control tissues. Immunohistochemistry showed that CENP-H was expressed in 127 of 171 ESCC cases (74.3%) and in 3 of 6 esophageal adenocarcinoma cases (50%). Statistical analysis of ESCC cases showed that there was a significant difference of CENP-H expression in patients categorized according to gender (P = 0.013), stage (P = 0.023) and T classification (P = 0.019). Patients with lower CENP-H expression had longer overall survival time than those with higher CENP-H expression. Multivariate analysis suggested that CENP-H expression was an independent prognostic marker for esophageal carcinoma patients. A prognostic value of CENP-H was also found in the subgroup of T3~T4 and N0 tumor classification.

Conclusion

Our results suggest that CENP-H protein is a valuable marker of esophageal carcinoma progression. CENP-H might be used as a valuable prognostic marker for esophageal carcinoma patients.
Prevalence of insulin resistance and its association with metabolic syndrome criteria among Bolivian children and adolescents with obesity
Authors: Caceres Margoth , Teran Carlos G , Rodriguez Susana , Medina Marcos
Published: August 2008

Background

Obesity is a one of the most common nutritional disorder worldwide, clearly associated with the metabolic syndrome, condition with implications for the development of many chronic diseases.

In the poorest countries of Latin America, malnourishment is still the most prevalent nutritional problem, but obesity is emerging in alarming rates over the last 10 years without a predictable association with metabolic syndrome.

The objective of our study was to determine the association between insulin-resistance and components of the metabolic syndrome in a group of Bolivian obese children and adolescents. The second objective was determining the relation of acanthosis nigricans and insulin-resistance.

Methods

We studied 61 obese children and adolescents aged between 5 and 18 years old. All children underwent an oral glucose tolerance test and fasting blood sample was also obtained to measure insulin, HDL, LDL and triglycerides serum level. The diagnosis of metabolic syndrome was defined according to National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP III) criteria adapted for children.

Results

Metabolic syndrome was found in 36% of the children, with a higher rate among males (40%) than females (32.2%) (p = 0.599). The prevalence of each of the components was 8.2% in impaired glucose tolerance, 42.6% for high triglyceride level, 55.7% for low levels of high-density lipoprotein cholesterol, and 24.5% for high blood pressure. Insulin resistance (HOMA-IR > 3.5) was found in 39.4% of the children, with a higher rate in males (50%) than females (29%). A strong correlation was found between insulin resistance and high blood pressure (p = 0.0148) and high triglycerides (p = 0.002). No statistical significance was found between the presence of acanthosis nigricans and insulin resistance.

Conclusion

Metabolic syndrome has a prevalence of 36% in children and adolescent population in the study. Insulin resistance was very common among children with obesity with a significant association with high blood pressure and high triglycerides presence.
Discriminative and predictive properties of disease-specific and generic health status indexes in elderly COPD patients
Authors: Conte Maria E , Pedone Claudio , Forastiere Francesco , Bellia Vincenzo , Antonelli-Incalzi Raffaele
Published: August 2008

Background

The association between bronchial obstruction severity and mortality in Chronic Obstructive Pulmonary Disease (COPD) is well established, but it is unknown whether disease-specific health status measures and multidimensional assessment (MDA) have comparable prognostic value.

Methods

We analyzed data coming from the Salute Respiratoria nell'Anziano (Respiratory Health in the Elderly – SaRA) study, enrolling elderly people attending outpatient clinics for respiratory and non-respiratory problems. From this population we selected 449 patients with bronchial obstruction (77.3% men, mean age 73.1). We classified patients' health status using tertiles of the Saint George Respiratory Questionnaire (SGRQ) and a MDA including functional (the 6' walking test, WT), cognitive (Mini-Mental State Examination, MMSE) and affective status (Geriatric Depression Scale, GDS). The agreement of the classification methods was calculated using the kappa statistic, and survival associated with group membership was evaluated using survival analysis.

Results

Pulmonary function, expressed by the FEV1, worsened with increasing SGRQ or MDA scores. Cognitive function was not associated with the SGRQ, while physical performance and mood status were impaired only in the highest tertile of SGRQ. A poor agreement was found between the two classification systems tested (k = 0.194). Compared to people in the first tertile of SGRQ score, those in the second tertile had a sex-adjusted HR of 1.22 (0.75 – 1.98) and those in the third tertile of 2.90 (1.92 – 4.40). The corresponding figures of the MDA were 1.49 (95% CI 1.02 – 2.18) and 2.01 (95% CI: 1.31 – 3.08). After adjustment for severity of obstruction, only a SGRQ in the upper tertile was associated with mortality (HR: 1.86; 95% CI: 1.14 – 3.02).

Conclusion

In elderly outpatients with mild-moderate COPD, a disease-specific health status index seems to be a better predictor of death compared to a MDA.
Protein-segment universe exhibiting transitions at intermediate segment length in conformational subspaces
Authors: Ikeda Kazuyoshi , Hirokawa Takatsugu , Higo Junichi , Tomii Kentaro
Published: August 2008

Background

Many studies have examined rules governing two aspects of protein structures: short segments and proteins' structural domains. Nevertheless, the organization and nature of the conformational space of segments with intermediate length between short segments and domains remain unclear. Conformational spaces of intermediate length segments probably differ from those of short segments. We investigated the identification and characterization of the boundary(s) between peptide-like (short segment) and protein-like (long segment) distributions. We generated ensembles embedded in globular proteins comprising segments 10–50 residues long. We explored the relationships between the conformational distribution of segments and their lengths, and also protein structural classes using principal component analysis based on the intra-segment C
α-C
α atomic distances.

Results

Our statistical analyses of segment conformations and length revealed critical dual transitions in their conformational distribution with segments derived from all four structural classes. Dual transitions were identified with the intermediate phase between the short segments and domains. Consequently, protein segment universes were categorized. i) Short segments (10–22 residues) showed a distribution with a high frequency of secondary structure clusters. ii) Medium segments (23–26 residues) showed a distribution corresponding to an intermediate state of transitions. iii) Long segments (27–50 residues) showed a distribution converging on one huge cluster containing compact conformations with a smaller radius of gyration. This distribution reflects the protein structures' organization and protein domains' origin. Three major conformational components (radius of gyration, structural symmetry with respect to the N-terminal and C-terminal halves, and single-turn/two-turn structure) well define most of the segment universes. Furthermore, we identified several conformational components that were unique to each structural class. Those characteristics suggest that protein segment conformation is described by compositions of the three common structural variables with large contributions and specific structural variables with small contributions.

Conclusion

The present results of the analyses of four protein structural classes show the universal role of three major components as segment conformational descriptors. The obtained perspectives of distribution changes related to the segment lengths using the three key components suggest both the adequacy and the possibility of further progress on the prediction strategies used in the recent de novo structure-prediction methods.
The magnitude and factors associated with delays in management of smear positive tuberculosis in Dar es Salaam, Tanzania
Authors: Mfinanga Sayoki G , Mutayoba Beatrice K , Kahwa Amos , Kimaro Godfather , Mtandu Rugola , Ngadaya Esther , Egwaga Said , Kitua Andrew Y
Published: August 2008

Objective

To assess the magnitude and factors responsible for delay in TB management.

Design

A cross sectional hospital based survey in Dar es Salaam region, May 2006.

Results

We interviewed 639 TB patients. A total of 78.4% of patients had good knowledge on TB transmission. Only 35.9% had good knowledge on the symptoms. Patient delay was observed in 35.1% of the patients, with significantly (X2 = 5.49, d.f. = 1, P = 0.019) high proportion in females (41.0%) than in males (31.5%). Diagnosis delay was observed in 52.9% of the patients, with significantly (X2 = 10.1, d.f. = 1, P = 0.001) high proportion in females (62.1%) than in males (47.0%). Treatment delay was observed in 34.4% of patients with no significant differences among males and females. Several risk factors were significantly associated with patient's delays in females but not in males. The factors included not recognizing the following as TB symptoms: night sweat (OR = 1.92, 95% CI 1.20, 3.05), chest pain (OR = 1.62, 95% CI 1.1, 2.37), weight loss (OR = 1.55, 95% CI 1.03, 2.32), and coughing blood (OR = 1.47, 95% CI 1.01, 2.16). Other factors included: living more than 5 Km from a health facility (OR = 2.24, 95% CI 1.41, 3.55), no primary education (OR = 1.74, 95% CI 1.01, 3.05) and no employment (OR = 1.77, 95% CI 1.20, 2.60). In multiple logistic regression, five factors were more significant in females (OR = 2.22, 95% CI 1.14, 4.31) than in males (OR = 0.70, 95% CI 0.44, 1.11). These factors included not knowing that night sweat and chest pain are TB symptoms, a belief that TB is always associated with HIV infection, no employment and living far from a health facility.

Conclusion

There were significant delays in the management of TB patients which were contributed by both patients and health facilities. However, delays in most of patients were due to delay of diagnosis and treatment in health facilities. The delays at all levels were more common in females than males. This indicates the need for education targeting health seeking behaviour and improvement in health system.
Differential expression of genes mapping to recurrently abnormal chromosomal regions characterize neuroblastic tumours with distinct ploidy status
Authors: Lavarino Cinzia , Garcia Idoia , Mackintosh Carlos , Cheung Nai-Kong V , Domenech Gema , Ríos José , Perez Noelia , Rodríguez Eva , de Torres Carmen , Gerald William L , Tuset Esperanza , Acosta Sandra , Beleta Helena , de Álava Enrique , Mora Jaume
Published: August 2008

Background

Neuroblastic tumours (NBTs) represent a heterogeneous spectrum of neoplastic diseases associated with multiple genetic alterations. Structural and numerical chromosomal changes are frequent and are predictive parameters of NBTs outcome. We performed a comparative analysis of the biological entities constituted by NBTs with different ploidy status.

Methods

Gene expression profiling of 49 diagnostic primary NBTs with ploidy data was performed using oligonucleotide microarray. Further analyses using Quantitative Real-Time Polymerase Chain Reaction (Q-PCR); array-Comparative Genomic Hybridization (aCGH); and Fluorescentin situHybridization (FISH) were performed to investigate the correlation between aneuploidy, chromosomal changes and gene expression profiles.

Results

Gene expression profiling of 49 primary near-triploid and near-diploid/tetraploid NBTs revealed distinct expression profiles associated with each NBT subgroup. A statistically significant portion of genes mapped to 1p36 (P= 0.01) and 17p13-q21 (P< 0.0001), described as recurrently altered in NBTs. Over 90% of these genes showed higher expression in near-triploid NBTs and the majority are involved in cell differentiation pathways. Specific chromosomal abnormalities observed in NBTs, 1p loss, 17q and whole chromosome 17 gains, were reflected in the gene expression profiles. Comparison between gene copy number and expression levels suggests that differential expression might be only partly dependent on gene copy number. Intratumoural clonal heterogeneity was observed in all NBTs, with marked interclonal variability in near-diploid/tetraploid tumours.

Conclusion

NBTs with different cellular DNA content display distinct transcriptional profiles with a significant portion of differentially expressed genes mapping to specific chromosomal regions known to be associated with outcome. Furthermore, our results demonstrate that these specific genetic abnormalities are highly heterogeneous in all NBTs, and suggest that NBTs with different ploidy status may result from different mechanisms of aneuploidy driving tumourigenesis.
Viruses, Immunity and Mental Disorder
Authors: King David J. , Cooper Stephen J.
Published: August 2008

Are viruses the cause of mental illness, or does stress or mental disorder produce impaired immunity, with increased susceptibility to infection? These two separate but not unrelated questions have been debated periodically and there has been much renewed interest recently, with increased sophistication in immunology and widespread topical concern about immunodeficiency. The neuropsychiatry of the acquired immunodeficiency syndrome (AIDS) (Snideret al,1983; Carne & Adler, 1986; Wortis, 1986; Burton, 1987; Fenton, 1987) and the validity of a ‘post-viral fatigue syndrome’ as a clinical entity (Behan, 1983; Southern & Oldstone, 1986; Dawson, 1987; Davidet al,1988) are not discussed here, but have been dealt with in the editorials and reviews cited.
Spastic dysphonia and denervation signs in a young man with tardive dyskinesia
Authors: Lieberman Jeffrey A. , Reife Ross
Published: August 2008

Pathophysiological theories of tardive dyskinesia (TD) suggest the possibility of structural changes in the central nervous system of patients with TD. This report describes a case of choreoathetoid dyskinesia and spastic dysphonia associated with clinical and electromyographic signs of muscle denervation. The findings of this case suggest that the neurological syndrome originates within basal ganglia nuclei but may also extend to the peripheral neuromuscular system.
Involuntary Movements Associated with Mianserin Treatment
Authors: Otani Koichi , Kaneko Sunao , Fukushima Yutaka , Kubota Shuji
Published: August 2008

A case showing various involuntary movements during mianserin treatment and after a withdrawal of mianserin is described. This is the first case report of mianserin-induced involuntary movements. The report suggests that these symptoms can occur with a therapeutic dose of mianserin in certain susceptible patients.
Depression in Self-Harm Patients
Authors: Ennis Jon , Barnes Rosemary A. , Kennedy Sidney , Trachtenberg Dvora D.
Published: August 2008

DSM-III diagnoses and responses to the Beck Depression Inventory (BDI) were examined in 71 consecutive admissions to an inpatient psychiatric crisis service following deliberate self-harm. Although 80% of the admitted patients were moderately or severely depressed according to BDI scores, only 31 % were diagnosed with a major depressive episode. While all of the self-harm patients may be viewed as experiencing severe subjective distress, only a minority were shown to suffer from DSM-III depressive illness. The high depression scores on the BDI may be related to the patients' extreme distress preceding a crisis admission and to the high prevalence of personality disorders in this group of patients.
Wernicke's Encephalopathy in an 18-Year-Old Woman
Authors: Turner Stuart , Daniels Lynn , Greer Steven
Published: August 2008

An unusually young woman (18 years old) who misused alcohol and developed Wernicke's encephalopathy is described.
Neuronal Misconnections and Psychiatric Disorder
Authors: Goodman Robert
Published: August 2008

Brain damage can induce anomalous neuronal connections in experimental animals, which can sometimes result in maladaptive behaviour, particularly when damage occurs early in development. Anomalous patterns of neuronal connection can also arise from genetic disorders. In humans, neuronal misconnections could be involved in a variety of psychiatric disorders. For example, they may account for the link between hyperkinesis and childhood hemiplegia, and for the link between schizophrenia and ‘alien tissue’ lesions of the temporal lobes. Predictions from misconnection hypotheses can potentially be tested in neuropathological, neurophysiological, and clinical studies.
The Toxicity of Antidepressants
Authors: Beaumont George
Published: August 2008

Considerable attention has been paid, both by regulatory authorities and clinicians, to the side-effects of antidepressants, but despite the known high suicide risk in depression, toxicity in overdosage has been largely ignored. On the basis of the evidence currently available, ‘older’ antidepressants appear to be more toxic than ‘newer’ agents. A case can be made for limiting the use of some of the older tricyclic antidepressants, especially in patients who remain in the community, when continuous supervision is lacking, in favour of newer, safer drugs.
The Scottish First Episode Schizophrenia Study
Authors: MacDonald H. L. , Best J. J. K. ,   The Scottish Schizophrenia Research Group, McCreadie Robin G. , Wiles David H. , Grant Stewart M. , Moore John W. , Crocket George T. , Mahmood Zahid , Livingston Martin G. , Watt James A. G. , Greene J. G. , Kershaw Peter W. , Todd Norman A. , Scott Angus M. , Dyer James A. T. , Loudon John , Philip Alistair E. , Batchelor David
Published: August 2008

This is the initial report of a prospective study by computerised tomography brain scan of first episode schizophrenia. Twenty-seven patients who met Research Diagnostic Criteria for schizophrenia were compared with volunteer controls on ventricular: brain ratio, sulcal: brain volume ratio, and the widths of third ventricle and Sylvian and interhemispheric fissures. The results provide evidence that sulcal enlargement, but not ventricular abnormalities, may be detected at first admission for schizophrenic illness, and are discussed in relation to findings from other studies.
Capgras' Syndrome and Folie à Deux Involving Mother and Child
Authors: Hart J. , McClure G. M. G.
Published: August 2008

A mother and her son shared delusional beliefs that doubles of themselves existed and that they were being harassed by the police and social and educational services. The nature of these ‘double double’ symptoms is discussed.
Community Care and the Difficult and Offender Patient
Authors: Scannell T. D.
Published: August 2008

Concern has been growing about a cyclical pattern or ‘periodicity’ in mental health care over the past 300 years, in which large-scale policy decisions have been made, and then reversed, paying little attention to the particular needs of differing patient groups. Turner (1985) drew attention to the reckless course followed by psychiatry, and how the “discipline that has lost its way” (Lancet,1985) may have done so owing to a poor grasp of its past history. In the movement towards community care, ‘difficult’ or the so-called ‘unrewarding’ (to use Scott's (1970) term) patients are a particularly vulnerable group (Aviram & Segal, 1973; Bachrach, 1980). Increasingly, community services are compelled to cater for less disturbed patients through being selective about whom they will accept. To a degree, forensic services on both sides of the Atlantic have partially filled the gap so created in service provision. For this and other reasons, it is difficult to make a general statement about the effectiveness of deinstitutionalisation and community care. To be more specific, there are basic conceptual difficulties in defining continuity of care and identifying subgroups for which it has different implications (Bachrach, 1981), and there are major methodological difficulties impeding an analysis of such a diffuse and fragmented provision. Scull's (1984) description of the overnight abolition of state facilities for juvenile offenders in Massachusetts in the US between 1969 and 1973 points to the impossibility of making a comparison ‘before and after’, when so much dissolution and decentralisation of services has occurred (see also Jones, 1982). A few model alternatives were described soon after the closures, and Bachrach (1980) has written about the dangers of generalising from model programmes, highlighting the differences between demonstration efforts and reality. It is proposed here that the difficult and offender population might act as a ‘litmus paper’ for the efficiency, or otherwise, of community care in general.
Depression Following Spinal Cord Injury
Authors: Judd Fiona K. , Stone Jillian , Webber John E. , Brown Douglas J. , Burrows Graham D.
Published: August 2008

In a systematic prospective study of 71 patients with acute spinal cord injury carried out in the acute and rehabilitation phases of treatment, 14 patients meeting the DSM-III criteria for major depressive disorder were identified. A further 13 patients had transient periods of depressed mood, while the majority of patients showed no clear evidence of depression. The BDI was found to be valid in this group of patients.
Thirty Years' War: A Battle with Insomnia
Authors: Newton J. R. , Shapiro C. , Stewart A.
Published: August 2008

A 72-year-old man with a 30-year complaint of intractable insomnia had a positive family history of depression. He first came to psychiatric attention in 1958, after attacking his wife. He was prescribed barbiturates, and later was given meprobamate and nitrazepam, but with no effect on his complaint. The patient tended to increase the dosage of any drug given, of his own accord. EEG sleep recording confirmed the diagnosis of nocturnal myoclonus. It was hoped that at the case conference further treatment stratagems would be suggested.
Alexithymia, Masked Depression and Loss in a Holocaust Survivor
Authors: Fisch Robert Z.
Published: August 2008

A woman who suffered multiple losses in childhood and adolescence became depressed 40 years later, after a series of new losses. Concomitant alexithymic features caused a masking of her depression by somatic symptoms. The relationships between alexithymia, masked depression and loss are discussed.
Mania in a Five-Year-Old Child with Tuberous Sclerosis
Authors: Khanna Rakesh , Borde Milind
Published: August 2008

A five-year-old girl presented with mania and adenoma sebaceum. Later she developed grand mal seizures, and EEG revealed a prominent right temporal focus. It is important to consider tuberous sclerosis as aetiologically related to mood disorders.
Status Epilepticus after Electroconvulsive Therapy
Authors: Scott Allan I. F. , Riddle William
Published: August 2008

Status epilepticus is a rare complication of ECT. We describe a patient who suffered a prolonged seizure which required termination with intravenous diazepam. The status epilepticus was not accompanied by motor movements, and the diagnosis was made only because of simultaneous EEG monitoring. The incidence of status epilepticus after ECT may be underestimated.
Epidemiology of Mental Disorders in Young Adults of a Newly Urbanised Area in Khartoum, Sudan
Authors: Rahim Sheikh Idris A. , Cederblad Marianne
Published: August 2008

Two hundred and four subjects, 22–35 years old, were selected from a surburban part of Khartoum. They were assessed using the Self-Rating Questionnaire, the Eysenck Personality Inventory, and a Sudanese rating scale of anxiety and depression. Socio-economic information was collected. A psychiatric interview and a medical examination were carried out. It was found that 40.3% had at least one psychiatric symptom, and 16.6% received clinical diagnoses according to DSM-III. The most common diagnoses were depressive illness (neurotic and endogenous) (8.4%) and generalised anxiety (3.4%). Alcohol abuse was very rare (0.4%). There was no sex difference.
Cognitive Aspects of Panic Attacks
Authors: Zucker D. , Taylor C. B. , Brouillard M. , Ehlers A. , Margraf J. , Telch M. , Roth W. T. , Agras W. S.
Published: August 2008

Twenty patients with panic attacks and ten controls were given a standardised interview about thoughts occurring during times of anxiety or panic attacks. The interviewer was blind to the subject's diagnosis. The 20 panic patients underwent a psychophysiological test battery which included a cold pressor test, mental arithmetic task, and 5.5% CO2 inhalation. More patients than controls reported thoughts centred on fears of losing control and shame when anxious. Panic patients rated their thoughts as stronger and clearer than did controls and they had more difficulty excluding them from their minds. A feeling of anxiety preceded anxious thoughts in patients. This suggests that ‘faulty cognitions' are not the initial event in a panic attack, although anxious thoughts may exacerbate or maintain them. Significant correlations were found between the intensity of anxiety-related thoughts in anticipation of mental arithmetic and changes in diastolic blood pressure and heart rate during mental arithmetic.
Concordance by Sex in Sibling Pairs with Schizophrenia is Paternally Inherited
Authors: Crow Timothy J. , DeLisi Lynn E. , Johnstone Eve C.
Published: August 2008

The hypothesis that the gene for schizophrenia is located in the pseudoautosomal region of the sex chromosomes predicts that same-sex concordance will occur in paternally rather than maternally derived pairs. In 120 families that included at least one sibling pair with schizophrenia, affected members were significantly more likely to be of the same sex when there was a history of illness on the paternal than on the maternal side, the difference remaining significant when parent of origin was assessed by three different methods. The finding is as predicted by the pseudoautosomal hypothesis: therefore a search for the gene should be focused on this small (three megabase) region of the genome. The ratio of same to mixed sex pairs in paternally-derived cases (approximately 3:1) suggests the gene is located in the centromeric one-third of the pseudoautosomal region.
Slowly Progressive Schizophrenia – Myth or Clinical Reality?
Authors: Smulevitch A. B. , Shafran B. , Merskey H. , Zoubok B.
Published: August 2008

We have attempted to render this article into intelligible English. The original was generally somewhat cumbersome. On occasion, a more polished translation might have been attempted, but as the reader should be able to estimate the author's intent, we have avoided any possible liberties in interpretation.
Distorting Patient or Distorting Instrument?
Authors: Bowden P. K. , Touyz S. W. , Rodriguez P. J. , Hensley R. , Beumont P. J. V.
Published: August 2008

Three current techniques for estimating body size (Image Marking, Visual Size Estimation, and Distorting Video techniques) were compared. Anorexia nervosa and bulimic patients and normal control subjects were required to make size judgements of the way they ‘knew’ they looked, the way they ‘felt’ they looked, and of the width of an inanimate control object. Results from the three techniques were not the same, thus implying that research findings can no longer be cross-compared. Moreover, while all subjects were similar in the accuracy of their estimation of a control object, anorexia nervosa and bulimic patients overestimated their own body size significantly more than normal controls. This difference was even more marked when affective instructions were compared.
Major Depression in Down's Syndrome
Authors: Warren A. C. , Holroyd S. , Folstein M. F.
Published: August 2008

Five patients with trisomy 21 (Down's syndrome (DS)), referred to us for evaluation of dementia, were instead found to have major depression. All had shown cognitive and behavioural deterioration and this had led to a mistaken diagnosis of Alzheimer's disease in two. We outline and contrast the features of major depression and Alzheimer's disease in DS, and suggest that electroconvulsive therapy is an effective treatment for major depression in DS.