bluuebunny/crossref_metadata_2025 huggingface dataset:
Amino acid availability and age affect the leucine stimulation of protein synthesis and eIF4F formation in muscle
Authors: Escobar Jeffery , Frank Jason W. , Suryawan Agus , Nguyen Hanh V. , Davis Teresa A.
Published: September 2007

We have previously shown that a physiological increase in plasma leucine for 60 and 120 min increases translation initiation factor activation in muscle of neonatal pigs. Although muscle protein synthesis is increased by leucine at 60 min, it is not maintained at 120 min, perhaps because of the decrease in plasma amino acids (AA). In the present study, 7- and 26-day-old pigs were fasted overnight and infused with leucine (0 or 400 μmol·kg−1·h−1) for 120 min to raise leucine within the postprandial range. The leucine was infused in the presence or absence of a replacement AA mixture (without leucine) to maintain baseline plasma AA levels. AA administration prevented the leucine-induced reduction in plasma AA in both age groups. At 7 days, leucine infusion alone increased eukaryotic initiation factor (eIF) 4E binding protein-1 (4E-BP1) phosphorylation, decreased inactive 4E-BP1·eIF4E complex abundance, and increased active eIF4G·eIF4E complex formation in skeletal muscle; leucine infusion with replacement AA also stimulated these, as well as 70-kDa ribosomal protein S6 kinase, ribosomal protein S6, and eIF4G phosphorylation. At 26 days, leucine infusion alone increased 4E-BP1 phosphorylation and decreased the inactive 4E-BP1·eIF4E complex only; leucine with AA also stimulated these, as well as 70-kDa ribosomal protein S6 kinase and ribosomal protein S6 phosphorylation. Muscle protein synthesis was increased in 7-day-old (+60%) and 26-day-old (+40%) pigs infused with leucine and replacement AA but not with leucine alone. Thus the ability of leucine to stimulate eIF4F formation and protein synthesis in skeletal muscle is dependent on AA availability and age.
Design of Components for a Low Cost CombiningSwitch
Authors: Dickey Susan R. , Kenner Richard
Published: September 2007

We present the design for the two VLSI components used in a processor‐to‐memory interconnection network for
a shared memory system. These components allow the combining of requests that are destined to the same memory
location. The design contains both semi‐systolic queues and an associative “wait buffer.” Transition equations and
schematics of the critical pieces of the design are included.
Scalability Analysis for Conservative Simulationof Logical Circuits
Authors: Keller Jörg , Rauber Thomas , Rederlechner Bernd
Published: September 2007

We investigate conservative parallel discrete event simulations for logical circuits on
shared‐memory multiprocessors. For a first estimation of the possible speedup, we
extend the critical path analysis technique by partitioning strategies. To incorporate
overhead due to the management of data structures, we use a simulation on an ideal
parallel machine (PRAM). This simulation can be directly executed on the SB‐PRAM
prototype, yielding both an implementation and a basis for data structure optimizations.
One of the major tools to achieve these optimizations is the SB‐PRAM′s
hardware support for parallel prefix operations. Our reimplementation of the PTHOR
program on the SB‐PRAM yields substantially higher speedups than before.
Scalable Clustered Time Warp and Logic Simulation
Authors: Avril Hervé , Tropper Carl
Published: September 2007

We introduce, in this paper, Clustered Time Warp (CTW), an algorithm for the parallel
simulation of discrete event models on a general purpose distributed memory
architecture. CTW has its roots in the problem of distributed logic simulation. It is a
hybrid algorithm which makes use of Time Warp between clusters of LPs and a
sequential algorithm within the clusters whereas Time Warp is traditionally
implemented between individual LPs.

We also develop a family of three checkpointing algorithms for use with CTW, each of
which occupies a different point in the spectrum of possible trade‐offs between memory
usage and execution time. The algorithms were implemented and tested on several digital
logic circuits and their speed, number of states saved and maximal memory consumption
were compared to Time Warp. Our results showed that one of the algorithms saved an
average of 40% of the maximal memory consumed by Time Warp while the other two
decreased the maximal usage by 15 and 22%, respectively. The latter two algorithms
exhibited a speed comparable to Time Warp, while the first algorithm was 60% slower.

We investigated the scalability of CTW using 3 different queuing models and different
service‐time distributions and showed that the algorithm acts to limit the explosion of
rollbacks exhibited by Time Warp. Furthermore, we showed that the memory
requirements for CTW are three times smaller than that of Time Warp for one model
and half as large for the two other models.
CADRE: A Low‐power, Low‐EMI DSP Architecture for Digital Mobile Phones
Authors: Lewis Mike , Brackenbury Linda
Published: September 2007

Current mobile phone applications demand high performance from the DSP, and future
generations are likely to require even greater throughput. However, it is important to
balance these processing demands against the requirement of low power consumption
for extended battery lifetime. A novel low‐power digital signal processor (DSP)
architecture CADRE (Configurable Asynchronous DSP for Reduced Energy) addresses
these requirements through a multi‐level power reduction strategy. A parallel architecture
and configurable compressed instruction set meets the throughput requirements
without excessive program memory bandwidth, while a large register file reduces the
cost of data accesses. Sign‐magnitude representation is used for data, to reduce switching
activity within the datapath. Asynchronous design gives fine‐grained activity control
without the complexities of clock gating, and gives low electromagnetic interference.
Finally, the operational model of the target application allows for a reduced interrupt
structure, simplifying processor design by avoiding the need for exact exceptions.
On Mixed PTL/Static Logic for Low‐power and High‐speed Circuits
Authors: Cho Geun Rae , Chen Tom
Published: September 2007

We present more evidence in a 0.25 μm CMOS technology that the pass‐transistor logic
(PTL) structure that mixes conventional PTL structure with static logic gates can
achieve better performance and lower power consumption compared to conventional
PTL structure. The goal is to use the static gates to perform both logic functions as well
as buffering. Our experimental results demonstrate that the proposed mixed PTL
structure beats pure static structure and conventional PTL in 9 out of 15 test cases for
either delay or power consumption or both in a 0.25 μm CMOS process. The average
delay, power consumption, and power‐delay product of the proposed structure for 15
test cases are 10% to 20% better of than the pure static implementations and up to 50%
better than the conventional PTL implementations.
Low Power Built‐In Self‐Test Schemes for Array and Booth Multipliers
Authors: Bakalist D. , Kavousianos X. , Vergos H. T. , Nikolos D. , Alexiou G. Ph.
Published: September 2007

Recent trends in IC technology have given rise to a new requirement, that of low power
dissipation during testing, that Built‐In Self‐Test (BIST) structures must target along
with the traditional requirements. To this end, by exploiting the inherent properties of
Carry Save, Carry Propagate and modified Booth multipliers, in this paper we propose
new power‐efficient BIST structures for them. The proposed BIST schemes are derived
by: (a) properly assigning the Test Pattern Generator (TPG) outputs to the multiplier
inputs, (b) modifying the TPG circuits and (c) reducing the test set length. Our results
indicate that the total power dissipated during testing can be reduced from 29.3% to
54.9%, while the average power per test vector applied can be reduced from 5.8% to
36.5% and the peak power dissipation can be reduced from 15.5% to 50.2% depending
on the implementation of the basic cells and the size of the multiplier. The test
application time is also significantly reduced, while the introduced BIST schemes
implementation area is small.
Expanding Spectrum of Human
RYR2
-Related Disease
Authors: Bhuiyan Zahurul A. , van den Berg Maarten P. , van Tintelen J. Peter , Bink-Boelkens Margreet T.E. , Wiesfeld Ans C.P. , Alders Marielle , Postma Alex V. , van Langen Irene , Mannens Marcel M.A.M. , Wilde Arthur A.M.
Published: September 2007

Background—

Catecholaminergic polymorphic ventricular tachycardia is a disease characterized by ventricular arrhythmias elicited exclusively under adrenergic stress. Additional features include baseline bradycardia and, in some patients, right ventricular fatty displacement. The clinical spectrum is expanded by the 2 families described here.

Methods and Results—

Sixteen members from 2 separate families have been clinically evaluated and followed over the last 15 years. In addition to exercise-related ventricular arrhythmias, they showed abnormalities in sinoatrial node function, as well as atrioventricular nodal function, atrial fibrillation, and atrial standstill. Left ventricular dysfunction and dilatation was present in several affected individuals. Linkage analysis mapped the disease phenotype to a 4-cM region on chromosome 1q42-q43. Conventional polymerase chain reaction–based screening did not reveal a mutation in either the Ryanodine receptor 2 gene (
RYR2
) or
ACTN2
, the most plausible candidate genes in the region of interest. Multiplex ligation-dependent probe amplification and long-range polymerase chain reaction identified a genomic deletion that involved
RYR2
exon-3, segregated in all the affected family members (n=16) in these 2 unlinked families. Further investigation revealed that the genomic deletion occurred in both families as a result of
Alu
repeat–mediated polymerase slippage.

Conclusions—

This is the first report on a large genomic deletion in
RYR2
, which leads to extended clinical phenotypes (eg, sinoatrial node and atrioventricular node dysfunction, atrial fibrillation, atrial standstill, and dilated cardiomyopathy). These features have not previously been linked to
RYR2
.
Theories of Policy Diffusion
Authors: Sugiyama Natasha Borges
Published: September 2007

Brazil's democratic constitution granted municipalities responsibility to design and implement social policies, allowing for tailored programs to meet local constituent demands. Yet instead of pursuing local diversity, many governments chose to emulate programs made famous elsewhere. What explains the diffusion of social programs across Brazil? This article investigates whether policy makers are motivated by political self-interest, ideology, or socialized norms. It draws on an event history analysis of two innovative programs that have diffused throughout Brazil's largest cities: Bolsa Escola, an education program, and Programa Saúde da Família, a family health program. The author argues that political incentives, such as electoral competition, cannot explain diffusion. Rather, diffusion occurs when left-of-center mayors are ideologically compelled to enact these programs and when public officials with connections to professional networks are socialized to follow professional norms.
Beneficial effect of moderate alcohol consumption on vascular disease: myth or reality?
Authors: Papadakis J.A. , Ganotakis E.S. , Mikhailidis D.P.
Published: September 2007

Moderate ethanol consumption (1-3 drinks/day on 5-6 days/week) has a favourable effect on vascular disease-related mortality and morbidity [especially ischaemic heart disease (IHD)]. This cardioprotective effect may be due to significant effects on cardiovascular risk factors such as high density cholesterol (HDL) concentration (HDL protects from IHD) and an inhibition of platelet aggregation (increased platelet aggregability predicts coronary events).

In contrast, alcoholics and problem drinkers have an excess of IHD-related, and possibly stroke-related, mortality. Excessive alcohol intake may raise the blood pressure. Prolonged alcohol abuse can also result in alcoholic ?? muscle disease. Alcohol is the major cause of non-ischaemic cardiomyopathy in Western society.

Although there is a widespread belief that red ?? protects more than other alcoholic beverages, several studies do not support this interpretation.
A rapid appraisal method for the selection and pre-testing of environmental health leaflets
Authors: Harvey H.D. , Fleming P.
Published: September 2007

This paper presents a rapid appraisal method for the selection and pre-testing of printed leaflets on environmental health issues. The method com bines a staff questionnaire, a readability test and a target population survey and is designed to aid leaflet selection in a way which is practically feasi ble yet retaining an acceptable level of face validi ty. A multiple, embedded case study was used to field-test the method and the feedback from this is discussed. The results suggest that the method has the potential to replace ad hoc arrangements by the gatekeepers and make the selection of leaflets more a matter of structured decision- making involving representatives of all the stake- holders.
A preliminary assessment of two hospital food service systems using parameters of food safety and consumer opinion
Authors: Hartwell H. , Edwards J S A
Published: September 2007

The goal of any hospital caterer should be to provide food that meets nutritional requirements, satisfies the patient, improves morale and is microbiologically safe. Food distribution to hospital wards plays a critical role. The aim of this study was to compare two hospital food service systems using parameters of food safety and consumer opinion.

An NHS hospital was selected where food delivery was due to change from a plated system to a cafeteria trolley system.

Samples (50g) of dishes (n=27) considered to be high-risk were collected for three consecutive days from breakfast, lunch and supper meals. The samples were taken from a pre-ordered tray (similar to that of a patient) in the plated system and from the trolley on the ward in the cafeteria system of meal delivery (approxi mately six months after its introduction). Consumer opinions cards (n=180) were distributed and interviews also conducted.

Microbiologically, the quality of food items delivered by both systems was satisfactory. However, concern was raised with the plated system, not for hot foods cooling down but for chilled foods warming up and being sustained in ambient conditions. Overall con sumer satisfaction and experience was enhanced with the trolley system. Food was hotter and generally per ceived to be of a better quality. Satisfaction with cold desserts was not dependent on the delivery system.
Health Monitoring in Industry: Medical Considerations
Authors: Gädian T.
Published: September 2007

MPROVED TECHNIQUES in monitoring the atmosphere and the worker have facilitated the task of the occupational physician in the prevention and early diagnosis of industrial disease.

There is still, however, much to be done, as in the case of many chemicals there is as yet insufficient knowledge of their harmful potential — in particular of what level of concentration, if any, is sufficiently small as to render them harmless.
Indoor Moulds and Asthma
Authors: Burr M.L. , Mullins J. , Merrett T.G. , Stott N.C.H.
Published: September 2007

SEVENTY-TWO ASTHMATIC patients aged 15 to 60 years were identified in a general practice. Together with 72 controls, matched for age and sex, they were investigated for evidence of allergy to moulds. Positive skin tests (weal at least 3mm greater in diameter than for saline control) to any of five moulds occurred in nine asthmatics and one control. Using RAST assay, IgE antibodies to any of four moulds were found in 38 asthmatics and 7 controls. Visible moulds were reported in the homes of 19 asthmatics (26%) and controls (12.5%). Penicillium was the mould most commonly found in the home and to which antibodies most often occurred, especially in the houses with mould. Exposure to indoor mould, especially Penicil lium, may be a contributory factor to the disease in some asthmatic patients.
Care of the Elderly : The Nurse's Role
Authors: Wright Stephen G.
Published: September 2007

THIS PAPER examines the nursing input past and present, in relation to organising the care of the older patient. It addresses itself specifically to the value of nurse and patient participation in designing decor and accommodation and draws upon the experiences with the opening of a new acute hospital unit and the restructuring of an old 'workhouse' setting. It examines the benefit and difficulties of such activity. The paper will also discuss the approach strategies for nurses in organising their care so that nurses and patients can work in partnership.
Bowel Habit and Dietary Fibre Intake Before and During Menstruation
Authors: Jill Davies G. , Collins Amanda L. P. , Mead Jacqueline J.
Published: September 2007

The stool frequency, faecal form and dietary fibre intakes of 25 menstruating women were recorded during the 4 days just before menstruation and the first 4 days of menstruation. At the time of the bleed there was a significant increase (P < 0.01) in stool frequency, a significant decrease (P < 0.001) in faecal form and a significant increase (P < 0.01) in dietary fibre intake. There are indications that cyclical changes in fibre intake may have some bearing on differences in bowel function between the luteal phase and menses although other factors would appear to play a dominant role.
The Research Challenge for the Professions Allied to Medicine
Authors: Williams C.S.
Published: September 2007

The transfer of health care schools into Higher Education, coupled with the universal development of degree programmes has resulted in the need to develop research strategies for the Professions Allied to Medicine (PAMs). While considerable reliance has to be placed on the University sector to lead and encourage research activity, it is essential to recognise the need to maintain and develop links with clinical colleagues and to promote the growth of interdisciplinary research. A variety of areas which could allow early fruition of collaborative work between the professions are proposed.
Sustaining Health Service Developments in the 'Third World'
Authors: MacLachlan Malcolm
Published: September 2007

An increasing number of 'third world' health development projects are proving to be unsustainable once foreign aid has been withdrawn. It is argued that this is partly due to the fact that such projects usually deliver health care free of charge rather than allowing communities to incorporate the costs of health care into their local economies. There

should be more emphasis on health development projects paying for themselves from the outset. Such projects might also incorporate the extant community based infra-structure of traditional medicine through direct collaboration with its practitioners.
Arena Tests with Piperonal, A New Louse Repellent
Authors: Peock Susan , Maunder J.W.
Published: September 2007

Piperonal, once used to kill lice in Australian hospitals, was acclaimed as an effective pediculicide (Corlette, 1925) by the standards of the day. It is unusual in also exhibiting a repellent action against lice, a property only recently realised. A new, easy to use, low-fragrance, pump action spray, which incorporates 2% piperonal, was tested in the laboratory using clothing lice in an arena test and was found to exhibit consistently high repellency after half an hour, dropping only slightly after 24 hours. A well known multi-purpose insect repellent, diethyltoluamide (DEET), was then tested against piperonal. A 2% solution of piperonal was found to be almost twice as effective as a 50% solution of DEET.

In arena tests using lice with the tip segments of both antennae removed, no behavioural differences or statistically significant differences from a random distribution could be found between untreated and Rappell-treated areas. This strongly suggests that sense organ(s) on the tip of the antenna are necessary for detection of the repellent.

Although there can be no strict correlation between results in the laboratory and potential efficacy in the field, materials such as insecticides found to be effective in the laboratory have been found to be equally effective in the field. Furthermore, what with the threat of resistance to head lice insecticides, ineffectual treatment and the lack of contact tracing, a repellent would be of obvious use in the control of head lice.
A Comparison of Community Pharmacists' and General Practitioners' Opinions on Rational Prescribing, Formularies and other Prescribing Related Issues
Authors: Nathan Alan , Sutters Carol Ann
Published: September 2007

A postal survey of Community Pharmacists (CPs) and General Medical Practitioners (GPs) in the Enfield and Haringey (E&H) and North Yorkshire (N Yorks) Family Health Services Authority (FHSA) areas was carried out to investigate:

a. their opinions regarding clinically orientated 'extended' roles for CPs, and the possibility of interprofessional collaboration on them, and

b. their views on a range of prescribing related issues.

The overall response rate was 67 % for CPs and 42% for GPs. There were no significant differences in responses to ques tions between CPs in both FHSAs, but significant differ ences in answers to some questions between the two groups of GPs, due to a large proportion of dispensing GPs in N Yorks. Results were therefore expressed as comparisons between total numbers of CPs and GPs, and between dispensing and non-dispensing GPs. The results showed an affinity of outlook between CPs and GPs on a range of prescribing related issues, and considerable goodwill between the two groups on which future cooperation could be founded. GPs were, however, significantly less enthusiastic than CPs about collaboration in areas which would concede a role to CPs in making prescribing decisions. GPs were most favourably disposed to collaboration in areas such as the provision of drug information, which could be considered as within CPs' domain of specialist expertise.
Lactation - How Important is it?
Authors: MacIntyre U.E. , Walker A R P
Published: September 2007

In Africa, with poverty rising, and health care diminishing, a nutritional question is — what are the limits of successful physiological adaptation to low dietary intakes? In this review the practice of lactation is discussed, from both past and present viewpoints. Orthodox Recommended Allowances for lactation are scarcely ever met. Yet, through various adaptations, the huge majority of African and similarly placed mothers lactate successfully and produce milk of good quantity and quality. The benefits from supplements are discussed; broadly, results have been disappointing. Some good and adverse non-dietary practices are considered. Benefits for infant and mother from lactation, even for protracted periods, far exceed drawbacks.
The aetiology of mandibular fractures at an urban centre
Authors: Asadi Syed Ghias , Asadi Zenobia
Published: September 2007

The objectives of this study were to determine the common aetiological factors leading to the fracture of the lower jaw (mandible) at an urban centre in England.

A total of 96 patients presented to the Manchester Royal Infirmary with mandibular fractures during the calendar years 1991 and 1992.

It was determined that the main aetiological factor leading to the disturbance of the mandibular contours was assault or interpersonal violence (74%) followed by falls, road traffic accidents and sporting injuries. The majority of the subjects were males and most of the patients were in the age group of 20-29 years.

In most of the patients there was a unilateral pattern of injury and the angle was the most vulnerable area of the lower jaw to be traumatised.
Psychological effects of cardiac surgery: a review of the literature
Authors: Gardner Freda V. , Worwood Emma V.
Published: September 2007

Cardiac surgery is now offered to more patients than ever before. Different age groups are affected by different forms of the disease and, as a result, patients range from new born infants to those in their eighties. In recent years attention has begun to focus on the psychological effects of such surgery. This article considers current research into the cognitive, psychiatric and psychological changes associated with cardiac surgery, with specific reference to coronary artery bypass grafting (CABG).
Promoting Oral Health in Institutionalised Older Adults
Authors: Holmes Susan
Published: September 2007

Current demographic trends necessitate that increased attention be paid to prob lems arising in the older population. One such area relates to the oral cavity, which may be affected by both the effects of aging and the effects of disease and illness. Yet the evidence shows a significant lack of adequate oral care, which may create major problems for affect ed individuals, causing oral and dental problems that may, in turn, predispose to nutritional deficiencies. communication difficulties and devastating dental disease (Ogle, 1982). This paper reviews the literature pertaining to this complex subject, concluding that although nurses have an important role in providing effective oral care for the institutionalised patient, it is difficult to identify appropriate techniques, agents and tools with which to provide such care. Further research in this field is undoubtedly needed.
A chemical biology screen identifies glucocorticoids that regulate c-maf expression by increasing its proteasomal degradation through up-regulation of ubiquitin
Authors: Mao Xinliang , Stewart A. Keith , Hurren Rose , Datti Alessandro , Zhu Xuegong , Zhu Yuanxiao , Shi Changxin , Lee Kyle , Tiedemann Rodger , Eberhard Yanina , Trudel Suzanne , Liang Shengben , Corey Seth J. , Gillis Lisa C. , Barber Dwayne L. , Wrana Jeffery L. , Ezzat Shereen , Schimmer Aaron D.
Published: September 2007

The oncogene c-maf is frequently overexpressed in multiple myeloma cell lines and patient samples and contributes to increased cellular proliferation in part by inducing cyclin D2 expression. To identify regulators of c-maf, we developed a chemical screen in NIH3T3 cells stably overexpressing c-maf and the cyclin D2 promoter driving luciferase. From a screen of 2400 off-patent drugs and chemicals, we identified glucocorticoids as c-maf–dependent inhibitors of cyclin D2 transactivation. In multiple myeloma cell lines, glucocorticoids reduced levels of c-maf protein without influencing corresponding mRNA levels. Subsequent studies demonstrated that glucocorticoids increased ubiquitination-dependent degradation of c-maf and up-regulated ubiquitin C mRNA. Moreover, ectopic expression of ubiquitin C recapitulated the effects of glucocorticoids, demonstrating regulation of c-maf protein through the abundance of the ubiquitin substrate. Thus, using a chemical biology approach, we identified a novel mechanism of action of glucocorticoids and a novel mechanism by which levels of c-maf protein are regulated by the abundance of the ubiquitin substrate.
Gene delivery into mouse retinal ganglion cells by in utero electroporation
Authors: Garcia-Frigola Cristina , Carreres Maria Isabel , Vegar Celia , Herrera Eloisa
Published: September 2007

Background

The neural retina is a highly structured tissue of the central nervous system that is formed by seven different cell types that are arranged in layers. Despite much effort, the genetic mechanisms that underlie retinal development are still poorly understood. In recent years, large-scale genomic analyses have identified candidate genes that may play a role in retinal neurogenesis, axon guidance and other key processes during the development of the visual system. Thus, new and rapid techniques are now required to carry out high-throughput analyses of all these candidate genes in mammals. Gene delivery techniques have been described to express exogenous proteins in the retina of newborn mice but these approaches do not efficiently introduce genes into the only retinal cell type that transmits visual information to the brain, the retinal ganglion cells (RGCs).

Results

Here we show that RGCs can be targeted for gene expression by in utero electroporation of the eye of mouse embryos. Accordingly, using this technique we have monitored the morphology of electroporated RGCs expressing reporter genes at different developmental stages, as well as their projection to higher visual targets.

Conclusion

Our method to deliver ectopic genes into mouse embryonic retinas enables us to follow the course of the entire retinofugal pathway by visualizing RGC bodies and axons. Thus, this technique will permit to perform functional studies in vivo focusing on neurogenesis, axon guidance, axon projection patterning or neural connectivity in mammals.
Severe mental illness and mortality of hospitalized ACS patients in the VHA
Authors: Plomondon Mary E , Ho P Michael , Wang Li , Greiner Gwendolyn T , Shore James H , Sakai Joseph T , Fihn Stephan D , Rumsfeld John S
Published: September 2007

Background

Severe mental illness (SMI) has been associated with more medical co-morbidity and less cardiovascular procedure use for older patients with myocardial infarction. However, it is unknown whether SMI is associated with increased long term mortality risk among patients presenting with acute coronary syndromes (ACS). We tested the hypothesis that SMI is associated with higher one-year mortality following ACS hospitalization.

Methods

All ACS patients (n = 14,194) presenting to Veterans Health Administration (VHA) hospitals between October 2003 and September 2005 were included. Survival analysis evaluated the association between SMI and one-year all-cause mortality, adjusting for demographics, co-morbidities, in-hospital treatment, and discharge medications.

Results

Overall, 18.4 % of ACS patients had SMI. Patients with SMI were more likely female, younger, Caucasian race, have a history of alcohol abuse, liver disease, dementia, hypertension and more likely to be a current smoker; however, prior cardiac history was similar between the 2 groups. There were no significant differences in cardiac procedure use, including coronary angiogram (38.7% vs. 40.3%, p = 0.14) or coronary revascularization (31.0% vs. 32.3%, p = 0.19), and discharge medications between those with and without SMI. One-year mortality was lower for patients with SMI (15.8% vs. 19.1%, p < 0.001). However, in multivariable analysis, there were no significant differences in mortality (HR 0.91; 95% CI 0.81–1.02) between patients with and without SMI.

Conclusion

Among ACS patients in the VHA, SMI is prevalent, affecting almost 1 in 5 patients. However, patients with SMI were as likely to undergo coronary revascularization and be prescribed evidence-based medications at hospital discharge, and were not at elevated risk of adverse 1-year outcomes compared to patients without SMI.
OCPAT: an online codon-preserved alignment tool for evolutionary genomic analysis of protein coding sequences
Authors: Liu Guozhen , Uddin Monica , Islam Munirul , Goodman Morris , Grossman Lawrence I , Romero Roberto , Wildman Derek E
Published: September 2007

Background

Rapidly accumulating genome sequence data from multiple species offer powerful opportunities for the detection of DNA sequence evolution. Phylogenetic tree construction and codon-based tests for natural selection are the prevailing tools used to detect functionally important evolutionary change in protein coding sequences. These analyses often require multiple DNA sequence alignments that maintain the correct reading frame for each collection of putative orthologous sequences. Since this feature is not available in most alignment tools, codon reading frames often must be checked manually before evolutionary analyses can commence.

Results

Here we report an online codon-preserved alignment tool (OCPAT) that generates multiple sequence alignments automatically from the coding sequences of any list of human gene IDs and their putative orthologs from genomes of other vertebrate tetrapods. OCPAT is programmed to extract putative orthologous genes from genomes and to align the orthologs with the reading frame maintained in all species. OCPAT also optimizes the alignment by trimming the most variable alignment regions at the 5' and 3' ends of each gene. The resulting output of alignments is returned in several formats, which facilitates further molecular evolutionary analyses by appropriate available software. Alignments are generally robust and reliable, retaining the correct reading frame. The tool can serve as the first step for comparative genomic analyses of protein-coding gene sequences including phylogenetic tree reconstruction and detection of natural selection. We aligned 20,658 human RefSeq mRNAs using OCPAT. Most alignments are missing sequence(s) from at least one species; however, functional annotation clustering of the ~1700 transcripts that were alignable to all species shows that genes involved in multi-subunit protein complexes are highly conserved.

Conclusion

The OCPAT program facilitates large-scale evolutionary and phylogenetic analyses of entire biological processes, pathways, and diseases.
Chronic fatigue syndrome
Authors: Lynch Sean
Published: September 2007

“Chronic fatigue syndrome” (Sharpeet al, 1991) is an operational definition for conditions of disabling physical fatigue, of over six months duration, unexplained by primary physical or psychiatric causes. It encompasses nomenclature such as “myalgic encephalomyelitis” (Acheson, 1959), “post-viral fatigue syndrome” (Behanet al, 1985) and “chronic mononucleosis syndrome” (Straus, 1988).
Psychological trauma in children and adolescents
Authors: Hendriks Jean Harris , Newman Martin
Published: September 2007

During the last decade, direct work with children who have experienced public disaster or private catastrophe, such as abuse, neglect and other intrafamilial crime, has led to the recognition that classifications of post-traumatic stress disorder are relevant to childhood psychopathology. Comorbidity is common. Traumatised children who also are bereaved or dislocated are hindered in mourning and in the capacity to sustain or form attachments. Adult psychopathology often may be linked with unrecognised or underestimated effects of psychological trauma during childhood and adolescence. This paper discusses therapeutic interventions, outlines research hypotheses and provides an introductory bibliography.
A district framework for managing psychosocial aspects of disaster
Authors: Hobbs Mike
Published: September 2007

Natural disasters occur infrequently in Europe, but the spate of transportation, crowd and other disasters in the late 1980s challenged our collective denial of potential catastrophe. Greater attention is now given also to the frequent small-scale traumatic events which are just as devastating to the many people affected by them, such as violent assaults and road accidents.
Cognitive behaviour therapy for whom?
Authors: Moorey Stirling
Published: September 2007

In many ways cognitive and behavioural therapies represent the acceptable face of psychotherapy for the general psychiatrist. They are brief, focused, problem-oriented treatments, which take symptoms seriously. They show an affinity for the medical model in their acceptance of diagnostic categories and their commitment to effective evaluation of treatments through randomised controlled trials. The wide applicability of these therapies is also attractive to the general psychiatrist. Cognitive and behavioural techniques are of major importance in the treatment of anxiety disorders, depression, eating disorders, and sexual dysfunctions, and beyond this core group the methods can be applied to enhance coping and change unwanted behaviours in conditions as diverse as cancer, chronic pain, substance abuse, anger control, schizophrenia, and challenging behaviours in people with learning disabilities.
Management of an acutely disturbed new admission
Authors: Cookson J.
Published: September 2007

A 25-year-old Bengali man was taken to casualty by relatives who were concerned about his unpredictable and dangerous behaviour. He lived close to his parents and five younger siblings, and there was no family history of mental disorder.
Medication in the treatment of alcohol dependence
Authors: Chick Jonathan
Published: September 2007

Social, cultural, emotional and biological influences determine whether people drink to excess and whether they then experience harm or cause harm to others (Cook, 1994). Psychosocial treatments for alcohol dependence are only modestly successful, with most studies finding that at least 50% of patients return to harmful drinking in the following year. In the past decade there has been new evidence for the role of pharmacological treatments in reducing harm from drinking and in preventing relapse.
The psychiatry of HIV infection
Authors: Catalan José
Published: September 2007

In 1981 the condition that was later to be known as the acquired immune deficiency syndrome (AIDS) was described, and in 1983 its causative agent, the human immunodeficiency virus 1 (HIV-1), was isolated. The past 15 years have led to a growing awareness of the global nature of the epidemic and, in parallel with it, to the recognition of its medical, socioeconomic and psychological consequences. In the UK, almost 12 000 AIDS cases have been reported since 1982, and more than 25 000 cases of HIV-1 infection have been identified since 1984. Most cases of AIDS and HIV-1 have been in the Thames Regions, and it is expected that this geographical pattern will continue until the end of the decade.
Persuading the sick or impaired doctor to seek treatment
Authors: Brandon Sydney
Published: September 2007

A recent working party report published by the Nuffield Provincial Hospitals Trust (1996) made a series of recommendations for the improvement and better coordination of existing services. This comes at a time when new and expensive counselling services are springing up everywhere, the most ambitious being the British Medical Association's 24-hour counselling service for doctors and their relatives.
Treatment of the patient with long-term schizophrenia
Authors: Mortimer Ann
Published: September 2007

At most, 15% of patients in Western countries remain free of relapse after their first episode of schizophrenia (Crow et al, 1986). Like many chronic illnesses, schizophrenia can be controlled by appropriate treatment, but there may be a gradual deterioration over time. This encompasses problems such as loss of self-care, communication and community skills; negative symptoms of poverty of affect and ideation; cognitive impairment; behaviour problems such as aggression; and poorly controlled positive symptoms.
Influence of parental eating disorder on children
Authors: Woolley H. , Wheatcroft R. , Stein A.
Published: September 2007

It is now well established that children of parents who have psychiatric disorders are at risk of developing disturbances themselves (Rutter, 1989; Garmezy & Masten, 1994). Of particular concern is that these disturbances may persist well after remission of the parental disorder. Eating disorders occur commonly among women of child-bearing age (Szmukler, 1985; Fairburn & Beglin, 1990) and the prevalence seems to be rising (Treasure et al, 1996). Estimates indicate that at least 2% of women aged 16–40 suffer from bulimia nervosa or anorexia nervosa, and up to 4% when other eating disorders are considered (Fairburn & Beglin, 1990; Hoek, 1993). It is therefore surprising that the potential implications for their offspring have received so little attention until recently. Knowledge of whether these children are at risk and the mechanisms underlying any transmission of disturbance is important so that appropriate treatment can be instituted and preventive strategies put in place.
Pharmacological management of treatment-resistant depression
Authors: Cowen P. J.
Published: September 2007

The management of patients with depression who have failed to respond to antidepressant medication is a common problem in general and old age psychiatry. It has been estimated that about 20–30% of patients with major depression fail to respond to treatment with a single antidepressant drug given in adequate dosage for an appropriate period of time. At the current time there are many possible ways to pursue pharmacological treatment, but few controlled trials to help us choose between the various options. In addition there are few clinical predictors to help match patients to an appropriate treatment.
Commentary
Authors: Neill D.
Published: September 2007

The article by Byrne gives a general overview of dementia with Lewy bodies (LBD) and discusses treatment in terms of modulation of neurotransmitter systems, treatment of psychotic symptoms and extrapyramidal features. However, as is the case with Alzheimer's disease, the dementia is related to underlying pathological processes which result in death and/or malfunction of neurons. Prevention or amelioration of this neuronal loss is therefore the ultimate aim of treatment. Such treatment is not yet available and the possibility of its development is likely to depend on further elucidation of the underlying pathological process. The relationship of LBD to Alzheimer's disease and Parkinson's disease should be considered, as this is important for the determination of the underlying pathological processes in LBD.
Commentary
Authors: Ballard C.
Published: September 2007

Byrne provides an excellent clinical overview. However, I have selected four areas of clinical interest for more detailed consideration.
Familial risks and genetic counselling for common psychiatric disorders
Authors: Scourfield Jane , McGuffin Peter
Published: September 2007

The main aim of genetic counselling is to inform about disorders that may have a genetic basis. The following definition is a helpful starting point:
Expert evidence and the courts: 1. The history of expert evidence
Authors: Rix Keith J. B.
Published: September 2007

Recommendations by Lord Woolf for the reform of the civil justice system in England and Wales include proposals which are already beginning to influence the provision of expert evidence to the courts. Lord Woolf has himself been instrumental in the establishment of an Expert Witness Institute which has caused some controversy in medical circles. It is no coincidence that all of this is happening at a time when the courts are delivering judgments which are particularly critical of some expert witnesses.
Planning services for the elderly
Authors: Spencer Greg , Jolley David
Published: September 2007

“The psychiatric aspects of ageing are a major problem in any country which, like our own, has a low net reproduction rate and a high standard of social responsibility. The proportion of old people in the community steadily increases so that they provide an increasingly high proportion of our mentally infirm who must be cared for”.
Research in India: success through collaboration
Authors: Thara R. , McCreadie R. G.
Published: September 2007

Those contemplating research in developing countries should bear in mind the following: the collective wisdom of both foreign and local investigators should be pooled to determine the most appropriate research questions and ethical obligations. Several collaborative research programmes launched by the World Health Organization (WHO) have shown that it is eminently possible to engage in high-quality cross-cultural research, and many of these studies have generated a wealth of data from developing countries. Rigorous and highly sophisticated studies are possible in the developing world (Wilson, 1990). At the Schizophrenia Research Foundation (SCARF) we have had several opportunities to collaborate successfully with researchers both within and outside India (Eaton et al, 1995; Thara & Eaton, 1996). This success has largely been due to mutual respect for one another's expertise and role with no room for patronisation and condescension.
Acquisition of clinical skills
Authors: Gask Linda
Published: September 2007

“No-one except you and the patient really know what happens when you take him for an interview. You learn from your own mistakes behind the closed door” (Adams & Cook, 1984).

Clinical skills in psychiatry are not best acquired in unsupervised practice or in learning by apprenticeship. In the past, it was reported that during the course of their clinical training, students' interviewing skills actually deteriorated rather than improved (Helfer, 1970; Maguire & Rutter, 1976), although recent research suggests that improved training is now having an impact (Davis & Nicholaou, 1992). The methods described below may be employed at both undergraduate and postgraduate level. Traditionally, psychiatrists have been actively involved, along with general practitioners, in the provision of communication skills training to undergraduates. In the future, this training will become a continuous process carried out alongside and within other teaching in all specialities (Gushing, 1996). One of the biggest challenges facing medical schools is how to engage and train clinical teachers from a range of specialities in facilitating students in the acquisition of clinical interpersonal skills.
Successful small group teaching
Authors: Worrall-Davies Anne
Published: September 2007

The aims of this article are to provide guidance on how to facilitate small group teaching and to address ways in which learners can be actively involved in the small group setting.
Assessment and examination
Authors: Jolly Brian
Published: September 2007

A 19-year-old student, wandering the streets of a Northern city, is picked up at 3am by a taxi driver. The student requests delivery to a fictitious destination. The student recounts to the driver a series of events including abandonment by parents at the age of six in a forest in the West Country, and subsequent adoption by an elderly couple who live in Birmingham. The taxi driver takes the student to the central police station, where, after a brief interview, sectioning under the Mental Health Act 1983 takes place.
Psychiatry in the new undergraduate curriculum
Authors: Ring Howard , Mumford David , Katona Cornelius
Published: September 2007

Recognising the vast extent of psychiatric morbidity internationally and the burden of mental illness on people, communities and nations, the World Psychiatric Association and the World Federation for Medical Education have recently published global guidelines for developing core curricula in psychiatry for medical students (Walton & Gelder 1999). More locally, major changes are taking place in undergraduate medical education throughout the UK. These changes represent a response to the appreciation, both by medical schools and by the General Medical Council (GMC), of two major pressures in undergraduate education. The first is that students have been asked over the years to accumulate more and more factual knowledge while the knowledge base in medicine itself expands and changes more rapidly. The second is that both understanding of illness and delivery of care are developing an increasing focus on the role of the community and community support. These general pressures have led to a number of specific recommendations, initially put forward by the GMC in their document Tomorrow's Doctors (GMC, 1993). This document encourages the reduction of ‘core knowledge’ taught to medical students to 65% of what has previously been taught, together with the identification of special study modules (SSMs), which would fill the remaining time in the curriculum. These SSMs would allow students to explore areas of particular interest in greater depth than was previously possible.