bluuebunny/crossref_metadata_2025 huggingface dataset:
Incorporating significant amino acid pairs to identify O-linked glycosylation sites on transmembrane proteins and non-transmembrane proteins
Authors: Chen Shu-An , Lee Tzong-Yi , Ou Yu-Yen
Published: October 2010

Background

While occurring enzymatically in biological systems, O-linked glycosylation affects protein folding, localization and trafficking, protein solubility, antigenicity, biological activity, as well as cell-cell interactions on membrane proteins. Catalytic enzymes involve glycotransferases, sugar-transferring enzymes and glycosidases which trim specific monosaccharides from precursors to form intermediate structures. Due to the difficulty of experimental identification, several works have used computational methods to identify glycosylation sites.

Results

By investigating glycosylated sites that contain various motifs between Transmembrane (TM) and non-Transmembrane (non-TM) proteins, this work presents a novel method, GlycoRBF, that implements radial basis function (RBF) networks with significant amino acid pairs (SAAPs) for identifying O-linked glycosylated serine and threonine on TM proteins and non-TM proteins. Additionally, a membrane topology is considered for reducing the false positives on glycosylated TM proteins. Based on an evaluation using five-fold cross-validation, the consideration of a membrane topology can reduce 31.4% of the false positives when identifying O-linked glycosylation sites on TM proteins. Via an independent test, GlycoRBF outperforms previous O-linked glycosylation site prediction schemes.

Conclusion

A case study of Cyclic AMP-dependent transcription factor ATF-6 alpha was presented to demonstrate the effectiveness of GlycoRBF. Web-based GlycoRBF, which can be accessed at http://GlycoRBF.bioinfo.tw, can identify O-linked glycosylated serine and threonine effectively and efficiently. Moreover, the structural topology of Transmembrane (TM) proteins with glycosylation sites is provided to users. The stand-alone version of GlycoRBF is also available for high throughput data analysis.
Analysis of conditional gene deletion using probe based Real-Time PCR
Authors: Weis Britta , Schmidt Joachim , Lyko Frank , Linhart Heinz G
Published: October 2010

Background

Conditional gene deletion using Cre-lox recombination is frequently used in mouse genetics; however recombination is frequently incomplete, resulting in a mixture of cells containing the functional (2lox) allele and the truncated (1lox) allele. Conventional analysis of 1lox/2lox allele ratios using Southern Blotting is time consuming, requires relatively large amounts of DNA and has a low sensitivity. We therefore evaluated the utility of Real-Time PCR to measure 1lox/2lox allele ratios.

Results

We show that SYBR Green based Real-Time PCR analysis of 1lox/2lox allele ratios can generate erroneous peaks in the melting curve that are possibly caused by alternate hybridization products promoted by the palindromic loxP sequence motif. Since abnormal melting curves frequently contribute to dismissal of SYBR Green based data, we developed a convenient method with improved specificity that avoids such erroneous signals. Our data show that probe based Real-Time PCR, using a universal probe directed against the loxP site, can accurately detect small differences in 1lox/2lox allele ratios. We also validated this method in Fabpl4× at -132-Cre transgenic mice, measuring 1lox/2lox allele ratios that are in agreement with published data. Our Real-Time PCR protocol requires the use of one probe only for all reactions. Also the universal probe established in our assay is generally applicable to any experiment analyzing Cre-lox recombination efficiency, such that only primer sequences have to be adapted.

Conclusions

Our data show that 1lox/2lox allele ratios are detected with high accuracy and high sensitivity with Real-Time PCR analysis using a probe directed against the loxP site. Due to the generally applicable probe the assay is conveniently adapted to all models of Cre-lox mediated gene deletion.
CoNSEnsX: an ensemble view of protein structures and NMR-derived experimental data
Authors: Ángyán Annamária F , Szappanos Balázs , Perczel András , Gáspári Zoltán
Published: October 2010

Background

In conjunction with the recognition of the functional role of internal dynamics of proteins at various timescales, there is an emerging use of dynamic structural ensembles instead of individual conformers. These ensembles are usually substantially more diverse than conventional NMR ensembles and eliminate the expectation that a single conformer should fulfill all NMR parameters originating from 1016 - 1017 molecules in the sample tube. Thus, the accuracy of dynamic conformational ensembles should be evaluated differently to that of single conformers.

Results

We constructed the web application CoNSEnsX (Consistency of NMR-derived Structural Ensembles with eXperimental data) allowing fast, simple and convenient assessment of the correspondence of the ensemble as a whole with diverse independent NMR parameters available. We have chosen different ensembles of three proteins, human ubiquitin, a small protease inhibitor and a disordered subunit of cGMP phosphodiesterase 5/6 for detailed evaluation and demonstration of the capabilities of the CoNSEnsX approach.

Conclusions

Our results present a new conceptual method for the evaluation of dynamic conformational ensembles resulting from NMR structure determination. The designed CoNSEnsX approach gives a complete evaluation of these ensembles and is freely available as a web service at http://consensx.chem.elte.hu.
A study of the TNF/LTA/LTB locus and susceptibility to severe malaria in highland papuan children and adults
Authors: Randall Louise M , Kenangalem Enny , Lampah Daniel A , Tjitra Emiliana , Mwaikambo Esther D , Handojo Tjandra , Piera Kim A , Zhao Zhen Z , de Labastida Rivera Fabian , Zhou Yonghong , McSweeney Karli M , Le Lien , Amante Fiona H , Haque Ashraful , Stanley Amanda C , Woodberry Tonia , Salwati Ervi , Granger Donald L , Hobbs Maurine R , Price Ric N , Weinberg J Brice , Montgomery Grant W , Anstey Nicholas M , Engwerda Christian R
Published: October 2010

Background

Severe malaria (SM) syndromes caused by Plasmodium falciparum infection result in major morbidity and mortality each year. However, only a fraction of P. falciparum infections develop into SM, implicating host genetic factors as important determinants of disease outcome. Previous studies indicate that tumour necrosis factor (TNF) and lymphotoxin alpha (LTα) may be important for the development of cerebral malaria (CM) and other SM syndromes.

Methods

An extensive analysis was conducted of single nucleotide polymorphisms (SNPs) in the TNF, LTA and LTB genes in highland Papuan children and adults, a population historically unexposed to malaria that has migrated to a malaria endemic region. Generated P-values for SNPs spanning the LTA/TNF/LTB locus were corrected for multiple testing of all the SNPs and haplotype blocks within the region tested through 10,000 permutations. A global P-value of < 0.05 was considered statistically significant.

Results

No associations between SNPs in the TNF/LTA/LTB locus and susceptibility to SM in highland Papuan children and adults were found.

Conclusions

These results support the notion that unique selective pressure on the TNF/LTA/LTB locus in different populations has influenced the contribution of the gene products from this region to SM susceptibility.
Anti-bacterial activity of intermittent preventive treatment of malaria in pregnancy: comparative in vitro study of sulphadoxine-pyrimethamine, mefloquine, and azithromycin
Authors: Capan Mesküre , Mombo-Ngoma Ghyslain , Makristathis Athanasios , Ramharter Michael
Published: October 2010

Background

Intermittent preventive treatment of malaria with sulphadoxine-pyrimethamine (SP) is recommended for the prevention of malaria in pregnancy in sub-Saharan Africa. Increasing drug resistance necessitates the urgent evaluation of alternative drugs. Currently, the most promising candidates in clinical development are mefloquine and azithromycin. Besides the anti-malarial activity, SP is also a potent antibiotic and incurs significant anti-microbial activity when given as IPTp - though systematic clinical evaluation of this action is still lacking.

Methods

In this study, the intrinsic anti-bacterial activity of mefloquine and azithromycin was assessed in comparison to sulphadoxine-pyrimethamine against bacterial pathogens with clinical importance in pregnancy in a standard microdilution assay.

Results

SP was highly active against Staphylococcus aureus and Streptococcus pneumoniae. All tested Gram-positive bacteria, except Enterococcus faecalis, were sensitive to azithromycin. Additionally, azithromycin was active against Neisseria gonorrhoeae. Mefloquine showed good activity against pneumococci but lower in vitro action against all other tested pathogens.

Conclusion

These data indicate important differences in the spectrum of anti-bacterial activity for the evaluated anti-malarial drugs. Given the large scale use of IPTp in Africa, the need for prospective clinical trials evaluating the impact of antibiotic activity of anti-malarials on maternal and foetal health and on the risk of promoting specific drug resistance of bacterial pathogens is discussed.
Enabling methods for community health mapping in developing countries
Authors: Ansumana Rashid , Malanoski Anthony P , Bockarie Alfred S , Sundufu Abu James , Jimmy David H , Bangura Umaru , Jacobsen Kathryn H , Lin Baochuan , Stenger David A
Published: October 2010

Background

Spatial epidemiology is useful but difficult to apply in developing countries due to the low availability of digitized maps and address systems, accurate population distributions, and computational tools. A community-based mapping approach was used to demonstrate that participatory geographic information system (PGIS) techniques can provide information helpful for health and community development.

Results

The PGIS process allowed for the rapid determination of sectional (neighborhood) boundaries within the city of Bo, Sierra Leone. When combined with data about hospital laboratory visits, a catchment area for one hospital in Bo could be established. A survey of households from within the catchment area determined that the average population per household (about 6 individuals) was similar to that found in the 2004 census. However, we also found that the average house was inhabited by more than one household, for an average of 17.5 inhabitants per residential building, which is critical information to know when estimating population size using remote imagery that can detect and enumerate buildings.

Conclusions

The methods developed in this paper serve as a model for the involvement of communities in the generation of municipal maps and their application to community and health concerns.
The effects of increased dose of exercise-based therapies to enhance motor recovery after stroke: a systematic review and meta-analysis
Authors: Cooke Emma V , Mares Kathryn , Clark Allan , Tallis Raymond C , Pomeroy Valerie M
Published: October 2010

Background

Exercise-based therapy is known to enhance motor recovery after stroke but the most appropriate amount, i.e. the dose, of therapy is unknown. To determine the strength of current evidence for provision of a higher dose of the same types of exercise-based therapy to enhance motor recovery after stroke.

Methods

An electronic search of: MEDLINE, EMBASE, CINHAL, AMED, and CENTRAL was undertaken. Two independent reviewers selected studies using predetermined inclusion criteria: randomised or quasi randomised controlled trials with or without blinding of assessors; adults, 18+ years, with a clinical diagnosis of stroke; experimental and control group interventions identical except for dose; exercise-based interventions investigated; and outcome measures of motor impairment, movement control or functional activity. Two reviewers independently extracted outcome and follow-up data. Effect sizes and 95% confidence intervals were interpreted with reference to risk of bias in included studies.

Results

9 papers reporting 7 studies were included. Only 3 of the 7 included studies had all design elements assessed as low risk of bias. Intensity of the control intervention ranged from a mean of 9 to 28 hours over a maximum of 20 weeks. Experimental groups received between 14 and 92 hours of therapy over a maximum of 20 weeks. The included studies were heterogeneous with respect to types of therapy, outcome measures and time-points for outcome and follow-up. Consequently, most effect sizes relate to one study only. Single study effect sizes suggest a trend for better recovery with increased dose at the end of therapy but this trend was less evident at follow-up Meta-analysis was possible at outcome for: hand-grip strength, -10.1 [-19.1,-1.2] (2 studies, 97 participants); Action Research Arm Test (ARAT), 0.1 [-5.7,6.0] (3 studies, 126 participants); and comfortable walking speed, 0.3 [0.1,0.5] (2 studies, 58 participants). At follow-up, between 12 and 26 weeks after start of therapy, meta-analysis findings were: Motricity Arm, 10.7 [1.7,19.8] (2 studies, 83 participants); ARAT, 2.2 [-6.0,10.4] (2 studies, 83 participants); Rivermead Mobility, 1.0 [-0.6, 2.5] (2 studies, 83 participants); and comfortable walking speed, 0.2 [0.0,0.4] (2 studies, 60 participants).

Conclusions

Current evidence provides some, but limited, support for the hypothesis that a higher dose of the same type of exercised-based therapy enhances motor recovery after stroke. Prospective dose-finding studies are required.
A possible new syndrome with double endocrine tumors in association with an unprecedented type of familial heart-hand syndrome: a case report
Authors: Demura Masashi , Yoneda Takashi , Karashima Shigehiro , Higashikata Toshinori , Mabuchi Hiroshi , Kawano Mitsuhiro , Yamagishi Masakazu , Takeda Yoshiyu
Published: October 2010

Introduction

The combination of a pituitary prolactinoma and an aldosterone-producing adrenal adenoma is extremely rare. To the best of our knowledge, double endocrine tumors in association with heart-hand syndrome have not previously been reported.

Case presentation

A 21-year-old Japanese woman presented with galactorrhea and decreased visual acuity. A large pituitary adenoma with an increased level of serum prolactin was apparent by computed tomography. She additionally showed mild hypertension (136/90 mmHg) accompanied by hypokalemia. The plasma aldosterone concentration was increased. Computed tomography showed a mass in the right adrenal gland. No other tumors were found despite extensive imaging studies. Physical and radiographic examinations showed skeletal malformations of the hands and feet, including hypoplasia of the first digit in all four limbs. An atrial septal defect was demonstrated by echocardiography. Similar digital and cardiac abnormalities were detected in our patient's father, and a clinical diagnosis of hereditary heart-hand syndrome was made.

Conclusion

No established heart-hand syndrome was wholly compatible with the family's phenotype. Her father had no obvious endocrine tumors, implying that the parent of transmission determined variable phenotypic expression of the disease: heart-hand syndrome with multiple endocrine tumors from the paternal transmission or no endocrine tumor from the maternal transmission. This suggests that the gene or genes responsible for the disease may be under tissue-specific imprinting control.
Lymphocytopenia and neutrophil-lymphocyte count ratio predict bacteremia better than conventional infection markers in an emergency care unit
Authors: de Jager Cornelis PC , van Wijk Paul TL , Mathoera Rejiv B , de Jongh-Leuvenink Jacqueline , van der Poll Tom , Wever Peter C
Published: October 2010

Introduction

Absolute lymphocytopenia has been reported as a predictor of bacteremia in medical emergencies. Likewise, the neutrophil-lymphocyte count ratio (NLCR) has been shown a simple promising method to evaluate systemic inflammation in critically ill patients.

Methods

We retrospectively evaluated the ability of conventional infection markers, lymphocyte count and NLCR to predict bacteremia in adult patients admitted to the Emergency Department with suspected community-acquired bacteremia. The C-reactive protein (CRP) level, white blood cell (WBC) count, neutrophil count, lymphocyte count and NLCR were compared between patients with positive blood cultures (n = 92) and age-matched and gender-matched patients with negative blood cultures (n = 92) obtained upon Emergency Department admission.

Results

Significant differences between patients with positive and negative blood cultures were detected with respect to the CRP level (mean ± standard deviation 176 ± 138 mg/l vs. 116 ± 103 mg/l; P = 0.042), lymphocyte count (0.8 ± 0.5 × 109/l vs. 1.2 ± 0.7 × 109/l; P < 0.0001) and NLCR (20.9 ± 13.3 vs. 13.2 ± 14.1; P < 0.0001) but not regarding WBC count and neutrophil count. Sensitivity, specificity, positive and negative predictive values were highest for the NLCR (77.2%, 63.0%, 67.6% and 73.4%, respectively). The area under the receiver operating characteristic curve was highest for the lymphocyte count (0.73; confidence interval: 0.66 to 0.80) and the NLCR (0.73; 0.66 to 0.81).

Conclusions

In an emergency care setting, both lymphocytopenia and NLCR are better predictors of bacteremia than routine parameters like CRP level, WBC count and neutrophil count. Attention to these markers is easy to integrate in daily practice and without extra costs.
Central venous O2 saturation and venous-to-arterial CO2 difference as complementary tools for goal-directed therapy during high-risk surgery
Authors: Futier Emmanuel , Robin Emmanuel , Jabaudon Matthieu , Guerin Renaud , Petit Antoine , Bazin Jean-Etienne , Constantin Jean-Michel , Vallet Benoit
Published: October 2010

Introduction

Central venous oxygen saturation (ScvO2) is a useful therapeutic target in septic shock and high-risk surgery. We tested the hypothesis that central venous-to-arterial carbon dioxide difference (P(cv-a)CO2), a global index of tissue perfusion, could be used as a complementary tool to ScvO2 for goal-directed fluid therapy (GDT) to identify persistent low flow after optimization of preload has been achieved by fluid loading during high-risk surgery.

Methods

This is a secondary analysis of results obtained in a study involving 70 adult patients (ASA I to III), undergoing major abdominal surgery, and treated with an individualized goal-directed fluid replacement therapy. All patients were managed to maintain a respiratory variation in peak aortic flow velocity below 13%. Cardiac index (CI), oxygen delivery index (DO2i), ScvO2, P(cv-a)CO2 and postoperative complications were recorded blindly for all patients.

Results

A total of 34% of patients developed postoperative complications. At baseline, there was no difference in demographic or haemodynamic variables between patients who developed complications and those who did not. In patients with complications, during surgery, both mean ScvO2 (78 ± 4 versus 81 ± 4%, P = 0.017) and minimal ScvO2 (minScvO2) (67 ± 6 versus 72 ± 6%, P = 0.0017) were lower than in patients without complications, despite perfusion of similar volumes of fluids and comparable CI and DO2i values. The optimal ScvO2 cut-off value was 70.6% and minScvO2 < 70% was independently associated with the development of postoperative complications (OR = 4.2 (95% CI: 1.1 to 14.4), P = 0.025). P(cv-a)CO2 was larger in patients with complications (7.8 ± 2 versus 5.6 ± 2 mmHg, P < 10-6). In patients with complications and ScvO2 ≥71%, P(cv-a)CO2 was also significantly larger (7.7 ± 2 versus 5.5 ± 2 mmHg, P < 10-6) than in patients without complications. The area under the receiver operating characteristic (ROC) curve was 0.785 (95% CI: 0.74 to 0.83) for discrimination of patients with ScvO2 ≥71% who did and did not develop complications, with 5 mmHg as the most predictive threshold value.

Conclusions

ScvO2 reflects important changes in O2 delivery in relation to O2 needs during the perioperative period. A P(cv-a)CO2 < 5 mmHg might serve as a complementary target to ScvO2 during GDT to identify persistent inadequacy of the circulatory response in face of metabolic requirements when an ScvO2 ≥71% is achieved.

Trial registration

Clinicaltrials.gov Identifier: NCT00852449.
Effect of histamine-2-receptor antagonists versus sucralfate on stress ulcer prophylaxis in mechanically ventilated patients: a meta-analysis of 10 randomized controlled trials
Authors: Huang Jiahao , Cao Yunfei , Liao Cun , Wu Liucheng , Gao Feng
Published: October 2010

Introduction

We conducted a meta-analysis in order to investigate the effect of histamine-2-receptor antagonists (H2RA) versus sucralfate on stress ulcer prophylaxis in mechanically ventilated patients in the intensive care unit (ICU).

Methods

A systematic literature search of Medline, EMBASE, Cochrane Central Register of Controlled Trials (1966 to January 2010) was conducted using specific search terms. A review of Web of Science and a manual review of references were also performed. Eligible studies were randomized control trials (RCTs) that compared H2RA and sucralfate for the prevention of stress ulcer in mechanically ventilated patients. Main outcome measures were rates of overt bleeding, clinically important gastrointestinal (GI) bleeding, ventilator-associated pneumonia, gastric colonization and ICU mortality.

Results

Ten RCTs with 2,092 participants on mechanical ventilation were identified. Meta-analysis showed there was a trend toward decreased overt bleeding when H2RA was compared with sucralfate (OR = 0.87, 95% CI: 0.49 to 1.53). A total of 12 clinically important GI bleeding events occurred among 667 patients (1.8%) in the H2RA group compared with 26 events among 673 patients (3.9%) in the sucralfate groups. Prophylaxis with sucralfate decreased the incidence of gastric colonization (OR = 2.03, 95% CI: 1.29 to 3.19) and ventilator-associated pneumonia (OR = 1.32, 95% CI: 1.07 to 1.64). Subgroup analysis showed H2RA was not superior to sucralfate in reducing early-onset pneumonia (OR = 0.62, 95%CI: 0.36 to 1.07) but had a higher late-onset pneumonia rate (OR = 4.36, 95%CI: 2.09 to 9.09) relative to sucralfate. No statistically significant reduction was observed in mortality of ICU between groups (OR = 1.08, 95% CI: 0.86 to 1.34).

Conclusions

In patients with mechanical ventilation, H2RA resulted in no differential effectiveness in treating overt bleeding, but had higher rates of gastric colonization and ventilator-associated pneumonia. Additional RCTs of stress ulcer prophylaxis with H2RA and sucralfate are needed to establish the net benefit and risks of adverse effect in mechanically ventilated patients.
An early circulating factor in severe sepsis modulates apoptosis of monocytes and lymphocytes
Authors: Vaki Ilia , Kranidioti Hariklia , Karagianni Vassiliki , Spyridaki Aikaterini , Kotsaki Antigone , Routsi Christina , Giamarellos-Bourboulis Evangelos J
Published: October 2010

We hypothesized that a factor may circulate in serum early during sepsis, modulating apoptosis of monocytes and lymphocytes. Serum was collected from 20 healthy volunteers and from 48 patients with severe sepsis/shock within 12 h from signs of the first failing organ. PBMCs were isolated from 20 healthy volunteers and incubated with collected sera. Apoptosis and expression of CD95 were determined by flow cytometry; experiments were run in the presence of caspase-8 and caspase-9 inhibitors and of CaCl2. Activity of caspase-3 was determined in cell lysates by a chromogenic kinetic assay. Incubation with serum of patients induced apoptosis of CD4 lymphocytes and inhibited apoptosis of CD14 monocytes. This was attenuated after diluting serum or mixing with healthy serum. Activity of caspase-3 was consistent with these findings. Induced apoptosis of CD4 lymphocytes was greater among nonsurvivors, and it was inhibited in the presence of caspase inhibitors. Inhibitors did not modify the effect of patients' serum on apoptosis of CD14 monocytes. CaCl2 reversed the inhibitory effect on apoptosis of CD14 moncytes. The above findings support the hypothesis for the existence of an early circulating factor in severe sepsis/shock, modulating apoptosis of CD4 lymphocytes and of CD14 monocytes by interaction with the two apoptotic pathways.
Ethics and economics: the case for mental healthcare
Authors: Byford Sarah , Barrett Barbara
Published: October 2010

In making treatment decisions, psychiatrists, like other medical professionals, must adhere to rules of ethical medical conduct. They may also need to negotiate the legalities associated with detention and treatment against a patient's wishes. The growth in guidance produced by organisations such as the National Institute for Health and Clinical Excellence has added further complexity. Practitioners are increasingly required to consider cost-effectiveness in their treatment decisions and this can appear to conflict with the principles of medical ethics. With particular reference to mental healthcare, this article attempts to answer two questions: Is economic evaluation unethical? And are the methods of economic evaluation unsound for the purpose of achieving an ethical distribution of resources?
Mental capacity assessment and ‘best interests’ decision-making in clinical practice: a case illustration
Authors: Biswas Asit B. , Hiremath Avinash
Published: October 2010

Mental capacity refers to a person's ability to make decisions, which may include consenting to medical treatment. People are presumed to have this capacity. Individuals may lack capacity because of an impairment or disturbance that affects the way their mind or brain works. Legal frameworks are in place for acting and making decisions on behalf of individuals who lack the mental capacity to do so for themselves, in their best interests. A case illustration is used to outline the principles involved under the Mental Capacity Act 2005 for England and Wales. We describe in detail the assessment of capacity to consent to treatment in this case and good practice in making best interests decisions in everyday clinical practice.
Interface between the Mental Health Act and Mental Capacity Act: deprivation of liberty safeguards
Authors: Brindle Nick , Branton Tim
Published: October 2010

The deprivation of liberty safeguards were introduced into the Mental Capacity Act in 2008 to enhance the protection of adults in residential homes or hospitals who lack capacity in relation to their care arrangements and who are or may be deprived of their liberty. Deprivation of liberty itself is an imprecise concept and there may be difficulty in applying the appropriate authority where there is a choice between the Mental Capacity Act 2005 and the Mental Health Act 1983. Therefore, this article explains the evolution of mental capacity legislation and the concept of deprivation of liberty, how it may be recognised, prevented and authorised by deprivation of liberty safeguards, along with some of the interface issues with the Mental Health Act 1983.
Advance statements in adult mental health
Authors: Jankovic Jelena , Richards Felicity , Priebe Stefan
Published: October 2010

This article reviews the literature on advance statements, including current mental health law and guidance in England and Wales, ethical and practical advantages, disadvantages and barriers to implementation. The idea of planning psychiatric treatment for a time when mental capacity may be impaired is not new. Yet there has been a renewed interest following the introduction of the Mental Capacity Act's 2005 provision of legally binding advance decisions to refuse treatment. In addition to information on treatment refusals, advance statements provide information on treatment preferences and personal care instructions which, although not legally binding, should inform treatment decisions. Advance statements are not yet widely used, but existing limited evidence suggests that they could reduce coercion and improve service users' satisfaction with treatment.
Mental health v. mental illness: Commentary on … Ethics and Economics
Authors: Coia Denise
Published: October 2010

This commentary focuses principally on the semantics of using the term ‘mental health’ rather than ‘mental illness’ and the effect this has in creating a paradigm shift in psychiatry in relation to other medical specialties. The consequences, intended or unintended, are demonstrated and the relationship between ethics and economics in mental health is discussed. The view that economic evaluation is methodologically unsound in ‘mental health’, that it is a special case because of its complexity, does not acknowledge the significant paradigm shift that has occurred. Casual acceptance of the term ‘mental health’ in a serious economic debate about resources for people with mental illnesses is worrying and further diminishes the medical specialty of psychiatry that deals with mental diseases.
Unappealing legislation?
Authors: Lyons Donald
Published: October 2010

The deprivation of liberty safeguards apply to England and Wales. In Scotland, trends and uncertainties in the use of welfare guardianship (the equivalent action under Scottish law) provide a useful comparison. In both jurisdictions, there are risks to the rights of individuals.
Letter from America: how will health reform affect psychiatric care?
Authors: Sharfstein Steven S.
Published: October 2010

Health reform in America will lead to major changes in medical care in the USA, with opportunities for improved access to care, especially for psychiatric patients. Combined with recently enacted ‘parity’ legislation, health reform will expand public and private insurance coverage to an additional 33 million Americans, leading to increased pressure on the psychiatrists who are willing to practise with the insured population and on opportunities for subspecialisation within the field. Some essential non-medical tasks will not be funded by insurance, and these must be given due consideration. A major emphasis of health reform is to integrate general health and mental health services. The reform will have an impact on the use of the hospital and emergency room as well. A major concern is the cost of care and how it will be controlled.
Guidelines for the management of depression: NICE work?
Authors: Kendrick Tony , Peveler Robert
Published: October 2010

The National Institute for Health and Clinical Excellence (NICE) recently updated its guidance on managing depression, adding specific guidance for depression in people with physical illness. The guidance should help improve the targeting of treatments, although implementation of the guidance on depression in physical illness is challenging in the National Health Service (NHS) context of separate primary and secondary care services.
Reflections on PTSD's future in DSM–V
Authors: Rosen Gerald M. , Lilienfeld Scott O. , Frueh B. Christopher , McHugh Paul R. , Spitzer Robert L.
Published: October 2010

Research findings have fuelled debate on the construct validity of post-traumatic stress disorder (PTSD). Accompanying these issues are competing suggestions to redefine PTSD's criteria, including a recent proposal by DSM–V committee members. We review various approaches to revising the PTSD diagnosis and conclude that proposed changes should be placed in the appendix that the DSM has used for experimental criteria sets.
Childhood adversities and adult psychopathology in the WHO World Mental Health Surveys
Authors: Kessler Ronald C. , McLaughlin Katie A. , Green Jennifer Greif , Gruber Michael J. , Sampson Nancy A. , Zaslavsky Alan M. , Aguilar-Gaxiola Sergio , Alhamzawi Ali Obaid , Alonso Jordi , Angermeyer Matthias , Benjet Corina , Bromet Evelyn , Chatterji Somnath , de Girolamo Giovanni , Demyttenaere Koen , Fayyad John , Florescu Silvia , Gal Gilad , Gureje Oye , Haro Josep Maria , Hu Chi-yi , Karam Elie G. , Kawakami Norito , Lee Sing , Lépine Jean-Pierre , Ormel Johan , Posada-Villa José , Sagar Rajesh , Tsang Adley , Üstün T. Bedirhan , Vassilev Svetlozar , Viana Maria Carmen , Williams David R.
Published: October 2010

Background

Although significant associations of childhood adversities with adult mental disorders are widely documented, most studies focus on single childhood adversities predicting single disorders.

Aims

To examine joint associations of 12 childhood adversities with first onset of 20 DSM–IV disorders in World Mental Health (WMH) Surveys in 21 countries.

Method

Nationally or regionally representative surveys of 51 945 adults assessed childhood adversities and lifetime DSM–IV disorders with the WHO Composite International Diagnostic Interview (CIDI).

Results

Childhood adversities were highly prevalent and interrelated. Childhood adversities associated with maladaptive family functioning (e.g. parental mental illness, child abuse, neglect) were the strongest predictors of disorders. Co-occurring childhood adversities associated with maladaptive family functioning had significant subadditive predictive associations and little specificity across disorders. Childhood adversities account for 29.8% of all disorders across countries.

Conclusions

Childhood adversities have strong associations with all classes of disorders at all life-course stages in all groups of WMH countries. Long-term associations imply the existence of as-yet undetermined mediators.
Economic costs and preference-based health-related quality of life outcomes associated with childhood psychiatric disorders
Authors: Petrou Stavros , Johnson Samantha , Wolke Dieter , Hollis Chris , Kochhar Puja , Marlow Neil
Published: October 2010

Background

Childhood psychiatric disorders may have deleterious consequences through childhood and into adulthood.

Aims

To estimate costs and preference-based health-related quality of life outcomes (health utilities) associated with a broad range of childhood psychiatric disorders during the eleventh year of life.

Method

Participants in a whole-population study of extremely preterm children and term-born controls (EPICure) undertook psychiatric assessment using the Development and Well Being Assessment (DAWBA) and the Kaufman–Assessment Battery for Children. Questionnaires completed by parents and teachers described the children's utilisation of health, social and education services during the eleventh year of life. Parents also described their child's health status using the Health Utilities Index Mark 2 and Mark 3 health status classification systems. Descriptive and multiple regression techniques were used to explore the association between psychiatric disorders and economic outcomes.

Results

The study presents detailed costs and health utilities associated with psychiatric disorders for the preterm population, term-born population and pooled study population, following appropriate controls.

Conclusions

The results of this study should be used to inform future economic evaluations of interventions aimed at preventing childhood psychiatric disorders or alleviating their effects. Further research is required that identifies, measures and values the longer-term economic impacts of these disorders in a valid and reliable manner.
Is the EQ–5D fit for purpose in mental health?
Authors: Brazier John
Published: October 2010

The EQ–5D is a widely used questionnaire for calculating quality-adjusted life-years (QALYs) for assessing cost-effectiveness in healthcare. It reflects the impact of common mental health conditions such as mild to moderate depression but seems to be more problematic for use in people with psychotic and severe and complex nonpsychotic disorders.
A patient satisfaction rating scale for psychiatric service
users
Authors: Hansen Lars K. , Vincent Selvaraj , Harris Scott , David Emily , Surafudheen Sheeba , Kingdon David
Published: October 2010

Aims and method

The patient's experience of the clinician is an increasingly important
area in time of ‘consumer choice’ and appraisal of the individual
practitioner. Validated, easy-to-use scales are scarce. The aim was to
validate a user-friendly, brief scale measuring patient satisfaction
(PatSat scale). Over three phases, patients were involved in developing
and validating the scale against the Verona satisfaction subscale.

Results

A highly significant correlation was found between the two scales
(Spearman's correlation coefficient 0.97, two-tailed P
<0.001).

Clinical implications

The PatSat is a new patient satisfaction scale validated in a psychiatric
out-patient population. It appeared popular with patients and took less
than 1 minute to fill in. The use of validated scales measuring patient
satisfaction is a pivotal part of mental health delivery and advancing
overall quality of care.
Domestic violence among female psychiatric patients:
cross-sectional survey
Authors: Morgan John F. , Zolese Gabriella , McNulty Jane , Gebhardt Sharon
Published: October 2010

Aims and method

To establish prevalence of domestic violence among female psychiatric
patients, including risk factors, health professional attention and
acceptability of routine enquiry. Participants were 70 adult women in an
inner-city community mental health team who received questionnaire and
case-note review. Main outcome measures were: lifetime/point prevalence
of domestic violence; attitudes to routine enquiry; past disclosure and
recording in psychiatric records; clinical and demographic risk
factors.

Results

Lifetime prevalence was 60% for physical violence from partners, 27%
during pregnancy and 40% receiving injuries. Point prevalence was not
reported, as an insufficient number of participants were currently in a
relationship. As many as 82% regarded routine enquiry as acceptable, but
only 24% had ever been questioned. Logistic regression analysis showed
prediction by presence of children, previous overdose, and experience of
sexual abuse.

Clinical implications

Domestic violence in female psychiatric patients is common but
undetected. Enquiry should be routine, but would require staff
training.
Prevalence of catatonic signs in acute psychiatric patients in
Scotland
Authors: Al Sayegh Amal , Reid David
Published: October 2010

Aims and method

Concerns have been raised that catatonia is underdiagnosed. Prevalence
varies (1.3-32%) depending on diagnostic criteria. We used the Modified
Rogers Scale to rate catatonic signs in patients consecutively admitted
to three psychiatric wards over a 10-month period.

Results

The prevalence of patients demonstrating any catatonic signs was at least
7.9-19.1%. The most common catatonic signs were marked underactivity (not
sedated), echolalia/palilalia, marked overactivity (not restlessness) and
gegenhalten. In those with catatonic signs, the most common diagnoses
were schizophrenia, schizoaffective disorder and dementia.

Clinical implications

Most of the most common catatonic signs in our sample were motor signs.
Antipsychotic-induced motor signs reflect interaction between drug and
disease. Catatonic signs are not anchored in any one diagnosis and are on
a spectrum of severity and quantity. Prevalence of these signs is higher
than often presumed.
Specialist community perinatal screening clinic: service evaluation
Authors: Magon Rakesh , White Ruth
Published: October 2010

Aims and method

To identify the outcomes of patients in the obstetric screening clinic. In 2 years, 180 women were referred by midwives to a clinic run by specialist community perinatal team. ‘Ultra-high risk’ patients were identified. There were four outcome measures predicated on level of care.

Results

Of those referred, 69 women were managed in primary care/generic community mental health teams, 90 by specialist perinatal team and 21 did not attend; 23 women were ultra-high risk. The majority of the ultra-high risk patients required treatment with specialist teams.

Clinical implications

Specialist community perinatal screening clinics are successful at identifying those at high risk of developing mental health problems. Ultra-high risk women needed a higher level of service. High morbidity in women who fail to attend the services demands more assertive follow-up. Cumulative personal and family history is an important risk factor.
Conceptualisation of recovery from psychosis: a service-user
perspective
Authors: Wood Lisa , Price Jason , Morrison Anthony , Haddock Gillian
Published: October 2010

Aims and method

There has been much uncertainty about the concept of recovery in
psychosis. The aim of this paper is to conceptualise recovery, through
service users' descriptions of their recovery stories. A qualitative
approach (interpretive phenomenological analysis) was used to guide
interviews and analysis of data.

Results

Eight service users were interviewed about their recovery from psychosis.
Data analysis revealed four superordinate themes: ‘impacts on mental
health’, ‘self-change and adaptation’, ‘social redefinition’ and
‘individualised coping mechanisms’.

Clinical implications

Data indicates that multiple dimensions of recovery are all important to
individuals when considering their subjective experiences of recovery
from psychosis. Recovery can only be conceptualised by the person making
the recovery journey and treatment outcome measures must reflect this
individuality.
Monitoring electrocardiograms of service users on high-dose
methadone substitution therapy: an audit
Authors: Ghosh Soumya , Kodagalli Anil , Bhatti Faiz , Bradbeer Timothy
Published: October 2010

Aims and method

To explore the extent to which 2007 Department of Health guidelines on
monitoring of high-dose (⩾100 mg) methadone were followed, the reasons
for non-adherence to these and the prevalence of QTc prolongation. We
developed a simple tool for collecting data from case notes.

Results

Out of 25 service users, 11 had had an electrocardiogram (ECG) and 7 had
evidence of requests sent to general practitioners. After implementation
of our recommendations, ten more service users had ECGs within 1 month.
All but one ECG was normal. Methadone prescribing in favour of lower
doses has been observed. QTc interval prolongation was not common.

Clinical implications

Effective communication between primary and secondary care services is
important in identifying cases and arranging ECGs.
Integrated course in psychiatry and literature during
preclinical years and medical students' grades in the general psychiatry
curriculum
Authors: Fan Angela Pei-Chen , Kosik Russell Oliver , Su Tung-Ping , Tsai Thomas C. , Syu Wan-Jr , Chen Chen-Huan , Lee Chen-Hsen
Published: October 2010

Aims and method

To examine the effect of taking an elective psychiatry and literature
course during the first year of medical school on performance in the
later mandatory general psychiatry curriculum. Class members were
surveyed for baseline characteristics at the time of their admission to
medical school. Following completion of their fourth year, average grades
in psychiatry were calculated and results compared for those who did and
those who did not take the course. Multiple regression analysis was used
to assess the effects of baseline characteristics that were significantly
different between the groups.

Results

Students who took the course had statistically significant
(t = −3.34, P <0.001) higher
grades in fourth year psychiatry. They had lower admission interview
scores (t = −2.15, P <0.05) and
reported less academic stress (t = −9.55,
P <0.01) before taking the course.

Clinical implications

Literature is an effective medium through which to teach medical students
psychiatry as it can lead to a greater understanding of the topic.
The flow fields involved in hydrodynamic imaging by blind Mexican cave fish (Astyanax fasciatus). Part II: gliding parallel to a wall
Authors: Windsor Shane P. , Norris Stuart E. , Cameron Stuart M. , Mallinson Gordon D. , Montgomery John C.
Published: October 2010

Blind Mexican cave fish (Astyanax fasciatus) are able to sense detailed information about objects by gliding alongside them and sensing changes in the flow field around their body using their lateral line sensory system. Hence the fish are able to build hydrodynamic images of their surroundings. This study measured the flow fields around blind cave fish using particle image velocimetry (PIV) as they swam parallel to a wall. Computational fluid dynamics models were also used to calculate the flow fields and the stimuli to the lateral line sensory system. Our results showed that characteristic changes in the form of the flow field occurred when the fish were within approximately 0.20 body lengths (BL) of a wall. The magnitude of these changes increased steadily as the distance between the fish and the wall was reduced. When the fish were within 0.02 BL of the wall there was a change in the form of the flow field owing to the merging of the boundary layers on the body of the fish and the wall. The stimuli to the lateral line appears to be sufficient for fish to detect walls when they are 0.10 BL away (the mean distance at which they normally swim from a wall), but insufficient for the fish to detect a wall when 0.25 BL away. This suggests that the nature of the flow fields surrounding the fish are such that hydrodynamic imaging can only be used by fish to detect surfaces at short range.
Temperature effects in articular cartilage biomechanics
Authors: June Ronald K. , Fyhrie David P.
Published: October 2010

Articular cartilage is the soft tissue that covers contacting surfaces of bones in synovial joints. Cartilage is composed of chondrocytes and an extracellular matrix containing numerous biopolymers, cations and water. Healthy cartilage functions biomechanically to provide smooth and stable joint movement. Degenerative joint diseases such as osteoarthritis involve cartilage deterioration, resulting in painful and cumbersome joint motion. Temperature is a fundamental quantity in mechanics, yet the effects of temperature on cartilage mechanical behavior are unknown. This study addressed the questions of whether cartilage stiffness and stress relaxation change with temperature. Samples of middle-zone bovine calf patellofemoral cartilage were tested in unconfined compression first at 24°C and then again after heating to 60°C. The data reveal that when temperature increases: (1) both peak and equilibrium stiffness increase by 150 and 8%, respectively, and (2) stress relaxation is faster at higher temperature, as shown by a 60% decrease in the time constant. The increases in temperature-dependent stiffness are consistent with polymeric mechanisms of matrix viscoelasticity but not with interstitial fluid flow. The changes in the time constant are consistent with a combination of both fluid flow and matrix viscoelasticity. Furthermore, we discovered a novel phenomenon: at stress-relaxation equilibrium, compressive stress increased with temperature. These data demonstrate a rich area of cartilage mechanics that has previously been unexplored and emphasize the role of polymer dynamics in cartilage viscoelasticity. Further studies of cartilage polymer dynamics may yield additional insight into mechanisms of cartilage material behavior that could improve treatments for cartilage degeneration.