Development of a decision support tool to facilitate primary care management of patients with abnormal liver function tests without clinically apparent liver disease [HTA03/38/02]. Abnormal Liver Function Investigations Evaluation (ALFIE)

Liver function tests (LFTs) are routinely performed in primary care, and are often the gateway to further invasive and/or expensive investigations. Little is known of the consequences in people with an initial abnormal liver function (ALF) test in primary care and with no obvious liver disease. Further investigations may be dangerous for the patient and expensive for Health Services. The aims of this study are to determine the natural history of abnormalities in LFTs before overt liver disease presents in the population and identify those who require minimal further investigations with the potential for reduction in NHS costs

Empirical evidence of the continuing improvement in cost efficiency of an endoscopic surveillance programme for gastric cancer in Singapore from 2004 to 2010

10.1186/1472-6963-13-139BMC Health Services Research131

Molecular dissection of the pea shoot apical meristem*

The shoot apical meristem (SAM) is responsible for the development of all the above-ground parts of a plant. Our understanding of the SAM at the molecular level is incomplete. This study investigates the gene expression repertoire of SAMs in the garden pea (Pisum sativum). To this end, 10 346 EST sequences representing 7610 unique genes were generated from SAM cDNA libraries. These sequences, together with previously reported pea ESTs, were used to construct a 12K oligonucleotide array to identify genes with differential SAM expression, as compared to axillary meristems, root apical meristems, or non-meristematic tissues. A number of genes were identified, predominantly expressed in specific cell layers or domains of the SAM and thus are likely components of the gene networks involved in stem cell maintenance or the initiation of lateral organs. Further in situ hybridization analysis confirmed the spatial localization of some of these genes within the SAM. Our data also indicate the diversification of some gene expression patterns and hence functions in legume crop plants. A number of transcripts highly expressed in all three meristems have also been uncovered and these candidates may provide valuable insight into molecular networks that underpin the maintenance of meristematic functionality

Protocol for north of England and Scotland study of tonsillectomy and adeno-tonsillectomy in children (NESSTAC). A pragmatic randomised controlled trial comparing surgical intervention with conventional medical treatment in children with recurrent sore throats

BACKGROUND: Uncertainties surrounding the effectiveness and cost-effectiveness of childhood tonsillectomy for recurrent sore throat led the NHS Health Technology Assessment Programme to commission this research to evaluate the effectiveness and cost-effectiveness of tonsillectomy and adeno-tonsillectomy in comparison with standard non-surgical management in children aged under 16 with recurrent throat infections. The aim is to evaluate if tonsillectomy and adeno-tonsillectomy reduces the number of episodes of sore throats among children to a clinically significant extent. METHODS/DESIGN: A simple prospective pragmatic randomised controlled trial with economic analysis and prospective cohort study of non-trial participants comparing surgical intervention with conventional medical treatment. The treatment arm will receive tonsillectomy and adeno-tonsillectomy while in the control arm non-surgical conventional medical treatment only will be used. The primary outcome measure will be reported number of episodes of sore throat over two years with secondary outcomes measures of reported number of episodes of sore throat, otitis media and upper respiratory tract infection which invoke a GP consultation; reported number of symptom-free days; reported severity of sore throats and surgical and anaesthetic morbidity. The study will take place in five hospitals in the UK. The trial population will be 406 children aged 4–15 on their last birthday with recurrent sore throat referred by primary care to the 5 otolaryngology departments. The duration of the study is seven years (July 2001- July 2008). DISCUSSION: As with all pragmatic randomised controlled trials it is impossible to control the external environment in which the research is taking place. Since this trial began a number of factors have arisen which could affect the outcome including; a reduction in the incidence of respiratory tract infections, marked socio-economic differences in consultation rates, the results from the National Prospective Tonsillectomy Audit and the Government's waiting list initiatives

Parallel Simulation of Compressible Atmospheric Flows: Bubble Convection

this paper we consider a semi-implicit treatment of the compressible equations proposed by Robert [10] to study vertical convection in the atmosphere at scales down to several metres. It is sometimes possible to further increase the time step and overcome the CourantFreidrichs -Lewy (CFL) stability bound with a semi-Lagrangian treatment of advection [9]. By integrating a characteristic equation backwards in time, the location of the departure point of a fluid particle in the Lagrangian frame of reference is found and then this particle is advected forward in time along the characteristic curve. The value at the foot of characteristic curve can be obtained by interpolation. In the more general setting of computational fluid dynamics, these schemes belong to the family of Eulerian-Lagrangian methods (ELM). Several authors, including Roache [7] and Oliveira and Baptista [6], note the equivalence of ELM's to Eulerian methods which have been translated or shifted by the advecting velocity. A general overview of their use in atmospheric models can be found in Staniforth and Cot'e [19]. In this paper, we focus on a parallel implementation of the semi-implicit, semi-Lagrangian scheme for the Euler equations. We have applied this scheme to the bubble convection problem [10] which is intended as a prototype for a more comprehensive atmospheric code. 3 2. Problem Formulatio

Gigantelline, gigantellinine and gigancrinine, cherylline- and crinine-type alkaloids isolated from Crinum jagus with anti-acetylcholinesterase activity

Three undescribed Amarylidaceae alkaloids, named gigantelline, gigantellinine and gigancrinine, were isolated from Crinum jagus (syn. = Crinum giganteum) collected in Senegal, together with the already known sanguinine, cherylline, lycorine, crinine, flexinine and the isoquinolinone derivative hippadine. Gigantelline, gigantellinine and gigancrinine were characterized as 4-(6,7-dimethoxy-2-methyl-1,2,3,4-tetrahydro-isoquinolin-4-yl)-phenol, its 7-O-demethyl-5.-hydroxy-4.-methoxy derivative and 5,6a,7,7a,8a,9-hexahydro-6,9a-ethano[1,3]dioxolo[4,5j]oxireno[2,3-b]phenanthridin-9-ol, respectively, by using spectroscopic (1D and 2D H-1 and C-13 NMR and HRESIMS) and chemical methods. Their relative configuration was assigned by NOESY NMR spectra and NMR calculations, while the absolute configuration was assigned using electronic circular dichroism (ECD) experiments and calculations. Sanguinine, cherylline, crinine, flexinine, and the isoquinolinone hippadine, were isolated for the first time from C. jagus. Cherylline, gigantellinine, crinine, flexinine and sanguinine inhibited the activity of AChE in a dose-dependent manner, and inhibition by sanguinine was remarkably effective (IC50 = 1.83 +/- 0.01 mu M). Cherylline and hippadine showed weak cytotoxicity at 100 mu M

Shared And Distributed Memory Implementations Of The Canadian MC2 Model

The Mesoscale Compressible Community (MC2) model is an extension of a fully compressible limited area model developed by Monique Tanguay, Andre Robert and Rene Laprise in the mid-1980's. The model employs a three-timelevel semi-implicit, semi-Lagrangian time discretisation with modified terrain following Gal-Chen coordinates. The semi-implicit scheme results in an elliptic boundary value problem with first-order derivative terms in the vertical direction and thus the resulting discretised system of equations has a large sparse nonsymmetric coefficient matrix. The original alternating direction implicit (ADI) elliptic solver has been replaced with a flexible Generalised Minimum Residual (GMRES) Krylov method with variable preconditioning. We report on the performance of successive over relaxation (SOR) and vertical line relaxation (ADI) as parallel preconditioners to improve the convergence rate of GMRES. Parallelisation of the model for a distributed-memory computing environment has be..