Inherited polyglutamine spinocerebellar ataxias in South Africa

Objective. To determine the frequency and distribution ofpolyglutamine spinocerebellar ataxias (SCAs) from referrals over a24-year period to the National Health Laboratory Service (NHLS)in South Africa (SA).Methods. Paper-based clinical reports in the University ofCape Town laboratory and the NHLS electronic patient recorddatabase spanning a 24-year period were mined for informationregarding the molecular diagnosis, ethnicity and CAG repeatlength for individuals referred for molecular genetic testing for thepolyglutamine SCAs.Results. SCA1 and 7 are the most frequent types of polyglutamineSCA in the SA patient population, followed by SCA2, 3 and 6.SCA1 is the most common type in the coloured, white and Indianpopulations, whereas the majority of indigenous black Africanpatients are affected with SCA7 and 2. Of individuals tested, 22%were found to be positive for one of the polyglutamine SCAs.Conclusion. Although trends in the frequency and distributionof the polyglutamine SCAs in SA have not changed significantlysince our previous study in 2003, they differ remarkably from thosereported elsewhere, and reflect the unique genetic and demographicbackground of SA. The provision of accurate and complete patientinformation and family history is crucial to the diagnostic process,to enable comprehensive epidemiological studies and assist indeveloping therapeutic and patient management strategies

True Neutrality as a New Type of Flavour

A classification of leptonic currents with respect to C-operation requires the separation of elementary particles into the two classes of vector C-even and axial-vector C-odd character. Their nature has been created so that to each type of lepton corresponds a kind of neutrino. Such pairs are united in families of a different C-parity. Unlike the neutrino of a vector type, any C-noninvariant Dirac neutrino must have his Majorana neutrino. They constitute the purely neutrino families. We discuss the nature of a corresponding mechanism responsible for the availability in all types of axial-vector particles of a kind of flavour which distinguishes each of them from others by a true charge characterized by a quantum number conserved at the interactions between the C-odd fermion and the field of emission of the corresponding types of gauge bosons. This regularity expresses the unidenticality of truly neutral neutrino and antineutrino, confirming that an internal symmetry of a C-noninvariant particle is described by an axial-vector space. Thereby, a true flavour together with the earlier known lepton flavour predicts the existence of leptonic strings and their birth in single and double beta decays as a unity of flavour and gauge symmetry laws. Such a unified principle explains the availability of a flavour symmetrical mode of neutrino oscillations.Comment: 19 pages, LaTex, Published version in IJT

Cost-effectiveness of problem-solving treatment in comparison with usual care for primary care patients with menthal health problems: a randomized trial

BACKGROUND: Mental health problems are common and are associated with increased disability and health care costs. Problem-Solving Treatment (PST) delivered to these patients by nurses in primary care might be efficient. The aim of this study was to evaluate the cost-effectiveness of PST by mental health nurses compared with usual care (UC) by the general practitioner for primary care patients with mental health problems. METHODS: An economic evaluation from a societal perspective was performed alongside a randomized clinical trial. Patients with a positive General Health Questionnaire score (score ≥ 4) and who visited their general practitioner at least three times during the past 6 months were eligible. Outcome measures were improvement on the Hospital Anxiety and Depression Scale and QALYs based on the EQ-5D. Resource use was measured using a validated questionnaire. Missing cost and effect data were imputed using multiple imputation techniques. Bootstrapping was used to analyze costs and cost-effectiveness of PST compared with UC. RESULTS: There were no statistically significant differences in clinical outcomes at 9 months. Mean total costs were €4795 in the PST group and €6857 in the UC group. Costs were not statistically significantly different between the two groups (95% CI -4698;359). The cost-effectiveness analysis showed that PST was cost-effective in comparison with UC. Sensitivity analyses confirmed these findings. CONCLUSIONS: PST delivered by nurses seems cost-effective in comparison with UC. However, these results should be interpreted with caution, since the difference in total costs was mainly caused by 3 outliers with extremely high indirect costs in the UC group. TRIAL REGISTRATION: Nederlands Trial Register ISRCTN5102101

The Pace of Prostatic Intraepithelial Neoplasia Development Is Determined by the Timing of Pten Tumor Suppressor Gene Excision

Loss of the PTEN tumor suppressor is a common occurrence in human prostate cancer, particularly in advanced disease. In keeping with its role as a pivotal upstream regulator of the phosphatidylinositol 3-kinase signaling pathway, experimentally-induced deletion of Pten in the murine prostate invariably results in neoplasia. However, and unlike humans where prostate tumorigenesis likely evolves over decades, disease progression in the constitutively Pten deficient mouse prostate is relatively rapid, culminating in invasive cancer within several weeks post-puberty. Given that the prostate undergoes rapid androgen-dependent growth at puberty, and that Pten excisions during this time might be especially tumorigenic, we hypothesized that delaying prostate-specific Pten deletions until immediately after puberty might alter the pace of tumorigenesis. To this end we generated mice with a tamoxifen-inducible Cre recombinase transgene enabling temporal control over prostate-specific gene alterations. This line was then interbred with mice carrying floxed Pten alleles. Despite evidence of increased Akt/mTOR/S6K axis activity at early time points in Pten-deficient epithelial cells, excisions induced in the post-pubertal (6 wk-old) prostate yielded gradual acquisition of a range of lesions. These progressed from pre-malignant changes (nuclear atypia, focal hyperplasia) and low grade prostatic intraepithelial neoplasia (PIN) at 16–20 wks post-tamoxifen exposure, to overtly malignant lesions by ∼1 yr of age, characterized by high-grade PIN and microinvasive carcinoma. In contrast, when Pten excisions were triggered in the pre-pubertal (2 week-old) prostate, neoplasia evolved over a more abbreviated time-frame, with a spectrum of premalignant lesions, as well as overt PIN and microinvasive carcinoma by 10–12 wks post-tamoxifen exposure. These results indicate that the developmental stage at which Pten deletions are induced dictates the pace of PIN development

Trends and variation in the management of oesophagogastric cancer patients: a population-based survey

<p>Abstract</p> <p>Background</p> <p>Previous evidence indicates potential variation in the quality of care of cancer patients. We aimed to examine whether recent changes in the treatment of oesophagogastric cancers have been distributed equally among different patient subgroups.</p> <p>Methods</p> <p>We analysed population-based cancer registry data about the treatment patterning of oesophagogastric cancer (other than oesophageal squamous cell carcinoma) during 1995-2006.</p> <p>Results</p> <p>There were 14,077 patients aged ≥40 years (69% men). There was only limited information on stage, and no information on co-morbidity status. During successive triennia, curative surgery use decreased from 28% to 20% (p < 0.001) whilst chemotherapy use increased from 9% to 30% (p < 0.001). Use of palliative surgery and of radiotherapy increased significantly but modestly (7% to 10%, and 9% to 11%, respectively). In multivariable logistic regression adjusting for age group, gender, diagnosis period and tumour type, curative surgery and chemotherapy were used less frequently in more deprived patients [per increasing deprivation group Odds Ratio (OR) = 0.96, 95% Confidence Interval (CI) 0.93-0.99, and OR = 0.90, 95%CI 0.87-0.93, respectively, p < 0.001 for both)]. Chemotherapy was also used less frequently in women (OR = 0.76, p < 0.001).</p> <p>Conclusions</p> <p>During the study period, curative surgery decreased by a third and chemotherapy use increased by more than three-fold, reflecting improvements in the appropriateness and quality of management, but chemotherapy use, in particular, was unequal, both by socioeconomic status and gender.</p

On supersymmetric quantum mechanics

This paper constitutes a review on N=2 fractional supersymmetric Quantum Mechanics of order k. The presentation is based on the introduction of a generalized Weyl-Heisenberg algebra W_k. It is shown how a general Hamiltonian can be associated with the algebra W_k. This general Hamiltonian covers various supersymmetrical versions of dynamical systems (Morse system, Poschl-Teller system, fractional supersymmetric oscillator of order k, etc.). The case of ordinary supersymmetric Quantum Mechanics corresponds to k=2. A connection between fractional supersymmetric Quantum Mechanics and ordinary supersymmetric Quantum Mechanics is briefly described. A realization of the algebra W_k, of the N=2 supercharges and of the corresponding Hamiltonian is given in terms of deformed-bosons and k-fermions as well as in terms of differential operators.Comment: Review paper (31 pages) to be published in: Fundamental World of Quantum Chemistry, A Tribute to the Memory of Per-Olov Lowdin, Volume 3, E. Brandas and E.S. Kryachko (Eds.), Springer-Verlag, Berlin, 200

Uncommon genetic syndromes and narrative production - Case Studies with Williams, Smith-Magenis and Prader- Willi Syndromes

This study compares narrative production among three syndromes with genetic microdeletions: Williams syndrome (WS), Smith-Magenis syndrome (SMS), and Prader-Willi syndrome (PWS), characterized by intellectual disabilities and relatively spared language abilities. Our objective is to study the quality of narrative production in the context of a common intellectual disability. To elicit a narrative production, the task Frog! Where Are You was used. Then, structure, process, and content of the narrative process were analysed in the three genetic disorders:WS (n52), SMS (n52), and PWS (n52). Data show evidence of an overall low narrative quality in these syndromes, despite a high variability within different measures of narrative production. Results support the hypothesis that narrative is a highly complex cognitive process and that, in a context of intellectual disability, there is no evidence of particular ‘hypernarrativity’ in these syndromes.This research was supported by the grants FEDER –

Marginal Level Dystrophin Expression Improves Clinical Outcome in a Strain of Dystrophin/Utrophin Double Knockout Mice

Inactivation of all utrophin isoforms in dystrophin-deficient mdx mice results in a strain of utrophin knockout mdx (uko/mdx) mice. Uko/mdx mice display severe clinical symptoms and die prematurely as in Duchenne muscular dystrophy (DMD) patients. Here we tested the hypothesis that marginal level dystrophin expression may improve the clinical outcome of uko/mdx mice. It is well established that mdx3cv (3cv) mice express a near-full length dystrophin protein at ∼5% of the normal level. We crossed utrophin-null mutation to the 3cv background. The resulting uko/3cv mice expressed the same level of dystrophin as 3cv mice but utrophin expression was completely eliminated. Surprisingly, uko/3cv mice showed a much milder phenotype. Compared to uko/mdx mice, uko/3cv mice had significantly higher body weight and stronger specific muscle force. Most importantly, uko/3cv outlived uko/mdx mice by several folds. Our results suggest that a threshold level dystrophin expression may provide vital clinical support in a severely affected DMD mouse model. This finding may hold clinical implications in developing novel DMD therapies

“Shake It Baby, Shake It”: Media Preferences, Sexual Attitudes and Gender Stereotypes Among Adolescents

In this study exposure to and preferences for three important youth media (TV, music styles/music TV, internet) were examined in relation to adolescents’ permissive sexual attitudes and gender stereotypes (i.e., views of men as sex-driven and tough, and of women as sex objects). Multivariate structural analysis of data from a school-based sample of 480 13 to 16-year-old Dutch students revealed that preferences, rather than exposure were associated with attitudes and stereotypes. For both girls and boys, preferences for hip-hop and hard-house music were associated positively with gender stereotypes and preference for classical music was negatively associated with gender stereotypes. Particularly for boys, using internet to find explicit sexual content emerged as a powerful indicator of all attitudes and stereotypes