Outcome of the depressed elderly living in the community in Liverpool: a 5-year follow-up

BACKGROUND: Comparatively little is known about the long-term natural history of depressive disorders in the elderly living in the community. This is a follow-up of a subsample of the Continuing Health in the Community study random sample of the elderly population living in Liverpool. METHODS: The investigators followed up 120 cases of depression identified by a semi-structured interview schedule (GMS) for a period of 5 years. A similar number of other subjects defined as subcases of depression, other cases of mental illness and a random selection of non-cases were also included. RESULTS: The 5-year outcome for the cases of depression was worse than the outcome of the non-cases (relative mortality risk of 2.1, 95% confidence interval 1.1 to 3.9). Thirty-four per cent of the cases of depression died and 28% had dropped out during the follow-up. Of the 46 cases of depression who had a complete follow-up, 22% recovered from their symptoms, 30% were found to be AGECAT cases at one of the three follow-up waves, 24% were AGECAT cases at two of the three follow-up waves and the remaining 24% were AGECAT cases at each follow-up wave. Fifteen per cent of the surviving cases of depression were organic cases at the follow-up. Their anxiety comorbid state and depression score were identified as predictors of poor outcome. CONCLUSION: The findings of this study indicate that depressive disorders (most of which were untreated) found in the elderly community have a poor prognosis.     

Potential application of p53 as an intermediate biomarker in Barrett's esophagus

Diagnosis of the neoplastic progression in Barrett's esophagus using the histologic classification of dysplasia is frequently difficult. The tumor suppressor protein p53, when mutated, confers a promoter effect on cell growth. The purpose of this study was to evaluate the applicability of p53 as an intermediate biomarker of malignancy in Barrett's esophagus. Archival analysis of 100 biopsy specimens of Barrett's esophagus and 10 esophageal adenocarcinomas were compared with 35 chronic esophagitis biopsy specimens. Immunocytochemistry using an anti-p53 monoclonal antibody was performed and elevated immunoreactivity quantitated microscopically. Data were analyzed using a logistic regression model. Significant p53 immunoreactivity occurred as follows: chronic esophagitis (0%), Barrett's esophagus without dysplasia (10%), with low-grade dysplasia (60%), with high-grade dysplasia (100%), and adenocarcinoma (70%). All cases of Barrett's esophagus were significantly immunoreactive when compared with the chronic esophagitis cases (p = 0.001). There was an increase in p53 immunoreactivity as the histologic classification progressed toward adenocarcinoma (p = 0.001). Progression to high-grade dysplasia may be predicted based on p53 immunoreactivity. These findings suggest a role for p53 as an intermediate biomarker in Barrett's esophagus.     

IMPSAC: synthesis of importance sampling and random sample consensus

This paper proposes a new method for recovery of epipolar geometry and feature correspondence between images which have undergone a significant deformation, either due to large rotation or wide baseline of the cameras. The method also encodes the uncertainty by providing an arbitrarily close approximation to the posterior distribution of the two view relation. The method operates on a pyramid from coarse to fine resolution, thus raising the problem of how to propagate information from one level to another in a statistically consistent way. The distribution of the parameters at each resolution is encoded nonparametrically as a set of particles. At the coarsest level, a random sample consensus Monte Carlo Markov chain (RANSAC-MCMC) estimator is used to initialize this set of particles, the posterior can then be approximated as a mixture of Gaussians fitted to these particles. The distribution at a coarser level influences the distribution at a finer level using the technique of sampling-importance-resampling (SIR) and MCMC, which allows for asymptotically correct approximations of the posterior distribution. The estimate of the posterior distribution at the level above is being used as the importance sampling function to generate a new set of particles, which can be further improved by MCMC. It is shown that the method is superior to previous single resolution RANSAC-style feature matchers.     

Topographically induced self-deformation of the nuclei of cells: dependence on cell type and proposed mechanisms

Osteosarcoma-derived cell lines (SaOs-2, MG63) have recently been shown to deform their nucleus considerably in response to surface topography. Such a deformation had not been described previously. Here we present results on additional cell lines, including cancerous (OHS4, U2OS), immortalized (F/STRO-1⁺A and FHSO6) and healthy cells (HOP). The cancerous cells were found to deform extensively, the immortalized cells showed small deformations, whereas the healthy cells showed deformation only at short incubation times. These results suggest a strong link between the malignant transformation of cells and the state of the cytoskeletal network. We propose mechanisms to explain the deformation in which the cytoskeleton either pushes down on the nucleus during spreading or pulls it down upon adhesion to the pillars.     

Efficient design of orthonormal wavelet bases for signal representation

The efficient representation of a signal as a linear combination of elementary "atoms" or building blocks is central to much signal processing theory and many applications. Wavelets provide a powerful, flexible, and efficiently implementable class of such atoms. In this paper, we develop an efficient method for selecting an orthonormal wavelet that is matched to a given signal in the sense that the squared error between the signal and some finite resolution wavelet representation of it is minimized. Since the squared error is not an explicit function of the design parameters, some form of approximation of this objective is required if conventional optimization techniques are to be used. Previous approximations have resulted in nonconvex optimization problems, which require delicate management of local minima. In this paper, we employ an approximation that results in a design problem that can be transformed into a convex optimization problem and efficiently solved. Constraints on the smoothness of the wavelet can be efficiently incorporated into the design. We show that the error incurred in our approximation is bounded by a function that decays to zero as the number of vanishing moments of the wavelet grows. In our examples, we demonstrate that our method provides wavelet bases that yield substantially better performance than members of standard wavelet families and are competitive with those designed by more intricate nonconvex optimization methods.     

Changes in serum osteocalcin, plasma phylloquinone, and urinary gamma-carboxyglutamic acid in response to altered intakes of dietary phylloquinone in human subjects

The response of osteocalcin and other biochemical markers of vitamin K status to diets formulated to contain different amounts of phylloquinone was assessed in nine healthy subjects aged 20-33 y. Subjects resided in a metabolic ward for two 15-d cycles with a minimum of 6 wk between cycles. A mixed diet containing 100 micrograms phylloquinone/d was fed throughout both cycles; however, the phylloquinone content of one of the cycles was increased to a total of 420 micrograms/d on days 6 through 10 by fortifying corn oil in the diet with phylloquinone (supplemented diet). Total serum osteocalcin concentrations were not affected by either of the dietary treatments. The percentage of undercarboxylated osteocalcin increased an average of 28% over the 15-d cycle with the mixed diet (P < 0.05) and declined significantly an average of 41% with 5 d of the supplemented diet (day 6: 21.9 +/- 1.3%, day 11: 12.8 +/- 1.1%; P = 0.0001) with a rise after the return to the mixed diet (16.7 +/- 1.3%, P < 0.001). Plasma phylloquinone concentrations increased significantly with supplementation (day 6: 0.95 +/- 0.16 nmol/L, day 11: 1.40 +/- 0.29 nmol/L; P < 0.001) and then rapidly returned to presupplementation concentrations on returning to the mixed diet. Twenty-four-hour ratios of urinary gamma-carboxyglutamic acid to creatinine were unchanged with the supplemented diet; however, excretion declined to 91 +/- 2% of baseline after 10 d on the mixed diet (P = 0.01). These results show that undercarboxylated osteocalcin, plasma phylloquinone, and urinary gamma-carboxyglutamic acid excretion appear to be sensitive measures of vitamin K nutritional status because all of these variables were responsive to changes in dietary intake.     

Open-source hardware

Open-source software has made great strides. You can now buy a machine with an open-source operating system, browser, and office productivity package. Recent reports have recommended users switch to open-source browsers, away from less-secure commercial ones. The market for these products is growing rapidly.     

The effects of perindopril on vascular smooth muscle polyploidy in stroke-prone spontaneously hypertensive rats

OBJECTIVE: To quantify vascular smooth muscle polyploidy and growth kinetics in aortic cells from stroke-prone spontaneously hypertensive rats (SHRSP) and from normotensive Wistar-Kyoto (WKY) rats, and to examine the effects of treatment with the angiotensin converting enzyme (ACE) inhibitor perindopril on these parameters. DESIGN: The following experimental groups were used: young (age < 20 weeks) and old (age > 20 weeks) untreated WKY rats and untreated SHRSP; SHRSP treated with perindopril, and age- and sex-matched control SHRSP; and SHRSP treated with hydralazine and hydrochlorothiazide and age- and sex-matched control SHRSP. The effects of treatment of the SHRSP with perindopril for 30 days on vascular smooth muscle polyploidy and growth kinetics were measured and compared with the effects of equivalent antihypertensive doses of hydralazine and hydrochlorothiazide. METHODS: Vascular smooth muscle polyploidy was measured using flow-cytometry DNA analysis of freshly harvested cells. Growth curves were performed on cultured aortic cells. Plasma renin activity was measured by an antibody-trapping method, plasma angiotensin II (Ang II) by radioimmunoassay and plasma ACE activity by a colorimetric method. Cardiac hypertrophy was evaluated by measuring the heart weight:body weight and left ventricle + septum weight:body weight ratios. RESULTS: The SHRSP had markedly and significantly elevated G2 + M phase of the cell cycle. Treatment with perindopril resulted in a significant reduction in polyploidy in the SHRSP, whereas treatment with hydralazine and hydrochlorothiazide had no effect on the percentage of cells in the G2 + M phase of the cell cycle. The regression of polyploidy after treatment with perindopril was associated with a significant reduction in the concentration of Ang II and ACE activity, and with a significant regression of cardiac hypertrophy. Increased mitogenesis of cultured vascular smooth muscle cells from the SHRSP was not altered by treatment with perindopril. CONCLUSIONS: ACE inhibition reduces vascular smooth muscle polyploidy in large conduit arteries. This type of vascular protection is mediated by the reduced Ang II and possibly by increased kinins level, rather than by the hypotensive effect alone.     

An introduction to spectral domain method-of-moments formulations

The capacitance per unit length of a microstrip transmission line is obtained using a spectral-domain method-of-moments (MoM) formulation. The paper emphasizes this problem as a teaching tool to introduce students of electromagnetics to this technique. Firstly, the derivation of the spectral-domain Green's function is outlined. Using this, the relevant integral equation is derived to which the Galerkin MoM approach is then applied. The MoM problem is solved in the spectral domain by also transforming the expansion and weighting functions. The inverse Fourier transform is then applied to find the spatial-domain charge distribution, and, hence, capacitance. The issues that arise here - both of selecting how much of the spectrum to include, and how to choose the number of integration points - are discussed, and the results of typical numerical experiments are presented. The time required to compute the elements of the immittance matrix is shown to be 0(N/sup 3/); the use of translational symmetry (and thus Toeplitz matrix structure) to reduce this is outlined. Classroom experience with this material is discussed. Finally, a hybrid spectral/spatial-domain formulation, introducing asymptotics, is outlined to accelerate the evaluation of the immittance matrix.