CpG-creating mutations are costly in many human viruses

Mutations can occur throughout the virus genome and may be beneficial, neutral or deleterious. We are interested in mutations that yield a C next to a G, producing CpG sites. CpG sites are rare in eukaryotic and viral genomes. For the eukaryotes, it is thought that CpG sites are rare because they are prone to mutation when methylated. In viruses, we know less about why CpG sites are rare. A previous study in HIV suggested that CpG-creating transition mutations are more costly than similar non-CpG-creating mutations. To determine if this is the case in other viruses, we analyzed the allele frequencies of CpG-creating and non-CpG-creating mutations across various strains, subtypes, and genes of viruses using existing data obtained from Genbank, HIV Databases, and Virus Pathogen Resource. Our results suggest that CpG sites are indeed costly for most viruses. By understanding the cost of CpG sites, we can obtain further insights into the evolution and adaptation of viruses.

Two-year follow-up of cognitive--behavioral therapy and supportive counseling in the treatment of persistent symptoms in chronic schizophrenia

The article reports the 2-year follow-up of patients suffering persistent symptoms of schizophrenia who entered a single blind randomized controlled trial. Patients were randomly allocated to cognitive-behavioral therapy (CBT) plus routine care (RC), supportive counseling (SC) plus RC, or RC alone. Treatment took place over 3 months, and follow-up was made 12 and 24 months after treatment finished. Sixty-one patients were available to the 2-year follow-up and assessed for positive and negative symptoms and clinical improvement; all of the 87 patients who entered the trial were assessed for relapse over the follow-up period. On all measures, patients who received RC alone did significantly worse at 2 years. There were no significant differences at 2 years between the CBT and SC groups.

Bringing people together for improvement

The MHA North Central Hospital Council's first involvement in community health issues began in 1995 and focused initially on conducting a comprehensive assessment of health status in the North Central Council (NCC) region. More recently, the council's board identified a desire to collaborate across northern Michigan in making measurable improvement in youth physical activity. What follows is a description of the process that we have followed in our efforts to move beyond mere assessment to bringing people together for programs directed at improving health.

Durability of the effects of cognitive-behavioural therapy in the treatment of chronic schizophrenia: 12-month follow-up

BACKGROUND

Persistent drug-resistant psychotic symptoms are a pervasive problem in the treatment of schizophrenia.

AIMS

To evaluate the durability of the treatment effects of cognitive-behavioural therapy for chronic schizophrenia one year after treatment termination.

METHOD

A comparison of clinical outcomes was made at one-year follow-up from a randomised trial of cognitive-behavioural therapy, supportive counselling and routine care alone in the treatment of chronic schizophrenia.

RESULTS

Seventy out of the 72 patients (97%) who completed treatment were assessed at follow-up. There were significant differences between the three groups when positive and negative symptoms were analysed by means of ANCOVAs. Between-group comparisons indicated significant differences between cognitive-behavioural therapy and routine care at follow-up for positive symptoms. There was a trend towards significance for both cognitive-behavioural therapy and supportive counselling to be superior to routine care alone on negative symptoms.

CONCLUSIONS

At 12-month follow-up the significant advantage of cognitive-behavioural therapy compared to routine care alone remained.

Individual cognitive-behavior therapy in the treatment of hallucinations and delusions: a review

The limitations of biochemical treatments in reducing the severity of hallucinations and delusions has led to an increased interest in the investigation of psychological treatments for these symptoms. These investigations have spanned the last 4 decades and have covered a range of psychological approaches from psychoanalytically oriented psychotherapy to behavioral approaches. More recently, findings that some psychotherapies are not effective treatments for psychosis and that cognitive-behavior therapy can be an effective treatment for neurotic disorders have led to increasing interest in the investigation of the effectiveness of cognitive-behavior therapy for psychosis. This review describes and evaluates the research on the cognitive-behavioral treatment of hallucinations and delusions and describes the cognitive models from which the treatments have developed. The conclusion is that, on the whole, the literature provides fairly strong evidence for the efficacy of cognitive-behavioral approaches in the management of chronic psychotic disorders and associated symptoms, although there are a number of areas where further development is necessary.

Randomised controlled trial of intensive cognitive behaviour therapy for patients with chronic schizophrenia

OBJECTIVES

To investigate whether intensive cognitive behaviour therapy results in significant improvement in positive psychotic symptoms in patients with chronic schizophrenia.

DESIGN

Patients with chronic schizophrenia were randomly allocated, stratified according to severity of symptoms and sex, to intensive cognitive behaviour therapy and routine care, supportive counselling and routine care, and routine care alone.

SETTING

Adjunct treatments were carried out in outpatient clinics or in the patient's home.

SUBJECTS

87 patients with persistent positive symptoms who complied with medication; 72 completed treatment.

OUTCOME MEASURES

Assessments of positive psychotic symptoms before treatment and 3 months after treatment. Number of patients who showed a 50% or more improvement in symptoms. Exacerbation of symptoms and rates of readmission to hospital.

RESULTS

Significant improvements were found in the severity (F=5.42, df =2,86; P=0.006) and number (F=4.99, df=2,86; P=0.009) of positive symptoms in those treated with cognitive behaviour therapy. The supportive counselling group showed a non-significant improvement. Significantly more patients treated with cognitive behaviour therapy showed an improvement of 50% or more in their symptoms (chi2=5.18, df=1; P=0.02). Logistic regression indicated that receipt of cognitive behaviour therapy results in almost eight times greater odds (odds ratio 7.88) of showing this improvement. The group receiving routine care alone also experienced more exacerbations and days spent in hospital.

CONCLUSIONS

Cognitive behaviour therapy is a potentially useful adjunct treatment in the management of patients with chronic schizophrenia.

The efficacy of orally administered theophylline, inhaled salbutamol, and a combination of the two as chronic therapy in the management of chronic bronchitis with reversible air-flow obstruction

The efficacy of bronchodilator therapy was assessed in the long-term management of patients with chronic bronchitis and varying degrees of reversible air-flow obstruction. Twenty-five patients with a mean forced expiratory volume in one second (FEV1) 38.7% predicted received: optimized doses of orally administered, sustained-release theophylline, inhaled salbutamol (200 micrograms 4 times a day), a combination of the 2 drugs, and identical placebo therapy for periods of 3 wk in a randomized, double-blind, crossover trial. Patients who deteriorated during treatment were assessed immediately and designated "treatment failures" if additional therapy proved necessary. Such "failures" occurred in 9 patients with placebo, in 8 with salbutamol, in 6 with theophylline, and in only 1 with combined therapy. Using a ranking system based on "treatment failures" and mean daily peak flow rates, first preference was given to combined therapy in 13 patients, theophylline in 6, salbutamol in 4, and placebo in 2. Thus, both combined therapy (p less than 0.001) and theophylline (p less than 0.05) were better than placebo, but this was not so for inhaled salbutamol. Objective improvements in FEV1 and forced vital capacity were a consistent finding with combined therapy compared with placebo, although not with single agents, and additive effects were clearly demonstrated. In the subgroup of patients able to tolerate placebo therapy, no subjective benefit could be discerned during any of the 3 periods of active treatment. Thus, the combination of orally administered, sustained-release theophylline and inhaled salbutamol offered significant advantages in the clinical control of patients with chronic bronchitis with air-flow obstruction.

Comparison of the beta-adrenoceptor blocking activity of oxprenolol, slow release oxprenolol and a combined oxprenolol diuretic preparation

1 Observations were made in five healthy subjects who exercised before and 2, 3, 6, 8 and 24 h after the oral administration on separate occasions of 160 mg oxprenolol, 160 mg slow release oxprenolol, 160 mg slow release oxprenolol with 0.25 mg cyclopenthiazide and placebo. Blood samples were obtained before and at 1, 2, 3, 6, 8, 12 and 24 h after drug administration and assayed for oxprenolol concentration. 2 The three formulations produced maximum reductions of 29% in the exercise tachycardia 3 to 6 h after drug administration. At 24 h the effects of the three preparations were not significantly different from placebo. 3 There were no significant differences in the plasma concentrations produced by the three formulations during the 24 h period. 4 These observations suggest that the slow release formulations of oxprenolol should be given twice daily to maintain cardiac beta-adrenoceptor blockade throughout a period of 24 h.

Effects of Steam Injection on the Performance of Gas Turbine Power Cycles

The effect of injecting steam generated by exhaust gas waste heat into a gas turbine with 3060°R turbine inlet temperature has been analyzed. Two alternate steam injection cycles are compared with a combined cycle using a conventional steam bottoming cycle. A range of compression ratios (8, 12, 16, and 20) and water mass injection ratios (0 to 0.4) were analyzed to determine effect on net turbine power output per pound of air and cycle thermodynamic efficiency. A water/fuel cost tradeoff analysis is also provided. The results indicate promising performance and economic advantages of steam injected cycles relative to more conventional utility power cycles. Application to coal-fired configuration is briefly discussed.