RNA-Seq analysis in MeV.

RNA-Seq is an exciting methodology that leverages the power of high-throughput sequencing to measure RNA transcript counts at an unprecedented accuracy. However, the data generated from this process are extremely large and biologist-friendly tools with which to analyze it are sorely lacking. MultiExperiment Viewer (MeV) is a Java-based desktop application that allows advanced analysis of gene expression data through an intuitive graphical user interface.

Nonmedical treatment of patients with dementia.

This article reviews some nonmedical interventions that psychiatrists and other clinicians in the field of neuroscience can provide to their patients with dementia. The author discusses how clinicians can help patients and their caregivers understand the diagnosis causing the dementia (whether it be Alzheimer's, traumatic brain injury, Parkinson's disease, or vascular dementia) and help them to set realistic expectations of the treatment process for the patient and his or her loved ones. The author also reviews how clinicians can help caregivers modify their interactions with the patients when required to enhance not only the quality of life for the patient but the quality of life for the caregiver as well.

Helping patients by involving their families.

Patients and their family members may become highly interdependent as patients near the end of life. To best help these patients, healthcare providers can try to become a member of the patient/family team. By becoming a member, careproviders can improve patients' and family members' access to medical information, more effectively offer advice, and assure patients and family members that they can still choose to do what they think is best.

MicroRNAs link estrogen receptor alpha status and Dicer levels in breast cancer.

To identify microRNAs (miRNAs) associated with estrogen receptor (ESR1) status, we profiled luminal A, ESR1+ breast cancer cell lines versus triple negative (TN), which lack ERα, progesterone receptor and Her2/neu. Although two thirds of the differentially expressed miRNAs are higher in ESR1+ breast cancer cells, some miRNAs, such as miR-222/221 and miR-29a, are dramatically higher in ESR1- cells (∼100- and 16-fold higher, respectively). MiR-222/221 (which target ESR1 itself) and miR-29a are predicted to target the 3' UTR of Dicer1.

How can careproviders most help patients during a disaster?

This article reviews careproviders' most difficult emotional challenges during disasters and provides approaches for responding optimally to them. It describes key approaches that careproviders may pursue to best help patients and others during a catastrophe. It raises unanswered questions regarding when, if ever, careproviders should provide active euthanasia to patients who are incompetent, and when, if ever, careproviders should give their own food and water to patients or others who may otherwise soon die without them.

Targets of miR-200c mediate suppression of cell motility and anoikis resistance.

Introduction: miR-200c and other members of the miR-200 family promote epithelial identity by directly targeting ZEB1 and ZEB2, which repress E-cadherin and other genes involved in polarity. Loss of miR-200c is often observed in carcinoma cells that have undergone epithelial to mesenchymal transition (EMT). Restoration of miR-200c to such cells leads to a reduction in stem cell-like characteristics, reduced migration and invasion, and increased sensitivity to taxanes.

Five skills psychiatrists should have in order to provide patients with optimal ethical care.

Analyses of empirical research and ethical problems require different skills and approaches. This article presents five core skills psychiatrists need to be able to address ethical problems optimally. These include their being able to recognize ethical conflicts and distinguish them from empirical questions, apply all morally relevant values, and know good from bad ethical arguments.

A possible application of care-based ethics to people with disabilities during a pandemic.

Should people with exceptionally profound disabilities be given an equal chance of surviving a pandemic, even when their care might require a greater use of limited medical resources? How might an ethics of care be used to shape a policy regarding these patients?

Therapeutic implications of GIPC1 silencing in cancer.

GIPC1 is a cytoplasmic scaffold protein that interacts with numerous receptor signaling complexes, and emerging evidence suggests that it plays a role in tumorigenesis. GIPC1 is highly expressed in a number of human malignancies, including breast, ovarian, gastric, and pancreatic cancers. Suppression of GIPC1 in human pancreatic cancer cells inhibits in vivo tumor growth in immunodeficient mice.

What Psychiatrists Should Know about Genes and Alzheimer's Disease.

Alzheimer's disease is a devastating illness, and patients may be exceptionally concerned that they have genes that contribute to this illness, especially if there is a family history of Alzheimer's disease. This article reviews core findings regarding the genes that contribute to the early-onset (familial) and late-onset forms of Alzheimer's disease and related findings regarding the needs of psychiatrists when discussing the disease with patients. Previously, clinicians believed that patients who tested positive for the APOE gene linked to late-onset Alzheimer's disease would be harmed by this knowledge to a greater extent than those who did not know they had the gene.

All careproviders need more opportunities to share their ethical concerns with others.

Attention to the ethical concerns of healthcare aides can provide important information about patients' needs to careproviders, improve the ethical environment of an institution, and benefit aides who suffer from bearing ethical concerns alone. All persons benefit from sharing their ethical concerns with others. Among other benefits, ethics consultation offers careproviders, caregivers, healthcare aides, patients, and patients' loved ones an opportunity to have their concerns heard.

Sliding "off" the sliding scale: allowing hope, determining capacity, and providing meaning when an illness is becoming worse but a treatment may help.

In this issue of The Journal of Clinical Ethics, Emily Bell and Eric Racine are guest editors of a special section focusing on the use of deep brain stimulation (DBS) to treat Parkinson's disease. In "Deep Brain Stimulation, Ethics, and Society," Bell and Racine report that DBS already has been used to treat more than 50,000 patients. The ethical issues raised in this special section are important not only in regard to Parkinson's disease and DBS, but in many areas of medicine.

Addressing obesity in the hospitalized patient: a needs assessment.

Objective: To perform a needs assessment to determine the extent to which hospitalist providers recognize and intervene upon obese patients in the hospital setting.

Methods: A chart review was performed for patients admitted to the hospitalist service at Johns Hopkins Bayview Medical Center between September 1 and October 1, 2008. Patient charts were reviewed for documentation of obesity and treatment plans were ordered and implemented.

Utilizing audit and feedback to improve hospitalists' performance in tobacco dependence counseling.

Introduction: Hospitalized smokers benefit from smoking cessation counseling and nicotine replacement therapy (NRT). However, inpatient providers who care for hospitalized patients carry out these preventive measures inconsistently.

Methods: We designed a peer-led audit and feedback intervention to improve (a) the frequency of smoking cessation counseling and (b) the appropriateness of the prescribing of NRT by hospitalist practitioners in our hospital.

Core ethical questions: what do you do when your obligations as a psychiatrist conflict with ethics?

Psychiatrists face many difficult ethical decisions in which they must exercise their discretion. In the most difficult decisions they confront, there are significant "harms," regardless of what they choose. The best they can do in these instance is to be as acutely aware of the most important pros and cons as they can.

"Third generation" ethics: what careproviders should do before they do ethics.

The author suggests that a "first generation" task in bioethics is to give patients the information they need; a "second generation" task is to do this in the most effective way; and a "third generation" task is to avoid harming patients by imposing value biases. The author discusses ways to pursue this third generation task.

Dental students' knowledge and perceptions of non-invasive dental caries management.

Background: An evidence-based, risk-specific, and non-invasive modality for caries management was implemented in the University of Sydney dentistry curriculum. This study reviews its impact on student learning outcomes and their perceptions of the efficacy of a risk-based caries management.

Methods: One hundred and nine Year 3 and Year 4 students were invited to complete a questionnaire to assess their understanding of the protocols and their perceptions of both the education process and value of the non-invasive treatment modality.

Loss of miR-200c: A Marker of Aggressiveness and Chemoresistance in Female Reproductive Cancers.

We focus on unique roles of miR-200c in breast, ovarian, and endometrial cancers. Members of the miR-200 family target ZEB1, a transcription factor which represses E-cadherin and other genes involved in polarity. We demonstrate that the double negative feedback loop between miR-200c and ZEB1 is functional in some, but not all cell lines.

Treatment initiatives for patients with Alzheimer's disease.

There are several treatment initiatives a psychiatrist should consider when treating a patient with Alzheimer's disease. The author discusses five treatment initiatives in the order in which they tend to arise during the illness progression of a patient with Alzheimer's disease: screening for Alzheimer's disease, providing information to patients on nonevidence-based treatments of Alzheimer's disease, assisting patients with contacting loved ones as the disease progresses, confronting patients with difficult decisions, and discussing moral concerns of the patient with his or her loved ones. Case examples and a review of literature are also provided.

Delivering health care on the streets: challenges and opportunities for quality management.

Street Medicine focuses on the health needs of unsheltered homeless through mobile teams that provide care in the locations where individuals are found. Innovative strategies are needed to manage the quality of care provided within the atypical clinical settings encountered. In our study, contextual elements and practices for managing quality of care were explored through qualitative analysis of program components presented at the 2007 and 2008 International Street Medicine Symposia.

Ethical Aspects of Evaluating a Patient's Mental Capacity.

When a patient's mental capacity to make decisions is open to question, the physician often calls in a psychiatrist to help make the determination. The psychiatrist's conclusions may be taken to a court to determine the patient's legal competency. In this article, the author presents several clinical criteria psychiatrists may use when determining patients' mental capacities.

Using nonevidence-based approaches to treat patients with alzheimer's disease.

In this article, the author discusses the rationale behind offering patients with Alzheimer's disease treatments that are not strongly evidence based. The author will discuss specific nonevidence-based (or not strongly evidence-based) interventions psychiatrists may consider offering their patients with AD, including nonpharmacological and pharmacological approaches. The author will also discuss positive and negative aspects of these interventions and suggest some steps psychiatrists can take to try to avoid the potential downsides.