An oral inhibitor of hedgehog pathway has antitumor activity
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Sonic hedgehog homolog (SHH) is one of 3 proteins in the mammalian hedgehog family (plus desert and Indian hedgehog). Sonic hedgehog controls cell division of adult stem cells and has been implicated in development of some cancers http://bit.ly/ODlig

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Image source: Sonic hedgehog specifies digit identity in mammalian development. Wikipedia, public domain.

England crabby about health care …
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… sound familiar, Canada?

 

NHS chiefs predict ward closures and job cuts


King's Fund report finds NHS finance directors pessimistic about health service reforms as waiting times rise.

Photograph: Pulse Picture Library/Press Association Images


The government's controversial health service reforms threaten wards and jobs, the King's Fund think tank warns.

NHS finance directors predict ward closures, job cuts and other reductions as they struggle to make ends meet and prepare for the reorganisation of England's health system, according to the King's Fund think tank.

With some online pharmacy waiting times the worst for three years, A&E departments overstretched, and surgeons warning that patients are being denied key treatments, the first in a series of planned quarterly monitoring reports highlights "significant concern" among some of those responsible for contributing to £20bn of "efficiency savings" in the NHS over four years and for ensuring that new bodies taking over services in the next three years do not start with deficits. Most say they are unlikely to meet productivity targets this year.

The challenging picture painted by the report, from a respected independent analyst of the health service, comes during the government's two-month "pause " in trying to push through its controversial legislation. It has promised to listen and make "substantive" changes to its plans, although NHS staff have been told by the chief executive, David Nicholson, to "maintain momentum on the ground".

The report analyses recent government figures, including those pertaining to the period between referral to hospital and treatment. In February this year, nearly 15% of hospital patients had waited more than 18 weeks to be admitted, the highest figure since April 2008, and part of a steady increase since the government relaxed waiting-time targets in June last year.

The views of 26 trust finance directors, collected over the internet last month, provided government critics with more ammunition. The panel, made up of directors from acute hospital, mental health and primary care trusts, was not intended to be statistically representative, but to give "a qualitative account" of what is happening, according to the report. Most warned that they are unlikely to meet this year's productivity targets. Workforce changes, sometimes involving only cuts to agency staff, were mentioned 16 times as a way of meeting targets, and closures of wards or other services were mentioned 12 times. Four directors specified reducing the length of time people spent in hospital, with one panel member commenting: "A saving is not a saving until the activity has reduced AND the beds or theatres have closed AND the jobs taken out, Only then do commissioners and providers save money."

"Back-office" savings were listed by six directors, although others expressed scepticism, with one saying that although these were "particularly popular with politicians", they made only a modest contribution.

More than half the panel said the government should be more realistic, including over the impact of treatment tariff changes on trust incomes and the need to ration treatments. Several wanted an end to incremental pay progression for staff.

John Appleby, chief economist at the King's Fund and lead author of the report, said: "It highlights significant concern amongst NHS finance directors – who are well placed to report the stresses in the system – about the prospects for the years ahead. With hospital waiting times rising, the NHS faces a considerable challenge in maintaining performance as the financial squeeze begins to bite."

The shadow health secretary, John Healey, said the report would increase concerns that the NHS was "slipping backwards again" under the Tories.

http://www.guardian.co.uk/society/2011/apr/20/nhs-directors-health-service-reforms

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The Ten That Made Springsteen; 6. Mitch Ryder & The Detroit Wheels - Devil With The Blue Dress On
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"Everybody's always asking the definition of Garage Rock. Well, I'm gonna tell you right now. It's white kids trying to play black Rhythm and Blues and failing......gloriously." Little Steven van Zandt.

I picked Mitch Ryder's classic rendition of Shorty Long's "Devil With The Blue Dress On ", but I might as well have picked the Kingsmen's "Louie Louie" or "Dirty Water" by the Standells, "Double Shot Of My Baby's Love" by the Swinging Medallions or "You Can't Sit Down" by the Dovels. I simply picked "Devil" because it was the template crowd pleaser "The Detroit Medley" that has been present in Springsteen's set lists since September 1975, all the way up to the Rising tour in 2003. Mitch Ryder was one of those quintessential Garage acts from the early mid to late sixties. "Devil" was one of Mitch's few hits peaking at #4 in the billboard charts. But contrary to popular believe this was not uncommon those days. Garage acts, or Frat Rock bands, though often one hit wonders, would regularly be on top of the charts. But since Garage was a factor in a time when the 45 still reigned supreme and in a time where small labels still were a force to be reckoned with, a lot of those hits became obscure nuggets when the album format took over R&R.

Garage was part of the tidal wave caused by the British Invasion, or rather the Beatles appearances on the Ed Sullivan show. Even though "Louie Louie" by the Kingsmen was released in 1963, as sort of an avant garde Garage release, those appearances were what busted the band culture wide open and prompted Springsteen to pick up the guitar and join his first band the Castilles. I believe that Garage became an important part of the aesthetic, romanticism and ethics that is at the base of Bruce Springsteen & The E-Street Band. Garage gave young kids the feeling that anybody could have that big record on the top of the charts. More than ever Garage made the dream of R&R accessible to just about anyone. By the time the Beatles hit, the first wave of R&R had perished. Radio was dominated for a while by R&R based pop, by the lavish productions of Phil Sector or Leiber & Stoller, or by the highly polished songwriting and performing of Sam Cooke and Roy Orbison. While that did give R&R more credibility and gave R&R more artistic value it also put R&R beyond the reach of many kids. The Beatles showed that you could do it yourself basically, they opened the doors to a whole new bag of R&R dreams.



That band ethic is why "Born To Run" turned out the way it did. Springsteen wanted to record his own Phil Spector album, but I believe he never even contemplated recording it with studio musicians and a proper producer. In stead he took the band in the studio trying to recreate the Spector sound with his own band, layer by layer. Spector simply had an army of musicians in the studio recording them simultaneously on a two track recorder. Although the musicians on Spector's record became known as the Wrecking Crew, they were never a band in the way the E-Street Band was. I think to Springsteen the R&R band represented the sort of mystic brotherhood busting out of class together, trying to get away from those fools. That romanticism created a different aesthetic from the producers approach Spector had, where musicians were secondary to his own genius. It was also the reason why "Born to Run" ultimately came out sounding different from Spector's ground breaking singles. Though recorded with a smaller band, the album ironically sounded a bit more cluttered and muddy than what Spector achieved with his two track. By the time "Born To Run" hit the market Spector was already far in his decline. Springsteen met him once in the studio when Phil was recording one of Bruce's idols, Dion, in '77. Spector merely turned to Springsteen and said "doesn't this make "Born To Run" suck".

Though the band ethics of Garage were important to Springsteen while recording his albums with the E-Street Band, on stage it wasn't as pronounced till Little Steven joined the band. Van Zandt has always been much more the Garage connoisseur and enthusiast. Though Springsteen tapped in to the Band ethics of the Garage movement and part of its aesthetic (taking his loud guitar sound from there), I think he himself was much more enamored with the R&R sound of the mid fifties to the early sixties. Van Zandt however was a hard core Garage fan. I think his enthusiastically running mouth is what made Springsteen realize how important the Garage sound was to the E-Street Band, often characterized as the greatest bar band of R&R. With Little Steven joining the Band the Garage classics became regulars in the set with "The Detroit Medley" turning out to be the ultimate rave up for the boys. In no other song Max's relentless pounding, Gary's throbbing base, Danny's raucous organ licks, Roy's rollicking piano or Clarence honking would come together in quite the same way building to a climax in a R&R frenzy. "The Detroit Medley" made clear we were indeed dealing with the heart stopping, pants dropping, earth shattering, hard rocking, hips shaking, earth quaking, nerve breaking, viagra taking, history making, legendary E-Street Band.



Springsteen's Garage sensibilities would be part of his break through success as well. By the time "Born To Run" hit the market R&R was threatening to collapse under its own pretenses. The album culture and art rock had taken the fun out of R&R. In a recent interview with Boulevard Magazine Little Steven called Art Rock "the anti-Christ", while trying to make an argument that songs like "Louie Louie", with their simple effectiveness, are actually harder to write than Pink Floyd's pretentious drivel of the early seventies. The Jack Holtzman release of Nuggets in 1972, with the infamous Lenny Kaye liner notes coining the term Punk, was signifying that something was simmering beneath R&R's pretentious surface. Nuggets stood as a reminder of R&R's dream and glory. While Springsteen played in the infamous Max's Kansas City, one of the key clubs to the birth of Punk, he was never part of that scene. Springsteen is never mentioned when it comes to the significance of Max's or the birth of Punk. Even though "Please Kill Me (the oral history of Punk)" does have a chapter called "Because The Night", a Springsteen penned Patti Smith song, Springsteen is never mentioned. Although Springsteen was trying to find that three minute essence of R&R, much as Punk was, Springsteen stood outside of that movement. Maybe that's because Springsteen, although undoubtedly part of the counter wave, simply was too good a musician and songwriter to be a part of the Punk scene. Springsteen wasn't marred by the artistic pretense Punk had before the Ramones hit the scene, he wasn't NY enough, but more importantly he wasn't held back by being unable to play even the simplest chords. Springsteen became the artist who infused the album culture of Rock with the aesthetics of early R&R and Garage, bringing R&R back down to earth.



But as Don McLeese pointed out in his classic article, "Abdicating the Rock 'n' Roll Pedestal: Bruce Springsteen Gets Down", for the Chicago reader in 1980 there was a paradox to Springsteen as well, "[By] treating a Springsteen as something special, we threaten to undermine what made him special in the first place". As early as '78 Springsteen realized that when the first River songs became part of the Darkness tour. Two of them "The Ties That Bind" but especially "Sherry Darling" were much closer to the the sounds of the Garage bands that inspired Springsteen. As "Tracks" showed, Springsteen had been writing songs like that for the E-Street Band as early as 1973 with "Seaside Bar Song". It wasn't until "The River" Springsteen started to bring those Garage sounds more to the foreground. Further scaling down his songwriting Springsteen abandoned much of the grand imagery that defined "Born To Run" and "Darkness On The Edge Of Town". Partly produced by Little Steven, "the River" was oozing with the sweat of the garage that gave birth to Bruce Springsteen and the E-Street Band in the first place.

"Devil With The Blue Dress On" - Mitch Ryder & The Detroit Wheels
"Dirty Water" - The Standells
"Double Shot Of My Baby's Love" - The Swingin' Medallions
"Sherry Darling" - Bruce Springsteen (live '78)

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Genetic defects high in kids of blood relatives
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Q I am going be married to my mother’s, brother’s son. Therefore, he is my cousin. Will we have normal children as I heard that when cousins marry the child isn’t born normal. Is this true?



It is true to a great extent. The incidence of still births, birth defects, blinding disorders, blood related problems and a deficient immune system is reported to be high in children born out of consanguineous marriages (marriages between blood relatives).



This again depends on the presence of defective genes being carried by the parents who would have inherited them from their ancestors. First cousins, as in your case, are reported to share 12.5 percent of their inherited genetic material as it originates from a common ancestor. In such situations, if there are any “silent” genetic defects, then such errors manifesting as a disease in the child of consanguineous parents is high. Other health factors of the parents can also be responsible for these defects.



Q I am 62 years old and suffer from a retrograded ejaculation problem. I developed the problem after a prostate operation that I underwent nine months ago. I also suffered from erectile cialis when the prostate developed around five years ago. What should I do about this problem?



In retrograde ejaculation, the semen travels backwards into the urinary bladder instead of coming out. As for sex, there will be no problem as the man can get an erection and can have sexual intercourse.



Retrograde ejaculation will only affect the ability to impregnate a woman. Yes, erections may be adversely affected in prostatic enlargement but since the problematic prostate has been removed, you should have no problems. Other causes of erectile dysfunction may be operative in your case. Check with a specialist.



The writer is a sexologist. You can mail him at dr.narayana@deccanmail.com



Content Courtesy:Deccan Chronicle

Proper Use of viagra
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Special patient directions come with sildenafil. Read the directions carefully before using the medicine .

This medicine usually begins to work within 30 minutes after taking it for erectile dysfunction. It continues to work for up to 4 hours, although its action is usually less after 2 hours.

Dosing—The dose of sildenafil will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of sildenafil. If your dose is different, do not change it unless your doctor tells you to do so.
For oral dosage form (tablets):
For treatment of erectile dysfunction:
Adults up to 65 years of age—50 mg as a single dose no more than once a day, 1 hour before sexual intercourse. Alternatively, the medicine may be taken 30 minutes to 4 hours before sexual intercourse. If needed, your doctor may increase your daily dose to 100 mg or decrease your daily dose to 25 mg.
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If you are taking protease inhibitors, such as for the treatment of HIV, your doctor may recommend a 25 mg dose and may limit you to a maximum single dose of 25 mg of purchase cialis in a 48 hour period
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