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Ibn ʿAbd al-Wahhāb's radical movement was well launched in Central Arabia before the pact with the Al Saʿūd in 1744. It had been gathering pace as a destabilising force in al-ʿUyayna and beyond for two years, generating controversy that local opponents regionalised by involving ulama in the Holy Cities, al-Aḥsāʾ and Basra. The latter incited local rulers against the Wahhābis and triggered a confrontation. Despite qualified support from al-ʿUyayna's ruler, the Wahhābis were subject to takfīr and persecution. They too wielded takfīr, but with discretion. Their jihad appears to have been defensive in practice. Although their doctrine gave scope for insurrection, there is no recorded instance of them using force independently to challenge the status quo. Their insurgency against opposing rulers in Najd did not start until after the pact with the Al Saʿūd and formal declaration of jihad by the Wahhābi regime.

The 1H, 2H and 13C NMR spectra of phenyl acetate, phenyl acetate-[13CO] and phenyl acetate-[C2H3] dissolved in a nematic liquid crystalline solvent have been analysed to yield dipolar coupling, D ij. These have been interpreted using the additive potential model to provide information on the molecular conformation, resulting in three possible shapes for V(φ), the potential energy for rotation about the ring-oxygen bond. A comparison with the results of molecular orbital calculations leads to the conclusion that a potential with a minimum at 54.4° ± 0.1° is the most probable.

Randomised controlled trials (RCTs) aim to provide unbiased estimates of treatment effects. However, the process of implementing trial procedures may have an impact on the performance of complex interventions that rely strongly on the intuition and confidence of therapists. We aimed to examine whether shifting effects over the recruitment period can be observed that might indicate such impact.Three RCTs investigating music therapy vs. standard care were included. The intervention was performed by experienced therapists and based on established methods. We examined outcomes of participants graphically, analysed cumulative effects and tested for differences between first vs. later participants. We tested for potential confounding population shifts through multiple regression models.Cumulative differences suggested trends over the recruitment period. Effect sizes tended to be less favourable among the first participants than later participants. In one study, effects even changed direction. Age, gender and baseline severity did not account for these shifting effects.Some trials of complex interventions have shifting effects over the recruitment period that cannot be explained by therapist experience or shifting demographics. Replication and further research should aim to find out which interventions and trial designs are most vulnerable to this new kind of performance bias.

We report the isolation and characterization of the Xenopus homolog to human T1 ANT (adenine nucleotide translocase). The 1290-nucleotide sequence contains initiation and termination signals, and encodes a conceptual protein of 298 amino acids. The sequence shares high amino acid identity with the mammalian adenine translocases. The transcript is present in unfertilized eggs, and it is expressed at higher levels during formation of the antero-posterior dorsal axis in embryos. Although low levels are expressed constitutively except in endodermal cells, adenine nucleotide translocase (ANT) expression is dynamically regulated during neurulation. At this stage, expression in ectoderm rapidly diminishes as the neural folds form, and then ANT expression increases slightly in mesoderm. At the culmination of neurulation, the neural tube briefly expresses ANT, and thereafter its expression predominates in the somitic mesoderm and also the chordoneural hinge. In addition, ANT expression is particularly high in the prosencephalon, the mesencephalon, the branchial arches, eye, and the otic vesicle. Treatment of embryos with retinoic acid has the effect of diminishing constitutive expression of ANT, but microinjection studies demonstrate that immediate and local repression cannot be induced in dorsal structures.

Xenopus Pitx1 is a homeobox gene whose family members are structurally and functionally conserved in organisms as diverse as Drosophila, chick, mouse, human, and frog. Present as a maternal transcript, the gene is zygotically expressed during gastrulation in a dorsal streak of cells. This streak restricts to a small circular domain underlying the center of presumptive neural plate. Shortly thereafter, a crescent of expression develops at the border of anterior neural ectoderm, and as the central plate domain diminishes, the crescent coalesces to define the presumptive cement gland. Expression remains high throughout cement gland development, and subsequently expands to include ectodermal cells involved in stomodeal invagination. During early organogenesis, expression ensues in developing eye, posterior lateral mesoderm, and first branchial arch derivatives. Ectopic expression of xPitx1 causes head deformities including enlarged cement gland, ectopic cement glands, and posterior deformities or, in extreme cases, inhibition of recognizable structures posterior to the cement gland. Expression of markers such as XCG-1, xOtx2, xPax6, neuralbeta tubulin, and xTwist suggest that increases in cement gland and lower mandibular size are likely at the expense of other head tissues. Paradoxically, overexpression is sufficient to partially rescue embryos that are axially perturbed by ultraviolet irradiation or retinoic acid administration. Ectopic expression of xPitx1 in ectodermal explants directly promotes cement gland development as there was no evidence that mesodermal or neural tissue was present in explants.

Flavohemoglobins, a family of two-domain proteins with homology to vertebrate hemoglobins, are found in a variety of prokaryotic and eukaryotic microorganisms. Recent studies suggest a role for these proteins in nitrogen oxide metabolism. We now show that nitric oxide donors positively regulate a chromosomal flavohemoglobin (hmp)/lacZ operon fusion in Salmonella typhimurium. hmp gene expression in the presence of NO. is independent of the SoxS, OxyR, and FNR transcription factors and instead relies on inactivation of the iron-dependent Fur repressor. Other Fur-repressed promoters in S. typhimurium are also activated by an NO. donor. In contrast to the wild-type strain, an hmp- mutant requires markedly lower concentrations of NO to induce the hmp/lacZ fusion, whereas its response to iron chelation is equivalent to wild type. These data unveil a new pathway for NO-dependent gene expression in S. typhimurium.

To examine general practitioners' (GP) awareness of depression in their elderly patients (aged over 65) and to identify characteristics of those patients least likely to be recognized and treated.A cross-sectional study comparing the clinical opinion of the GP with assessment of mental state using a validated interview schedule (the Short Comprehensive Assessment and Referral Evaluation).510 elderly residents in the Gospel Oak area of Camden in North London registered with 28 GPs at 13 practices.Agreement between GP view and patients interview. Evidence of active management measured by examining GP records for appointments, referrals and prescription of psychotropic mediation.GPs were aware of depression in 36 (51%) of 70 depressed patients. Those least likely to be recognized were men, the married, those with high levels of physical handicap, those suffering from visual impairment and those who were least well educated. Of the 32 patients believed to be depressed, 12 (38%) were prescribed antidepressant medication and/or referred to mental health/social services.Levels of recognition of depression were lower than other recent reports. These findings may reflect the continued debate about the most suitable management of the elderly depressed in primary care and stress the need for further evaluation of appropriate treatment strategies for this group.

Human lumbar vertebral bodies were used to biomechanically test three different pars interarticularis defect repair techniques. A posteriorly directed force was applied to the inferior facets so that a bending moment was created across the pars.The stiffness and strength of each type of repair was measured and compared with the intact values.The Buck screw provided both the stiffest and strongest repair overall and within each group of cadaveric specimens. This was followed by the Morscher hook screw. Both the screw and hook repair were statistically significantly stronger and stiffer than the wire repair. There was no statistical difference between the screw and hook repairs regarding strength or stiffness.Using the intact L1 vertebral body as a control for each cadaver, the three surgical techniques for pars repair could be evaluated.The screw repair provided 64% of the intact stiffness and 58% of the intact strength. The hook repair provided an average of 52% of the intact stiffness and 40% of the intact strength. The wire provided only 3.5% of the intact stiffness and 12% of the intact strength.The screw repair technique is the stiffest and strongest pars repair method. The wire technique restores the least stiffness and strength.

The faculty of the North American Spine Society and Scoliosis Research Society pedicle fixation workshop were questioned about their use of pedicle screw implants for fixation of the spine.This study ascertained which faculty members used pedicle implants given specific clinical scenarios and analyzed the data for trends and consensus.For the past 4 years, the North American Spine Society in conjunction with the Scoliosis Research Society has sponsored a course on pedicle fixation of the spine. During these courses, techniques of pedicle fixation have been discussed. The indications, however, for pedicle fixation have remained controversial, even among the course faculty.A questionnaire was developed with 20 clinical scenarios, and the faculty were asked whether they would use pedicle implants as part of their surgical treatment.Thirty-eight of 45 (84%) questionnaires have been received and analyzed. For most scenarios, there was statistically significant consensus among the faculty that they would use a pedicle implant. There was statistically significant consensus that the faculty would not use pedicle implants for thoracic fractures or adolescent idiopathic scoliosis.This study is useful in assessing pedicle implant usage in our community but should not be used as a guide for their indications and contraindications.

A 2-year-old child became cyanosed and apnoeic while having a febrile convulsion. The child’s mother, who had previously undertaken Basic Life Support (BLS) training, noticed the bluish discolouration of the child’s lips. She was concerned that this had …

Szmukler & Holloway ([2000][1]) have expressed their concern that proposed changes to the Mental Health Act 1983 owe more to the current preoccupation with public safety than to concern for patient care. We believe that many other psychiatrists share these concerns. This is supported by the results

The Sa⊂ūdī Civil War, which developed after the death of the Imām Faiṣal at al-Riyāḍ in A.H. 1282/A.D. 1865, and which was largely responsible for the debilitation and ultimate demise of the Second Sa⊂ūdī State, has received relatively little attention from either Sa⊂ūdī or Western historians. In neglecting this period, modern Sa⊂ūdī scholars may have been influenced by the consideration which led Wahhābī chroniclers of an earlier generation to provide only cursory treatment of the Civil War in their accounts of Najdī history; the decade between the Imām Faiṣal's death and the resolution of the conflict in 1293/1876, characterised as it was by persistent fraternal rivalry and displays unprincipled political opportunism, does not represent a particularly creditable episode in the history of the āl Sa⊂ūd.

A female infant, born to a 21-year-old mother with systemic lupus erythematosus, had cutaneous discoid lupus at birth. The lesions resolved spontaneously over the first few months and by the age of 1 year the infant's skin was normal. Other possible complications of this maternal disease are discussed and the need for caution in counselling mothers is recommended.