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B McCarthy

Publications and source records attributed to B McCarthy.

At least 19 recordsLinked to original sources

The activity of abdominal stretch receptors during non-giant swimming in the crayfish Cherax destructor and their role in hydrodynamic efficiency.

Recordings were made from the nerve innervating the stretch receptors of the abdominal muscle receptor organs and slow extensor muscles of tethered crayfish, Cherax destructor, during so-called "non-giant swimming". The stretch receptors were active during the flexor phase of swimming but the duration and pattern of activity varied from cycle to cycle. Their pattern of firing was modified by the activity of the large accessory neurons which make direct inhibitory synapses upon them. Neither the stretch receptors nor the accessory neurons were active during the extensor phase of the cycle. The timing and extent of tailfan movements during the period of stretch receptor activity were measured from video records before and after the stretch receptor nerves were cut in the second to fifth segments. The promotion of the tailfan during flexion was significantly delayed and the minimum angle to which the uropods were remoted at the end of flexion significantly larger in denervated animals. We propose that afferent information from the stretch receptors coordinates the timing and extent of tailfan movements according to variations in the positioning and movement of the abdominal segments such that the hydrodynamic efficiency of the tailfan is enhanced on a cycle by cycle basis during non-giant swimming.

Abdominal Muscles↗

Studies in NZB IL-10 knockout mice of the requirement of IL-10 for progression of B-cell lymphoma.

NZB mice develop an age-related malignant expansion of a subset of B cells, B-1 cells, with autocrine production of IL-10. IL-10, a pleiotropic cytokine with anti-inflammatory properties, is a potent growth and survival factor for malignant B cells. To further examine the in vivo requirement for IL-10 in the development and expansion of malignant B-1 clones in NZB mice, we developed a strain of homozygous IL-10 knockout (KO) mice on an NZB background. The NZB IL-10 KO mice develop peritoneal B-1 cells with approximately the same frequency as heterozygous and wild-type littermates. In contrast, the development of malignant B-1 cells in the peripheral blood and spleen, observed in wild-type NZB, rarely occurred in the NZB IL-10 KO. Phenotypic analysis of surface marker expression in splenic B cells indicated that, in contrast to the NZB with malignant B-1 splenic lymphoma, the surface marker expression of NZB IL-10 KO splenic B cells indicated that the majority of the B cells were typical B-2 cells. In the absence of IL-10, spontaneously activated B cells and antiapoptotic gene expression were reduced and lymphoma incidence was decreased. These results indicate that IL-10 is a critical factor for the progression of this B-cell malignant disease.

Animals↗

Prevalence estimates for primary brain tumors in the United States by behavior and major histology groups.

Prevalence rates are used to supplement descriptions of disease and are unavailable for all primary brain tumors in the United States. Data from two population-based tumor registries were obtained from the Central Brain Tumor Registry of the United States and used to compute age-specific incidence rates (1985-1994) and survival curves for further use in a statistical model to estimate prevalence rates. Prevalence rates were then used to estimate the number of individuals living with a brain tumor diagnosis in the U.S. population for the year 2000. The overall incidence rate in these regions is 13.8 per 100,000 with 2-, 5-, and 10-year survival rates of 58%, 49%, and 38%, respectively. The prevalence rate for all primary brain tumors is 130.8 per 100,000 with approximately 350,000 individuals estimated to be living with this diagnosis in the United States in 2000. The prevalence rate for malignant tumors, 29.5 per 100,000, is similar to previous reports. The prevalence rate for benign tumors, 97.5 per 100,000, is new. Unlike incidence data, the proportion (and expected number) of existing benign tumors (75%, 267,000) is considerably greater than that for malignant tumors (23%, 81,000), reflecting the better prognosis of benign tumors diagnosed in individuals younger than 60 years old. These data underscore the impact of primary brain tumors in the U.S. health care system and emphasize the need for quality-of-life considerations, particularly for those long-term survivors of benign tumors.

Adolescent↗

Residential subsurface flow treatment wetlands in northern Minnesota.

Approximately 30% of Minnesotans use on-site systems (approximately 500,000 residences) and >50% are failing or non-compliant with regulations due to restrictive soils and site conditions. Many sites occur near lakes and streams creating health hazards and deteriorating water quality. SSF CWs have been evaluated year-round at two northern sites since 1995. The NERCC CWs simulate single homes and the Grand Lake demonstration CW treats STE from a cluster of 9 lakeshore homes. Systems were generally able to achieve design criteria of 25 mg TSS/L and 30 mg BOD5/L and the NERCC CWs required only 0.3 m of unsaturated soil to achieve consistent disinfection to <200 fecals/100 mL year round. Seeding experiments with Salmonella indicated removal efficiencies of 99.8% in summer and 95% in winter. High strength (approximately 300 mg BOD/L, 95 mg TN/L) influent at NERCC probably limited system performance, particularly N-removal (mass) which was approximately 42% in summer and 20% in winter. The data indicate CW's are a viable, year-round treatment option for homeowners in terms of performance, ease of operation, and cost but require additional maintenance related to inconsistent vegetation growth, winter insulation, and meeting concentration-based regulatory standards since they were seasonally and annually variable due to rain events, partial freezing, spring snowmelt, and summer evapotranspiration.

Cold Temperature↗

The descriptive epidemiology of brain tumors.

Brain tumors have been the subject of controversy both with respect to patterns of occurrence and to potential causes. This article provides a description of current data resources on brain tumors and outlines issues affecting the interpretation of population-based data. A template for estimating regional expected values for brain tumors is provided, and current patterns of incidence, survival, and conditional survival are described. The occurrence of second primary tumors and quality of life studies are also reviewed.

Age Distribution↗

Influenza immunization in a managed care organization.

OBJECTIVE: To compare the effects of different types of computer-generated, mailed reminders on the rate of influenza immunization and to analyze the relative cost-effectiveness of the reminders. DESIGN: Randomized controlled trial. SETTING: Multispecialty group practice. PATIENTS: We studied 24,743 high-risk adult patients aligned with a primary care physician. INTERVENTION: Patients were randomized to one of four interventions: (1) no reminder, which served as control; (2) a generic postcard; (3) a personalized postcard from their physician; and (4) a personalized letter from their physician, tailored to their health risk. MEASUREMENTS: The immunization rate was measured using billing data. A telephone survey was conducted in a subgroup of patients to measure reactions to the mailed reminders. To evaluate the cost-effectiveness, a model was constructed that integrated the observed effect of the interventions with published data on the effect of immunization on future inpatient health care costs. MAIN RESULTS: All three of the reminders studied increased the influenza vaccination rate when compared with the control group. The vaccination rate was 40.6% in the control group, 43.5% in the generic postcard group, 44.7% in the personalized postcard group, and 45.2% in the tailored letter group. The rates of immunization increased as the intensity of the intervention increased (p < .0001). Seventy-eight percent of patients in the letter group deemed the intervention useful, and 86% reported that they would like to get reminders in the future. The cost-effectiveness analysis estimated that in a nonepidemic year, the net savings per 100 reminders sent would be $659 for the personalized postcard intervention and $735 for the tailored letter intervention. When these net cost-savings rates were each applied to the entire high-risk cohort of 24,743 patients, the estimated total net savings was $162,940 for the postcard and $181,858 for the tailored letter. CONCLUSIONS: Although the absolute increase in immunization rates with the use of reminders appeared small, the increases translated into substantial cost savings when applied to a large high-risk population. Personalized reminders were somewhat more effective in increasing immunization, and personalized letters tailored to the patients' condition were deemed useful and important by the individuals who received them and had a beneficial indirect effect on patient satisfaction.

Adult↗

Health service use by African Americans and Caucasians with asthma in a managed care setting.

Managed care plan members provide a population for analysis that minimizes the financial barriers to routine medical care that have been linked to high rates of asthma-related hospitalization, emergency care, and mortality among urban African Americans. We examined patterns of asthma care among 464 African American (AA) and 1,609 Caucasian (C) asthma patients, age 15 to 45 yr, in a southeast Michigan managed care system during 1993. Compared with C, AA had fewer visits to asthma specialists (0.32 versus 0.50 visits/yr, p = 0.002), and filled fewer prescriptions for inhaled steroids (1.44 versus 1.74 Rx/yr, p = 0.038), while being more likely to visit the emergency department with asthma (0.71 versus 0.28 visits/yr, p < 0. 001), to be hospitalized with asthma (0.08 versus 0.03 admissions/yr, p = 0.002), or to have filled prescriptions for oral steroids (0.91 versus 0.59 Rx/yr, p < 0.001). AA were equally likely to have visited a primary care physician for asthma (0.95 versus 0.93 visits/yr, p = 0.81). Similar physician visit profiles and discrepancies in the use of oral steroids persisted when analyzing exclusively low socioeconomic status subgroups. These results suggest that ethnic differences in patterns of asthma-related health care persist within managed care settings and are only partially due to financial barriers.

Adult↗

Molecular IDDM epidemiology: international studies. WHO DiaMond Molecular Epidemiology Sub-Project Group.

The WHO DiaMond Molecular Epidemiology Sub-Project is testing the hypothesis that the geographic differences in IDDM incidence reflect population variation in the frequency of IDDM susceptibility genes (i.e., DQA1 and DQB1 alleles with sequences coding for arginine (R) in position 52 of the DQ alpha-chain, and an amino acid other than aspartic acid (ND) in position 57 of the DQ beta-chain, respectively) using a standardized case-control design. Data from twelve populations which have completed (or have nearly completed) recruitment and HLA molecular analyses are presented. There was an approximate 2-fold increase in the frequencies of DGA1*0301, DQB1*0201 and DQB11*0302 among IDDM cases compared to non-diabetic controls in most populations. Interestingly, DQA*0301 was more common in low versus moderate-high incidence countries. DQB1*0201 and DQB1*0302 were more prevalent in the moderate-high incidence areas. DQA1*R and DQB1*ND were both consistent markers of IDDM risk, with stronger associations in moderate-high versus low incidence areas. In general, individuals homozygous for both DQA1*R and DQB1*ND had the highest genotype-specific IDDM incidence rates, which approximated risk estimates for first degree relatives in several countries. These data revealed considerable variation in the frequencies of DQB1 and DQA1 alleles across countries, which likely contribute to the global patterns of IDDM incidence.

Alleles↗

The low prevalence of immunogenetic markers in Korean adult-onset IDDM patients.

OBJECTIVE: IDDM is an autoimmune disease that occurs among genetically susceptible individuals. In Asian populations, it is not uncommon for adult patients with NIDDM to eventually lose beta-cell function and develop IDDM. These individuals may be characterized by autoantibodies to GAD and high-risk HLA-DQ alleles, which are unlikely to be prevalent among patients with true NIDDM or in the general population. The objective of the present study was to evaluate and compare the prevalence of these immunogenetic markers in NIDDM patients and healthy nondiabetic individuals from Korea. RESEARCH DESIGN AND METHODS: The prevalences of anti-GAD antibodies and HLA-DQA1 and DQB1 alleles among 121 patients with newly diagnosed NIDDM identified from a population-based study in Yonchon, Korea, and 100 matched healthy control subjects were evaluated and compared. RESULTS: The overall prevalence of anti-GAD antibodies was 1.7% (2 of 121) in patients with previously undiagnosed NIDDM, whereas 1 of 100 control subjects had a positive test for antibodies. Among those who tested positive, titers of antibodies to GAD were not high. No statistically significant differences in the distributions of either mean levels of anti-GAD antibodies or DQA1 and DQB1 alleles were found comparing NIDDM patients with control subjects. Interestingly, the frequency of DQB1*non-Asp-57 and DQA1*Arg-52 alleles in the Korean adult control population was similar to that in the U.S. white population (DQB1*non-Asp-57: 0.431 vs. 0.475; DQA1*Arg-52: 0.492 vs. 0.463). CONCLUSIONS: The low prevalence of anti-GAD antibodies and HLA-DQA1 and DQB1 susceptibility alleles among recent-onset NIDDM patients, which was similar to observations in control subjects, suggests that diabetes in Korean adults is unlikely to have an autoimmune component to its pathogenesis.

Adult↗

Continuously improving primary care.

BACKGROUND: This article describes efforts to understand and improve the daily work processes of primary care within the Henry Ford Health System, where continuous quality improvement (CQI) has been a key business strategy since 1988. We began a pilot project in 1990 that attempted to accelerate the implementation of continuous improvement in primary care. The clinical site was the general internal medicine (GIM) ambulatory clinic, which has 50,000 patient visits annually. STRATEGIES FOR IMPROVEMENT: For four key elements--physicians as leaders, prevention and primary care, patient access, and innovation and team work--we planned and implemented continuous improvement based on three questions: What were we trying to accomplish? What can we change that would lead to an improvement? How would we know a change is an improvement? EXAMPLE: Prevention and Primary Care. In our primary care setting, an appropriate clinical process to improve would include preventive medicine, specifically Pap-smear performance. In our partnership with the department of obstetrics/gynecology, GIM physicians wanted to improve the rate of adequate Pap smears. To reduce variation in the rates with which physicians collected specimens that were adequate for cytologic examination, the team recommended use of a specific tool, a cervi-brush, which should be more effective in producing adequate specimens. As cervi-brush use increased, rates of inadequate Pap smears dropped from 20%-25% in 1989 to less than 10% for the first six months of 1991. CONCLUSIONS: By focusing attention and resources on a limited number of improvement teams, our initial success built enthusiasm and commitment within GIM and accelerated changes that were incorporated into strategic planning for the Henry Ford Health System as a whole.

Female↗

A partnership to save children's lives--the school nurse/Medic Alert kids program.

The Medic Alert Foundation, in a soon-to-be-launched national program, seeks to educate families about Medic Alert and how its emergency information service helps prevent emergencies from becoming tragedies. This report discusses the role the school nurse plays in determining which children are at risk, what needs to be done, and how Medic Alert can provide the needed protection.

Child↗

Job$ '92.

Explore the source record for details and available documents.

Administrative Personnel↗

Streetlife and delinquency.

The correlation between class and delinquency often observed in areal studies and assumed in prominent sociological theories is elusive in studies of individuals commonly used to test these theories. A restricted conceptualization of class in terms of parental origins and the concentration of self-report survey designs on adolescents in school have removed from this area of research street youth who were once central to classic studies of delinquency. We argue that street youth experience current class conditions that cause serious delinquency, and that life on the street is an important intervening variable that transmits indirect effects of control and strain theory variables, including parental class origins. Data gathered from nearly 1000 Toronto school and street youth are analyzed with important implications for the conceptualization of class and delinquency, testing and integrating sociological theories of delinquency, the measurement of delinquency, and the use of cross-sectional and longitudinal research designs. Our findings especially encourage incorporation of street-based samples into research on class-based aspects of theories of delinquency.

Adolescent↗

New technique for Hartmann's reconstruction.

Since the introduction of Hartmann's operation and its broader applications, restoration of intestinal continuity has posed technical challenges and significant morbidity. We describe a technique for Hartmann's reconstruction, utilizing a circular anastomotic stapling device that is simple and fast and that minimizes the potential for contamination, in which the bowel lumen remains closed at all times.

Anastomosis, Surgical↗

Pubic osteolysis. A benign lesion of the pelvis closely mimicking a malignant neoplasm.

Pubic osteolysis is now recognized as a distinct diagnostic entity. It is characterized by roentgenographic findings of rapidly progressing destructive changes in the pubic rami, pubis, or pubic symphysis. A soft-tissue mass with calcification may be present. Overlapping roentgenographic and even histopathologic features with chondrosarcoma may lead to erroneous diagnosis and over-treatment. Each of the six new cases of pubic osteolysis in this report involved middle-aged to elderly females. Three out of six cases had no antecedent trauma. The pathologic findings were extensive reparative changes that included metaplastic cartilage, bone formation, and granulation tissue with myxoid and angiomatoid patterns. Four of the six cases were initially diagnosed after biopsy as low-grade malignancies. One of these was treated with a partial pelvectomy. The follow-up period in the cases was from one to 41 months. In all cases, the initial complaints of pain about the pelvis gradually subsided with conservative therapy. Differentiating pubic osteolysis, osteitis pubis, and pubic osteomyelitis should not be difficult; pertinent differential features are discussed.

Aged↗

International collaborative effort (ICE) on birth weight, plurality, perinatal, and infant mortality. III: A method of grouping underlying causes of infant death to aid international comparisons.

Underlying causes of infant death, as coded in the ninth revision of the International Classification of Diseases, have been grouped into a system of seven functional categories plus one additional group of "other and unclassifiable" diagnoses. The groups comprise congenital anomalies, asphyxia related conditions, immaturity related conditions, infections, sudden death, deaths due to external causes, and other specific conditions. The groups were constructed by using a frequency distribution of underlying cause of death in 200,000 infant deaths in 1980-84 in the U.S.A. When analysed according to age at death and according to birth weight, the distribution of the functional groups had patterns which corresponded to what might be expected clinically. Each functional group has common features which require intervention at a specific time for prevention and treatment. We propose that it is used as a tool in epidemiological surveillance and to guide health authorities in priorities for disease control. International comparisons of time trends will be undertaken.

Asphyxia Neonatorum↗

International Collaborative Effort (ICE) on birthweight; plurality; and perinatal and infant mortality. I: Methods of data collection and analysis.

This paper describes the collection and analysis of data by a group of international collaborators (International Collaborative Effort on Perinatal and Infant Mortality) interested in comparative studies on birthweight distributions and reproductive outcome. This is the first of a series of reports on the results of these studies. It gives an account of the countries or states involved, and the collection and characteristics of the data. The countries and states included sixteen of the United States, plus England and Wales, Denmark, Bavaria and North Rhine-Westphalia from the Federal Republic of Germany, Israel, Japan, Norway, Scotland, and Sweden. The data comprised birthweight distributions in 500-gram groups for all births and for singletons separately, for livebirths, stillbirths, first week deaths and, where available, late neonatal and infant deaths, from 1970 up to 1985.

Birth Weight↗