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Biomedical subjects

J Miller

Publications and source records attributed to J Miller.

At least 127 records · Page 7Linked to original sources
PubMed2001

Anticipated psychological impact of receiving medical feedback about HIV treatment outcomes.

Two hundred and seven persons taking antiretroviral HIV medications rated anticipated affective responses to two vignettes depicting different medical feedback situations. Participants were randomly assigned to a medical feedback vignette which varied between participants by (a) the direction of HIV viral load change (increase, decrease, no change) and (b) whether or not a medication change was recommended by the physician. The first experimental vignette was always followed by a second vignette depicting a viral load decrease (indicating treatment success in suppressing the virus). A mixed 3 (viral load change) x 2 (medication change) x 2 (within-subjects factor) factorial design was used. Significant differences in anticipated affective responses to treatment outcome situations were found, suggesting feedback about success or failure of treatment regimens impacts psychosocial adjustment of persons living with HIV.

Adaptation, Physiological↗
PubMed2001

Patterns of informal and formal caregiving among elders with private long-term care insurance.

PURPOSE: The purpose of this report is to provide basic descriptive information on community-dwelling, disabled, private long-term care (LTC) insurance policyholders who have accessed policy benefits. We focus on how benefits are used, whether claimants feel they are getting appropriate value from their policies, and what the patterns are of formal and informal service use. DESIGN AND METHODS: Data were obtained from a nationally representative sample of 693 LTC insurance claimants who were receiving benefits while living in the community and 424 of their informal caregivers. Eight of the largest LTC insurance companies representing about 80% of the market participated in the study. RESULTS: LTC insurance benefits are well targeted; they serve those truly dependent on ongoing care. The vast majority of claimants are satisfied with their policies, understand their coverage, and find it easy to file claims. Because of their LTC benefits, substantial numbers of disabled elderly individuals report that they are able to remain at home instead of being forced to seek institutional care. The availability of LTC benefits reduces stress among informal caregivers. For most claimants, formal care did not replace informal caregiving. IMPLICATIONS: As the LTC insurance market continues to grow and mature, there will be changes in the profile of claimants, the service delivery system, and the design of policies. Expansions in the private market will be associated with a greater number of disabled elderly remaining in their homes with a maintenance of and enhanced resiliency of informal support networks.

Aged↗
PubMed2001

Care-centered organizations: Part 1: Nursing governance.

In the first of a three-part series on the role of nursing in care-centered organizations, the authors describe the thinking and process that lead to the creation of care centers and related governance structures. They explore the rationale for the establishment of care centers, describe the process for determining governance structures, and examine the changing role of nurse executives in a large academic medical center reorganized around care centers.

Academic Medical Centers↗
PubMed2001

Neutron production from polyethylene and common spacecraft materials.

We report experimental measurements of neutron production from collisions of neutron beams with polyethylene blocks simulating tissue at the Los Alamos National Laboratory Neutron Science Center and 1 GeV/amu iron nuclei with spacecraft shielding materials at the Brookhaven National Laboratory AGS.

Elementary Particle Interactions↗
PubMed2001

Macromolecular organization of the Yersinia pestis capsular F1 antigen: insights from time-of-flight mass spectrometry.

Mass spectrometry has been used to examine the subunit interactions in the capsular F1 antigen from Yersinia pestis, the causative agent of the plague. Introducing the sample using nanoflow electrospray from solution conditions in which the protein remains in its native state and applying collisional cooling to minimize the internal energy of the ions, multiple subunit interactions have been maintained. This methodology revealed assemblies of the F1 antigen that correspond in mass to both 7-mers and 14-mers, consistent with interaction of two seven-membered units. The difference between the calculated masses and those measured experimentally for these higher-order oligomers was found to increase proportionately with the size of the complex. This is consistent with a solvent-filled central cavity maintained on association of the 7-mer to the 14-mer. The charge states of the ions show that an average of one and four surface accessible basic side-chains are involved in maintaining the interactions between the 7-mer units and neighboring subunits, respectively. Taken together, these findings provide new information about the stoichiometry and packing of the subunits involved in the assembly of the capsular antigen structure. More generally, the data show that the symmetry and packing of macromolecular complexes can be determined solely from mass spectrometry, without any prior knowledge of higher order structure

Bacterial Capsules↗
PubMed2001

Candidate disease resistance genes in sunflower cloned using conserved nucleotide-binding site motifs: genetic mapping and linkage to the downy mildew resistance gene Pl1.

Disease resistance gene candidates (RGCs) belonging to the nucleotide-binding site (NBS) superfamily have been cloned from numerous crop plants using highly conserved DNA sequence motifs. The aims of this research were to (i) isolate genomic DNA clones for RGCs in cultivated sunflower (Helianthus annuus L.) and (ii) map RGC markers and Pl1, a gene for resistance to downy mildew (Plasmopara halstedii (Farl.) Berl. & de Toni) race 1. Degenerate oligonucleotide primers targeted to conserved NBS DNA sequence motifs were used to amplify RGC fragments from sunflower genomic DNA. PCR products were cloned, sequenced, and assigned to 11 groups. RFLP analyses mapped six RGC loci to three linkage groups. One of the RGCs (Ha-4W2) was linked to Pl1, a downy mildew resistance gene. A cleaved amplified polymorphic sequence (CAPS) marker was developed for Ha-4W2 using gene-specific oligonucleotide primers. Downy mildew susceptible lines (HA89 and HA372) lacked a 276-bp Tsp5091 restriction fragment that was present in downy mildew resistant lines (HA370, 335, 336, 337, 338, and 339). HA370 x HA372 F2 progeny were genotyped for the Ha-4W2 CAPS marker and phenotyped for resistance to downy mildew race 1. The CAPS marker was linked to but did not completely cosegregate with Pl1 on linkage group 8. Ha-4W2 was found to comprise a gene family with at least five members. Although genetic markers for Ha-4W2 have utility for marker-assisted selection, the RGC detected by the CAPS marker has been ruled out as a candidate gene for Pl1. Three of the RGC probes were monomorphic between HA370 and HA372 and still need to be mapped and screened for linkage to disease resistance loci.

Base Sequence↗
PubMed2001

Don't blame the iceberg.

At the above-mentioned study day, Lesley Fudge gave a colleague's paper on risk management. The colleague was Jill Ashley-Jones, then a Health Safety Manager at the Frenchay Hospital at the North Bristol NHS Trust, and she had been unable to attend the day. She had focused on the risk management issues associated with the sinking of the Titanic and had based it on the actual reports written following the disater. There was no mention of Leonardo or Kate, of course. It was also a clever approach when one looks at what happened, and inspired this article by Jim Miller. The mistakes were fundamental and the risk management issues are absolutely classic. Jill associated some of the lessons learnt with what is happening in the NHS, which can, in turn, be applied to a specific team, to a department or to an organisation.

Education, Professional↗
PubMed2001

Stromal PRs mediate induction of 17beta-hydroxysteroid dehydrogenase type 2 expression in human endometrial epithelium: a paracrine mechanism for inactivation of E2.

Progesterone stimulates the expression of 17beta-hydroxysteroid dehydrogenase (HSD) type 2, which catalyzes the conversion of the potent estrogen, E2, to an inactive form, estrone, in epithelial cells of human endometrial tissue. Various effects of progesterone on uterine epithelium have recently been shown to be mediated by stromal PRs in mice. We describe herein a critical paracrine mechanism whereby progesterone induction of 17beta-HSD type 2 enzyme activity, transcript levels, and promoter activity in human endometrial epithelial cells are mediated primarily by PR in endometrial stromal cells. Medium conditioned with progestin-pretreated human endometrial stromal cells robustly increased 17beta-HSD type 2 enzyme activity (2-fold) and mRNA levels (13.2-fold) in Ishikawa malignant endometrial epithelial cells. In contrast, direct progestin treatment of Ishikawa epithelial cells gave rise to much smaller increases in enzyme activity (1.2-fold) and mRNA levels (4-fold). These results suggest that progesterone- dependent paracrine factors arising from stromal cells are primarily responsible for the induction of epithelial 17beta-HSD type 2 expression in the endometrium. We transfected serial deletion mutants of the -1,244 bp 5'-flanking region of the 17beta-HSD type 2 gene into Ishikawa cells. No progesterone response elements could be identified upstream of the 17beta-HSD type 2 promoter. Stromal PR-dependent induction of the 17beta-HSD type 2 promoter was mediated by a critical regulatory region mapped to the -200/-100 bp sequence. Direct treatment of Ishikawa cells with progestin gave rise to a maximal increase in the activity of -200 bp/Luciferase construct only by 1.2-fold, whereas medium conditioned by progestin-pretreated endometrial stromal cells increased promoter activity up to 2.4-fold in a time- and concentration-dependent manner. The stimulatory effect of medium conditioned by progestin-pretreated stromal cells was enhanced strikingly by increasing stromal cell PR levels with the addition of estrogen. This epithelial-stromal interaction was specific for endometrial epithelial cells, since 17beta-HSD type 2 could not be induced in malignant breast epithelial cells by media conditioned with progestin-treated breast or endometrial stromal cells. In conclusion, progesterone regulates the conversion of biologically active E2 to estrone by inducing the 17beta-HSD type 2 enzyme in human endometrial epithelium primarily via PR in stromal cells, which secrete factors that induce transcription mediated primarily by the -200/-100 bp 5'-regulatory region of the 17beta-HSD type 2 promoter.

17-Hydroxysteroid Dehydrogenases↗
PubMed2001

Selective rescue of early haematopoietic progenitors in Scl(-/-) mice by expressing Scl under the control of a stem cell enhancer.

The stem cell leukaemia gene (Scl) encodes a basic helix-loop-helix transcription factor with a pivotal role in both haematopoiesis and endothelial development. During mouse development, Scl is first expressed in extra-embryonic mesoderm, and is required for the generation of all haematopoietic lineages and normal yolk sac angiogenesis. Ectopic expression of Scl during zebrafish development specifies haemangioblast formation from early mesoderm. These results suggest that SCL is essential for establishing the transcriptional programme responsible for the formation of haematopoietic stem cells and have focused attention on the transcriptional regulation of Scl itself. Previous studies have identified a panel of Scl enhancers each of which directed expression to a subdomain of the normal Scl expression pattern. Among them, a 3' enhancer directed expression during development to vascular endothelium and haematopoietic progenitors but not to Ter119(+) erythroid cells. The expression in haematopoietic stem cells, however, remained undetermined. We demonstrate that this 3' enhancer directs lacZ expression in transgenic mice to most foetal and adult long-term repopulating haematopoietic stem cells, and therefore functions as a stem cell enhancer. Consistent with these results, expression in Scl(-/-) embryos of exogenous Scl driven by the stem cell enhancer rescued the formation of early haematopoietic progenitors and also resulted in normal yolk sac angiogenesis. By contrast, erythropoiesis remained markedly deficient in rescued embryos. This observation is consistent with the inactivity of the stem cell enhancer in erythroid cells and reveals an essential role for SCL during erythroid differentiation in vivo.

Animals↗
PubMed2001

Measuring physical inclusion of people with developmental disabilities: evaluation of the Macomb-Oakland Regional Center.

The Macomb-Oakland Regional Center has been facilitating the movement of persons with developmental disabilities into the community for 27 years. To measure randomness of their home locations, we used a geographic-based spatial analytic approach. Involvement of allies in planning futures, number of people with disabilities residing in each home, proportion of earned income, level of disability, and level of mobility were used as explanatory variables. Monte Carlo procedures using Moran's I, a measure of spatial autocorrelation, did not reveal significant clustering of residences. Regression procedures, however, did reveal that earned income was the independent variable that most explained the degree to which people were physically included. People living in smaller homes were more randomly dispersed.

Activities of Daily Living↗
PubMed2001

Destruction of bacteria in the digestive tract of the maggot of Lucilia sericata (Diptera: Calliphoridae).

Green fluorescent protein-producing Escherichia coli were used to investigate the fate of bacteria in the alimentary tract of sterile grown maggots, Lucilia sericata (Meigen), using a laser scanning confocal microscope. A computer program was used to analyze the intensity of the fluorescence and to quantify the number of bacteria. The crop and the anterior midgut were the most heavily infected areas of the intestine. A significant decrease in the amount of bacteria was observed in the posterior midgut. The number of bacteria decreased even more significantly in the anterior hindgut and practically no bacteria were seen in the posterior end, near the anus. The viability of bacteria in the different gut sections was examined. It was shown that 66.7% of the crops, 52.8% of the midguts, 55.6% of the anterior hindguts, and 17.8% of posterior hindguts harbored living bacteria. In conclusion, during their passage through the digestive tract the majority of E. coli was destroyed in the midgut. Most of the remaining bacteria were killed in the hindgut, indicating that the feces were either sterile or contained only small numbers of bacteria.

Animals↗
PubMed2001

Evaluation of IgG concentration and IgG subisotypes in foals with complete or partial failure of passive transfer after administration of intravenous serum or plasma.

The purpose of this study was to evaluate the ability of an equine plasma product i.v. and a concentrated serum product i.v. to deliver antibodies to 46 foals with failure of passive transfer (FPT). Treatment of FPT was as per manufacturers recommendations, using plasma (950 ml/unit) or a concentrated serum product (250 ml/unit). Significant variables affecting the 3 day post-transfusion serum immunoglobulin G (IgG) concentration of foals included body weight, pretransfusion IgG concentration, number of product units transfused, foaling season and product administered. Plasma treatment had a greater increase in post-transfusion serum IgG concentrations compared to the serum product treatment mainly because plasma contained approximately twice the amount of IgG per unit as the serum product. The change in equine influenza virus and tetanus toxoid-specific IgGa, IgGb, and IgG(T) titres was measured in foals from pretransfusion to 3 days post-transfusion. For each gram of IgG transfused, the change in antigen-specific IgG subisotypes were similar for both treatment groups. The results of this study suggest that similar foal serum IgG concentrations can be achieved 3 days post-transfusion by administering 1 unit of plasma or 2-3 units of serum product.

Animals↗
PubMed2001

Locus of the redundant-signals effect in bimodal divided attention: a neurophysiological analysis.

We reanalyzed the data from the study of Lamarre, Busby, and Spidalieri (1983). In that study, the activity of single neurons in area 4 of the motor cortex was recorded during a bimodal detection task in which a monkey (Macaca mulatta) had to respond as quickly as possible to a visual or an auditory signal or to both (redundant trials). Manual responses on redundant trials were speeded by the presence of both signals, as is typically found. The times between signal onsets and the first changes in neuronal activity were also speeded by redundant signals, but there was no difference between redundant-signals and single-signal trials in the time between the change in neuronal activity and movement onset. These results suggest that late motor processes are not speeded by redundant signals in bimodal detection tasks.

Animals↗
PubMed2001

On the analysis of psychometric functions: the Spearman-Kärber method.

With computer simulations, we examined the performance of the Spearman-Kärber method for analyzing psychometric functions and compared this method with the standard technique of probit analysis. The Spearman-Kärber method was found to be superior in most cases. It generally yielded less biased and less variable estimates of the location and dispersion of a psychometric function, and it provided more power to detect differences in these parameters across experimental conditions. Moreover, the Spearman-Kärber method provided information about the skewness and higher moments of psychometric functions that is beyond the scope of probit analysis. These advantages of the Spearman-Kärber method suggest that it should often be used in preference to probit analysis for the analysis of observed psychometric functions.

Confidence Intervals↗
PubMed2001

Impact of histological grade of hepatocellular carcinoma on the outcome of liver transplantation.

HYPOTHESIS: Histological grade of hepatocellular carcinoma (HCC) is an important prognostic factor affecting patient survival after orthotopic liver transplantation (OLT). DESIGN: Retrospective analysis. SETTING: University-based teaching hospital. PATIENTS: Of 952 OLTs performed between June 1991 and January 1999, 56 OLT recipients had histologically proven HCC in the explant liver. Of those, 53 patients with complete clinicopathologic data were analyzed. A single pathologist blinded to the outcome of each patient reviewed all histological specimens. RESULTS: Median follow-up was 709 days. Overall survival for patients with tumors sized 5 cm or less at 1, 3, and 5 years was 87%, 78%, and 71%, respectively (Kaplan-Meier). Univariate analysis revealed the size, number, and distribution of tumors; the presence of microscopic vascular invasion and lymph node metastasis; histological differentiation; and pTNM stage to be statistically significant factors affecting survival. Multivariate analysis revealed histological differentiation and pTNM stage to be the independent and statistically significant factors affecting survival (P =.002 and.03, respectively). When pTNM stage was excluded from multivariate analysis, histological differentiation and size remained the significant independent factors (P =.02 and.03, respectively). Three-year survival for patients with small (</=5 cm) tumor with well- to moderately differentiated and poorly differentiated HCC was 82% and 67%, respectively. Three-year survival for patients with large (>5 cm) tumor with well- to moderately differentiated and poorly differentiated HCC was 62.5% and 0%, respectively. CONCLUSIONS: In our retrospective experience, histological differentiation had a statistically significant effect on the prognosis of HCC after OLT. However, before altering the current OLT selection criteria for patients with HCC, prospective studies are required to confirm the impact of histological grade on clinical outcome.

Carcinoma, Hepatocellular↗
PubMed2001

Use of alternative and complementary therapies for pediatric asthma.

This survey of 48 multicultural parents of children with asthma identifies and compares alternative and complementary treatments used for asthma, and compares any potentially effective or harmful effects. Thirty-nine (81%) of the parents used at least one form of alternative or complementary therapy to treat their child's asthma. Nontraditional therapies included prayer, over-the-counter medications, herbal teas, vitamins, and massage. African-American parents were more likely to rely on prayer, and Hispanic parents were more likely to use herbal and massage therapies. Use of over-the-counter medications and vitamins was similar among groups. Three herbal remedies were potentially toxic: lobelia, possible pennyroyal mint, and tree tea oil. Medical histories for all patients should include inquiries into the use of alternative therapies.

Adolescent↗