Biomedical subjects
Publications and source records attributed to J Morris.
Recent studies have revealed that the Par-1 protein, in addition to its established role in anterior-posterior patterning of the Drosophila oocyte, has both microtubule-dependent and microtubule-independent roles very early in oogenesis.
OBJECTIVE: To determine the role of dopamine in the executive resource component of sentence comprehension. METHODS: We studied sentence-picture matching in 20 right-handed, non-demented, native English speakers with mild Parkinson's disease (PD) when 'on' and 'off' their levodopa, taking into account disease duration to control for endogenous dopamine metabolism. We also administered a verbal working memory measure that does not involve specific grammatical manipulations. RESULTS: PD patients 'off' levodopa demonstrated a significant discrepancy in their comprehension of grammatically complex sentences compared to grammatically simpler sentences that was not evident when PD patients were 'on' levodopa. An error analysis demonstrated that impaired comprehension of grammatically complex sentences when 'off' levodopa was associated with poorer performance on foils requiring working memory resources. Performance on an independent measure of verbal working memory correlated only with comprehension of grammatically complex sentences during levodopa supplementation, but working memory according to this measure did not differ during 'on' and 'off' states. CONCLUSION: Dopamine supports the executive resources contributing to sentence comprehension in PD.
BACKGROUND: The influence of tube feeding on survival in hospitalized patients with advanced dementia is controversial. OBJECTIVE: To assess long-term survival in an inception cohort, incident tube feeding placement during the index hospitalization, and the influence of tube feeding on survival in this group of patients. SUBJECTS AND METHODS: Ninety-nine hospitalized patients with advanced dementia and an available surrogate decision maker were followed up through and after the index hospitalization for mortality and placement of a feeding tube. Other variables measured included advance directive status, presence of a long-term primary care physician, level of involvement of the surrogate decision maker, admitting diagnosis, prior hospitalizations, comorbidities, and diagnosis related group diagnostic category. RESULTS: A new feeding tube was placed in 50% (51/99) of the study patients during the index hospitalization, 31% (31/99) left the hospital without a feeding tube, and 17% (17/99) were admitted with a feeding tube already in place. By stepwise logistic regression analysis, predictors of new feeding tube placement included African American ethnicity (odds ratio, 9.43; 95% confidence interval, 2.1-43.2) and residence in a nursing home (odds ratio, 4.9; 95% confidence interval, 1.02-2.5). Median survival of the 99 patients was 175 days. Eighty-five (85%) survived the index hospitalization, and 28 (28%) were still alive at last follow-up, a range of 1.3 to 4.2 years after enrollment in the study. Tube feeding was not associated with survival (P =.90). An admitting diagnosis of infection was associated with higher mortality (odds ratio, 1.9; 95% confidence interval, 1.01-3.6). CONCLUSIONS: In this cohort of hospitalized patients with advanced dementia, risk of receiving a new feeding tube is high, associated with African American ethnicity, and prior residence in a nursing home, and has no measurable influence on survival. With or without a feeding tube, these patients have a 50% six-month median mortality.
The 1998 survey of Adult Dental Health in the UK was carried out under the auspices of the Office of National Statistics together with the Universities of Birmingham, Dundee, Newcastle-upon-Tyne and Wales. A key behavioural indicator in these decennial surveys is whether people say they go to a dentist for a regular dental check-up, an occasional dental check-up or only when they have trouble with their teeth. The proportion of dentate adults in the UK who report attending for regular dental check-ups has risen from 43% in 1978 to 59% in 1998. Older adults (over 55 years old) in 1998 were the most likely to say they attend for regular dental check-ups. Many younger adults (16-24) in 1998 said they went to a dentist less often than 5 years previously, they were also the least likely to say they attend for regular dental check-ups. Dental anxiety remains a problem for many dental patients but another factor of importance to many is their want to be involved in the treatment process and especially to be given an estimate of treatment costs.
BACKGROUND: Previous studies have shown that from 1965 to 1996, coronary heart disease was a frequent natural cause of death among world leaders. OBJECTIVE: To assess incidence of and death from coronary heart disease among world leaders and to determine the effect of this disease on office-holding ability. DESIGN: Archive search of worldwide English-language and translated press and media reports from 1970 to 1999 for reference to coronary events. SETTING: U.S. federal government medical analytic unit. PARTICIPANTS: National principal decision makers in countries with populations greater than 250 000. MEASUREMENTS: Reports of angina, heart attack, myocardial infarction, and arrhythmia attributed to coronary artery disease; use of cardiac procedures; receipt of foreign care; death; and removal from office. RESULTS: 64 leaders had initial coronary heart disease events while holding their nation's highest office. Initial event rates decreased from the 1970s to the 1990s (1.9 events per 100 person-years vs. 1.1 events per 100 person-years). Survival, use of procedures, and receipt of foreign care increased over time. Most leaders who survived an acute event continued to function in office. CONCLUSIONS: Incidence of and death from coronary heart disease among office-holding world leaders has decreased over the past 30 years, possibly because of increased use of cardiac procedures. A coronary event in a world leader is unlikely to presage a change in government.
OBJECTIVE: To examine whether the admission characteristics of nursing home residents predict mortality and to look for factors that account for different mortality rates between those homes. METHODS: A retrospective case note audit of the admission characteristics of residents in nursing homes registered with the Manchester Health Authority who died within a 12 month period and a group of current residents matched by age, sex and length of stay. Time between admission and death was examined using actuarial estimators of survival and factors predicting time between admission and death were examined using the proportional hazards model of Cox. Standardised mortality ratios (SMR) were calculated on each of the homes from the Office for National Statistics for Greater Manchester Metropolitan County. Logistic regression was used to assess those factors that predicted death at 1, 2 and 4 weeks and 3, 6 and twelve months after admission. RESULTS: Following admission the mean survival time was 5.9 years. There was a wide variation in the mortality ratio between the homes and five of the 32 studied had SMRs of over 7. Increasing age, male sex, poor appetite, sleep disturbance, build, place of admission from, history of malignancy and respiratory disease and the number of prescribed drugs were all found to be significant predictors of mortality. Malignancy, pressure sores, poor appetite and number of prescribed drugs predicted death with 4 weeks after admission. CONCLUSION: Some nursing homes have higher mortality rates than others although this was accounted for by the characteristics of the residents and not by any measurable characteristic of the nursing home environment.
We have previously developed an adsorption-limited model to describe the exchange of lung surfactant and its fractions to and from an air-liquid interface in oscillatory surfactometers. Here we extend this model to allow for diffusion in the liquid phase. Use of the model in conjunction with experimental data in the literature shows that diffusion-limited transport i.s important for characterizing the transient period from the start of oscillations to the achievement of steady-state conditions. Matching previous data shows that upon high levels of film compression, large changes occur in adsorption rate, desorption rate, and diffusion constant, consistent with what one might expect if the subsurface region was greatly enriched in DPPC. Collapse of the surfactant film that occurs during compression leads to a .significant elevation of surfactant concentration immediately heneath the interface, consistent with the subsurface depot of surfactant that has heen postulated by other investigators. Modeling studies also uncovered a phenomenon of surfactant behavior in which the interfacial tension remains constant at its minimum equilibrium value while the film is compressed, hut without collapse of the film. The phenomenon was due to desorption of surfactant from the interface and termed "pseudo-film collapse.'' The new model also gave improved agreement with steady-state oscillatory cycling in a pulsating bubble surfactometer.
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The latest of the decennial surveys of the United Kingdom was undertaken in 1998 by the Office of National Statistics in collaboration with the dental schools of the Universities of Birmingham, Dundee, Newcastle and Wales. Dentate adults in 1998 have fewer missing teeth and more sound and untreated teeth on average than in 1978. The average number of decayed teeth has dropped significantly from 1.9 in 1978 to 1.1 in 1998. The average number of filled teeth has remained fairly constant over the same time but its distribution has changed quite markedly towards older adults having more filled teeth than people of a similar age in the past whilst the reverse is true for younger adults. The overall trends are encouraging, but there is a need to review the way disease is managed in adults in the United Kingdom.
The 1998 Adult Dental Health Survey, published this year, showed that the number of people without teeth should fall over the next three decades, to only 4% of the UK population. Patterns of tooth loss and retention are also changing. This article, the first of a series on the interpretation of the Adult Dental Health Survey, discusses the implications of these trends for dentistry.
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There is an intricate network of molecules called cell fate determinants that instruct the cells of the embryo to take on either an anterior or posterior fate. In a lively Perspective, Lehmann and her colleagues discuss new findings in the fruit fly that identify a key protein, PAR-1, which ensures that the cell fate determinants are themselves located in the correct region of the oocyte. In this way, the anterior-posterior axis is set up in the fruit fly egg before fertilization.
Patients with idiopathic Parkinson's disease (PD) were asked to identify the agent of the action in orally presented sentences with subject-relative or object-relative center-embedded clauses while simultaneously performing a secondary task that was less resource-demanding (finger tapping) or more resource-demanding (recognition span). We found that a subgroup of PD patients with impaired sentence comprehension at baseline (no secondary task) did not differ from random in their accuracy understanding all types of sentences during the more demanding (recognition span) condition and also had difficulty understanding the most complex sentences during the less demanding (finger tapping) condition. Control subjects and PD patients without baseline sentence comprehension difficulty were random only in their comprehension of the most complex sentences under the more demanding (recognition span) secondary task condition. Examination of response latencies for accurately understood sentences revealed only an effect for the type of sentence, and this was equally evident across all groups of subjects and regardless of the condition under which the sentences were administered. The sensitivity of PD patients' sentence comprehension accuracy to secondary task resource demands is most consistent with the hypothesis that limited cognitive resources contribute to sentence comprehension difficulty in PD.
AIMS: To investigate whether health care professionals had differing attitudes about cost and survival issues in regard to the treatment of advanced ovarian cancer. METHODS: A questionnaire designed for the study was mailed to hospital doctors, hospital nurses, Crown Health Enterprise (CHE) managers and health authority managers who were working in the same geographical area. A total of 391 questionnaires were mailed and 186 were completed reflecting an overall response rate of 47%. Replies were received from 46% of the health authority managers, 61% of the CHE managers, 59% of the doctors and 27% of nurses. RESULTS: Results indicated a threshold for how much individuals were willing to pay. Group differences were evident with the nurses and CHE managers willing to spend less than the other two groups. In addition, those with experience of cancer treatment were willing to spend less than those with no such experience. CONCLUSIONS: There are differences in attitudes to costs and benefits of treatment between individuals working in different areas of health care. Health sector workers value treatments which extend life expectancy without necessarily being curative.
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A series of new nitrogen-carbon-linked (azolylphenyl)oxazolidinone antibacterial agents has been prepared in an effort to expand the spectrum of activity of this class of antibiotics to include Gram-negative organisms. Pyrrole, pyrazole, imidazole, triazole, and tetrazole moieties have been used to replace the morpholine ring of linezolid (2). These changes resulted in the preparation of compounds with good activity against the fastidious Gram-negative organisms Haemophilus influenzae and Moraxella catarrhalis. The unsubstituted pyrrolyl analogue 3 and the 1H-1,2,3-triazolyl analogue 6 have MICs against H. influenzae = 4 microgram/mL and M. catarrhalis = 2 microgram/mL. Various substituents were also placed on the azole moieties in order to study their effects on antibacterial activity in vitro and in vivo. Interesting differences in activity were observed for many analogues that cannot be rationalized solely on the basis of sterics and position/number of nitrogen atoms in the azole ring. Differences in activity rely strongly on subtle changes in the electronic character of the overall azole systems. Aldehyde, aldoxime, and cyano azoles generally led to dramatic improvements in activity against both Gram-positive and Gram-negative bacteria relative to unsubstituted counterparts. However, amide, ester, amino, hydroxy, alkoxy, and alkyl substituents resulted in no improvement or a loss in antibacterial activity. The placement of a cyano moiety on the azole often generates analogues with interesting antibacterial activity in vitro and in vivo. In particular, the 3-cyanopyrrole, 4-cyanopyrazole, and 4-cyano-1H-1,2,3-triazole congeners 28, 50, and 90 had S. aureus MICs </= 0.5-1 microgram/mL and H. influenzae and M. catarrhalis MICs = 2-4 microgram/mL. These analogues are also very effective versus S. aureus and S. pneumoniae in mouse models of human infection with ED(50)s in the range of 1. 2-1.9 mg/kg versus 2.8-4.0 mg/kg for the eperezolid (1) control.
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