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Biomedical subjects

M Cox

Publications and source records attributed to M Cox.

At least 19 recordsLinked to original sources

Extreme patterns of variance in small populations: placing limits on human Y-chromosome diversity through time in the Vanuatu Archipelago.

Small populations are dominated by unique patterns of variance, largely characterized by rapid drift of allele frequencies. Although the variance components of genetic datasets have long been recognized, most population genetic studies still treat all sampling locations equally despite differences in sampling and effective population sizes. Because excluding the effects of variance can lead to significant biases in historical reconstruction, variance components should be incorporated explicitly into population genetic analyses. The possible magnitude of variance effects in small populations is illustrated here via a case study of Y-chromosome haplogroup diversity in the Vanuatu Archipelago. Deme-based modelling is used to simulate allele frequencies through time, and conservative confidence bounds are placed on the accumulation of stochastic variance effects, including diachronic genetic drift and contemporary sampling error. When the information content of the dataset has been ascertained, demographic models with parameters falling outside the confidence bounds of the variance components can then be accepted with some statistical confidence. Here I emphasize how aspects of the demographic history of a population can be disentangled from stochastic variance effects, and I illustrate the extreme roles of genetic drift and sampling error for many small human population datasets.

Alleles↗

Prediction of breast tumor size by mammography and sonography--A breast screen experience.

Concise preoperative assessment of breast Tumor size is important when considering surgical approach and the staging of breast cancer. A retrospective study of 400 uni-focal, invasive ductal carcinomas compared the accuracy of sonographic and mammographic measuring modalities with histological size. Sub-groups for tumor size, type and grade, with other variables, were also considered in intra-modal correlations of lesion dimension. Mammography (R2=0.74), although slightly over estimating tumor size, appeared to be more useful than sonography (R2=0.60) following logistical analysis of the data. Correlational significance for both imaging modalities decreased for tumors larger than 20mm. Sonography under estimated lesions in over 50% of cases; the average underestimate being 9.9 mm, and ranging from 1mm to 30 mm. Consideration of both imaging measurements in cohort should improve the accuracy of radiological reporting of pre-surgical tumor size.

Adult↗

Pedometer steps in primary school-aged children: a comparison of school-based and out-of-school activity.

While studies of the physical activity habits of New Zealand children have been carried out, the findings have been restricted by the use of proxy and self-report measures and limited to total overall daily activity. Objective measurement of children's in-school and out-of school physical activity using pedometry is likely to provide more accurate data on habitual daily activity. To date, no such data are available for New Zealand children. In the present study, children from school years 1-6 (girls, n=46; boys, n=45) at a New Zealand primary school wore a Yamax Digiwalker SW-200 pedometer to record school-based and out-of-school steps over a 3-day period. Mean daily steps for the overall sample were 14 333 (S.D.=4110). Boys (X=15 606; S.D.=4601) were significantly more active than girls (X=13 031; S.D.=3079) (p=.00). Mean steps were also significantly higher in older age groups for both boys (p=.03) and in particular, girls (p=.00). Of note, for the overall sample, steps taken out of school made up 52.4% of total daily steps. Girls (53.6%) and boys (51.3%) took a similar proportion of their overall daily steps outside of the school environment. While a significant difference was found between the most and least active tertiles in steps taken during both during school hours (p=.00) and outside of school hours (p=.00), the most active third of the sample completed significantly more of their daily steps outside of school (55.1%) than did their least active (46.7%) counterparts (p=.00). These results suggest that physical activity outside of the school environment is a key contributor to a child's overall level of physical activity, reinforcing the need for interventions targeting the family and community as well as the school environment.

Age Factors↗

Synthesis by-products from the Wacker oxidation of safrole in methanol using rho-benzoquinone and palladium chloride.

This paper reports the identification of a number of by-products, which are produced during the Wacker oxidation of safrole to 3,4-methylenedioxyphenyl-2-propanone (MDP2P) using rho-benzoquinone and palladium chloride when methanol is utilised as the solvent. Also described is the retrieval of these compounds from illicit samples from a clandestine laboratory, which was uncovered in South Australia in September 2003.

Journal Article↗

Creatine in Huntington disease is safe, tolerable, bioavailable in brain and reduces serum 8OH2'dG.

In a randomized, double-blind, placebo-controlled study in 64 subjects with Huntington disease (HD), 8 g/day of creatine administered for 16 weeks was well tolerated and safe. Serum and brain creatine concentrations increased in the creatine-treated group and returned to baseline after washout. Serum 8-hydroxy-2'-deoxyguanosine (8OH2'dG) levels, an indicator of oxidative injury to DNA, were markedly elevated in HD and reduced by creatine treatment.

8-Hydroxy-2'-Deoxyguanosine↗

Embolus of surgical adhesive to the extremities causing acute ischemia: report of two cases.

We present 2 cases in which a surgical adhesive embolized to the extremities. In the first case an adhesive was successfully used in the repair of a DeBakey type I aortic dissection. The patient was seen 2 months postoperatively with acute lower extremity ischemia, and a large piece of adhesive was extracted from the iliac and femoral arteries at embolectomy. In the second case the adhesive was used to seal a pericardial patch during repair of a ventricular septal defect. This patient was seen 1 day postoperatively with acute arm ischemia, and the adhesive particle was extracted from the brachial artery during embolectomy.

Acute Disease↗

Complications of obstetric regional analgesia: how much information is enough?

Two hundred parturients who had received epidural analgesia during labour (100 in Melbourne, Australia and 100 in London, UK) were asked on the first postnatal day about their sources of antenatal information on pain relief in labour, their awareness of potential complications of epidural analgesia and the level of risk at which they would wish to be informed before consenting to a procedure. Sources of antenatal information were similar in the two countries although more women in Australia received information from an anaesthetist or obstetrician than in the UK, whilst more women in the UK received information from the media than in Australia. Knowledge of risks was also similar although the Australian subjects were more aware of infective complications while those in the UK were more aware of intravascular injection of local anaesthetic; these differences may reflect recent high-profile cases in the two countries. The preferred level of risk at which women wanted to be informed about a complication varied from 1:1 to 1:1,000,000,000 in all three centres. The majority of women considered that the benefits of epidural analgesia outweighed each of the potential complications. Women differ in their requirements for antenatal information about regional analgesia and its complications, with some wanting to know every complication, however rare. Anaesthetists should be flexible in their disclosure of information when obtaining consent for regional analgesia and consider the particular wishes of each patient rather than follow rigid centralised guidelines.

Adult↗

The role of dietary vitamin E in experimental Listeria monocytogenes infections in turkeys.

The current study was designed to determine if dietary vitamin E influenced either the gut clearance or levels of peripheral blood CD4+ and CD8+ T lymphocytes in adult turkeys experimentally infected with Listeria monocytogenes. Turkeys were fed vitamin E (0, 100, or 200 IU) from day of hatch to time of necropsy. After 6 wk on the experimental diet, turkeys were orally inoculated with L. monocytogenes (approximately 10(9) cfu). To monitor infection status, cloacal swabs were taken on selected days post-inoculation (DPI). At necropsy, samples of viscera, including liver, spleen, cecum, duodenum, ileum, and colon were collected and cultured for L. monocytogenes. In experiments 1 and 2, recovery of L. monocytogenes from cloacal swabs, tissues, and intestines from turkeys fed vitamin E was generally lower than that from turkeys fed the control diet, although these differences were not statistically significant. When data from both trials were combined, L. monocytogenes was cultured less frequently from cloacal swabs of the vitamin E-treated group (200 IU) on 2 and 3 DPI, when compared to controls (0 IU, P < 0.01). There were no changes in virulence characteristics of L. monocytogenes cells, as measured by in vitro killing of Ped-2E9 cells, recovered from cloacal swabs or tissues of experimentally infected turkeys fed the control or a vitamin E treatment diet. Flow cytometric analysis indicated that CD4+ and CD8+ peripheral blood T lymphocytes were elevated at 6 and 8 DPI in infected turkeys given 200 IU vitamin E.

Animals↗

Malignant potential in a Brunner's gland hamartoma.

Brunner's gland hamartomas are rare tumours of the duodenum. These lesions have previously been described as being benign, with no malignant potential. A case report is presented of a Brunner's gland hamartoma, whose histology revealed a focus of well marked epithelial dysplasia. This case suggests a dysplastic stage in the natural history of Brunner's gland hamartoma, and questions the malignant potential of these lesions.

Aged↗

Evaluation of the 3D BacT/ALERT automated culture system for the detection of microbial contamination of platelet concentrates.

Bacterial transmission remains the major component of morbidity and mortality associated with transfusion-transmitted infections. Platelet concentrates are the most common cause of bacterial transmission. The BacT/ALERT 3D automated blood culture system has the potential to screen platelet concentrates for the presence of bacteria. Evaluation of this system was performed by spiking day 2 apheresis platelet units with individual bacterial isolates at final concentrations of 10 and 100 colony-forming units (cfu) mL-1. Fifteen organisms were used which had been cited in platelet transmission and monitoring studies. BacT/ALERT times to detection were compared with thioglycollate broth cultures, and the performance of five types of BacT/ALERT culture bottles was evaluated. Sampling was performed immediately after the inoculation of the units, and 10 replicates were performed per organism concentration for each of the five types of BacT/ALERT bottles. The mean times for the detection of these 15 organisms by BacT/ALERT, with the exception of Propionibacterium acnes, ranged from 9.1 to 48.1 h (all 10 replicates were positive). In comparison, the time range found using thioglycollate was 12.0-32.3 h (all 10 replicates were positive). P. acnes' BacT/ALERT mean detection times ranged from 89.0 to 177.6 h compared with 75.6-86.4 h for the thioglycollate broth. BacT/ALERT, with the exception of P. acnes, which has dubious clinical significance, gave equivalent or shorter detection times when compared with the thioglycollate broth system. The BacT/ALERT system detected a range of organisms at levels of 10 and 100 cfu mL-1. This study validates the BacT/ALERT microbial detection system for screening platelets. Currently, the system is the only practically viable option available for routinely screening platelet concentrates to prevent bacterial transmission.

Aerobiosis↗

Comparison between clinical and radiologic outcome measures after reconstruction of acetabular fractures.

OBJECTIVES: To compare clinical and radiologic outcome measures in patients after reconstruction of acetabular fractures and to investigate whether an objective radiologic outcome could be used as a proxy for a clinical outcome. DESIGN: Follow-up survey with retrospective analysis of consecutive case records. PATIENTS AND INTERVENTION: Over a ten-year period, 201 consecutive patients had open reduction and internal fixation of acetabular fractures performed by a single surgeon. The outcome measures on 166 fractures were available for analysis when the twenty-six patients who were lost to follow-up and the fourteen patients who had salvage total hip replacement were excluded. MAIN OUTCOME MEASUREMENTS: The assessment of patients was performed by one of two independent assessors, who used the Merle d'Aubigné (1954) clinical outcome score and a radiologic score of degenerative hip disease (Matta, 1994). RESULTS: Although the overall correlation between the clinical and radiologic outcome grades was good (r = 0.63, p < 0.001), their agreement (i.e., the prediction of a specific clinical outcome by a corresponding radiologic one) was poor (Kappa = 0.24). The authors found that the clinical scoring system was difficult to apply specifically to acetabular trauma in 29 percent of fractures because of complications related to associated injuries. When the individual Merle d'Aubigné scores for pain, range of motion, and walking were correlated with the radiologic score, it was found that the walking score had a significant association with the radiologic score and the pain and range of movement scores. CONCLUSIONS: The Merle d'Aubigné score has shortcomings as an outcome measure for acetabular fractures. Our aim to use a radiologic outcome as a proxy for this clinical grading system was not realized, but we propose that the patient's walking ability could be used as an objective local outcome measurement.

Acetabulum↗

'What do our patients really want from us?': Investigating patients perceptions of the validity of the Chartermark criteria.

BACKGROUND: The 'restructuring' of the NHS over the last decade has demanded a 'market oriented' service more receptive to the needs and priorities of 'clients'receiving health care. These changes have been important to the provision of dental health care in which there has been a similar need to provide increasingly patient and market oriented services. One of the ways in which quality care has been assessed within NHS Trusts is through the national 'Chartermark' award, which identifies national centres of excellence in health care and research. AIM: The aim of this paper is to assess whether patients themselves considered the criteria identified by the Chartermark award important in the provision of good quality dental services METHOD: This is a pilot study consisting of a structured questionnaire conducted face-to-face with a 'convenience' sample of 46 patients. ANALYSIS: Data were inputted into SPSS and thematic analysis was conducted on the data. RESULTS: The Chartermark criteria relevant to patient involvement were divided into four main themes.The findings from this small pilot study suggest that in relation to dental care, although patients are interested in information on standards, performance and complaints, there is considerable disinterest in organisational and financial dimensions.

Awards and Prizes↗

Characterization of the promoter and upstream activating sequence from the Pseudomonas alcaligenes lipase gene.

Pseudomonas alcaligenes secretes a lipase with a high pH optimum, which has interesting properties for application in detergents. The expression of the lipase is strongly dependent on the presence of lipids in the growth medium such as soybean oil. The promoter of the gene was characterized and found to have resemblance to sigma54 controlled promoters, which are known to be tightly regulated. The transcription start was mapped precisely downstream of a sequence with close similarity to the -12/-24 consensus sequence of sigma54 controlled promoters. Interestingly, a hyperproducer mutant strain was isolated and found to have a C to T mutation in the -12/-24 promoter consensus region. In addition an Upstream Activating Sequence (UAS) with homology to sigma54 UAS consensus sequences was identified. It was demonstrated that an increase of the distance from the UAS to the transcription start or the deletion of the UAS results in significantly lower expression levels of lipase. A systematic mutational analysis of the UAS sequence has resulted in a variant with an increased lipase expression.

Amino Acid Sequence↗

Inhibition of tendon cell proliferation and matrix glycosaminoglycan synthesis by non-steroidal anti-inflammatory drugs in vitro.

The purpose of this study was to investigate the effects of some commonly used non-steroidal anti-inflammatory drugs (NSAIDs) on human tendon. Explants of human digital flexor and patella tendons were cultured in medium containing pharmacological concentrations of NSAIDs. Cell proliferation was measured by incorporation of 3H-thymidine and glycosaminoglycan synthesis was measured by incorporation of 35S-Sulphate. Diclofenac and aceclofenac had no significant effect either on tendon cell proliferation or glycosaminoglycan synthesis. Indomethacin and naproxen inhibited cell proliferation in patella tendons and inhibited glycosaminoglycan synthesis in both digital flexor and patella tendons. If applicable to the in vivo situation, these NSAIDs should be used with caution in the treatment of pain after tendon injury and surgery.

Adult↗

Healed or quiescent temporal arteritis versus senescent changes in temporal artery biopsy specimens.

Temporal arteritis (TA) is a common idiopathic vasculitis of the elderly. It is controversial whether, in the absence of an active inflammatory process, vessel damage secondary to temporal arteritis is distinguishable from changes secondary to arteriosclerosis. The primary goal of this study was to attempt to differentiate microscopically between healed temporal arteritis and arteriosclerosis, in the absence of active vasculitis. This was a retrospective study in which 47 temporal artery biopsy specimens, done between 1981 and 1997 at University of British Columbia Hospital, were reviewed. As well, temporal arteries harvested from 10 autopsy cases with no clinical evidence of vasculitis were used as controls. Haematoxylin and Eosin and Movat's pentachrome stains were used to assess the degree of intimal thickening, presence or absence of inflammation, type of inflammatory cell(s), the degree of reduplication of elastic lamina, calcification, fibrosis, neovascularisation and gaps or losses in the internal and external elastic lamina. No histological findings were specific for temporal arteritis except the presence of mural inflammation. A high degree of variability existed for all other features assessed, within all groups studied. These results indicate that, in the absence of active inflammation, structural changes in the vessel wall do not allow reliable differentiation between healed or quiescent temporal arteritis and arteriosclerosis. The common practice of performing special stains in all temporal artery biopsy cases does not contribute to the ability to recognise temporal arteritis.

Aged↗