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R H Jones

Publications and source records attributed to R H Jones.

At least 55 records · Page 3Linked to original sources

Relating the classical covariance adjustment techniques of multivariate growth curve models to modern univariate mixed effects models.

The relationship between the modern univariate mixed model for analyzing longitudinal data, popularized by Laird and Ware (1982, Biometrics 38, 963-974), and its predecessor, the classical multivariate growth curve model, summarized by Grizzle and Allen (1969, Biometrics 25, 357-381), has never been clearly established. Here, the link between the two methodologies is derived, and balanced polynomial and cosinor examples cited in the literature are analyzed with both approaches. Relating the two models demonstrates that classical covariance adjustment for higher-order terms is analogous to including them as random effects in the mixed model. The polynomial example clearly illustrates the relationship between the methodologies and shows their equivalence when all matrices are properly defined. The cosinor example demonstrates how results from each method may differ when the total variance-covariance matrix is positive definite, but that the between-subjects component of that matrix is not so constrained by the growth curve approach. Additionally, advocates of each approach tend to consider different covariance structures. Modern mixed model analysts consider only those terms in a model's expectation (or linear combinations), and preferably the most parsimonious subset, as candidates for random effects. Classical growth curve analysts automatically consider all terms in a model's expectation as random effects and then investigate whether "covariance adjusting" for higher-order terms improves the model. We apply mixed model techniques to cosinor analyses of a large, unbalanced data set to demonstrate the relevance of classical covariance structures that were previously conceived for use only with completely balanced data.

Biometry↗

Novel hepatoselective insulin analogues: studies with covalently linked thyroxyl-insulin complexes.

To explore the possibility that insulin analogues designed to have restricted access to peripheral tissues may display relative hepatoselectivity in vivo, Nalphabeta1-thyroxyl-insulin (B1-T4-Ins) and Nalphabeta1-thyroxyl-aminohexanoyl insulin (B1-T4-AHA-Ins) were synthesized. These insulin analogues bind thyroid hormone binding proteins to form high molecular weight complexes. Effects of intravenous infusions of B1-T4-Ins; B1-T4-AHA-Ins; combined thyroxine binding globulin (TBG) and B1-T4-Ins and combined TBG and B1-T4-AHA-Ins were compared with those of insulin infusion in hyperinsulinaemic euglycaemic clamp protocols in anaesthetized beagles (n=4 and n=3 for combined TBG infusions). Glucose turnover rates were measured using D-[3-3H]glucose infusion. With all 5 protocols the rate of glucose disappearance (Rd) was increased and the rate of endogenous glucose production (Ra) decreased from basal level 13.53+/-0.60 micromol kg(-1) min(-1)(p<0.05). Insulin-like activity for Ra and Rd was calculated as the area between the basal values of each variable and the subsequent values plotted graphically against time (AUC). For insulin, B1-T4-Ins, B1-T4-AHA-Ins, combined infusions of TBG+B1-T4-Ins, and TBG+B1-T4-AHA-Ins, respectively, AUC for Rd values were 6.30+/-0.69, 3.35+/-0.53, 4.40+/-0.64, 2.82+/-0.40 and 3.46+/-0.95 (mmol kg(-1)), all analogue infusions being different from insulin (p<0.05). AUC for Rd was further reduced by addition of TBG to B1-T4-AHA-Ins (p<0.05). In contrast the effect of all analogues on AUC for Ra was similar to that of insulin. These observations are compatible with the suggestion that insulin analogues which bind to thyroid hormone binding proteins retain access to hepatic insulin receptors which primarily control Ra. The reduced peripheral insulin-like effect (Rd) could be due to reduced transcapillary access to peripheral insulin receptor sites.

Animals↗

Cardiopulmonary bypass time does not affect cerebral blood flow.

BACKGROUND: A time-dependent decline in cerebral blood flow (CBF) has been reported in cardiac surgical patients despite stable pump flows and arterial carbon dioxide tension. Other studies have failed to support these hypothermic cardiopulmonary bypass (CPB) results, showing preservation of CBF during CPB. The purpose of the study was to define the influence of mildly hypothermic CPB duration on CBF. METHODS: Cerebral blood flow was measured using xenon-133 washout and alpha-stat blood gas management during nonpulsatile CPB. Cerebral blood flow measurements were made after the initiation of CPB and near the end of bypass during pump flows of 2.4 L.min-1.m-2. RESULTS: Fifty-two coronary artery bypass patients were studied. The average time between CBF measurements was 54 +/- 20 minutes (mean +/- standard deviation), with a range of 10 to 100 minutes. Temperature and arterial carbon dioxide tension were controlled: after the initiation of CPB, temperature was 35.5 degrees +/- 0.4 degree C and carbon dioxide tension was 37 +/- 2.8 mm Hg; whereas near the end of bypass temperature was 35.6 degrees +/- 0.5 degree C and carbon dioxide tension was 36 +/- 2.3 mm Hg. We found no correlation between CBF and time on CPB (p = 0.47; r = 0.101), in contrast to other studies suggesting that CPB duration may intrinsically affect CBF. CONCLUSIONS: Our experimental results include the following: (1) during mildly hypothermic bypass, CBF does not decrease in relation to time and (2) cerebral flow-metabolism coupling is intact at 35 degrees C.

Blood Pressure↗

Determinants of 15-year outcome with 1,119 standard Carpentier-Edwards porcine valves.

BACKGROUND: The determinants of long-term outcome 15 years or more after porcine valve replacement are poorly documented. METHODS: A retrospective review was performed of patients undergoing valve replacement with standard Carpentier-Edwards aortic (n = 531), mitral (n = 492), and tricuspid (n = 96) valves. RESULTS: Patient survival was 26%+/-3%, 23%+/-2%, and 31%+/-8% 15 years after aortic, mitral, and tricuspid valve replacements, respectively. Independent determinants of impaired long-term survival for aortic or mitral valve replacement were multiple valve replacement, older age, renal disease, lung disease, or coronary disease. Actual (versus actuarial) freedom from reoperation at 15 years was 86%+/-2%, 76%+/-2%, and 95%+/-2% after aortic, mitral, and tricuspid valve replacement, respectively. Risk factors for reoperation were young age for aortic or mitral valve replacement, previous operation for aortic valve replacement, and large valve size for mitral valve replacement. Freedom from thromboembolism was 77%+/-4%, 62%+/-9%, and 80%+/-5%; from hemorrhage, 95%+/-5%, 87%+/-4%, and 82%+/-6%; and from endocarditis, 94%+/-1%, 96%+/-1%, and 89%+/-5% 15 years after aortic, mitral, and tricuspid valve replacement, respectively. Risk factors for thromboembolism or hemorrhage were multiple valve replacement and age. CONCLUSIONS: The standard Carpentier-Edwards bioprosthesis continues to provide relatively low complication rates at 15 years, especially in the aortic and tricuspid positions, and especially in patients older than 60 years or with significant comorbdity.

Actuarial Analysis↗

Effects of passive immunization using antibody against an alpha-inhibin peptide on follicle-stimulating hormone concentrations and litter size in sows.

The objective of the experiment was to determine whether passive immunization against inhibin at weaning would increase FSH secretion and thereby influence postweaning reproductive performance in sows. Commercial Yorkshire sows (n = 173) were assigned within parity to 5 alpha-inhibin fragment antibody (alpha-IF-Ab) dosage groups: 0 (control), 3.25, 6.5, 13 and 26 RP-2 kU/kg alpha-IF-Ab. Antibody had been semipurified from ovine antisera raised against alpha-IF, a peptide that mimicked the N-terminal region of inhibin's alpha-subunit. A RP-2 U refers to a laboratory reference preparation. Sows were administered a single intramuscular injection of control solution or alpha-IF-Ab just before 21-d-old piglets were weaned. Blood samples were taken immediately before immunization and 24 h later. Sows were bred upon expression of estrus. Serum alpha-IF-Ab titers in sows 24 h following passive immunization increased (P < 0.001) with dosage. In control sows serum FSH concentrations decreased 24% by 24 h postweaning (P < 0.001). The decrease was diminished or prevented by alpha-IF-Ab treatment in a dose-responsive manner (P < 0.001). Most (167/173) sows were bred within 10 d postweaning, and wean-to-service intervals tended (P < 0.1) to be shorter in the 13 and 26 RP-2 kU/kg alpha-IF-Ab dosage groups. Farrowing rate was 72% (124/173) and was similar among sows in the alpha-IF-Ab dosage groups. Litter size, expressed as total or live piglets born per sow or per sow farrowed, was unchanged by alpha-IF-Ab treatment. Results demonstrate that 1) inhibin plays a key role in regulating FSH secretion at weaning, and 2) blocking the acute postweaning drop in FSH secretion has little if any effect on subsequent reproductive performance.

Animals↗

Improving power with repeated measures: diet and serum lipids.

The inability to detect associations between diet and serum cholesterol in cross-sectional population studies has been attributed to measurement error in diet assessments and between-subject variability in lipid concentrations. Current statistical methods can reduce the effects of measurement error and allow within-subject comparisons when replicate measures on individuals are available, even if the time between replicates is as long as 4 y and replicate data are not available for all subjects. Data from 928 nondiabetic participants of the San Luis Valley Diabetes Study with measures of 24-h dietary intake and fasting lipid concentrations at baseline, at a 4-y follow-up visit, or both were analyzed in a random-effects model that allowed for an unbalanced design. Sex was included as a non-time-varying covariate and age, body mass index, and energy intake were included as time-varying covariates. The findings when LDL cholesterol (mmol/L) was regressed on saturated fat intake (20 g/d) with all observations in a random-effects model (beta = 0.14, P = 0.0016) were compared with results with observations restricted to the first visit only (beta = 0.05, P = 0.52), a balanced design using averages across visits (beta = -0.12, P = 0.28), and a balanced design with random effects obtained by excluding subjects without two observations (beta = 0.12, P = 0.0092). Study power was greatest in the random-effects model using all observations and time-varying covariates. These findings highlight the importance of even a single replicate observation on a subsample of subjects. We recommend analyzing all data rather than averaging measures across visits or omitting observations to create a balanced design.

Adult↗

Irritable bowel syndrome, gastro-oesophageal reflux, and bronchial hyper-responsiveness in the general population.

BACKGROUND: Associations have been shown between irritable bowel syndrome (IBS) and gastro-oesophageal reflux, between gastro-oesophageal reflux and asthma, and more recently between IBS and bronchial hyper-responsiveness (BHR). AIMS: To explore the inter-relations between these conditions. SUBJECTS: A randomly selected community sample of 4432 adults. METHODS: A validated postal symptom questionnaire investigating the associations between IBS, gastro-oesophageal reflux symptoms, and symptomatic BHR. RESULTS: 3169 questionnaires (71.7% response) returned by 1451 men and 1718 women were analysed. One year prevalences, in men and women respectively, of IBS were 10.5% and 22.9%, of dyspepsia 26.3% and 25. 25%, of gastro-oesophageal reflux symptoms 29.4% and 28.2%, of BHR 13.2% and 14.6%, and of chronic bronchitis 8.3% and 4.9%. Logistic regression showed independent associations between IBS and BHR, gastro-oesophageal reflux symptoms, and dyspepsia. There was no significant independent association between IBS and chronic bronchitis. In men and women the odds ratio with 95% confidence interval (CI) for IBS and gastro-oesophageal reflux symptoms was 2.6 (2.1-3.1; p<0.001) and for IBS and BHR 2.1 (1.7-2.7; p<0.001). These associations held on stratifying for sex and consultation behaviour. IBS, gastro-oesophageal reflux symptoms, and bronchial hyper-responsiveness occurred more frequently together than expected, 2.5% (95% CI 2.41-2.57) of the sample having all three conditions compared with an expected prevalence of 0.7% (95% CI 0.66-0.71). The conditions were independently associated with each other. CONCLUSIONS: These observations may indicate the presence of an underlying disorder producing symptoms in gastrointestinal and respiratory systems.

Adult↗

Correlation between IgG anti-type II collagen levels and arthritic severity in murine arthritis.

This study examines the relationship between the serum levels of IgG antibodies to heterologous and homologous type II collagen and the subsequent arthritic severity in a collagen induced arthritis model. Arthritis was induced in DBA-1 mice using intradermal injections of heterologous type II collagen in Freunds complete adjuvant, the time of arthritis onset was noted and the severity was monitored regularly. Serum samples were taken and IgG levels of anti-heterologous and homologous type II collagen were analyzed both pre and post arthritis onset. We observed that post induction/pre arthritic serum IgG anti-heterologous and homologous type II collagen levels showed a significant correlation (both p < 0.01) with the severity of the arthritis that subsequently developed. Mice with early arthritis showed a highly significant correlation (p < 0.002) between sera IgG anti-homologous type II collagen levels and arthritic severity, a lesser correlation was also apparent between anti-heterologous type II collagen titres and arthritic severity (p < 0.05). The high levels of correlation observed in this study between anti-type II collagen titres and arthritic severity before actual onset of arthritis, clearly suggest that the magnitude of the initial humoral response to type II collagen plays a crucial role in determining the resultant arthritic severity. This observation is only apparent due to the use of an arthritis susceptible inbred mouse strain, which removes variables such as H-2 restriction, antigen processing/presentation and possible complement deficiencies, and the early time scale of the analysed sera samples.

Animals↗

Using a nonlinear mixed model to evaluate three models of human stature.

The modern mixed model approach is used to evaluate three current nonlinear models of development of human stature. By combining both fixed and random effects in the same model, the mixed approach incorporates variability between subjects in the estimation of the mean parameter values. This allows us to provide a single statistical test for the differences between each pair of statistical models. Asymptotic growth models from Preece and Baines (1978), Jolicoeur et al. (1988, 1991,1992), and Kanefuji and Shohoji (1990) were applied to height data collected from 28 males and 25 females. The NLINMIX Macro from SAS was used to evaluate the fit of each model allowing for two random components in addition to the fixed mean parameter values. In every case, the addition of random parameters improved the fit of each growth model. Models were evaluated by the calculation of the Akaike Information Criterion, differences in -2 log likelihood, and determination of the residual variance. For males, the Jolicoeur et al. model was superior, while for females, the Kanefuji and Shohoji model provided the best fit. This new approach is more parsimonious than previous techniques by allowing for individual variation in the estimation of model parameters in a population average model of growth.

Humans↗

The effects of zygomatic and chin augmentation on facial aesthetics.

The most obvious and prominent parts of the facial anatomy which affect aesthetics are the nose, the prominence of the zygoma and the chin. These three structures are extremely important when assessing facial aesthetics, and whilst basal structures of the maxilla and mandible are important, it is the positioning of the zygoma, nose and chin which ultimately are the determining factors of good facial aesthetics. This paper outlines the various methods of zygomatic and chin augmentation and describes the intra-oral approach to performing an osteotomy of the zygoma. These procedures are commonly performed in association with orthognathic surgical procedures to correct the occlusion and can be carried out primarily with the initial surgery, or secondarily for aesthetic enhancement.

Bone Transplantation↗

Prognosis by measurements of left ventricular function during exercise. Duke Noninvasive Research Working Group.

UNLABELLED: This study was performed to determine whether gated equilibrium radionuclide angiogram measurements of left ventricular function during rest and exercise add independent information to clinical and catheterization data in predicting cardiac death. METHODS AND RESULTS: The study population consisted of 863 consecutive patients undergoing exercise gated equilibrium radionuclide angiography within 90 days of cardiac catheterization with data prospectively entered into the Duke Cardiovascular Database. All patients were symptomatic, medically treated, with significant coronary artery disease and had undergone follow-up for < or = 6 yr. A univariable and multivariable Cox regression analysis was utilized to evaluate the independent power in predicting 147 (17.0%) cardiac deaths. This risk-adjusted analysis revealed that only rest and exercise ejection fraction as well as maximum workload contained independent prognostic information; the nuclear variables contributed 63% of the total information within the model. A multivariable model including exercise ejection fraction and clinical history variables provided slightly more prognostic information than the combination of cardiac catheterization and clinical data. CONCLUSION: Multigated equilibrium radionuclide angiography is a key predictor of cardiac death when compared to clinical and cardiac catheterization data in patients with symptomatic, medically treated coronary artery disease. Thus, long-term outcome for patients may be determined by utilizing this noninvasive tool even when clinical and cardiac catheterization data are also available.

Cardiac Catheterization↗

Relationship between diabetes mellitus and long-term survival after coronary bypass and angioplasty.

BACKGROUND: Recent subgroup analyses of randomized trials have suggested that percutaneous intervention in diabetic patients with multivessel disease results in higher mortality than coronary artery bypass graft surgery (CABG). We studied the relationship between diabetes and survival after revascularization in a large prospective cohort of patients with multivessel coronary artery disease. METHODS AND RESULTS: By analyzing data for 3220 patients (24% diabetic) with symptomatic two- or three-vessel coronary disease who were undergoing percutaneous transluminal coronary angioplasty (PTCA) or CABG at Duke University Medical Center between 1984 and 1990, we found that at 5 years, unadjusted survival in the group of patients undergoing CABG was 74% in diabetics and 86% in nondiabetics. Similarly, 5-year survival among PTCA patients was 76% in diabetics and 88% in patients without diabetes. After adjustment for baseline characteristics, diabetic patients receiving either PTCA or CABG had significantly poorer survival than nondiabetics (chi2=43.56, P<.0001). Unlike previous studies, however, there was no significant differential effect of diabetes on outcome between patients treated with PTCA and those treated with CABG (chi2=0.01, P=.91). CONCLUSIONS: Although diabetes was associated with a worse long-term outcome after both PTCA and CABG in patients with multivessel coronary artery disease, the effect of diabetes on prognosis was similar in both treatment groups. Thus, our findings support the concept that the choice of initial revascularization strategy should not be based exclusively on a history of diabetes but rather should rely on other factors, such as angiographic suitability and clinical status.

Aged↗

Usefulness of serial radionuclide angiography in predicting cardiac death after coronary artery bypass grafting and comparison with clinical and cardiac catheterization data.

This investigation assesses the prognostic value of radionuclide measurements of cardiac function in patients undergoing coronary artery bypass grafting (CABG). Radionuclide angiograms during exercise and at rest were obtained in 182 patients before (< or = 30 days), early (< or = 3 months), and late (< or = 3 years) after CABG. Cox proportional hazard regression analysis was used to identify independent predictors of 44 cardiac deaths that occurred a median 12 years after bypass. Although the exercise ejection fractions before and early after CABG were significantly related to subsequent cardiac death (chi-square = 10.84, p = 0.001, and chi-square = 7.4, p = 0.006, respectively), the late postoperative exercise ejection fraction was the strongest predictor (chi-square = 13.9, p = 0.0002), contributing above and beyond clinical and catheterization data. These data document the validity of the exercise ejection fraction as an important predictor of cardiac death after CABG and suggest the potential clinical application of serial measurements of the exercise ejection fraction as an important noninvasive adjunct to postoperative evaluation of these patients.

Cardiac Catheterization↗

Magnetic source imaging evidence of sex differences in cerebral lateralization in schizophrenia.

BACKGROUND: It has been postulated that schizophrenia represents a disorder of anomalous cerebral lateralization. This study is a replication of earlier preliminary findings using a multichannel neuromagnetometer, suggesting altered lateralization in schizophrenia in male subjects, with an extension of the findings to female subjects. METHODS: We used magnetoencephalography-based magnetic source imaging to estimate the intracranial location of the 100-millisecond latency auditory-evoked field component (M100) in both left and right hemispheres of 20 patients with paranoid schizophrenia and 20 controls without schizophrenia. Neuroanatomical data were obtained by means of magnetic resonance imaging, from which we segmented and computed volumes of both total brain and left and right superior temporal gyri. RESULTS: Locations of M100 source were compatible with neuronal generators located in the transverse gyri of Heschl on the superior temporal gyri in both study groups; M100 sources were asymmetric in all the control subjects. The male patient subgroup exhibited significantly less asymmetry than the control group, while the female patient subgroup actually showed significantly more asymmetry. The male patient subgroup generally had smaller superior temporal gyri than the control group. No evidence of total brain volume differences was observed. CONCLUSIONS: Our findings support previous magnetoencephalography-based studies suggesting anomalous cerebral lateralization in schizophrenia. Further, in extending our studies to female patients, our data suggest that the nature of this anomaly is sex specific, a finding that, to our knowledge, has not previously been reported.

Adult↗

Reduction in the incidence and severity of collagen-induced arthritis in DBA/1 mice, using exogenous dehydroepiandrosterone.

OBJECTIVE: This study examined the effect of exogenous dehydroepiandrosterone (DHEA) on the onset, incidence, and severity of collagen-induced arthritis (CIA). METHODS: DHEA was administered subcutaneously prior to arthritis induction in DBA/1 mice, and the severity of the subsequent arthritis was monitored. Serum levels of total IgG and IgG isotype-specific anti-murine type II collagen were measured. RESULTS: Repeated administration of DHEA during arthritis induction delayed the onset and decreased the severity of arthritis in male and female DBA/1 mice. DHEA failed to have an observable effect on established arthritis. IgG isotype autoantibody levels were found to be decreased in the sera of DHEA-treated mice. CONCLUSION: Administration of exogenous DHEA offered protection against the development of CIA. These data support the results of human studies in which low DHEA levels have been identified as a potential risk factor for the development of rheumatoid arthritis. These findings also highlight DHEA as a potential therapy worthy of further investigation.

Animals↗

Atmospheric mold spore counts in relation to meteorological parameters.

Fungal spore counts of Cladosporium, Alternaria, and Epicoccum were studied during 8 years in Denver, Colorado. Fungal spore counts were obtained daily during the pollinating season by a Rotorod sampler. Weather data were obtained from the National Climatic Data Center. Daily averages of temperature, relative humidity, daily precipitation, barometric pressure, and wind speed were studied. A time series analysis was performed on the data to mathematically model the spore counts in relation to weather parameters. Using SAS PROC ARIMA software, a regression analysis was performed, regressing the spore counts on the weather variables assuming an autoregressive moving average (ARMA) error structure. Cladosporium was found to be positively correlated (P < 0.02) with average daily temperature, relative humidity, and negatively correlated with precipitation. Alternaria and Epicoccum did not show increased predictability with weather variables. A mathematical model was derived for Cladosporium spore counts using the annual seasonal cycle and significant weather variables. The model for Alternaria and Epicoccum incorporated the annual seasonal cycle. Fungal spore counts can be modeled by time series analysis and related to meteorological parameters controlling for seasonallity; this modeling can provide estimates of exposure to fungal aeroallergens.

Air Microbiology↗