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Respiratory distress and sudden death associated with receipt of a peripheral parenteral nutrition admixture.

OBJECTIVE: To detect respiratory adverse reactions potentially related to receipt of peripheral parenteral nutrition (PPN) in hospitalized patients and to determine risk factors for their occurrence. DESIGN: Retrospective cohort study. SETTING: Federal tertiary-care hospital. PATIENTS: Medical and pharmacy records of all patients who received PPN from October 1992 to February 1994 were abstracted for demographics, diagnoses, medications received, indications for and formulation of PPN, and severity of illness as measured by Acute Physiology and Chronic Health Evaluation II scores. RESULTS: A case-patient was defined as any patient who, while receiving PPN, had unexplained chest pain, dyspnea, cardiopulmonary arrest, or new interstitial infiltrates on chest radiograph. Patients who received PPN in which FreAmine was the amino acid source were more likely than those who received PPN made with Travasol to meet the case definition (5/11 vs 0/39; relative risk, > 18; 95% confidence interval, 3.3->136; P < .001). CONCLUSIONS: A change in the amino acid source of a PPN admixture was associated with respiratory adverse events that ranged from interstitial infiltrates to sudden death. These events apparently resulted from the infusion of a calcium phosphate precipitate in an opaque admixture. Each new PPN admixture should be tested for stability before clinical use and infused into patients through an appropriate filter.

APACHE↗

Similarity between the in vitro activity and toxicity of two different Fungizone/Lipofundin admixtures.

PURPOSE: Amphotericin B (AmB), an antifungal agent that presents a broad spectrum of activity, remains the gold standard in the antifungal therapy. However, sometimes the high level of toxicity forbids its clinical use. The aim of this work was to evaluate and compare the efficacy and toxicity in vitro of Fungizon (AmB-D) and two new different AmB formulations. METHODS: three products were studied: Fungizon, and two Fungizon /Lipofundin admixtures, which were diluted through two methods: in the first one, Fungizon was previously diluted with water for injection and then, in Lipofundin (AmB-DAL); the second method consisted of a primary dilution of AmB-D as a powder in the referred emulsion (AmB-DL). For the in vitro assay, two cell models were used: Red Blood Cells (RBC) from human donors and Candida tropicallis (Ct). The in vitro evaluation (K+ leakage, hemoglobin leakage and cell survival rate-CSR) was performed at four AmB concentrations (from 50 to 0.05 mg x L(-1)). RESULTS: The results showed that the action of AmB was not only concentration dependent, but also cellular type and vehicle kind dependent. At AmB concentrations of 50 mg x L(-1), although the hemoglobin leakage for AmB-D was almost complete (99.51), for AmB-DAL and AmB-DL this value tended to zero. The p = 0.000 showed that AmB-D was significantly more hemolytic. CONCLUSION: The Fungizon-Lipofundin admixtures seem to be the more valuable AmB carrier systems due to their best therapeutic index presented.

Amphotericin B↗

Genetic admixture in three Mexican Mestizo populations based on D1S80 and HLA-DQA1 loci.

This study compares genetic polymorphisms at the D1S80 and HLA-DQA1 loci in three Mexican Mestizo populations from three large states (Nuevo León, Jalisco, and the Federal District). Allele frequency distributions are relatively homogenous in the three samples; only the Federal District population shows minor differences of the HLA-DQA1 allele frequencies compared with the other two. In terms of genetic composition, these Mestizo populations show evidence of admixture with predominantly Spanish-European (50-60%) and Amerindian (37-49%) contributions; the African contribution (1-3%) is minor. Together with the observation that in Nuevo León, the admixture estimates based on D1S80 and HLA-DQA1, are virtually the same as those reported earlier from blood group loci, suggests that DNA markers, such as D1S80 and HLA-DQA1 are useful for examining genetic homogeneity/heterogeneity across Mestizo populations of Mexico. The inverse relationship of the proportion of gene diversity due to population differences (Gst) to within population gene diversity (Hs) is also consistent with theoretical predictions, supporting the use of these markers for population genetics studies.

DNA↗

DNA diversity and population admixture in Anatolia.

The Turkic language was introduced in Anatolia at the start of this millennium, by nomadic Turkmen groups from Central Asia. Whether that cultural transition also had significant population-genetics consequences is not fully understood. Three nuclear microsatellite loci, the hypervariable region I of the mitochondrial genome, six microsatellite loci of the Y chromosome, and one Alu insertion (YAP) were amplified and typed in 118 individuals from four populations of Anatolia. For each locus, the number of chromosomes considered varied between 51-200. Genetic variation was large within samples, and much less so between them. The contribution of Central Asian genes to the current Anatolian gene pool was quantified using three different methods, considering for comparison populations of Mediterranean Europe, and Turkic-speaking populations of Central Asia. The most reliable estimates suggest roughly 30% Central Asian admixture for both mitochondrial and Y-chromosome loci. That (admittedly approximate) figure is compatible both with a substantial immigration accompanying the arrival of the Turkmen armies (which is not historically documented), and with continuous gene flow from Asia into Anatolia, at a rate of 1% for 40 generations. Because a military invasion is expected to more deeply affect the male gene pool, similar estimates of admixture for female- and male-transmitted traits are easier to reconcile with continuous migratory contacts between Anatolia and its Asian neighbors, perhaps facilitated by the disappearance of a linguistic barrier between them.

Adult↗

Estimation of race admixture--a new method.

The contribution of a parental population in the gene pool of a hybrid population which arose by hybridization with one or more other populations is estimated here at the population level from the probability of gene identity. The dynamics of accumulation of such admixture is studied incorporating the fluctuations due to finite size of the hybrid population. The method is illustrated with data on admixture in Cherokee Indians.

Alleles↗

Admixture in a biologically African caste of black Americans.

Social and historical factors account for much of the variation in European ancestry among different Black American populations, including that of McNary, Arizona. The Black population of McNary is socioculturally and geographically isolated. Admixture estimates based upon reflectometry and serological data suggest that this population has less than 5% European ancestry. Anthropometric and hemoglobin data also suggest that this population is more African in ancestry than other Black American populations. Admixture estimates for the population are complicated by several factors. Genetic drift has probably affected Black McNary; estimated effective population size (Ne) is 52.11 and the coefficient of breeding isolation is less than 50. Frequencies of the alleles B, O, and r support this hypothesis; they are quite atypical for a Black American group. Selective migration and occupational selection may also have influenced the current genetic composition of Black McNary. Over 80% of the Black residents of McNary were born in backwoods lumbering towns in the American South. Most Black families in McNary trace their economic reliance on lumbering back several generations. Historical sources and demographic data from Black McNary suggest that Southern Black millworking families formed an endogamous unit that produced this caste, which has a relatively small amount of European ancestry.

Black or African American↗

Genetic variation in Arizona Mexican Americans: estimation and interpretation of admixture proportions.

Mexican Americans are a numerous and fast growing ethnic population in the United States. Yet little is known about their genetic structure. Since they are a hybrid, it is of interest to identify their parental populations and to estimate the relative contributions of these groups. This information is relevant to historical, biomedical, and evolutionary concerns. New genetic typings on 730 Arizona Mexican Americans for the HLA-A, HLA-B, ABO, Rh, MNSs, Duffy, Kidd, and Kell loci are presented here and they are used to estimate ancestral contributions. We considered both a dihybrid model with Amerindians and Spaniards as proposed ancestors, and a trihybrid model with Amerindians, Spaniards, and Africans as proposed ancestors. A modified weighted least squares method that allows for linkage disequilibrium was used to estimate ancestral contributions for each model. The following admixture estimates were obtained: Amerindian, 0.29 +/- 0.04; Spaniard, 0.68 +/- 0.05; and African, 0.03 +/- 0.02. The interpretation of these results with respect to Amerindian and Spanish ancestry is straightforward. African ancestry is strongly supported by the presence of a marker of African descent, Fy, despite the fact that the standard error of the estimate is as large as the estimated admixture proportion. An evaluation of the sensitivity of these results to a number of variables is presented: 1) our choices of ancestral allele frequencies, 2) the possibility of selection at HLA and the blood groups, and 3) genetic drift in Mexican Americans.

Africa↗

Genetic structure of the population of Cabo Verde (west Africa): evidence of substantial European admixture.

The population of Cabo Verde was founded in the fifteenth century (1462), on the basis of slaves brought from the West African coast and a few Europeans, mainly from Portugal. The polymorphism of six red cell enzymes (ADA, AK1, ALAD, ESD, GLO1, and PGD) and ten plasma proteins (AHSG, BF, F13A, F13B, GC, HP, ORM, PLG, TBG, and TF) was studied in a sample of 268 individuals from Cabo Verde (West Africa). There is no statistical evidence of genetic heterogeneity between the two groups of islands which constitute the archipelago, Barlavento and Sotavento. The gene frequency distribution observed in Cabo Verde differs, in many markers, from that of West African populations, suggesting an important European influence. The proportion of Caucasian genes in the population of Cabo Verde has been calculated to be M = 0.3634 +/- 0.0510, and the considerable dispersion of the locus-specific admixture estimates seems to indicate random drift has also played a role in the evolution of the allele frequencies in the archipelago. Partition of the variance of the mean estimate in evolutionary and sampling variance shows the evolutionary variance is more than ten times higher than the sampling variance. When dendrograms are constructed on the basis of different genetic distances, the population of Cabo Verde clusters with Afro-Americans, forming a different group from the populations of the African continent. This is interpreted as a consequence of the importance of Caucasian admixture both in Afro-Americans and in the population of Cabo Verde.

Africa, Western↗

Admixture and Selection Driven by El Ni&#xf1;o-Southern Oscillation Events Shape the Genetic Structure of Octopus mimus-O. hubbsorum Complex Across the Humboldt and South Equatorial Current Transition Zone.

Marine transition zones, where contrasting water masses converge, can function as natural laboratories for studying admixture and early stages of speciation. The genomic structure of the eastern Pacific Octopus mimus-O. hubbsorum complex was investigated by analyzing whole-genome sequencing data from 67 individuals sampled along the west coast of the Americas, spanning Mexico and the Peruvian coast. This includes the South Equatorial Current, the transition zone, and the Humboldt Current System. The mitochondrial genomes fell into two major genetic clades that largely corresponded to the warm-water northern (O. hubbsorum) and cold-water southern (O. mimus) lineages. Analyses of the nuclear genomes revealed the same bipartite structure but also identified a broad admixture zone characterized by two different admixed clades (Admixed-Cold and Admixed-Warm). The results suggest that episodic relaxation of oceanographic barriers during El Ni&#xf1;o-Southern Oscillation (ENSO) events promotes secondary contact and gene flow, resulting in admixed individuals recurrently during ENSO years. However, the survival of these admixed individuals depends on the adaptive genetic composition of each organism and the prevailing environmental conditions. Outlier SNP analysis supports these findings, where the Admixed-Cold cluster shares mainly the adaptive genetic component identified as outliers in O. mimus, while Admixed-Warm is linked to those in O. hubbsorum. The O. mimus-O. hubbsorum complex is currently occupying a gray zone of speciation, in which selection and climate-driven connectivity act in tandem to shape genomic divergence.

gene flow↗

Distribution of the admixture test for the detection of linkage under heterogeneity.

The admixture test for the detection of linkage under heterogeneity is considered. We show that the null distribution of this test statistic has half its weight concentrated on zero and the other half on a complicated distribution that can be approximated by max (X1,X2) where X1 and X2 are independent X1(2) variables. We also investigate the stability of the size of the test for small samples. The power of this test to detect linkage, when heterogeneity is present, can be substantially greater than the standard test that assumes homogeneity. Even when heterogeneity is not present, the test is only slightly less powerful than the homogeneous test. This would suggest the use of the admixture test in preference to the homogeneous test if the presence of heterogeneity is at all suspected.

Genetic Linkage↗

Computational prediction of the stability of lipid emulsions in total nutrient admixtures.

The relationships between the stability of lipid emulsions in a number of parenteral total nutrient admixtures (TNAs) and their electrokinetic properties were examined. Previous studies have attempted to measure or calculate zeta potentials of lipid emulsions in nutrient admixtures to rationalize their stability behavior, but there has been no demonstration that zeta potentials do actually determine emulsion stability or that such computational approaches can be successful. The present study demonstrates that emulsion stability in a range of TNAs is dependent on the emulsion zeta potential and also that van der Waals forces, influenced by the presence of glucose, are important. By accounting for these factors we show that it is possible to calculate the stability of TNAs by Deryaguin-Landau-Verwey-Overbeck-based methods and obtain reasonable agreement with experimental stability data in most systems.

Drug Stability↗

Two-locus admixture linkage analysis of bipolar and unipolar affective disorder supports the presence of susceptibility loci on chromosomes 11p15 and 21q22.

Following a report of a linkage study that yielded evidence for a susceptibility locus for bipolar affective disorder on the long arm of chromosome 21, we studied 23 multiply affected pedigrees collected from Iceland and the UK, using the markers PFKL, D21S171, and D21S49. Counting only bipolar cases as affected, a two-point LOD of 1.28 was obtained using D21S171 (theta = 0.01, alpha = 0.35), with three Icelandic families producing LODs of 0.63, 0.62, and 1.74 (all at theta = 0.0). Affected sib pair analysis demonstrated increased allele sharing at D21S171 (P = 0.001) when unipolar cases were also considered affected. The same set of pedigrees had previously been typed for a tyrosine hydroxylase gene (TH) polymorphism at 11p15 and had shown some moderate evidence for linkage. When information from TH and the 21q markers was combined in a two-locus admixture analysis, an overall admixture LOD of 3.87 was obtained using the bipolar affection model. Thus the data are compatible with the hypothesis that a locus at or near TH influences susceptibility in some pedigrees, while a locus near D21S171 is active in others. Similar analyses in other datasets should be carried out to confirm or refute our tentative finding.

Bipolar Disorder↗

High level of male-biased Scandinavian admixture in Greenlandic Inuit shown by Y-chromosomal analysis.

We have used binary markers and microsatellites on the Y chromosome to analyse diversity in a sample of Greenlandic Inuit males. This sample contains Y chromosomes typical of those found in European populations. Because the Y chromosome has a unique and robust phylogeny of a time depth that precedes the split between European and Native American populations, it is possible to assign chromosomes in an admixed population to either continental source. On this basis, 58+/-6% of these Y chromosomes have been assigned to a European origin. The high proportion of European Y chromosomes contrasts with a complete absence of European mitochondrial DNA and indicates strongly male-biased European admixture into Inuit. Comparison of the European component of Inuit Y chromosomes with European population data suggests that they have their origins in Scandinavia. There are two potential source populations: Norse settlers from Iceland, who may have been assimilated 500 years ago, and the Danish-Norwegian colonists of the eighteenth century. Insufficient differentiation between modern Icelandic and Danish Y chromosomes means that a choice between these cannot be made on the basis of diversity analysis. However, the extreme sex bias in the admixture makes the later event more likely as the source.

Asian People↗

Racial admixture and its impact on BMI and blood pressure in African and Mexican Americans.

Admixed populations such as African Americans and Hispanic Americans present both challenges and opportunities in genetic epidemiologic research. Because of variation in admixture levels among individuals, case-control association studies may be subject to stratification bias. On the other hand, admixed populations also present special opportunities both for examining the role of genetic and environmental factors for observed racial/ethnic differences, and for possibly mapping alleles that contribute to such differences. Here we examined the distribution and relationship of individual admixture (IA) estimates with BMI and three measures of blood pressure in two admixed populations in the NHLBI Family Blood Pressure Program (FBPP): African Americans and Mexican Americans. For the African Americans, we observed modest but significant differences in average African IA among four recruitment sites. We observed a slight excess of African IA among hypertensives compared to normotensives, and a positive (non-significant) regression of African IA on blood pressure in untreated participants. Within Mexican Americans, we found no difference in average IA between hypertensives and normotensives, but a positive (marginally significant) regression of African IA on diastolic blood pressure. We also observed a significant positive regression of Caucasian IA (and negative regression of Native American IA) on BMI. Our results are suggestive of genetic differences between Africans and non-Africans that influence blood pressure, but such effects are likely to be modest compared to environmental ones. Excess obesity among Native Americans compared to whites is not consistent with a simple genetic explanation.

Adult↗

Estimating European admixture in African Americans by using microsatellites and a microsatellite haplotype (CD4/Alu).

We have analyzed 10 unlinked microsatellites and a linked Alu deletion polymorphism at the CD4 locus in an African American population sample from Chicago (USA). Heterozygosity estimates at the microsatellite loci range from 0.727+/-0.025 (D3S1358) to 0.873+/-0.017 (D18S51), with an average of 0.794+/-0.016. These values are comparable to or higher than those reported for Europeans, with only one exception (D3S1358). The CD4/Alu haplotypic diversity (0.887+/-0.012) is comparable to diversity levels observed in sub-Saharan African populations and is higher than the diversity levels reported in European populations. No consistent pattern of within, between, or multi-locus deviations from Hardy-Weinberg expectations is observed, suggesting a low sub-heterogeneity within the sampled population. We have applied a maximum likelihood method and estimated the proportion of European admixture to the African American gene pool to be 0.26+/-0.02. The narrow confidence interval indicates that allele frequency data from multiple microsatellite loci, whether analyzed independently or as haplotypes, are particularly useful for estimating genetic admixture.

Black or African American↗

The effect of assortative mating upon genetic association studies: spurious associations and population substructure in the absence of admixture.

Spurious associations due to confounding factors are an often cited and intensely debated concern for genetic association studies. Great attention has been focused upon the specific threat of confounding due to population stratification. This emphasis has spurred the development of many statistical genetic methods to detect and correct for the potentially confounding effects of admixture. Unfortunately, this emphasis on admixture has led some authors to suggest that if ethnically homogenous populations are used, spurious associations are unlikely to occur. We show that under small and realistic degrees of assortative mating over time, spurious associations arise even in ethnically homogeneous populations. We demonstrate that structured association and genomic control tests can, under certain conditions, correct for these spurious associations. We conclude that investigators should not assume spurious associations will not occur in association studies using ethnically homogenous populations and recommend the use of genomic control methods and/or family-based association tests within genetic association studies.

Chromosome Mapping↗

Functional venous admixture in the lungs of the turtle, Chrysemys scripta.

Pulmonary functional venous admixture was determined during forced, unidirectional ventilation with pure O2 and air. At a normal lung volume of 140 ml X kg-1, anatomical shunts (physical bypass of gas exchange surface by the blood) averaged 10% of pulmonary blood flow but it increased to 28% as lung volume declined to 30 ml X kg-1. Diffusion limitation and possibly inhomogeneity in ventilation: perfusion ratio also contributed to a total functional venous admixture of about 25% at normal lung volume.

Animals↗

Psychometric deviance in offspring at risk for schizophrenia: II. Resolving heterogeneity through admixture analysis.

The longitudinal and prospective study of offspring at risk for schizophrenia is complicated by within-group heterogeneity in liability, as only a subgroup of those at risk will ultimately become affected. Here, we attempt to resolve such heterogeneity in the New York High-Risk Project by conducting an admixture analysis of values on a psychometric index of liability to schizophrenia derived from the Minnesota Multiphasic Personality Inventory (MMPI). We fit mixtures of components to the overall distribution in 171 children from three criterion groups: offspring at risk (HR) for schizophrenia, psychiatric comparison (PC) offspring at risk for affective illness, and normal comparison (NC) offspring not at increased risk for psychiatric morbidity. The distribution of psychometric scores was bimodal, and separation of two latent classes showed that there is a valid and nonarbitrary distinction between a subgroup of MMPI-deviant (primarily HR) offspring and a larger homogeneous group of MMPI-nondeviant HR, PC, and NC subjects. While continued followup is required to demonstrate a correspondence between these two classes and an underlying taxonomy of liability to schizophrenia, our findings demonstrate the utility of objective psychometric measurement and admixture analysis for resolving within-group heterogeneity in high-risk research. The wider implications of including our MMPI indicators in other genetic investigations of schizophrenia are discussed.

Adolescent↗