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PubMed1990

Comparison of transesophageal echocardiographic and scintigraphic estimates of left ventricular end-diastolic volume index and ejection fraction in patients following coronary artery bypass grafting.

Transesophageal echocardiography (TEE) has become a commonly used monitor of left ventricular (LV) function and filling during cardiac surgery. Its use is based on the assumption that changes in LV short-axis ID reflect changes in LV volume. To study the ability of TEE to estimate LV volume and ejection immediately following CABG, 10 patients were studied using blood pool scintigraphy, TEE, and thermodilution cardiac output (CO). A single TEE short-axis cross-sectional image of the LV at the midpapillary muscle level was used for area analysis. Between 1 and 5 h postoperatively, simultaneous data sets (scintigraphy, TEE, and CO) were obtained three to five times in each patient. End-diastolic (EDa) and end-systolic (ESa) areas were measured by light pen. Ejection fraction area (EFa) was calculated (EFa = (EDa - ESa)/EDa). When EFa was compared with EF by scintigraphy, correlation was good (r = 0.82 SEE = 0.07). EDa was taken as an indicator of LV volume and compared with LVEDVI which was derived from EF by scintigraphy and CO. Correlation between EDa and LVEDVI was fair (r = 0.74 SEE = 3.75). The authors conclude that immediately following CABG, a single cross-sectional TEE image provides a reasonable estimate of EF but not LVEDVI.

Adult↗
PubMed2003

Rural/urban differences in vocational outcomes for state vocational rehabilitation clients with TBI.

OBJECTIVE: To evaluate differences in demographics, injury severity, and vocational outcomes for persons with TBI based on rural vs. urban residency. PARTICIPANTS: 78 individuals with TBI (28 from rural counties, 50 from urban counties) who requested services from the Missouri Division of Vocational Rehabilitation (VR) over a two year period. MEASURES: Demographics (i.e., age, race, education), injury severity (i.e., loss of consciousness, post traumatic amnesia, length of hospitalization, neuropsychological test scores), VR services provided (e.g., transportation, maintenance, on-the-job training, etc.), and VR outcomes (successfully vs. unsuccessfully employed; cost per case). PROCEDURE: All participants completed a standard neuropsychological evaluation and completed VR services (i.e., were followed from enrollment to case closure). Rural and urban residency was determined using U.S Office of Management and Budget definitions of metropolitan and non-metropolitan areas. ANALYSIS: Chi-squares, Fisher's Exact tests, Wilcoxon Rank Sums test, and MANOVAs. RESULTS: Few if any differences were found between the groups in demographics (i.e., more African Americans in urban areas), injury severity (i.e., more rural residents with multiple TBIs), or neuropsychological test scores. However, individuals from urban areas received significantly more maintenance funds (46% vs. 21%), transportation services (36% vs. 11%), and on-the-job training (28% vs. 7%), and had more spent on them ($1,816 vs $1,242). Although statistically non-significant (p < 0.15), 24% of individuals from urban areas were successfully employed at VR case closure, compared to only 7% of individuals from rural areas. CONCLUSIONS: Individuals with TBI from rural and urban settings have generally similar demographic, injury severity, and neuropsychological abilities, although they appear to differ in terms of vocational outcomes and number of VR services received, possibly related to limited availability of resources in rural areas.

Adult↗
PubMed1997

Census tract analysis of lead exposure in Rhode Island children.

There has been increasing interest in a targeted approach to the screening and prevention of lead exposure in children. Targeted screening requires an understanding of variation in lead exposure in individual children or by region. In order to better understand variation by region, we studied Rhode Island lead poisoning screening data, examining average lead exposure to children living in 136 Providence County census tracts (CTs). The study population included 17,956 children aged 59 months and under, who were screened between May 1, 1992, and April 30, 1993. We evaluated the relationship between the percentage of children with blood lead > or = 10 micrograms/dL (pe10) and sociodemographic and housing characteristics, derived from United States 1990 Census data, of these CTs. CT descriptors included population density, percentage of households receiving public assistance income, median per capita income, percentage of households female headed, percentage of houses owner occupied, percentage of houses built before 1950, percentage of houses vacant, percentage of population Black, percentage of recent immigrants, and intraurban mobility. On average, 109 children were screened in each census tract; mean screening rate was 44%. There was wide variation in average lead exposure among census tracts, with pe10 ranging from 3 to 60% of screened children (mean 27%). Individual census variables explained between 24 and 67% of the variance in pe10 among CTs. A multiple regression model including percentage screened, percentage of households receiving public assistance, percentage of houses built before 1950, In (percentage of houses vacant), and percentage of recent immigrants explained 83% of variance in pe10. The percentage of houses built before 1950, a variable which models the presence of lead paint in old houses, displayed the largest adjusted effect on pe10 over the range observed for that variable in RI CTs. The percentage of houses vacant was also a highly significant and robust predictor; we suggest that vacancy is an ecological marker for the deterioration of leadbased paint, with higher vacancy neighborhoods containing houses in poorer condition. In Rhode Island, census tracts with high vacancy rates also have high rates of recent immigration, making immigrant groups vulnerable to lead exposure. Small-areas analysis may be useful in directing resources to high risk areas, explaining the sociocultural forces which produce such exposure and analyzing the effects of housing policy over time in states with high screening penetration.

Child, Preschool↗
PubMed1979

A communication on health and development in the Kainji Lake area of Nigeria.

A study of the health care delivery facilities in the Kainji Lake area of Nigeria (an artificial lake created in 1968) showed that hospitals, a health centre, maternal and child health centres, public health units, dispensaries and leper institutions, controlled by various organizations, are available. Dispensaries and leper settlements/clinics form the most numerous health providers in the rural areas. Analysis of 1973 data from eight dispensaries around Lake Kainji showed that malaria, gastroenteritis, chest and skin infections, venereal diseases and shistosomiasis constitute the major health problems. Observations of the environmental sanitation in the study area by the author support the idea that the diseases emanate particularly from the low standard of environmental health. A suggestion is made for the establishment of a central organization charged with the responsibilities for health planning and development. The evaluation of the impact of hte dispensaries as health providers is needed for future health planning. A health care delivery system supported by operational research should be initiated at the village level.

Delivery of Health Care↗
PubMed2005

Further analysis of the effects of immunotoxic lesions of the basal nucleus of Meynert reveals substantial impairment on visual discrimination learning in monkeys.

In this paper we undertake a combined analysis of several studies in which marmoset monkeys received immunotoxic lesions of the cortical cholinergic projections from the basal nucleus of Meynert (NBM) bilaterally and/or in combination with immunotoxic lesions of other parts of the cholinergic system or ablations of the target inferotemporal neocortical area. Analysis of the mean learning scores across all visual discriminations learning tasks for each lesion combination revealed highly significant impairments where the NBM was lesioned bilaterally or where an NBM lesion in one hemisphere was crossed with an inferotemporal cortical ablation in the other hemisphere. This demonstrates that the cholinergic projection from the NBM to the major target area of neocortex involved in visual discrimination learning, i.e. the inferotemporal cortex, makes an important contribution to the perceptuo-mnemonic processes necessary for this type of learning. A new study demonstrates a significant effect of a subtotal bilateral cholinergic lesion confined to the NBM on a concurrent object-reward association task using black objects which is perceptually and mnemonically demanding. These results do not preclude the possibility that cholinergic projections from the NBM to other parts of the neocortex make a contribution to other cortical functions which are not mnemonic. It is well established that lesions of the cholinergic projection from the diagonal band of Broca disrupts the mnemonic functions of the hippocampus. The results described here suggest that degeneration of the cholinergic projections in Alzheimer's disease and other dementias will contribute to the loss of those mnemonic functions which are dependent on the neocortex.

Analysis of Variance↗
PubMed1985

Corneal endothelial polymegathism induced by PMMA contact lens wear.

Central corneal endothelial photographs were taken for 15 persons who had worn polymethylmethacrylate (PMMA) contact lenses for 7-15 yr and for a nonwearing control group matched for age and sex. An individual cell area analysis was made from the cell tracings. Significant endothelial polymegathism was noted for each member of the contact lens wearing group. PMMA wearers showed an average coefficient of variation of 0.445 for central corneal endothelial cell area compared to 0.245 for nonwearers (81.6% increase in polymegathism). The average maximum/minimum cell size ratio was 8.06 for the PMMA wearers vs 3.42 for the nonwearing control group. The frequency distributions for the cell areas reveal that the contact lens wearer develops cells that are much smaller and larger than normal.

Adult↗
PubMed1986

Lung deformation and macrophage displacement in smoke-exposed and normal mice (Mus musculus) following different fixation procedures.

Lung deformation (shrinkage or inflation) and displacement of pulmonary parenchymal macrophages were evaluated after immersion fixation, intratracheal instillation of fixative and lung lavage followed by intratracheal fixative instillation in cigarette smoke-exposed, sham-treated and control pallid male mice. Lung volume displacement and lung section and alveolar area analysis revealed that degree of deformation was uniform in lungs from all treatment groups fixed by immersion but not by instillation of fixative and fixative instillation following lavage. In situ pulmonary parenchymal macrophage number per lung section area of fixative-instilled lungs and lavaged lungs followed by fixative instillation was significantly greater than in those following immersion fixation in all corresponding treatment groups. A paucity of macrophages was noted in airways of fixative-instilled and lavaged followed by instillation of fixative lungs. Pulmonary macrophages were uniformly distributed throughout lung parenchyma following immersion fixation, while in fixative-instilled and lavaged prior to instillation of fixative lungs these cells tended to be concentrated in alveoli near terminal bronchioles. Lavage procedures removed an unknown portion of lung macrophages and appeared to ineffectively sample the pulmonary parenchymal macrophage population. Intratracheal instillation of fixative with or without prior lavage apparently alters the distribution of pulmonary macrophages by displacing airway phagocytes into the alveoli. Data reported suggest that fractional estimates of in situ lung parenchymal macrophage population can be obtained by counting the number of these cells per area of tissue from lungs fixed by immersion.

Animals↗
PubMed2000

Final height, gonadal function and bone mineral density of adolescent males with central precocious puberty after therapy with gonadotropin-releasing hormone analogues.

UNLABELLED: Few data are available on the outcome of boys with central precocious puberty (CPP) treated with gonadotropin-releasing hormone (GnRH) analogues. We report on final height, endocrine and exocrine testicular function, and bone mineral density (BMD) in nine males (age 16.7 +/- 1.5 years) treated with GnRH analogues from the age 6.0 +/- 1.8 years for a mean period of 5.6 +/- 2.4 years. The following parameters were evaluated: final height, serum gonadotropin and gonadal steroid levels, spermarche, semen analysis, area and volumetric BMD. Final height (-0.4 +/- 1.1 SDS) was significantly higher than pre-treatment predicted adult height (-2.0 +/- 1.2 SDS) and not significantly different than midparental height (-0.1 +/- 0.8 SDS). Pubertal response of gonadotropins to GnRH test occurred within 1.5 years (mean 0.7 +/- 0.4 years) and spermarche (n = 7) from 0.7 to 3 years (1.8 +/- 0.9 years) after the discontinuation of GnRH analogue therapy. No alteration in semen analysis was found (n = 6, sperm count, 10(6)/ml: 52.0 +/- 18.7; normal motility (%): 49.5 +/- 18.7; atypical morphology (%): 44.5 +/- 11.4). Area and volumetric BMD were not reduced (0.2 +/- 1.0 SDS and -0.1 +/- 0.9 SDS, respectively). CONCLUSION: Long-term treatment with gonadotropin-releasing hormone analogues improves final height in boys with central precocious puberty. Post-therapy data demonstrating normal endocrine and exocrine testicular function support the safety of gonadotropin-releasing hormone analogues on reproductive function. Long-term pharmacological suppression of testicular function in childhood does not impair bone mineral density in late adolescence.

Adolescent↗
PubMed1989

Topographic distribution of EEG alpha activity during ethanol-induced intoxication in women.

Topographic maps of brain electrical activity from scalp EEG electrodes were obtained from healthy adult female volunteers using a Brain Electrical Activity Mapping (BEAM) system. Each woman received both ethanol (0.7 g/kg, p.o.) and placebo in a counterbalanced order under double-blind conditions at an interval of 1-6 days. Subjective reports of intoxication were obtained continuously via an instrumental joystick device. Subjects reported when they detected ethanol and qualitatively pleasant (i.e., euphoric) or unpleasant (i.e., dysphoric) effects. All subjects reliably discriminated ethanol from placebo. Pronounced increases in EEG alpha activity occurred during ethanol-induced intoxication in all subjects. Analysis of topographic maps revealed that the distribution of high-amplitude, fast-frequency EEG alpha activity extended further frontally to the central sulcus and temporally during ethanol intoxication than during control sessions or after placebo administration. Area analysis and significant probability mapping techniques were used to quantify the increased alpha activity and to monitor changes during the process of intoxication in each individual. One woman, with a positive family history of alcoholism, experienced only a mild degree of ethanol intoxication. This behavioral response was accompanied by a slight decrease or no change in both slow- and fast-frequency alpha activity. This finding in a single subject provides additional evidence that a possible genetic predisposition for ethanol-related effects on behavior may be reflected in measures of brain electrical activity. Overall, these data also suggest that ethanol induces rapid and widespread increases in EEG alpha activity which may be associated with the reinforcing properties of ethanol.

Adult↗
PubMed1983

A reevaluation of the functional organization and cytoarchitecture of the feline lateral posterior complex, with observations on adjoining cell groups.

The organization of the cat's lateral posterior complex was reevaluated and its cytoarchitecture described. Analysis of visual representations within the complex confirmed that the pulvinar, lateral zone (LPL), and interjacent zone (LPi) correspond to separate representations of the visual field and established that the zones exhibit heterogeneous connections as a result of retinotopic interconnections with extrastriate areas which represent varying amounts of the visual field. A common system of visual representation extending through layers with differing anatomical connections was identified within zone LPL. The concept of an "isorepresentation cord" was introduced to describe these variable correspondences between sensory representations and connectional relationships. Isorepresentation cords are conceived as holding in common representation of a common locus on a sensory surface without functioning as a unit with respect to connections. Visual representations within the lateral posterior complex consist of many such cords arranged in orderly array. Zone LPm (medial) was also delineated more accurately on the basis of its connections with the ectosylvian visual area. Analysis of termination patterns which occupy boundary regions adjacent to and between the principal zones further established the existence of a collection of cell groups which form a thin, irregular shell investing the principal zones. The identification of these additional cell groups and the recognition of connectional heterogeneity within the principal zones of the complex made it possible to identify and describe the subtle cytoarchitectural differences which characterize the subdivisions of the lateral posterior complex and their boundaries with adjoining nuclear groups. The present findings are discussed with respect to the functions of the lateral posterior complex in interconnecting cortical visual and visuomotor areas, and with respect to the conceptual issues raised by variable correspondences between sensory representations and connectional relationships within thalamus.

Animals↗
PubMed1999

An aggregate level analysis of the socioeconomic correlates of drink driving offenders.

Research within urban sociology and social geography has discussed the relation between the spatial or aggregate level distribution of various social and demographic variables and a wide range of social problems. This paper takes the spirit of these studies as a starting point and applies methods of social area analysis to study drink driving offender rates within the Sunshine Coast-Brisbane-Gold Coast conurbation. The major findings of the paper are that at the aggregate level there is a strong correlation between rates of drink driving offenders and particular social and demographic factors. As such the findings support existing studies that have identified given social characteristics of drink drivers. In addition, the findings also illustrate the need to consider a range of aggregate social and demographic variables in future research.

Adult↗
PubMed2006

Delayed enhancement magnetic resonance imaging predicts response to cardiac resynchronization therapy in patients with intraventricular dyssynchrony.

OBJECTIVES: We evaluated the ability of delayed enhancement magnetic resonance imaging (DE-MRI) to predict clinical response to cardiac resynchronization therapy (CRT). BACKGROUND: Cardiac resynchronization therapy reduces morbidity and mortality in selected heart failure patients. However, up to 30% of patients do not have a response. We hypothesized that scar burden on DE-MRI predicts response to CRT. METHODS: The DE-MRI was performed on 28 heart failure patients undergoing CRT. Patients with QRS > or =120 ms, left ventricular ejection fraction < or =35%, New York Heart Association functional class II to IV, and dyssynchrony > or =60 ms were studied. Baseline and 3-month clinical follow-up, wall motion, 6-min walk, and quality of life assessment were performed. The DE-MRI was performed 10 min after 0.20 mmol/kg intravenous gadolinium. Scar measured by planimetry was correlated with response criteria. RESULTS: Twenty-three patients completed the protocol (mean age 64.9 +/- 11.7 years), with 12 (52%) having a history of myocardial infarction. Thirteen (57%) patients met response criteria. Percent total scar was significantly higher in the nonresponse versus response group (median and interquartile range of 24.7% [18.1 to 48.7] vs. 1.0% [0.0 to 8.7], p = 0.0022) and predicted nonresponse by receiver-operating characteristic analysis (area = 0.94). At a cutoff value of 15%, percent total scar provided a sensitivity and specificity of 85% and 90%, respectively, for clinical response to CRT. Similarly, septal scar < or =40% provided a 100% sensitivity and specificity for response. Regression analysis showed linear correlations between percent total scar and change in each of the individual response criteria. CONCLUSIONS: The DE-MRI accurately predicted clinical response to CRT. This technique offers unique information in the assessment of patients referred for CRT.

Aged↗
PubMed2000

[Relationship between growth of young children and complementary feeding].

Description analysis, correlation regression analysis and logistic regression analysis were applied to evaluate the impact of complementary food on the growth of children from the aged 4 to 24 months, results on the effect of the complementary feeding were presented. Among children under 2 years in poor rural areas, 42% of them got complementary food containing animal food, 30.5% got milk, 57.8% got starchy foods, and 48.6% got vegetables and fruits. The coverage of complementary food containing animal food, vegetables/fruits was only half of that in the urban areas. Analysis revealed significantly positive correlation of HAZ, WAZ of all age group of children under 2 years with the appearance of animal foods, vegetable and fruit in the complementary food, but there was no significantly correlation with starchy foods. According to the regression coefficient, it was estimated that the prevalence of stunting aged 18-24 months could be reduced 2.6 percentage points if 10% increase of coverage of animal food containing complementary food in the CFNSS site was achieved. Logistic regression analysis showed the odds ratio (OR) of non-animal food complementary food for stunting was 2.21 for children aged 4-6 months, 1.73 for 6-12 months, 2.81 for 12-18 months, 2.58 for 18-24 months, OR for underweight was 2.87 for 12-18 months, and 2.08 for 18-24 months.

Child Development↗
PubMed1992

Tibiotalar contact and fibular malunion in ankle fractures. A cadaver study.

Six cadaveric ankles were dissected, preserving medial and lateral ligaments; an axial load of 455N was applied to the tibia supported by the foot and ankle. The unconstrained tibia was moved through 20 degrees of flexion and extension to simulate walking. The tibiotalar contact area was defined using carbon black suspension, recorded photographically, and measured using computerized area analysis. Osteotomy of the distal fibula was performed and fixed with a specially modified plate; a selection of plates provided fixation with 0 degrees or 30 degrees of external rotation in combination with 0 or 2 mm of shortening. The contact area was measured for each of the plates and after division of the deltoid ligament. There were greater than 30 percent decreases in tibiotalar contact with both fibular shortening and external rotation, doubled with a divided deltoid ligament. Anatomic restoration of both fibular length and rotation is essential for normal ankle mechanics. The deltoid ligament has crucial effects on the stability of the ankle mortise.

Ankle Joint↗
PubMed2004

Stable amorphous danazol nanostructured powders with rapid dissolution rates produced by spray freezing into liquid.

The objective of this study was to produce, by spray freezing into liquid (SFL) technology, high-potency, high glass transition temperature (Tg) danazol/polymer powders that remain amorphous and exhibit high dissolution rates after 6 months. Three polymers were investigated, including polyvinylpyrrolidone (PVP) K-15, poloxamer 407, and PEG 8000. The physicochemical properties of SFL powders were characterized by X-ray diffraction (XRD), scanning electron microscopy, particle size distribution, surface area analysis, moisture content, and dissolution rate. The influence of moisture content, drug potency, and excipient type on Tg of SFL powders was investigated using modulated differential scanning calorimetry (mDSC). XRD results indicated that danazol was amorphous for each added excipient. The surface area of danazol/PVP K-15 powders (89.8 m2/g) was higher than that of danazol/PEG 8000 (12.0 m2/g) and danazol/poloxamer 407 (5.49 m2/g). The SFL powders with the various excipient types exhibited similar and significantly enhanced dissolution rates relative to micronized bulk danazol. As the potency of danazol in the SFL danazol/PVP K-15 powders was increased from 33% to 91%, the Tg decreased from 126 degrees C to 104 degrees C. The SFL powders, which were packaged in sealed 30-mL glass vials with a desiccant, were physically stable when stored at 25 degrees C for 6 months, based on dissolution rates and mDSC and XRD measurements. SFL danazol/PVP K-15 powders with high surface areas and high glass transition temperatures remain amorphous and exhibit rapid dissolution rates after 6 months' storage.

Danazol↗
PubMed2004

Mental health nursing practice in acute psychiatric close-observation areas.

The provision of evidence-based therapeutic nursing care in close-observation units or psychiatric intensive care units, has been identified as a problem internationally. These areas of nursing practice have been the subject of considerable discussion particularly in relation to the management of aggression, violence, involuntary treatment, and seclusion. This study used a participatory action research framework to identify qualitative and quantitative measures of activity in the area. Quantitative data collected included rates of critical incidents, the use of prn medication, and the use of seclusion. These data were used as base-line data and were predicted as a measure of change. Qualitative data, collected by interview and focus groups, were used to reveal the experience of patients, relatives, and nurses in a close-observation area. Analysis of this data revealed three main themes: design and environment, lack of activity and structured time, and nursing care. The importance of this study is in demonstrating the multiple problems that exist in the provision of care in close-observation areas and the corresponding need for fundamental changes.

Acute Disease↗
PubMed1998

Computational space reduction and parallelization of a new clustering approach for large groups of sequences.

MOTIVATION: The explosive growth of the biological sequences databases stimulated by genome projects has modified the framework of several applications in the biological sequence analysis area. In most cases, this new scenario is characterized by studies on large sets of sequences, suggesting the need for effective and automatic methods for their clustering. A more effective clustering of the database could be followed by the application of common family analysis schemes to the groups so formed. RESULTS: In this work, we present a new strategy to reduce the computational cost associated with the clustering of large sets of sequences which are expected to contain several families. The strategy is based on the grouping of the sequences into families by using a dynamic threshold on a pairwise sequence similarity criterion. Routine clustering of large data sets can now be done very efficiently. The method developed here achieves a computational space reduction of about an order of magnitude over more traditional ones of all-versus-all comparisons. The outcome of this approach produces family groupings that reproduce closely already accepted biological results. Our work includes a parallel implementation for distributed memory multiprocessors with a dynamic scheduling strategy for performance optimization. AVAILABILITY: By anonymous ftp at ftp.ac.uma.es (/pub/ots/pCluster directory), or from our Web site http://www.cnb. uam.es/www/software/software_index.html CONTACT: ots@ac.uma.es

Algorithms↗
PubMed2006

Response of Reticulitermes flavipes (Isoptera: Rhinotermitidae) to disturbance in laboratory arenas at different temperatures and soldier proportions.

This study examined the evacuation response of groups of Reticulitermes flavipes (Kollar) workers after disturbance in laboratory arenas across a range of temperatures (16, 21, and 27 degrees C) and soldier proportions (1, 3, and 5%). Groups of workers and soldiers were disturbed in a central chamber and then monitored during a 5-d period to examine the percentage that initially evacuated, percentage of evacuees that returned, time to evacuate, time to return, and rates (percentage per hour) of evacuation and return between different temperatures and between soldier levels. Disturbance response patterns were observed that generally consisted of partial evacuation followed by movement back into disturbed areas. General alarm responses were observed and initiated specific alarm responses that resulted in more termites eventually returning to disturbed areas than originally evacuated. The typical evacuation response was not observed in groups with 5% soldiers. Instead, clustering in disturbed areas replaced evacuation. Regression revealed significant correlations between temperature and evacuation time, return time, evacuation rate, and return rate, indicating that R. flavipes alarm behaviors are influenced by temperature. There was a significant correlation between soldier proportions and the percentage of evacuees returning to disturbed areas. Analysis of variance (ANOVA) revealed significant differences between temperatures in the time to evacuate, evacuation rate, time to return, and return rate. ANOVA also showed significant differences between soldier proportions in the mean percentage of evacuees from and the rate of return to disturbed areas. Our results demonstrate that temperature influences the rate, but not the magnitude, of alarm response, whereas the influence of soldiers may not be as important in the context of general alarm as specific alarm.

Animals↗