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The bioavailability of a mixed micellar preparation of vitamin K1, and its procoagulant effect in anticoagulated rabbits.

We have investigated the pharmacokinetics and procoagulant activity of a new, mixed-micellar preparation of vitamin K1 (MM-K) in male New Zealand White rabbits. Oral administration of MM-K alone caused a significant (P less than 0.01) increase in the plasma concentrations of vitamin K1 as measured by normal-phase high-performance liquid chromatography (HPLC). Maximum plasma concentrations of vitamin K1 (450 ng mL-1, range 133-824 ng mL-1) were recorded at 3.3 h (range 3-5 h), and were significantly (P less than 0.05) greater than those seen after administration of an existing polyethoxylated castor oil preparation (PE-K; Konakion), which were 260 ng mL-1, range 198-390 ng mL-1 (tmax 0.8 h, range 0.4-1.2 h). AUC after MM-K (4.6 micrograms mL-1 h-1, range 2.1-6.3 micrograms ML-1 h-1) was also significantly (P less than 0.05) greater than after PE-K (1.6 micrograms mL-1 h-1, range 1.0-2.1 micrograms ML-1 h-1). However, the bioavailability of vitamin K1 after administration of MM-K was poor (9.4%), and there was considerable intra-individual variability between the concentrations of vitamin K1 recorded in the plasma samples. Both preparations of vitamin K1 stimulated clotting factor synthesis in rabbits anticoagulated with the potent and long-acting coumarin, brodifacoum. Maximum stimulation of clotting factor synthesis by vitamin K1 after MM-K was 87%, range 44-124% (%PCA). The maximum was seen later (tmax 12 h) than after PE-K (PCA 82%, range 47-125%; tmax 5 h). However, there was considerable intra-individual variability in response to both MM-K and PE-K.(ABSTRACT TRUNCATED AT 250 WORDS)

4-Hydroxycoumarins↗

Impact of the variability of cyclosporin A trough levels on long-term renal allograft function.

BACKGROUND: Among renal allograft recipients, there is a considerable variability in cyclosporin A (CsA) trough levels. Some of the CsA metabolites are pharmacologically active. The variability of polyclonal CsA trough levels may contribute to the fact that long-term renal allograft survival is still not satisfactory. In a retrospective, single-centre study, we investigated the influence of the variability of polyclonal CsA trough levels on long-term renal allograft function. METHODS: Patients (n=381) received double immunosuppression consisting of CsA and methylprednisolone (MP). For each patient the CsA coefficient of variation (CCV) and the mean CsA trough level during the observation period (5 years) were calculated. Based on receiver operating characteristic (ROC) analysis, patients were divided into two groups: group I, CCV <28.05%, n=231; group II, CCV >28.05%, n=150. Additionally, patients were divided into three groups according to their mean CsA trough level: group A, <270 ng/ml, n=50; group B, 270-370 ng/ml, n=282; group C: >370 ng/ml, n=49. RESULTS: Compared to group I, patients in group II experienced a higher incidence of acute rejection episodes (40.7% vs 29.4%, P=0.02), reduced 5-year graft survival (81.1% vs 93.3%, P=0.002), and higher serum creatinine levels (1.7+/-1.2 mg/dl vs 1.4+/-0.5 mg/dl, P=0.03). In patients with low mean CsA trough levels, the incidence of acute rejection episodes was elevated (group A vs B, 50.0% vs 30.9%, P=0.008) and 5-year graft survival was reduced (group A vs B, 79.8% vs 89.5%, P=0.005). Multiple logistic regression analysis confirmed that the risk of graft failure within 5 years after transplantation was markedly elevated in group II (RR: 6.2, P=0.013) and in group A (RR: 8.9, P=0.008). Whereas the effect of CCV on 5-year graft survival was still evident in patients with normal or high mean CsA trough levels (>270 ng/ml, 81.9% vs 94.8%, P=0.0005), graft survival was independent from CCV in patients with low mean CsA trough levels (<270 ng/ml, 77.0% vs 81.7%, P=NS). CONCLUSIONS: Both, the intra-individual variability and the mean of polyclonal CsA trough levels influence long-term renal allograft survival. Targeting at sufficiently high mean CsA levels with a low intra-individual variability may help to further improve long-term renal allograft survival.

Analysis of Variance↗

Individual difference variables that predict response to training in phonological awareness.

The cognitive abilities that predicted growth in response to a 12-week training program in phonological awareness were investigated with a sample of 100 kindergarten children. The children were selected from two elementary schools with historically low achievement in reading. Sixty children received training in both analytic and synthetic awareness skills, and 40 children constituted a no-treatment control group. Pretest measures included assessment of phonological awareness, phonological memory and naming rate, letter knowledge, reading and spelling, and general verbal ability. Growth in phonological awareness was assessed during the middle and at the end of the training period. Hierarchical linear modeling was used to estimate individual growth curves in phonological awareness for children in both the treatment and control groups. Initial comparisons between children in the two groups indicated substantial overall training effects in phonological awareness for children in the treatment group. For children in the training group, the model that best predicted growth in analytic awareness included invented spelling and general verbal ability, while growth in synthetic awareness was predicted best by a combination of invented spelling and rapid automatic naming of digits.

Awareness↗

Role of hypokinesia and bradykinesia in gait disturbances in Huntington's disease: a biomechanical study.

OBJECTIVE: To evaluate specific patterns of locomotion in Huntington's disease (HD) and notably the respective roles of hypokinesia (i. e. a decrease in the amplitude of movement) and bradykinesia (i. e. difficulty in executing a movement, slowness) in gait disturbance. METHODS: Kinematic, spatial (stride length, speed), temporal (cadence, speed, and stride time) and angular gait parameters (joint ankle range) were recorded in 15 early-stage HD patients by means of a video motion analysis system and then compared with 15 controls and 15 Parkinson's disease (PD) patients. Hypokinesia was studied in terms of both spatial (decrease in stride length) and angular gait parameters (decrease in joint ankle range), whereas hyperkinesia was characterized by an increase in joint ankle range. Bradykinesia (defined by a decrease in gait velocity) was also assessed in terms of temporal parameters (cadence, stride time). We studied the influence of clinical symptoms (motor dysfunction, chorea, overall disability and cognitive impairment) and the CAG repeat number on gait abnormalities. RESULTS: we observed a clear decrease in gait speed, a decrease in cadence and an increase in stride time (i. e. bradykinesia) for HD, with significant intra-individual variability. Cadence remained normal in PD. In HD, there was no evidence for a clear decrease in stride length, although the latter is a characteristic feature of hypokinetic gait (such as that observed in PD). Angle analysis revealed the coexistence of hyperkinesia and hypokinesia in HD, which thus participate in gait abnormalities. Gait speed in HD was correlated to the motor part of the UHDRS. CONCLUSION: Gait in HD is mainly characterized by a timing disorder: bradykinesia was present, with severe intra-individual variability in temporal gait parameters.

Adult↗

Imaging genomics and response to treatment with antipsychotics in schizophrenia.

Recent important advancements in genomic research have opened the way to new strategies for public health management. One of these questions pertains to how individual genetic variation may be associated with individual variability in response to drug treatment. The field of pharmacogenetics may have a profound impact on treatment of complex psychiatric disorders like schizophrenia. However, pharmacogenetic studies in schizophrenia have produced conflicting results. The first studies examined potential associations between clinical response and drug receptor genes. Subsequent studies have tried to use more objective phenotypes still in association with drug receptor genes. More recently, other studies have sought the association between putative causative or modifier genes and intermediate phenotypes. Thus, conflicting results may be at least in part explained by variability and choice of the phenotype, by choice of candidate genes, or by the relatively little knowledge about the neurobiology of this disorder. We propose that choosing intermediate phenotypes that allow in vivo measurement of specific neuronal functions may be of great help in reducing several of the potential confounds intrinsic to clinical measurements. Functional neuroimaging is ideally suited to address several of these potential confounds, and it may represent a powerful strategy to investigate the relationship between behavior, brain function, genes, and individual variability in the response to treatment with antipsychotic drugs in schizophrenia. Preliminary evidence with potential susceptilibity genes such as COMT, DISC1, and GRM3 support these assumptions.

Antipsychotic Agents↗

On the relationship between EEG and P300: individual differences, aging, and ultradian rhythms.

The literature on the relationship between background EEG and event-related brain potentials (ERPs) is reviewed, with the conclusion that variation in the former can contribute to individual variability in the latter. The effects of background EEG activity on the P300 component are then described using the results of three experiments. Study 1 assayed the association between EEG spectral power/mean frequency and P300 amplitude/latency measures in young adults. For the slower delta, theta, and alpha bands generally strong correlations who obtained for both types of measures. Study 2 employed similar techniques to assess a large sample of adults who varied in age from 20-80+ years. EEG power in the slower bands was correlated positively with P300 amplitude across the age range, but few effects for mean frequency/component latency were observed. Study 3 measured a group of young adults ten times very 20 min to assess for temporal changes in the relationship between EEG and ERPs. The correlations between spectral power and P300 amplitude measures were found to vary in a manner that suggested the influence of ultradian rhythms on neuroelectric activity. Taken together, the findings from all three study indicate that background EEG variation contributes significantly to the individual variability of the P300 ERP. Theoretical and applied implications of the findings are discussed.

Activity Cycles↗

Expression of acquired immunity to a local isolate of Haemonchus contortus by the Nigerian West African Dwarf goat.

The capacity of young Nigerian West African Dwarf (WAD) goats to express good acquired immunity to their native geographic strain of Haemonchus contortus and the correlates of this responsiveness were studied in a laboratory experiment involving forty 7-8 month old kids. A primary immunising infection with 2000 L3 (equivalent to 260-450 L3/kg body weight) with or without challenge on D42 with 2000 L3 resulted in a mild chronic infection with a pre-patent period of 18-20 days and little or no reduction in worm burden between D14 and D56. In contrast, another group (D) of kids, whose immunising infection had been truncated with fenbendazole on D35 and later received similar challenge infection, developed good protection against challenge. Thus, worm burdens were largest in group E (challenge control), larger in group C (primary+challenge) and least in group D. Of the measures of infection used, namely faecal worm egg counts (FECs), circulating eosinophil (EOS) responses, packed cell volume (PCV) and body weight, FEC and EOS responses exhibited marked individual variability, but only FEC (geometric mean of transformed counts) and PCV showed strong correlation with worm burden. There was also a significant negative correlation between FEC and PCV. The size of inoculum used was well tolerated by the kids, as it induced only mild changes in PCV in some goats and no effect at all on body weights. This suggests that the WAD goat may possess a good measure of resistance to the pathogenic effects of its native strain of H. contortus. The wide individual variability in FEC and its strong relationships to worm burden and PCV are pointers to its likely genetic basis. There are, therefore, good prospects for further studies to identify H. contortus resistant genotypes among the WAD goat population.

Animals↗

Longitudinal chromatic aberration of the human eye and wavelength in focus.

The wavelength in focus on the retina was determined for 14 observers from measurements of the longitudinal chromatic aberration of the eye. Measurements were made at two viewing distances: 3 m and 40 cm. The results show a large amount of individual variability for the wavelength in focus at each distance. The range of values at 3 m was 457 to 593 nm with a mean of 518 nm, and 375 to 548 nm with a mean of 468 nm at 40 cm. The chromatic aberration measured at 3 m is the same as previously reported data by other investigators for distant viewing. The average results of this study indicate very little difference for the chromatic aberration measured at near compared to distant viewing but, again, considerable individual variability exists.

Accommodation, Ocular↗

Variability of breast sucking, associated milk transfer and the duration of lactational amenorrhoea.

Quantitative relationships between physical parameters of sucking, milk transfer and the duration of amenorrhoea were examined in normal mother-baby pairs under exclusive breastfeeding. Sucking pressures were recorded twice on the second and once on the fifth month after birth, during complete breastfeeding episodes, by means of a catheter attached to the nipple and connected to a pressure transducer, the signals of which were analysed by computer. Babies were weighed before and after each sucking episode to estimate milk transfer. In the first nursing episode after noon, 2-month-old babies sucked from 140 to > 800 times during 4-15 min from the first breast, obtaining from 20 to > 100 g milk. The physical parameters of sucking and milk transfer exhibited high inter-individual but low intra-individual variabilities. There were significant differences in the physical parameters of sucking and milk transfer efficiency between first and second breast and between the second and fifth months after birth. Milk transfer efficiency was inversely correlated with time occupied by non-sucking pauses > or = 1.5 s, and was directly correlated with mean intersuck intervals in the first breast and with duration of the sucking episode, number of sucks, mean pressure and area under the pressure curve in the second breast. There was no correlation between the physical parameters of sucking and duration of lactational amenorrhoea (n = 62). However, significantly more mothers had amenorrhoea lasting > 180 days among those whose babies spent a longer proportion of the nursing episode in non-sucking pauses > or = 1.5 s. This finding indicates that sensory stimulation of the nipple produced during a nursing episode by stimuli other than sucking itself may have an important role in sustaining lactational amenorrhoea. It is concluded that nursing episodes have a complex structure that allows the development of a breastfeeding phenotype in each mother-baby pair, exhibiting important inter-individual variability. The present analysis does not support the contention that this source of variability accounts for the variability in the duration of lactational amenorrhoea.

Amenorrhea↗

Evaluation of reproducibility of solid-phase gastric emptying in healthy subjects.

Radionuclide gastric emptying studies are performed as a matter of clinical routine. Our aim was to evaluate the inter- and intra-individual variability and the reproducibility of gastric emptying studies in healthy young male volunteers using a single solid-phase, standard meal. The meal consisted of a pancake (500 KJ) tagged with technetium 99m sulphur colloid and no additional liquid. Continuous acquisitions of gastric activity in anterior projection were taken during 90 min, starting from the onset of the meal. Gastric emptying was evaluated three times in a 3-week period. Five different parameters were evaluated. Our results show that there is important inter- and intra-individual variability in normal volunteers. In spite of this variability, no significant difference between the different series of gastric emptying studies was observed.

Adult↗

Passive sustainable hydration of the stratum corneum following surfactant challenge.

Surfactants exhibit a protein-denaturating potency which is responsible for water uptake and swelling of the stratum corneum. There is also an increased transepidermal water loss related to the alteration of the barrier function. In the present prospective study, we evaluated sodium lauryl sulphate (SLS)-dependent changes in electrometric properties of skin. Single and iterative SLS challenges were performed. Measurements were made using a NOVA DPM on continuous mode for 5 min in order to assess both the baseline surface hydration and the rate of changes during probe occlusion. The present noninvasive instrumental evaluation of surfactant irritancy shows high sensitivity in each subject, but suffers from large inter-individual variability in the skin response following single and iterative sodium lauryl sulphate (SLS) challenges. The baseline surface hydration, that is almost unaffected 1 h after removing SLS patches, significantly decreases after a lag time of 24 h. The rate of water accumulation in the stratum corneum during the probe occlusion is significantly increased by SLS and is proportional to the SLS concentration and the number of iterative patches. Single water- or SLS-patch-tests fail to predict the skin response to cumulative SLS challenges and inter-individual variability is large for all electrometric variables.

Adult↗

Offset control during recurrent 20% carbon dioxide-enriched air induction: relation to individual difference variables.

Although control over aversive events maintains a central role in contemporary models of anxiety pathology, particularly panic disorder, there is little understanding about the emotional consequences of specific types of control processes. In the present study, offset control over 8 20% carbon dioxide-enriched air administrations was experimentally manipulated in a large nonclinical population (n = 96) varying in anxiety sensitivity (high or low) and gender. Dependent measures included self-reported anxiety, affective reports of valence, arousal, emotional control, and physiological indices of heart rate and skin conductance. High anxiety-sensitive participants who lacked offset control reported significantly greater elevations in self-reported anxiety, emotional displeasure, arousal, and dyscontrol relative to their yoked counterparts with offset control. In contrast, low anxiety-sensitive individuals responded with similar levels of cognitive and affective distress regardless of the offset control manipulation. Although the provocation procedure reliably produced bodily arousal relative to baseline, at a physiological level of analysis, no significant differences emerged across conditions. These findings are discussed in relation to offset control during recurrent interoceptive arousal, with implications for better understanding anxiety about abrupt bodily sensations.

Adult↗

Polymorphisms in factor II and factor VII genes modulate oral anticoagulation with warfarin.

BACKGROUND AND OBJECTIVES: There is very considerable inter-individual variability in warfarin dosages necessary to achieve target therapeutic anticoagulation. The variability is largely genetically determined but can only partly be explained by genetic variability in the cytochrome CYP2C9 locus. Polymorphisms within the genes coding for vitamin K-dependent proteins have been suggested to predict sensitivity to warfarin therapy. DESIGN AND METHODS: In a cohort of 147 patients followed-up at one specialized clinic from the start of anticoagulation with warfarin, we investigated whether factor II (Thr165Met; G20210A) and factor VII polymorphisms (G-402A; G-401T) affected the doses of warfarin necessary to acquire the target intensity of anticoagulation. RESULTS: Regardless of the presence of confounding variables, the mean adjusted dose of warfarin required was higher among patients with the factor II Thr/Thr 165 genotype (4.2 mg) than among patients carrying the Met165 allele (2.9 mg; p=0.041) and higher in carriers of the factor VII GG-401 genotype (4.1 mg) than in those with the T-401 allele (3.1 mg; p=0.029). No significant effect was found for factor II A20210G and factor VII G-402A polymorphisms. All together, the genetic variants investigated accounted for about a quarter (r2: 0.261) of the inter-individual variability calculated in the present setting. INTERPRETATION AND CONCLUSIONS: Genetic variants of factor II and factor VII modulate the mean daily dose of warfarin required to achieve a target intensity of anticoagulation.

Administration, Oral↗

Variables associated with the assessment of systemic tumor necrosis factor alpha levels during hemodialysis.

Conflicting results have been published concerning the systemic induction of the cytokine tumor necrosis factor alpha (TNF alpha) during hemodialysis (HD). We therefore evaluated in vitro TNF alpha production in whole blood as well as in vivo variability of TNF alpha levels in patients on long-term HD. Whole blood was incubated at room temperature (RT) with or without exogenously added endotoxin (ET), and plasma-TNF alpha was measured after 5, 30, 120, 240, and 960 min by specific enzyme immunoassay. Additionally, plasma-TNF alpha before and after 120 and 240 min HD was studied longitudinally once a week over a period of 4 weeks in 36 patients on Cuprophan (CU, n = 23) or polysulfone-F60 (PSu, n = 13) HD. Mean plasma TNF alpha levels in vitro rose from (mean) 8 pg/ml after 5 min to 12 pg/ml (120') and 32 pg/ml (960') even without ET addition, and to 18 pg/ml (after 120') and 88 pg/ml (after 960') when 0.1 microgram/ml ET were added. Pre-dialytic as well as intra-dialytic TNF alpha levels in patients showed high intra-individual variability. A substantial (> 100%) increase in plasma TNF alpha was observed during only 14 out of 84 treatments with CU and 20 out of 47 with PSu, however, the increase in TNF alpha was not statistically significant in either group. We conclude that the sampling procedure, if not carefully standardized, is a potential source of artifacts with regard to "systemic" TNF alpha levels. The high intra and inter-individual variability of plasma TNF alpha suggests that results of cross-sectional studies are questionable.

Cellulose↗

Real-time polymerase chain reaction analysis of CYP1B1 gene expression in human liver.

Procarcinogen-activating cytochrome P450 (CYP) enzymes such as CYP1B1, CYP1A1, and CYP1A2 are considered to play an important role in chemical carcinogenesis. However, conflicting data exist with respect to CYP1B1 expression in human liver. In the present study, we measured CYP1B1 mRNA and protein expression in liver samples from 12 individuals (7 nonsmokers, 4 smokers, and 1 ex-smoker) and compared the levels to those of CYP1A1 and CYP1A2. As analyzed by real-time polymerase chain reaction, CYP1B1 mRNA was present in all samples and the inter-individual variability was 16-fold. The group mean level was 5-fold greater in smokers than nonsmokers (121 +/- 46 vs. 26 +/- 5 molecules/ng double-stranded DNA, p < 0.05). By comparison, CYP1A1 mRNA was detectable in samples from 4 of 7 nonsmokers, 3 of 4 smokers, and one ex-smoker, whereas CYP1A2 mRNA was detectable in samples from 5 nonsmokers, 4 smokers, and the ex-smoker. The mean levels of CYP1A1 and CYP1A2 mRNA were 4-fold and 9-fold greater, respectively, in smokers than nonsmokers, but the differences were not statistically significant. The inter-individual variability in CYP1A1 and CYP1A2 mRNA expression was 26-fold and 500-fold, respectively. Immunoblot analysis using several antibodies and with a larger panel (n = 27) of liver microsomes showed that CYP1A1 and CYP1B1 proteins were undetectable, whereas CYP1A2 was detectable in all samples and quantifiable in 24 of 27 samples. In summary, our novel finding indicates that CYP1B1 mRNA is expressed in human liver and the levels are increased in smokers, but the protein is undetectable.

Adolescent↗

Variability in individual cell cycles of Saccharomyces cerevisiae.

The kinetics of cell proliferation of Saccharomyces cerevisiae were studied at 4 growth rates using time-lapse cinephotomicrography. Cells were grown on media with a high refractive index to reveal greater intracellular detail under the phase-contrast microscope. The morphological cell-cycle events scored were: bud emergence, nuclear migration, nuclear division, onset of cytokinesis and cell separation. Cell size was measured at cell separation and at bud emergence. The daughter-cycle time was always longer than the parent-cycle time mainly due to the large difference in the lengths of the unbudded phases. Parent cells had a shorter budded period than daughter cells. The large variance in daughter-cycle times was accounted for by the large variance in the lengths of the unbudded phase of daughter cells. The duration and variability of the periods in the cyclc from nuclear migration onwards were equivalent for parent and daughter cells. Daughter cells were always smaller than parent cells at division. There was wide variation in cell size at both division and bud emergence. The results indicated that a modified deterministic model could best explain cell proliferation kinetics in yeast. The data were used to evaluate 2 different models. The 'sloppy size control' model of Wheals (1981 a) was more consistent with the data than the 'tandem' model of Shilo, Shilo & Simchen (1976). The distribution of unbudded periods of daughter cells suggested that there was an additional incompressible period not present in parent cells.

Cell Cycle↗

The effects of aerobic exercise on psychological and behavioral variables of individuals with developmental disabilities: a critical review.

Physical fitness of persons who are developmentally disabled has received relatively little attention in the special education literature when compared to intellectual functioning (e.g., learning, memory, and language) and to acquisition of functional skills (e.g., self-care, community, and vocational). Despite an increased interest in recreational programming stimulated by the concept of functional curricula, teachers may still be reluctant to include physical fitness activities in their students' schedules. Perhaps physical fitness programming for those with developmental disabilities would have wider appeal and application if it were embedded in the broader context of psychological and behavioral change (i.e., engagement in exercise produces generalized changes beyond direct improvement in physical well-being). This article is a review and critique of literature that focuses on the effects of participation in aerobic exercise on three classes of psychological/behavioral variables for persons with mental retardation and associated disabilities. The methodology that characterizes this literature is analyzed, and recommendations for future research are proposed.

Persons with Disabilities↗

Determination of fetal age by immunohistochemical estimation of surfactant-producing alveolar type II cells.

We monitored the immunohistochemically determined amount of surfactant-producing alveolar type II cells in human fetal lung using polyclonal antibodies against apoprotein B and C of human pulmonary surfactant. Lungs of 30 dead-born fetuses without lung affection aged between 15 and 38 weeks of gestation were evaluated and the surface density of surfactant-producing alveolar type II cells was determined by morphometry. In lungs of fetuses with a gestational age less than 22 weeks no relevant number of positively reacting cells could be found. Between the 22nd and 29th week a progressive increase with considerable inter-individual variability was observed. From the 30th week on the number of the type II pneumocytes appeared rather constant without further significant increase. We provide evidence that the immunohistochemical detection of surfactant-producing alveolar type II cells is useful for the determination of the age of unknown and especially fragmented fetuses: The lack of surfactant-producing alveolar type II cells in fetal lungs before the 22nd week allows a rather safe distinction between fetal lungs of higher age from those of lesser age. Between the 22nd and 29th week an age-dependent increase in the number of these cells occurs with wide inter-individual variability allowing only an approximate age determination. In particular, this may be an important piece of information in fragmented fetal corpses. Furthermore, the number of surfactant-producing alveolar type II cells provides additional information on pulmonary maturation and may thus be helpful in the estimation of a theoretical survival chance.

Apoproteins↗