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PubMed1991

Application of the Hydra attenuata assay for identifying developmental hazards among natural waters and wastewaters.

This study concerns application of the Hydra attenuata assay to detect the developmental toxicity potential of various aqueous samples. First, the assay was modified for testing aqueous samples because water quality has a major impact on aquatic toxicity testing and the results thus obtained. Ranges of sample pH, salinity (conductivity), and hardness were examined for their adverse effects upon the hydra. Adult hydra were unaffected morphologically by pH 5.5-9.5, and the artificial embryo ("embryo") developed normally in a pH range of 6.25 to 8.25. For water hardness, the minimal affective concentration was 1000 mg/liter (as CaCO3) in adults and 625 mg/liter in the embryos; the NOAELs for these were 750 mg/liter in the adult and 250 mg/liter CaCO3 in the embryo. Salinity in excess of 5 ppt was lethal to adults and embryos, indicating the assay may not be applicable to marine or highly saline samples. Finally, grab samples were tested from rivers in Maryland, Pennsylvania, New Jersey, and Delaware, some of which are impacted by industrial and agricultural activities, as well as several samples of industrial wastewaters from one major facility. The assay functioned normally with these diverse samples and yielded results that can be used in assessing the potential developmental hazard of these materials.

Animals↗
PubMed1994

Active and passive protection against variant and classic infectious bursal disease virus strains induced by baculovirus-expressed structural proteins.

Infectious bursal disease virus (IBDV) is responsible for a highly immunosuppressive disease in young chickens which causes significant economic losses to the poultry industry worldwide. The structural protein genes (VP2, VP3 and VP4) of a variant IBDV strain (GLS) were expressed in insect cells using a baculovirus expression system. Susceptible chickens vaccinated with a single dose of the recombinant IBDV antigens were completely protected against challenge with two variant strains of IBDV (GLS and Delaware), and partially protected against the standard challenge strain (STC). A booster dose of the recombinant antigens induced higher levels of neutralizing antibodies and afforded complete protection against both variant and standard virus challenges. Specific-pathogen-free hens vaccinated with a single dose of the same subunit vaccine produced virus-neutralizing antibodies that were capable of passively protecting the progeny from infection with variant IBDV.

Animals↗
PubMed1990

Stability-complexity relationships within models of natural systems.

Drawing on the qualitative loop analysis models prepared by Lane for a Delaware Bay plankton community, we evaluated 12 systems that ranged from 14 to 18 entities (population, guild or nutrient). Our approach was to study models of extended trophic biotic communities and examine the stability-complexity issue not only as it exists between systems (the traditional approach) but also with respect to the entities and relationships within a given system. We found no statistically significant inverse relationship for stability and complexity between systems. Within a system, a significant inverse relationship at the entity level was observed embedded in an increasing stability positively related to increasing subsystem size. Also, within a system and from system to system, several entities were seen to vary their roles with respect to stability. These results extend the stability-complexity issue to models of relatively large biotic communities and raise issues concerning the roles, with respect to stability, played by entities within communities.

Animals↗
PubMed1993

Juvenile orthodontic treatment claims within a large dental insurer.

Despite many investigations regarding the relationship of health care insurance and the use of dental services, few studies have specifically examined coverage for orthodontic care. This preliminary investigation provides descriptive data concerning orthodontic services from one of the nation's largest health care insurance companies. Of the more than 1.3 million juvenile patients (ages 5 through 15 years) treated between 1986 and 1989, approximately 10.6% received comprehensive orthodontic therapy. Claims were also analyzed for variation across states and National Institute for Dental Research (NIDR) regions (with Alaska and Hawaii comprising region VIII) in terms of use and class of malocclusion. The largest percentage of comprehensive orthodontic cases in relation to the number of persons receiving any dental care exists in region III (Midwest) (11.6%). Analysis by state shows Washington, Delaware, and Pennsylvania as the leading orthodontic providers (14.3%, 13.5%, and 13.0%, respectively). Female patients comprised 56.5% of those with full-mouth treatment. Treatment most frequently commences at ages 12 years (23%) and 13 years (21.8%). In terms of classes of malocclusion, comprehensive treatment for Angle Class II is predominant (55.7%), followed by Class I (40.1%), and Class III (4.2%). Relative to total orthodontic use, Region VIII demonstrates the highest concentration of Class I patients (46%). Region I (New England) displays the greatest number of Class II cases (59.8%), whereas the largest number of Class III patients is found in the southeastern United States (region IV) (5.2%). Overall, the use of comprehensive orthodontic treatment is relatively constant over all regions, (except regions V, VI, and VIII, which fall below 10%), and mirrors that of overall dental services.

Adolescent↗
PubMed2005

Tobacco use, secondhand smoke exposure and their related knowledge, attitudes and behaviors among Asian Americans.

The present study examined tobacco use, secondhand smoke exposure and related knowledge, attitudes and behaviors among Asian Americans in the Delaware Valley of Pennsylvania and New Jersey, and the relationship between acculturation and smoking, social influence patterns on smoking, and stages of change of smoking among Asian subgroups. Study sample was 1174 Chinese, Koreans, Vietnamese, Cambodians, and other Asians. Findings revealed mean age of initiation to be 18.3, 40% ever and 30% current users. Significant differences were reflected in smoking by gender, ethnicity, educational level, marital and employment status. While knowledge and attitudes about smoking and secondhand smoke were associated with these variables, ethnic pride and smoking status played significant roles. Fathers and brothers had greater social influence on young male smoking behavior; smoking friends had influence on both genders. Stages of change of smoking and acculturation impact on smoking varied with gender, age, and time living in the U.S. Findings provide comprehensive insights into tobacco use and related KAB among Asian Americans that reflect the need for developing culturally appropriate programs for this underserved population.

Acculturation↗
PubMed2004

Twice-yearly exams unnecessary for patients taking quetiapine.

PURPOSE: To determine the necessity for the heightened level of monitoring for cataract development in patients taking quetiapine (Seroquel, AstraZeneca Pharmaceuticals, Wilmington, Delaware) dictated by the Physicians' Desk Reference. Also, to explore the possibility of cataractogenesis because of quetiapine therapy. DESIGN: Observational case series. METHODS: Data were garnered from a series of 80 case reports collected at the National Registry of Drug-Induced Ocular Side Effects (Portland, Oregon). The World Health Organization (WHO) causality assessment guidelines were used to assess the relationship between quetiapine and cataractogenesis. RESULTS: There were 34 reports of cataracts associated with quetiapine therapy. Average age was 44 years with 23 females and 11 males studied. Average duration of therapy was 29.3 weeks on standard doses. CONCLUSIONS: Cataractogenesis secondary to quetiapine is "unlikely" by WHO guidelines. This probably makes it unnecessary to require biannual ophthalmic examinations as routine eye examinations are sufficient to screen for this condition.

Adolescent↗
PubMed2005

Using the Omaha System to document the wellness needs of the elderly.

Capturing health promotion, education, and disease prevention outreach service data and outcomes is difficult. The rapid pace of health fairs that offer free health services challenges record keeping. To address this issue, the University of Delaware Nursing Center developed short, efficient survey tools using the Omaha System of documentation. These tools allow for standardization of data, easy record keeping, and focused health assessments by various providers.

Aged↗
PubMed2006

A predictive model for copper partitioning to suspended particulate matter in river waters.

A chemical equilibrium-based predictive model expressing Cu partitioning as a function of aqueous and solid phase characteristics was developed. The model takes into account only the most important factors that govern Cu partitioning, and therefore results in a relatively simple formulation. It assumes particulate organic carbon (POC) and dissolved organic carbon (DOC) binding sites play the most important role in solid and aqueous phases. The model formulation assumed one-surface site and two dissolved organic matter (DOM) sites, and included the "solids effect". Proton effects were considered for both the particle surface sites and the DOM. The model was calibrated with data for samples collected from the Susquehanna River, and validated with White Clay Creek and Delaware River samples. Copper partitioning in natural water systems with different pH, and concentrations of alkalinity, DOC, POC, total suspended solids (TSS), and total copper was predicted reasonably well.

Binding Sites↗
PubMed2008

Percutaneous closure of an iatrogenic atrial septal defect.

We report the successful percutaneous closure of an iatrogenic atrial septal defect in a 71-year-old woman. The patient had undergone mitral valve replacement and coronary artery bypass grafting, followed by redo surgery to repair a para-valvular mitral leak. Post-operatively she remained significantly limited by dyspnoea. Repeat transoesophageal echocardiography documented a large iatrogenic atrial septal defect. The patient underwent percutaneous, trans-femoral closure of the defect using the Helex septal occluder (W.L. Gore, Newark, Delaware, USA) with dramatic clinical improvement.

Aged↗
PubMed2006

Gene expression in normal urothelium depends on location within the bladder: a possible link to bladder carcinogenesis.

OBJECTIVES: Clinical studies have shown that more than 70% of primary bladder tumours arise in the area around the ureteric orifice. In this study a genomic approach was taken to explore the molecular mechanisms that may influence this phenomenon. METHODS: RNA was isolated from each individual normal ureteric orifice and the dome biopsy from 33 male patients. Equal amounts of the pooled ureteric orifice and dome mRNAs were labelled with Cy3 and Cy5, respectively before hybridising to the gene chip (UniGEM 2.0, Incyte Genomics Inc., Wilmington, Delaware, USA). RESULTS: Significant changes (more than a twofold difference) in gene expression were observed in 3.1% (312) of the 10,176 gene array: 211 genes upregulated and 101 downregulated. Analysis of Cdc25B, TK1, PKM, and PDGFra with RT-PCR supported the reliability of the microarray result. Seladin-1 was the most upregulated gene in the ureteric orifice: 8.3-fold on the microarray and 11.4-fold by real time PCR. CONCLUSIONS: Overall, this study suggests significant altered gene expression between these two anatomically distinct areas of the normal human bladder. Of particular note is Seladin-1, whose significance in cancer is yet to be clarified. Further studies of the genes discovered by this work will help clarify which of these differences influence primary bladder carcinogenesis.

Adult↗
PubMed2006

The effects of combined versus selective adrenergic blockade on left ventricular and systemic hemodynamics, myocardial substrate preference, and regional perfusion in conscious dogs with dilated cardiomyopathy.

OBJECTIVES: Given that adverse effects of chronic sympathetic activation are mediated by all three adrenergic receptor subtypes (beta1, beta2, alpha1), we examined the effects of standard doses of carvedilol and metoprolol succinate (metoprolol controlled release/extended release [CR/XL]) on hemodynamics, myocardial metabolism, and regional organ perfusion. BACKGROUND: Both beta1 selective and combined adrenergic blockade reduce morbidity and mortality in heart failure. Whether there are advantages of one class over the other remains controversial, even in the wake of the Carvedilol Or Metoprolol European Trial (COMET). Similarly, the mechanistic basis for the relative differences is incompletely understood. METHODS: Thirty-three conscious, chronically instrumented dogs with pacing-induced (240 min(-1) for 4 weeks) dilated cardiomyopathy (DCM) were randomized to carvedilol (25 mg twice daily, Coreg, Glaxo Smith Kline, Research Triangle, North Carolina) or metoprolol succinate (100 mg qd, Toprol XL, Astra Zeneca, Wilmington, Delaware). Left ventricular and systemic hemodynamics, myocardial substrate uptake, and norepinephrine spillover were measured before and after three days of treatment. Regional (renal, hepatic, skeletal muscle) blood flows were measured using neutron-activated microspheres. RESULTS: Both agents had comparable heart rate effects. However, carvedilol-treated dogs showed significantly greater increases in stroke volume and cardiac output and decreases in left ventricular end-diastolic pressure and systemic vascular resistance. Carvedilol increased renal, hepatic, and skeletal muscle blood flow. Carvedilol increased myocardial glucose uptake and suppressed norepinephrine and glucagon. Carvedilol antagonized the response to exogenous norepinephrine to a greater extent than metoprolol CR/XL. CONCLUSIONS: At doses inducing comparable heart rate reductions, short-term treatment with carvedilol had superior hemodynamic and metabolic effects compared with metoprolol CR/XL. These data suggest important advantages of blocking all three adrenergic receptor subtypes in DCM.

Adrenergic Antagonists↗
PubMed2004

Development of a culturally appropriate smoking cessation program for Chinese-American youth.

PURPOSE: To identify potential cultural factors to enhance the efficacy of smoking cessation curricula for Asian-American adolescents, Chinese-Americans, and to present the process and challenges of implementing a culturally specific curriculum. METHODS: Chinese-American male (n = 17) youth smokers, aged 14-19 years, were recruited from community-based Asian-American organizations in the Delaware Valley Region of Pennsylvania and New Jersey. A 36-item questionnaire was developed to measure smoking behavior, attitudes, and culturally related factors. Focus groups were conducted. Cultural themes were addressed, such as interdependency and collective orientation of the Asian culture, importance of harmony in Asian families, and culturally related factors for smoking initiation and maintenance. A pre-post quasi-experimental research design was used. Data were analyzed using the Mann-Whitney U test to determine differences in the intervention and control groups in smoking behavior and the Chi-square test for differences in program characteristics. RESULTS: Participants almost never read their native language, they disagreed that their friends would accept them more if they were nonsmokers, and they thought they smoked because of high parental expectations. Asian teens perceived that a high percentage of their Asian-American peers smoke. The most important facilitator characteristics, program processes, relevant cultural factors and topics were identified for the program. Two groups were compared, a standard smoking cessation curriculum (SC) and a culturally modified program (ACT) for Asian adolescents. A 23.1% quit rate for the SC program and an 18.2% quit rate for the ACT program at 3-month follow-up was achieved. Among participants who continued to smoke, there was a larger reduction in reported weekend and weekday cigarette use among ACT participants, than the Standard (SC) group. There was a reduction of 6.7 cigarettes on a typical weekday and 6 cigarettes on a typical weekend day for ongoing smokers of the ACT group. CONCLUSIONS: Given the positive results among a high-risk population, the ACT program needs to be tested among a larger population of Chinese-Americans.

Adolescent↗
PubMed2005

Environmental and economic analysis of switchgrass production for water quality improvement in northeast Kansas.

The primary objectives of this research were to determine SWAT model predicted reductions in four water quality indicators (sediment yield, surface runoff, nitrate nitrogen (NO(3)-N) in surface runoff, and edge-of-field erosion) associated with producing switchgrass (Panicum virgatum) on cropland in the Delaware basin in northeast Kansas, and evaluate switchgrass break-even prices. The magnitude of potential switchgrass water quality payments based on using switchgrass as an alternative energy source was also estimated. SWAT model simulations showed that between 527,000 and 1.27 million metric tons (Mg) of switchgrass could be produced annually across the basin depending upon nitrogen (N) fertilizer application levels (0-224 kg N ha(-1)). The predicted reductions in sediment yield, surface runoff, NO(3)-N in surface runoff, and edge-of-field erosion as a result of switchgrass plantings were 99, 55, 34, and 98%, respectively. The average annual cost per hectare for switchgrass ranged from about 190 US dollars with no N applied to around 345 US dollars at 224 kg N ha(-1) applied. Edge-of-field break-even price per Mg ranged from around 41 US dollars with no N applied to slightly less than 25 US dollars at 224 kg N ha(-1) applied. A majority of the switchgrass produced had an edge-of-field break-even price of 30 Mg(-1) US dollars or less. Savings of at least 50% in each of the four water quality indicators could be attained for an edge-of-field break-even price of 22-27.49 US dollars Mg(-1).

Costs and Cost Analysis↗
PubMed2004

How I do it: miniplate reconstruction of the lateral thyroid lamina: one-stage restoration of voice after teflon granuloma resection.

This case report describes a one-stage technique for long-term voice restoration and laryngeal reconstruction in the treatment of Teflon (Dupont, Wilmington, Delaware) granuloma. A patient who presented with severe dysphonia underwent resection of a Teflon granuloma via a lateral laryngotomy. A pedicled strap muscle flap was used to reconstruct the paraglottic space. The muscle flap was positioned through the lateral laryngotomy with direct endoscopic visualization of the endolarynx to ensure correct vertical positioning and medialization of the vocal fold. The muscle flap was secured in this position with suture fixation. The trapdoor piece of cartilage that was elevated to create the window in the lateral thyroid lamina was repositioned over the pedicled muscle flap and reinforced with a titanium miniplate, which was secured to the remaining thyroid cartilage. The patient had excellent voice results and has not required revision or augmentation. Reinforcement of the lateral thyroid lamina using titanium miniplate fixation helps to stabilize the muscle pedicle flap and the position of the vocal fold, in this case resulting in good long-term voice results after a single-stage reconstruction.

Female↗
PubMed2004

Narcotic antagonists in drug dependence: pilot study showing enhancement of compliance with SYN-10, amino-acid precursors and enkephalinase inhibition therapy.

We decided to test the hypothesis that possibly by combining a narcotic antagonist and amino-acid therapy consisting of an enkephalinase inhibitor (D-phenylalanine) and neurotransmitter precursors (L-amino- acids) to promote neuronal dopamine release might enhance compliance in methadone patients rapidly detoxified with the narcotic antagonist Trexan (Dupont, Delaware). In this regard, Thanos et al. [J. Neurochem. 78 (2001) 1094] and associates found increases in the dopamine D2 receptors (DRD2) via adenoviral vector delivery of the DRD2 gene into the nucleus accumbens, significantly reduced both ethanol preference (43%) and alcohol intake (64%) of ethanol preferring rats, which recovered as the DRD2, returned to baseline levels. This DRD2 overexpression similarly produced significant reductions in ethanol non-preferring rats, in both alcohol preference (16%) and alcohol intake (75%). This work further suggests that high levels of DRD2 may be protective against alcohol abuse [JAMA 263 (1990) 2055; Arch, Gen. Psychiatr. 48 (1991) 648]. The DRD2 A1 allele has also been shown to associate with heroin addicts in a number of studies. In addition, other dopaminergic receptor gene polymorphisms have also associated with opioid dependence. For example, Kotler et al. [Mol. Phychiatr. 3 (1997) 251] showed that the 7 repeat allele of the DRD4 receptor is significantly overpresented in the opioid-dependent cohort and confers a relative risk of 2.46. This has been confirmed by Li et al. [Mol. Psychiatry 2 (1997) 413] for both the 5 and 7 repeat alleles in Han Chinese case control sample of heroin addicts. Similarly Duaux et al. [Mol. Psychiatry 3 (1998) 333] in French Heroin addicts, found a significant association with homozygotes alleles of the DRD3-Bal 1. A study from NIAAA, provided evidence which strongly suggests that DRD2 is a susceptibility gene for substance abusers across multiple populations (2003). Moreover, there are a number of studies utilizing amino-acid and enkephalinase inhibition therapy showing reduction of alcohol, opiate, cocaine and sugar craving behavior in human trials (see Table 1). Over the last decade, a new rapid method to detoxify either methadone or heroin addicts utilizing Trexan sparked interest in many treatment centers throughout the United States, Canada, as well as many countries on a worldwide basis. In using the combination of Trexan and amino-acids, results were dramatic in terms of significantly enhancing compliance to continue taking Trexan. The average number of days of compliance calculated on 1000 patients, without amino-acid therapy, using this rapid detoxification method is only 37 days. In contrast, the 12 subjects tested, receiving both the Trexan and amino-acid therapy was relapse-free or reported taking the combination for an average of 262 days (p < 0.0001F). Thus coupling amino-acid therapy and enkephalinase inhibition while blocking the delta-receptors with a pure narcotic antagonist may be quite promising as a novel method to induce rapid detox in chronic methadone patients. This may also have important ramifications in the treatment of both opiate and alcohol-dependent individuals, especially as a relapse prevention tool. It may also be interesting too further test this hypothesis with the sublingual combination of the partial opiate mu receptor agonist buprenorphrine.

Adult↗
PubMed2006

Three presentations of monocular vision loss.

BACKGROUND: Carotid artery disease is estimated to affect 30% of persons older than 50. Risk factors include hypertension, cigarette smoking, hyperlipidemia and diabetes mellitus. Symptoms ascribed to carotid artery lesions with stenosis of the artery or plaque formation include monocular vision loss and transient ischemic attacks. Patients can present with transient monocular vision loss as their initial symptom. CASE REPORTS: Three patients from a geriatric clinic in Wilmington, Delaware presented with different complaints of vision loss with similar overall outcomes. Patient A was an 87-year-old woman who presented with dimming of vision on extreme left head turn. Dilated fundus examination found a retinal arterial emboli in the left eye (O.S.). Carotid duplex examination found 50% to 79% left internal carotid stenosis with no hemodynamic stenosis of the right internal carotid. Patient B was a 78-year-old woman who presented with a right superior altitudinal defect and transient vision loss in the right eye. Dilated fundus examination found retinal arterial emboli in the right eye (O.D.). Carotid duplex examination found 50% to 79% carotid stenosis in both the left and right internal carotids. Patient C was an 84-year-old man who complained of a superior altitudinal visual field defect O.D. Dilated fundus examination found a retinal arterial emboli O.D. Carotid duplex results showed calcified atherosclerotic plaques present at the level of the common carotid artery bifurcations bilaterally, with 50% to 70% narrowing of the right internal carotid artery with no significant narrowing of the left internal carotid artery. CONCLUSIONS: These 3 presentations show that in patients older than 50 who present with chief complaints of monocular vision loss, a differential diagnosis of carotid artery disease must be considered. Patients who exhibit retinal arterial emboli are at increased risk for stroke and vascular death. Appropriate measures for confirming a diagnosis include duplex ultrasound imaging, magnetic resonance angiography (MRA), and carotid angiography. Surgical techniques such as carotid angioplasty and carotid endarterectomy may be recommended.

Aged↗
PubMed2005

Gender of offspring and maternal ovarian cancer risk.

OBJECTIVE: A single live birth compared to nulliparity significantly reduces the risk for ovarian cancer, but exactly how pregnancy reduces ovarian cancer risk is unknown. We sought to determine whether offspring gender, which differentially alters maternal hormonal milieu, may be associated with maternal ovarian cancer risk. METHODS: Parous women (n = 511) with incident ovarian cancer were compared to parous community controls (n = 1136) participating in a population-based case-control study of ovarian cancer (Delaware Valley, 1994-1998). In subgroup specific models for women with one, two, or three births, multivariate logistic regression was used to assess the relationship between ovarian cancer and offspring gender, adjusting for age, race, education, oral contraceptives, breast feeding, tubal ligation, and ovarian cancer family history. RESULTS: Compared to having all girls, women with all boys tended to have a reduced risk of ovarian cancer (OR = 0.80 95% CI: 0.58, 1.10), while women with boys and girls conferred the greatest protection (OR = 0.58, 95% CI: 0.43, 0.79). Among women with two births, the association was observed for those with one boy and one girl (OR = 0.63, 95% CI: 0.40, 1.00), but not for those with two male offspring (OR = 1.12, 95% CI: 0.68, 1.85). This result was consistent among women with three births (OR = 0.42, 95% CI: 0.21, 0.84; OR = 0.47, 95% CI: 0.23, 0.95; OR = 0.49, 95% CI: 0.20, 1.21; for one, two, and three boys, respectively, compared to all girls). CONCLUSION: Compared to having all girls, bearing both male and female offspring may be associated with a decrease in maternal ovarian cancer risk, although the biologic relevance of this observation is unclear.

Adult↗
PubMed2005

Knowledge, attitudes and behavior regarding secondhand smoke among Asian Americans.

BACKGROUND: This study seeks to measure exposure to secondhand smoke and to evaluate potential differences in knowledge, attitudes, and tolerance of secondhand smoke among subgroups of Asian Americans in the Delaware Valley region of Pennsylvania and New Jersey. METHODS: A cross-sectional study was conducted among 1374 Asian Americans, which included Chinese, Koreans, Vietnamese, and Cambodians. The sample was selected by using a stratified-cluster proportional sampling technique. Study measures included demographic variables, smoking status, exposure to secondhand smoke, and knowledge, attitudes, and behavior regarding secondhand smoke. Data were analyzed using SPSS. RESULTS: Involuntary exposure to secondhand smoke remains a common public health hazard among Asian Americans, with 38.3% reporting exposure at home and 40.3% at the worksite. Knowledge and tolerance differed significantly by ethnic groups, gender, education, and smoking status. Knowledge level had a significant effect on tolerance behavior. CONCLUSIONS: Findings indicate an urgent need for a smoke-free policy at home, in the work place, and in public areas. Tobacco prevention/intervention and cessation programs for Asian Americans should emphasize the adverse health effects of secondhand smoke and promote a smoke-free environment. Further studies are needed to explore the unexplained differences in tolerance levels regarding secondhand smoke across ethnic groups.

Adult↗