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PubMed2003

Optical aberrations of the human anterior cornea.

PURPOSE: (1). To investigate the distribution of anterior corneal higher-order aberrations (HOAs, 3rd to 6th orders) in the population; (2). to evaluate the symmetry of anterior corneal aberrations between right and left eyes of individuals; and (3). to study the variations in anterior corneal aberrations with aging. SETTING: Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. METHODS: Using the CTView program (Sarver and Associates, Inc.), corneal HOAs were computed from the central 6.0 mm zone of the corneal topographic maps (Humphrey Atlas, Carl Zeiss, Inc.) of 228 eyes of 134 subjects (mean age 50 years +/- 17 (SD); range 20 to 79 years; manifest spherical equivalent between -3.0 and +3.0 diopters [D]). Correlation analysis was performed to investigate the aberration symmetry between the right and left eyes and to assess the association between anterior corneal HOAs and age. RESULTS: There was wide individual variability in aberrations with ranges of individual Zernike terms from -0.579 to +0.572 microm. The mean coefficient of the 4th-order spherical aberration (SA) (Z(4)(0)) was 0.280 +/- 0.086 microm and was positive in all corneas. The mean root-mean-square (RMS) values were 0.479 +/- 0.124 microm for HOA, 0.281 +/- 0.086 microm for SA (Z(4)(0)and Z(6)(0)), and 0.248 +/- 0.135 microm for coma (Z(3)(-1), Z(3)(1), Z(5)(-1), and Z(5)(1)). Moderate to high correlations were found between right and left eyes for HOA, SA, and coma (Pearson r = 0.565, 0.751, and 0.565, respectively; all P<.001); 8 of the 9 Zernike terms in the 3rd and 4th orders were significantly correlated between eyes (Bonferroni correction P'<.05/22). Higher-order aberration RMS and coma RMS increased with aging (r = 0.434 and 0.290, respectively; both P<.001); SA RMS was not correlated with change in age (r = 0.034). CONCLUSION: Anterior corneal wavefront aberrations varied greatly among subjects and increased slightly with aging. All corneas had positive 4th-order SAs, and the values did not change with aging. A moderate to high degree of mirror symmetry existed between right and left eyes.

Adult↗
PubMed1979

Efficacy of cognitive/noncognitive measures in predicting resident-physician performance.

There has been relatively little research on the relationship between the clinical performance of physicians and the criteria used by medical school admissions and promotions committees. The studies which have been done primarily relate clinical performance to cognitive criteria. They have usually found only negligible relationships. By considering both cognitive and noncognitive variables, several investigators recently have improved the prediction of clinical performance in medical school. The present authors attempt to determine the increase in predictive efficiency attained by adding noncognitive variables to cognitive variables in predicting clinical performance of residents. The results of this investigation indicate that a combination of cognitive and noncognitive predictor variables functions much better than any individual variable or even any specific class of variables in predicting the postgraduate clinical performance of physicians.

Clinical Competence↗
PubMed1986

In vitro effectiveness of dental floss in plaque removal.

This study was designed to determine whether there was any measurable difference in the effectiveness of bacterial plaque removal between 4 commercially available dental flosses. By means of a highly standardized and controlled in vitro experimental model technique utilizing 50 freshly extracted third molars, the possibility of intra- and inter-individual variability was eliminated. Each tooth was individually mounted in a formatray block and the surface was finished to either a "planed" or "unplaned" surface configuration. The "planed" root surface (dentin) was achieved by using 600 grit wet-sandpaper for tooth surface reduction while the "unplaned" root surface was achieved by using 600 gift wet-sandpaper. The teeth were then individually processed to effect the growth of bacterial plaque (S. mutans) on the prepared surfaces. Each tooth was subsequently disclosed, flossed and photographed without interruption. The flossing was carried out on a flossing machine utilizing a controlled force of 50 g. A controlled direction of the stroke perpendicular to the long axis of the tooth, and a controlled frequency of flossing (2 strokes per trial) was used. The results of the clinical trials were evaluated utilizing Ektachrome slides of the previously flossed and disclosed tooth surfaces. The photographs were projected, measured, and statistically analyzed (Student t-test and paired t-test) for the effectiveness of plaque removal of the 4 dental flosses and the effect of root surface roughness on the ability of the flosses to remove bacterial plaque. It was found that on smooth, "planed" root surfaces, there were no measurable difference among the 4 flosses.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental Devices, Home Care↗
PubMedDate not supplied

Physiologic circadian rhythmicity in preterm infants.

This study investigated evidence of a circadian rhythm in the physiologic variables of transcutaneous oxygen (tcPO2) level, pulse rate, respiratory rate, frequency of respiratory pauses, and skin temperature in six 34- to 37-week-preterm infants. A value for each variable was noted every 30 minutes for 24 hours, providing 245 observations for each infant. An adaptation of cosinor analysis, a least squares procedure that determines the cosine curve for a 24-hour period that best fits the observed pattern of values, was applied to the data. Statistically significant circadian rhythmicity was found for five of the six subjects with regard to skin temperature. Significant circadian rhythm was also demonstrated in two or three patients for all other variables. No significant consistent synchrony for individual variables across subjects was found. Actual peak values of respiratory pause frequency and trough values of tcPO2, however, occurred between midnight and 4:30 A.M. for every infant. Preterm infants exhibited evidence of a circadian rhythm in skin temperature, and tcPO2 and respiratory pause frequency exhibited day/night pattern characteristics.

Circadian Rhythm↗
PubMed1993

Sulphur dioxide sensitivity in South African asthmatic children.

Sulphur dioxide (SO2) is a well-known precipitant of asthmatic attacks. Many foodstuffs are preserved with SO2 and other sulphites. In this study 37 asthmatic children attending the Allergy Clinic at the Red Cross Children's Hospital were challenged with SO2 in apple juice in a dose similar to that commonly ingested in soft-drinks containing this preservative. The responses of these children were compared with the responses of 22 asthmatics challenged with apple juice alone. Sixteen out of 37 children (43.2%) challenged with SO2 reacted with a fall in forced expiratory volume in 1 second (FEV1) of more than 10% compared with none of the 22 control asthmatic children challenged with apple juice alone (P = 0.0016). Girls were found to be more sensitive than boys. A 20% or more fall in FEV1 occurred in 8 (21.6%) of the children challenged with SO2 compared with none in the control group (P = 0.039). There was an individual variability in the responses of sensitive individuals to the SO2 challenge. Reactions occurred in spite of maintenance medication and occurred within 5-30 minutes of challenge. Since sulphite sensitivity is common in asthmatic children, ingestion of sulphites should be avoided.

Adolescent↗
PubMed2002

The personality variable openness to experience as it relates to homophobia.

The present study investigated personality and demographic variables of homophobic and non-homophobic individuals. Variables explored included the personality characteristics Neuroticism, Extroversion, and Openness to Experience. The following demographic variables were also explored: gender role beliefs, gender, and personal contact. Participants included 123 students from a large Western university, enrolled in introductory courses in psychology or sociology. Participants completed a questionnaire packet containing a demographic inquiry and three psychological measures-the NEO Personality Inventory, the Assessment of Attitudes Towards Lesbians and Gay Men, and the Bem Sex Role Inventory. Results revealed the variable contact as the most critical predictor of homophobia, followed by gender, and the personality variable Openness to Experience. Furthermore, those who had not had previous contact with a homosexual individual and men were significantly more homophobic. No significant differences were found among gender roles in relation to self-reported indices of homophobia. The results provide attitudinal and behavioral differences that differentiate individuals who are intolerant of homosexuality from those that are more accepting of alternative lifestyles.

Adult↗
PubMed2006

A broad diversity of volatile carboxylic acids, released by a bacterial aminoacylase from axilla secretions, as candidate molecules for the determination of human-body odor type.

Human body odor is to a large part determined by secretions of glands in the axillary regions. Two key odoriferous principles, 3-methylhex-2-enoic acid (3MH2; 4/5) and 3-hydroxy-3-methylhexanoic acid (HMHA; 6) have been shown to be released from glutamine conjugates secreted in the axilla by a specific N(alpha)-acyl-glutamine aminoacylase (N-AGA) obtained from axilla isolates of Corynebacteria sp. However, the low number of different odorants reported in humans stands in contrast to the observed high inter-individual variability in body odors. Axilla secretions of individual donors were, therefore, analyzed in detail. The secretions were treated with N-AGA, analyzed by GC/MS, and compared to undigested controls. Over 28 different carboxylic acids were released by this enzyme from odorless axilla secretions (Table 1). Many of these body odorants have not been reported before from a natural source, and they include several aliphatic 3-hydroxy acids with 4-Me branches, 3,4-unsaturated, 4-Et-branched aliphatic acids, and a variety of degradation products of amino acids. The odor threshold of some of the acids was found to be in the range of 1 ng. Most of these compounds were present in all donors tested, but in highly variable relative amounts, and they are, thus, candidate molecules as key components of a 'compound odor' determining the individual types of human body odor.

Actinomycetales↗
PubMed1984

Multiple testing of hypotheses in comparing two groups.

Researchers frequently encounter studies that compare two groups on many variables. We discourage the use of multiple tests of hypotheses on individual variables, an approach that ignores the correlation among the variables and increases the chance of a type I error. Instead of examining each variable separately, we recommend using multivariate procedures that integrate all measures on a person into a unified analysis of the differences between the two groups. We describe three multivariate procedures: Hotelling's T2, discriminant analysis, and logistic regression. We also discuss the use of Bonferroni's adjustment to preserve the overall chance of a type I error in conducting individual tests on each variable after doing the multivariate procedures. We review the underlying assumptions and relative merits and disadvantages of the three multivariate methods and recommend which method to use in various circumstances.

Analysis of Variance↗
PubMed2005

A physiologically based toxicokinetic model of inhalation exposure to xylenes in Caucasian men.

Widespread exposure to the volatile aromatic hydrocarbons, ortho-, meta-, and para-xylene occurs in many industries including the manufacture of plastics, pharmaceuticals, and synthetic fibers. This paper describes the development of a physiologically based toxicokinetic model using biomonitoring data to quantify the kinetics of ortho-, meta-, and para-xylenes. Serial blood concentrations of deuterium-labeled xylene isomers were obtained over 4 days after 37 controlled, 2h inhalation exposures to different concentrations of the isomers. Peak toxicant concentrations in blood occurred in all subjects at the termination of exposure. Systemic clearance averaged 116 L/h+/-34 L/h, 117 L/h+/-23 L/h, and 129 L/h+/-33 L/h for ortho-, para-, and meta-xylene, respectively. The half-life of each toxicant in the terminal phase (>90 h post-exposure) was fit by the model, yielding values of 30.3+/-10.2 h for para-xylene, 33.0+/-11.7 h for meta-xylene and 38.5+/-18.2 h for ortho-xylene. Significant isomeric differences were found (p<0.05) for toxicant half-life, clearance and extrahepatic metabolism. Inter-individual variability seen in this study suggests that airborne concentration guidelines may not protect all workers. A Biological Exposure Index is preferred for this purpose since it is integrative and reflective of inter-individual kinetic variability.

Adipose Tissue↗
PubMed2004

Obstacle avoidance during locomotion using haptic information in normally sighted humans.

The goal of the study was to examine the accuracy and precision of control of adaptive locomotion using haptic information in normally sighted humans before and after practice. Obstacle avoidance paradigm was used to study adaptive locomotion; individuals were required to approach and step over different sizes of obstacles placed in the travel path under three sensory conditions: full vision (FV); restricted lower visual field (RLVF) using blinders on custom glass frames; and no vision (NV) using haptic information only. In the NV condition, individuals were a given an appropriate-sized cane to guide their locomotion. Footfall patterns were recorded using the GAITRite system, and lead and trail limb trajectories were monitored using the OPTOTRAK system, which tracked infrared diodes placed on the toes and the cane. Approach step lengths were reduced for the haptic condition: this slowed the forward progression and allowed greater time for haptic exploration, which ranged from 2.5 to 4 s and consisted of horizontal cane movements (to detect the width and relative location of the obstacle) and vertical cane movements (to detect the height of the obstacle). Based on feed-forward and on-line sensory (under both vision and haptic conditions) information about location of the obstacle relative to the individual, variability of foot placement reduced as the individual came closer to the obstacle, as has been shown in the literature. The only difference was that the reduction in variability of foot placement under haptic condition occurred in the last step compared with earlier under vision. Considering that the obstacle is detected only when the cane comes in contact, as opposed to vision condition when it is visible earlier, this difference is understandable. Variability and magnitude of lead and trail limb elevation for the haptic condition was higher than the RLVF and FV conditions. In contrast, only the magnitude of lead and trail limb elevation was higher in the RLVF condition when compared with the FV condition. This suggests that it is the inability of the haptic sense to provide accurate information about obstacle characteristics compared with the visual system, and not simple caution that lead to higher limb elevation. In the haptic and RLVF condition when vision was unavailable for on-line monitoring of lead limb elevation, kinesthetic information from lead limb elevation was used to fine-tune trail limb elevation. Both the control of approach phase and limb elevation findings held up even after sufficient practice to learn haptic guidance of adaptive locomotion in the second experiment. These results provide a clear picture of the efficacy of the haptic sensory system to guide locomotion in a cluttered environment.

Adaptation, Psychological↗
PubMed2005

Individual differences in pain responses.

The experience of pain is characterized by tremendous inter-individual variability. Indeed, an identical noxious stimulus can produce vastly different pain responses across individuals. Historically, scientists have regarded this variability as a nuisance; however, substantial data suggest that these individual differences may provide valuable information that can be used to enhance clinical management of pain. This paper discusses several factors that contribute to individual differences in pain perception, including demographic (ie, sex, age, and ethnicity), genetic, and psychosocial variables. These factors are discussed in the context of the biopsychosocial model of pain, which posits that pain perception is influenced by interactions among biologic, psychosocial, and sociocultural factors. Finally, the clinical and scientific implications of individual differences in pain are discussed.

Age Factors↗
PubMed1999

Latency and amplitude variability in serial median nerve SEP recordings.

OBJECTIVES: Intra-individual variability of SEP parameters was investigated by serial SEP recordings. METHODS: Median nerve SEP of 53 normal subjects (mean age 25.5+/-2.7 years) were evaluated. Recordings were repeated 1 week, 2 weeks, and 6 months after the initial recording. RESULTS: Mean values of latencies from right median nerve stimulation were slightly longer (+0.1 ms) as compared to the left. The intra-individual (within stimulation side) variance did not depend on the time interval between recordings. The total within-stimulation-side variance of latencies was 0.056 ms2 for N20 (C3/4' vs. Fz), 0.070 ms2 for N13 (C7 vs. Fz), 0.048 ms2 for N10 (Erb's point vs. Fz), 0.111 ms2 for P9 (C3/4' vs. contralateral forearm), and 0.148 ms2 for P14 (C3/4' vs. contralateral forearm), and was about 3 times smaller than between-side variability with regard to cortical or spinal potentials. Upper limits for latency differences and lower limits for amplitude ratios in repeated recordings, as well as upper and lower limits for between-side latency differences and amplitude ratios were calculated, using F distributions with worst-case assumptions for degrees of freedom and error probability P = 0.05. Upper limits of within-stimulation-side latency differences were 0.55 ms for N20, 0.62 ms for N13, 0.51 ms for N10, 0.78 ms for P9, and 0.90 ms for P14, and corresponding lower limits of amplitude ratios were 0.69, 0.62, 0.66, 0.45, and 0.50, respectively. CONCLUSIONS: Our results demonstrate a small systematic, and a larger random difference between right and left side stimulation, one arising from the peripheral, and the other one from the central pathway proximal to the source of N10.

Adolescent↗
PubMed1995

The variable effects of 2'-deoxyadenosine on human sperm motility and hyperactivation in vitro.

The response of human sperm motility and hyperactivation to the stimulant 2'-deoxyadenosine (2'-DEA) was studied in vitro using computer-assisted sperm motion analysis. A total of 20 randomly selected individuals with normal sperm counts as defined by the World Health Organization were chosen and their migration-separated spermatozoa exposed to a range (0.1-10.0 mM) of concentrations of 2'-DEA. The straight line velocity (VSL) was increased above control values only at 0.1 mM, while the curvilinear velocity (VCL) and lateral head displacement (ALH) were increased significantly at all concentrations. Linearity of progression (LIN), on the other hand, declined with increasing concentration of 2'-DEA. These changes were related to a significant increase in the number of spermatozoa exhibiting hyperactive-like motion. There was, however, considerable intra-individual variability in the response to 2'-DEA. In some individuals VCL and ALH exhibited little or no response to 2'-DEA, whilst in others an increase above the control of 50-55% occurred. The maximum response for VCL and ALH occurred at 2.5 mM 2'-DEA. Individuals showed greater variability in the percentage of spermatozoa exhibiting hyperactivity in response to 2'-DEA, with increases ranging from 76 to 948% of the control value, although the maximum response was also most commonly seen at 2.5 mM 2'-DEA. The diversity of response to 2'-DEA emphasizes the importance of tailoring doses to the individual rather than employing one concentration for all. Further tests on a subgroup of the individuals examined the longevity of spermatozoa in response to 24 h of continued exposure to 2'-DEA.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2006

The circadian body temperature rhythm in the elderly: effect of single daily melatonin dosing.

The present study is part of a more extensive investigation dedicated to the study and treatment of age-dependent changes/disturbances in the circadian system in humans. It was performed in the Tyumen Elderly Veteran House and included 97 subjects of both genders, ranging from 63 to 91 yrs of age. They lived a self-chosen sleep-wake regimen to suit their personal convenience. The experiment lasted 3 wks. After 1 control week, part of the group (n=63) received 1.5 mg melatonin (Melaxen) daily at 22:30 h for 2 wks. The other 34 subjects were given placebo. Axillary temperature was measured using calibrated mercury thermometers at 03:00, 08:00, 11:00, 14:00, 17:00, and 23:00 h each of the first and third week. Specially trained personnel took the measurements, avoiding disturbing the sleep of the subjects. To evaluate age-dependent changes, data obtained under similar conditions on 58 young adults (both genders, 17 to 39 yrs of age) were used. Rhythm characteristics were estimated by means of cosinor analyses, and intra- and inter-individual variability by analysis of variance (ANOVA). In both age groups, the body temperature underwent daily changes. The MESOR (36.38+/-0.19 degrees C vs. 36.17+/-0.21 degrees C) and circadian amplitude (0.33+/-0.01 degrees C vs. 0.26+/-0.01 degrees C) were slightly decreased in the elderly compared to the young adult subjects (p<0.001). The mean circadian acrophase was similar in both age groups (17.19+/-1.66 vs. 16.93+/-3.08 h). However, the inter-individual differences were higher in the older group, with individual values varying between 10:00 and 23:00 h. It was mainly this phase variability that caused a decrease in the inter-daily rhythm stability and lower group amplitude. With melatonin treatment, the MESOR was lower by 0.1 degrees C and the amplitude increased to 0.34+/-0.01 degrees C, a similar value to that found in young adults. This was probably due to the increase of the inter-daily rhythm stability. The mean acrophase did not change (16.93 vs. 16.75 h), although the inter-individual variability decreased considerably. The corresponding standard deviations (SD) of the group acrophases were 3.08 and 1.51 h (p<0.01). A highly significant correlation between the acrophase before treatment and the phase change under melatonin treatment indicates that this is due to a synchronizing effect of melatonin. Apart from the difference in MESOR, the body temperature rhythm in the elderly subjects undergoing melatonin treatment was not significantly different from that of young adults. The data clearly show that age-dependent changes mainly concern rhythm stability and synchronization with the 24 h day. A single daily melatonin dose stabilizes/synchronizes the body temperature rhythm, most probably via hypothermic and sleep-improving effects.

Adolescent↗
PubMed2003

Time perception deficits in attention-deficit/ hyperactivity disorder and comorbid reading difficulties in child and adolescent samples.

BACKGROUND: Our objective was to investigate time perception in Attention-Deficit/Hyperactivity Disorder (ADHD) with and without comorbid reading difficulties (RD) in child and adolescent participants. METHOD: In study 1, 50 children with ADHD (31 ADHD, 19 ADHD+RD) and age-matched healthy controls (n = 50) completed three psychophysical tasks: duration discrimination (target duration of 400 ms versus a foil duration), frequency discrimination (a control condition to evaluate general perceptual ability), and a duration estimation task using the method of reproduction for intervals of 400 ms, 2000 ms, and 6000 ms. Study 2 used the same tasks with an adolescent sample (35 ADHD, 24 ADHD+RD, 39 controls). RESULTS: In both studies, children and adolescents with ADHD and ADHD+RD displayed some impairments in duration discrimination and the precision with which they reproduced the intervals on the estimation task, particularly the shorter 400 ms interval. The most severe impairments tended to occur in the comorbid ADHD+RD group. No impairments were found on the frequency discrimination task. ADHD participants also displayed significant intra-individual variability in their performance on the estimation task. Finally, short-term and working memory, estimated full-scale IQ, and teacher report of hyperactivity/impulsivity were found to differentially predict performance on the time perception measures in the adolescent clinical sample. CONCLUSIONS: Deficits in duration discrimination, duration estimation, and intra-individual performance variability may have cascaded effects on the temporal organisation of behaviour in children and adolescents with ADHD and ADHD+RD.

Adolescent↗
PubMed2006

Population-based analysis of methadone distribution and metabolism using an age-dependent physiologically based pharmacokinetic model.

Limited pharmacokinetic (PK) and pharmacodynamic (PD) data are available to use in methadone dosing recommendations in pediatric patients for either opioid abstinence or analgesia. Considering the extreme inter-individual variability of absorption and metabolism of methadone, population-based PK would be useful to provide insight into the relationship between dose, blood concentrations, and clinical effects of methadone. To address this need, an age-dependent physiologically based pharmacokinetic (PBPK) model has been constructed to systematically study methadone metabolism and PK. The model will facilitate the design of cost-effective studies that will evaluate methadone PK and PD relationships, and may be useful to guide methadone dosing in children. The PBPK model, which includes whole-body multi-organ distribution, plasma protein binding, metabolism, and clearance, is parameterized based on a database of pediatric PK parameters and data collected from clinical experiments. The model is further tailored and verified based on PK data from individual adults, then scaled appropriately to apply to children aged 0-24 months. Based on measured variability in CYP3A enzyme expression levels and plasma orosomucoid (ORM2) concentrations, a Monte-Carlo-based simulation of methadone kinetics in a pediatric population was performed. The simulation predicts extreme variability in plasma concentrations and clearance kinetics for methadone in the pediatric population, based on standard dosing protocols. In addition, it is shown that when doses are designed for individuals based on prior protein expression information, inter-individual variability in methadone kinetics may be greatly reduced.

Adult↗
PubMed2005

Some distinctions between flavin-containing and cytochrome P450 monooxygenases.

This minireview summarizes information concerning the differences and similarities of the human flavin-containing- (FMO, E.C. 1.14.13.8) and the cytochrome P450-monooxygenases (CYP, E.C. 1.14.14.1). Human FMO oxygenates soft nucleophiles. CYP mainly catalyzes C-H abstraction but also oxidizes nitrogen- and sulfur-containing compounds. Both FMO and CYP generally convert lipophilic compounds into more hydrophilic metabolites. The mechanism by which each monooxygenase operates is quite distinct. Sometimes, CYP or FMO bioactivate chemicals to reactive metabolites but to date, drug toxicity thus far observed in the clinic is mainly the result of CYP-dependent oxidation. Both FMO and CYP possess genetic variability that may contribute to inter-individual variability observed for drug metabolism. In contrast to CYP, FMO is not induced or readily inhibited and potential adverse drug-drug interactions are minimized for drugs prominently metabolized by FMO. These properties may provide advantages in drug design, and by incorporating FMO detoxication pathways into drug candidates, more drug-like materials may emerge.

Animals↗
PubMed2003

The ideal characteristics of antiepileptic therapy: an overview of old and new AEDs.

New and improved anti-epileptic drugs (AEDs) have made the concept of choice, according to the individual prognosis and probable response to specific regimens, increasingly feasible. Inter-individual variability in syndrome severity and complexity make individualization necessary. We propose three categories of disorder control according to the individual objectives of the patient: (1) seizure control, (2) epilepsy control and ultimately, (3) "epilepsy cure"; the latter remaining a largely idealistic target today. An AED is likely to be successful if it exhibits "optimal" characteristics, such as drug efficacy, tolerability, pharmacokinetics, interactions and cost-effectiveness. This review discusses the "optimal" characteristics of add-on AEDs, which, in addition to seizure control, will contribute to the achievement of epilepsy control and therefore address the currently unmet clinical needs of epilepsy treatment.

Anticonvulsants↗