Showing papers by "University of Vermont published in 2002"
TL;DR: The Multi-Ethnic Study of Atherosclerosis was initiated in July 2000 to investigate the prevalence, correlates, and progression of subclinical cardiovascular disease (CVD) in a population-based sample of 6,500 men and women aged 45-84 years for identification and characterization of CVD events.
Abstract: The Multi-Ethnic Study of Atherosclerosis was initiated in July 2000 to investigate the prevalence, correlates, and progression of subclinical cardiovascular disease (CVD) in a population-based sample of 6,500 men and women aged 45-84 years. The cohort will be selected from six US field centers. Approximately 38% of the cohort will be White, 28% African-American, 23% Hispanic, and 11% Asian (of Chinese descent). Baseline measurements will include measurement of coronary calcium using computed tomography; measurement of ventricular mass and function using cardiac magnetic resonance imaging; measurement of flow-mediated brachial artery endothelial vasodilation, carotid intimal-medial wall thickness, and distensibility of the carotid arteries using ultrasonography; measurement of peripheral vascular disease using ankle and brachial blood pressures; electrocardiography; and assessments of microalbuminuria, standard CVD risk factors, sociodemographic factors, life habits, and psychosocial factors. Blood samples will be assayed for putative biochemical risk factors and stored for use in nested case-control studies. DNA will be extracted and lymphocytes will be immortalized for genetic studies. Measurement of selected subclinical disease indicators and risk factors will be repeated for the study of progression over 7 years. Participants will be followed through 2008 for identification and characterization of CVD events, including acute myocardial infarction and other coronary heart disease, stroke, peripheral vascular disease, and congestive heart failure; therapeutic interventions for CVD; and mortality.
3,367 citations
TL;DR: The Standardization and Terminology Committee (STC) of the International Society of Biomechanics proposes definitions of JCS for the ankle, hip, and spine, and suggests that adopting these standards will lead to better communication among researchers and clinicians.
2,650 citations
TL;DR: The article concludes with several issues for future research, among them the question of how to optimize extinction and other putative "unlearning" treatments so as to prevent the various forms of relapse discussed here.
1,477 citations
TL;DR: A meta-analysis of 96 published presence–absence matrices and used a realistic “null model” to generate patterns expected in the absence of species interactions establishes that observed co-occurrence in most natural communities is usually less than expected by chance.
Abstract: J. M. Diamond's assembly rules model predicts that competitive interactions between species lead to nonrandom co-occurrence patterns. We conducted a meta-analysis of 96 published presence–absence matrices and used a realistic “null model” to generate patterns expected in the absence of species interactions. Published matrices were highly nonrandom and matched the predictions of Diamond's model: there were fewer species combinations, more checkerboard species pairs, and less co-occurrence in real matrices than expected by chance. Moreover, nonrandom structure was greater in homeotherm vs. poikilotherm matrices. Although these analyses do not confirm the mechanisms of Diamond's controversial assembly rules model, they do establish that observed co-occurrence in most natural communities is usually less than expected by chance. These results contrast with previous analyses of species co-occurrence patterns and bridge the apparent gap between experimental and correlative studies in community ecology.
909 citations
TL;DR: By measuring discounting at an unprecedented range of real rewards, this study has systematically replicated the robust finding in human delay discounting research that discount rates decrease with increasing magnitude of reward.
Abstract: A within-subject design, using human participants, compared delay discounting functions for real and hypothetical money rewards. Both real and hypothetical rewards were studied across a range that included $10 to $250. For 5 of the 6 participants, no systematic difference in discount rate was observed in response to real and hypothetical choices, suggesting that hypothetical rewards may often serve as a valid proxy for real rewards in delay discounting research. By measuring discounting at an unprecedented range of real rewards, this study has also systematically replicated the robust finding in human delay discounting research that discount rates decrease with increasing magnitude of reward. A hyperbolic decay model described the data better than an exponential model.
900 citations
TL;DR: The hypothesis that there is a specific physiological basis to the geriatric syndrome of frailty that is characterized in part by increased inflammation and elevated markers of blood clotting is supported and that these physiological differences persist when those with diabetes and cardiovascular disease are excluded.
Abstract: Background The biological basis of frailty has been difficult to establish owing to the lack of a standard definition, its complexity, and its frequent coexistence with illness. Objective To establish the biological correlates of frailty in the presence and absence of concurrent cardiovascular disease and diabetes mellitus. Methods Participants were 4735 community-dwelling adults 65 years and older. Frail, intermediate, and nonfrail subjects were identified by a validated screening tool and exclusion criteria. Bivariate relationships between frailty level and physiological measures were evaluated by Pearson χ 2 tests for categorical variables and analysis of variance F tests for continuous variables. Multinomial logistic regression was performed to evaluate multivariable relationships between frailty status and physiological measures. Results Of 4735 Cardiovascular Health Study participants, 299 (6.3%) were identified as frail, 2147 (45.3%) as intermediate, and 2289 (48.3%) as not frail. Frail vs nonfrail participants had increased mean ± SD levels of C-reactive protein (5.5 ± 9.8 vs 2.7 ± 4.0 mg/L), factor VIII (13 790 ± 4480 vs 11 860 ± 3460 mg/dL), and, in a smaller subset, D dimer (647 ± 1033 vs 224 ± 258 ng/mL) ( P ≤.001 for all, χ 2 test for trend). These differences persisted when individuals with cardiovascular disease and diabetes were excluded and after adjustment for age, sex, and race. Conclusions These findings support the hypothesis that there is a specific physiological basis to the geriatric syndrome of frailty that is characterized in part by increased inflammation and elevated markers of blood clotting and that these physiological differences persist when those with diabetes and cardiovascular disease are excluded.
891 citations
TL;DR: A novel function of IL-6 is discussed: the control of T helper (Th) 1/Th2 differentiation, which plays a dual role in Th1/Th1 differentiation by using two independent molecular mechanisms.
795 citations
TL;DR: Major changes in both obstetric and neonatal care during the 1990s were associated with decreases in mortality and morbidity for VLBW infants during the first half of the decade, but since 1995, no additional improvements in mortality or morbidity have been seen, ending a decades-long trend of improving outcomes for these infants.
Abstract: Background. Medical care for very low birth weight (VLBW) infants and their mothers has changed dramatically during the 1990s, yet it is unclear how these changes have affected mortality and morbidity. Objective. We used the Vermont Oxford Network Database to identify trends in clinical practice and patient outcomes for VLBW infants born from 1991 to 1999. Methods. Logistic regression was used to evaluate temporal trends in practices and outcomes while adjusting for patient characteristics and accounting for clustering of cases within hospitals. Results. There were 118 448 infants 501 to 1500 g from 362 neonatal intensive care units enrolled in the Network Database from 1991 to 1999. Prenatal care, cesarean section, multiple births, antenatal steroids, and 1-minute Apgar scores increased during this period, as did the use of nasal continuous positive airway pressure, high-frequency ventilation, surfactant, and postnatal steroids. The proportion of white infants decreased; the proportions of Hispanic infants and those of other races increased. The crude and adjusted rates of mortality, pneumothorax, intraventricular hemorrhage (IVH), and severe IVH declined from 1991 to 1995, whereas from 1995 to 1999, the rates of mortality, IVH, and severe IVH did not change significantly, and pneumothorax increased. Conclusions. There have been major changes in both obstetric and neonatal care during the 1990s. These changes were associated with decreases in mortality and morbidity for VLBW infants during the first half of the decade. However, since 1995, no additional improvements in mortality or morbidity have been seen, ending a decades-long trend of improving outcomes for these infants.
763 citations
TL;DR: The data showing no relationship of some arterial risk factors with VTE corroborate the view that the etiology of VTE differs from atherosclerotic cardiovascular disease and suggest a hypothesis that avoidance of obesity and diabetes or vigilance in prophylaxis in patients with those conditions may prevent some venous thromboses.
Abstract: Background The association between traditional cardiovascular risk factors and risk of venous thromboembolism (VTE) has not been extensively examined in prospective studies. Methods To determine whether atherosclerotic risk factors are also associated with increased incidence of VTE, we conducted a prospective study of 19 293 men and women without previous VTE in 6 US communities between 1987 and 1998. Results There were 215 validated VTE events (1.45 per 1000 person-years) during a median of 8 years of follow-up. The age-adjusted hazard ratio was 1.4 (95% confidence interval [CI], 1.1-1.9) for men vs women, 1.6 (95% CI, 1.2-2.2) for blacks vs whites, and 1.7 (95% CI, 1.5-2.0) per decade of age. Cigarette smoking, hypertension, dyslipidemia, physical inactivity, and alcohol consumption were not associated with risk of VTE. Age-, race-, and sex-adjusted hazard ratios for body mass index categories (calculated as the weight in kilograms divided by the height in meters squared) of less than 25, 25 to less than 30, 30 to less than 35, 35 to less than 40, and 40 or more were 1.0, 1.5, 2.2, 1.5, and 2.7, respectively (P Conclusions Our data showing no relationship of some arterial risk factors with VTE corroborate the view that the etiology of VTE differs from atherosclerotic cardiovascular disease. In addition, the findings suggest a hypothesis that avoidance of obesity and diabetes or vigilance in prophylaxis in patients with those conditions may prevent some venous thromboses.
687 citations
TL;DR: A revised, complete, and significantly edited practice management guidelines for the prevention of venous thromboembolism in trauma patients is presented herein.
Abstract: These original guidelines were developed by interested trauma surgeons in 1997 for the EAST Web site (www.eas- t.org), where a brief summary of four guidelines was pub- lished. A revised, complete, and significantly edited practice management guidelines for the prevention of venous throm- boembolism in trauma patients is presented herein. The step-by-step process of practice management guide- line development, as outlined by the Agency for Health Care Policy and Research (AHCPR), has been used as the meth- odology for the development of these guidelines. 2 Briefly, the first step in guideline development is a classification of sci- entific evidence. A Class I study is a prospective, randomized controlled trial. A Class II study is a clinical study with prospectively collected data or large retrospective analyses with reliable data. A Class III study is retrospective data, expert opinion, or a case report. Once the evidence is classi- fied, it can be used to make recommendations. A Level I recommendation is convincingly justifiable on the basis of the scientific information alone. Usually, such a recommen- dation is made on the basis of a preponderance of Class I data, but some strong Class II data can be used. A Level II rec- ommendation means the recommendation is reasonably jus- tifiable, usually on the basis of a preponderance of Class II data. If there are not enough Class I data to support a Level I recommendation, they may be used to support a Level II recommendation. A Level III recommendation is generally only supported by Class III data. These practice guidelines address eight different areas of practice management as they relate to the prevention and diagnosis of venous thromboembolism in trauma patients. There are few Level I recommendations because there is a paucity of Class I data in the area of trauma literature. We believe it is important to highlight areas where future inves- tigation may bring about definitive Level I recommendations.
645 citations
TL;DR: Because a full-term pregnancy in early life is associated with a reduction in breast carcinogenesis, an understanding of the mechanisms by which these hormones bring about secretory differentiation may offer clues to the prevention of breast cancer.
Abstract: The endocrine system coordinates development of the mammary gland with reproductive development and the demand of the offspring for milk. Three categories of hormones are involved. The levels of the reproductive hormones, estrogen, progesterone, placental lactogen, prolactin, and oxytocin, change during reproductive development or function and act directly on the mammary gland to bring about developmental changes or coordinate milk delivery to the offspring. Metabolic hormones, whose main role is to regulate metabolic responses to nutrient intake or stress, often have direct effects on the mammary gland as well. The important hormones in this regard are growth hormone, corticosteroids, thyroid hormone, and insulin. A third category of hormones has recently been recognized, mammary hormones. It currently includes growth hormone, prolactin, PTHrP, and leptin. Because a full-term pregnancy in early life is associated with a reduction in breast carcinogenesis, an understanding of the mechanisms by which these hormones bring about secretory differentiation may offer clues to the prevention of breast cancer.
TL;DR: IFNβ-1a 44 μg subcutaneously tiw was more effective than IFNβ -1a 30 μg IM qw on all primary and secondary outcomes investigated after 24 and 48 weeks of treatment.
Abstract: Background: Interferon β (IFNβ) reduces relapses and MRI activity in relapsing-remitting MS (RRMS), with variable effects on disability. The most effective dose regimen remains controversial. Methods: This randomized, controlled, multicenter trial compared the efficacy and safety of IFNβ-1a (Rebif®) 44 μg subcutaneously three times weekly (tiw), and IFNβ-1a (Avonex®) 30 μg IM once weekly (qw) in 677 patients with RRMS. Assessors blinded to treatment performed neurologic and MRI evaluations. The primary endpoint was the proportion of patients who were relapse free at 24 weeks; the principal MRI endpoint was the number of active lesions per patient per scan at 24 weeks. Results: After 24 weeks, 74.9% (254/339) of patients receiving IFNβ-1a 44 μg tiw remained relapse free compared with 63.3% (214/338) of those given 30 μg qw. The odds ratio for remaining relapse free was 1.9 (95% CI, 1.3 to 2.6; p = 0.0005) at 24 weeks and 1.5 (95% CI, 1.1 to 2.1; p = 0.009) at 48 weeks, favoring 44 μg tiw. Patients receiving 44 μg tiw had fewer active MRI lesions ( p p p = 0.002) and altered leukocyte counts (11% vs 5%, p = 0.003) compared with the 30 μg qw dosage. Neutralizing antibodies developed in 25% of 44 μg tiw patients and in 2% of patients receiving 30 μg qw. Conclusions: IFNβ-1a 44 μg subcutaneously tiw was more effective than IFNβ-1a 30 μg IM qw on all primary and secondary outcomes investigated after 24 and 48 weeks of treatment.
University of California, San Francisco1, National Institutes of Health2, Group Health Cooperative3, University of Washington4, University of Vermont5, University of Nevada, Reno6, University of North Carolina at Chapel Hill7, University of New Mexico8, Dartmouth College9, Fred Hutchinson Cancer Research Center10
TL;DR: Overall, approximately 1 in every 1300 screening mammography examinations leads to a diagnosis of DCIS, and the clinical significance of screen-detected DCIS needs further investigation.
Abstract: Background: With the large number of women having mammography—an estimated 28.4 million U.S. women aged 40 years and older in 1998—the percentage of cancers detected as ductal carcinoma in situ (DCIS), which has an uncertain prognosis, has increased. We pooled data from seven regional mammography registries to determine the percentage of mammographically detected cancers that are DCIS and the rate of DCIS per 1000 mammograms. Methods: We analyzed data on 653 833 mammograms from 540 738 women between 40 and 84 years of age who underwent screening mammography at facilities participating in the National Cancer Institute’s Breast Cancer Surveillance Consortium (BCSC) throughout 1996 and 1997. Mammography results were linked to population-based cancer and pathology registries. We calculated the percentage of screen-detected breast cancers that were DCIS, the rate of screen-detected DCIS per 1000 mammograms by age and by previous mammography status, and the sensitivity of screening mammography. Statistical tests were two-sided. Results: A total of 3266 cases of breast cancer were identified, 591 DCIS and 2675 invasive breast cancer. The percentage of screendetected breast cancers that were DCIS decreased with age (from 28.2% [95% confidence interval (CI) = 23.9% to 32.5%] for women aged 40–49 years to 16.0% [95% CI = 13.3% to 18.7%] for women aged 70–84 years). However, the rate of screen-detected DCIS cases per 1000 mammograms increased with age (from 0.56 [95% CI = 0.41 to 0.70] for women aged 40–49 years to 1.07 [95% CI = 0.87 to 1.27] for women aged 70–84 years). Sensitivity of screening mammography in all age groups combined was higher for detecting DCIS (86.0% [95% CI = 83.2% to 88.8%]) than it was for detecting invasive breast cancer (75.1% [95% CI = 73.5% to 76.8%]). Conclusions: Overall, approximately 1 in every 1300 screening mammography examinations leads to a diagnosis of DCIS. Given uncertainty about the natural history of DCIS, the clinical significance of screen-detected DCIS needs further investigation. [J Natl Cancer Inst 2002;94: 1546–54]
TL;DR: Adiposity was a significant predictor of plasma CRP in postmenopausal women on a cross-sectional basis and caloric restriction–induced weight loss decreased plasmaCRP levels, suggesting weight loss may represent an important intervention to reduce CRP levels.
Abstract: Background — C-reactive protein (CRP) has been proposed as an independent risk factor for cardiovascular disease and has been positively associated with body weight and body fatness. We examined the hypothesis that weight loss would reduce plasma CRP levels in obese postmenopausal women.
Methods and Results — In a sample of 61 obese (body mass index, 35.6±5.0 kg/m2), postmenopausal women (age, 56.4±5.2 years), we found that plasma CRP levels were positively associated with dual x-ray absorptiometry–measured total body fatness ( r =0.36, P <0.005) and CT-measured intra-abdominal body fat area ( r =0.30, P <0.02). Significant correlations were also found between plasma CRP and triglyceride levels ( r =0.33, P <0.009) and glucose disposal measured by the hyperinsulinemic-euglycemic clamp technique ( r =−0.29, P <0.03). Twenty-five of the 61 women tested at baseline completed a weight loss protocol. The average weight loss was 14.5±6.2 kg (−15.6%, P <0.0001), with losses of 10.4±5.4 kg fat mass (−25.0%, P <0.0001) and 2.8±1.4 kg fat-free mass (−6.0%, P <0.0001). Visceral and subcutaneous fat areas were reduced by −36.4% and −23.7%, respectively ( P <0.0001). Plasma CRP levels were significantly reduced by weight loss: average −32.3%, from 3.06 (+0.69, −1.29) to 1.63 (+0.70, −0.75) μg/mL ( P <0.0001, medians and interquartile differences). Changes in body weight and in total body fat mass were both positively associated with plasma CRP level reductions.
Conclusions — Adiposity was a significant predictor of plasma CRP in postmenopausal women on a cross-sectional basis. Moreover, caloric restriction–induced weight loss decreased plasma CRP levels. Weight loss may represent an important intervention to reduce CRP levels, which may mediate part of its cardioprotective effects in obese postmenopausal women.
Received September 10, 2001; revision received November 19, 2001; accepted November 22, 2001.
TL;DR: Evidence is provided that a transient receptor potential channel (TRPC6) homologue has a major role in this depolarizing response to pressure and it is proposed that TRPC6 channels play an essential role in regulation of myogenic tone.
Abstract: Elevation of intravascular pressure causes depolarization and constriction (myogenic tone) of small arteries and arterioles, and this response is a key element in blood flow regulation. However, the nature of pressure-induced depolarization has remained elusive. In the present study, we provide evidence that a transient receptor potential channel (TRPC6) homologue has a major role in this depolarizing response to pressure. Antisense oligodeoxynucleotides to TRPC6 decreased TRPC6 protein expression and greatly attenuated arterial smooth muscle depolarization and constriction caused by elevated pressure in intact cerebral arteries. Suppressing the expression of this channel protein also reduced the current density of a major cation current in resistance artery smooth muscle cells. We propose that TRPC6 channels play an essential role in regulation of myogenic tone.
TL;DR: In this paper, three types of marketing firms are identified: phase I firms learn primarily through modeling and are typically limited to manager-driven incremental innovation. Phase II firms learn through adaptive learning, and phase III firms engage in generative learning and pursue ongoing radical innovation.
Abstract: Many scholars now agree that market orientation is necessary, but not sufficient to facilitate the type of innovation that breeds long-term competitive advantage (cf. Dickson, 1996). In addition to a strong market orientation, a firm must also be able to institutionalize higher order learning processes, the type of learning that enables radical innovation. Recent research (cf. Baker and Sinkula, 1999) has empirically established a synergistic effect of market orientation and learning orientation on organizational performance. This paper attempts to add to the literature by offering a more complete theoretical explanation of how these two constructs interact to affect product innovation capabilities. Three types of marketing firms are identified. Phase I firms learn primarily through modeling and are typically limited to manager-driven incremental innovation. Phase II firms learn primarily through adaptive learning and are typically limited to market-driven incremental innovation. Phase III firms engage in generative learning and pursue ongoing radical innovation. We propose that only Phase III firms are capable of maintaining competitive advantage in dynamic market environments.
TL;DR: It is proposed that the anatomical relationship of acupuncture points and meridians to connective tissue planes is relevant to acupuncture's mechanism of action and suggests a potentially important integrative role for interstitial connectIVE tissue.
Abstract: Acupuncture meridians traditionally are believed to constitute channels connecting the surface of the body to internal organs. We hypothesize that the network of acupuncture points and meridians can be viewed as a representation of the network formed by interstitial connective tissue. This hypothesis is supported by ultrasound images showing connective tissue cleavage planes at acupuncture points in normal human subjects. To test this hypothesis, we mapped acupuncture points in serial gross anatomical sections through the human arm. We found an 80% correspondence between the sites of acupuncture points and the location of intermuscular or intramuscular connective tissue planes in postmortem tissue sections. We propose that the anatomical relationship of acupuncture points and meridians to connective tissue planes is relevant to acupuncture’s mechanism of action and suggests a potentially important integrative role for interstitial connective tissue. Anat Rec (New Anat) 269:257–265, 2002. © 2002 Wiley-Liss, Inc.
TL;DR: The concept of "sense of place" typically is used to refer to an individual's ability to develop feelings of attachment to particular settings based on combinations of use, attentiveness, and emoti...
Abstract: The concept of “sense of place” typically is used to refer to an individual's ability to develop feelings of attachment to particular settings based on combinations of use, attentiveness, and emoti...
TL;DR: A phylogeny of haemosporidian parasites (phylum Apicomplexa, family Plasmodiidae) was recovered using mitochondrial cytochrome b gene sequences from 52 species in 4 genera (Plasmodium, Hepatocystis, Haemoproteus, and Leucocytozoon), including parasite species infecting mammals, birds, and reptiles from over a wide geographic range.
Abstract: A phylogeny of haemosporidian parasites (phylum Apicomplexa, family Plasmodiidae) was recovered using mitochondrial cytochrome b gene sequences from 52 species in 4 genera (Plasmodium, Hepatocystis, Haemoproteus, and Leucocytozoon), including parasite species infecting mammals, birds, and reptiles from over a wide geographic range. Leucocytozoon species emerged as an appropriate out-group for the other malarial parasites. Both parsimony and maximum-likelihood analyses produced similar phylogenetic trees. Life-history traits and parasite morphology, traditionally used as taxonomic characters, are largely phylogenetically uninformative. The Plasmodium and Hepatocystis species of mammalian hosts form 1 well-supported clade, and the Plasmodium and Haemoproteus species of birds and lizards form a second. Within this second clade, the relationships between taxa are more complex. Although jackknife support is weak, the Plasmodium of birds may form 1 clade and the Haemoproteus of birds another clade, but the parasites of lizards fall into several clusters, suggesting a more ancient and complex evolutionary history. The parasites currently placed within the genus Haemoproteus may not be monophyletic. Plasmodium falciparum of humans was not derived from an avian malarial ancestor and, except for its close sister species, P. reichenowi, is only distantly related to haemospordian parasites of all other mammals. Plasmodium is paraphyletic with respect to 2 other genera of malarial parasites, Haemoproteus and Hepatocystis. Explicit hypothesis testing supported these conclusions.
TL;DR: After three years of follow-up, the objective results of anterior cruciate ligament Replacement with a bone-patellar tendon-bone autograft were superior to those of replacement with a two-strand semitendinosus-gracilis graft with regard to knee laxity, pivot-shift grade, and strength of the knee flexor muscles.
Abstract: Background: The purpose of this investigation was to evaluate replacement of a torn anterior cruciate ligament with either a bone-patellar tendon-bone autograft or a two-strand semitendinosus-gracilis autograft to compare the results of clinical testing, patient satisfaction, activity level, functional status, and muscle strength.
Methods: Fifty-six patients with a torn anterior cruciate ligament were enrolled in a prospective, randomized, controlled study. Twenty-eight underwent reconstruction with a bone-patellar tendon-bone autograft, and twenty-eight were treated with a two-strand semitendinosus-gracilis autograft. Patients were followed for an average of thirty-nine months (range, thirty-six to fifty-seven months). At the time of final follow-up, twenty-two patients in each group were evaluated in terms of clinical test findings, patient satisfaction, activity level, functional status, and isokinetic muscle strength.
Results: The objective outcome of replacement of the torn anterior cruciate ligament with a bone-patellar tendon-bone graft was superior to that obtained with a two-strand semitendinosus-gracilis graft. At the three-year follow-up interval, the patients in whom a hamstring graft had been used had an average of 4.4 mm of increased anterior knee laxity compared with the laxity of the contralateral, normal knee, whereas the patients in whom a bone-patellar tendon-bone graft had been used had an average of 1.1 mm of increased knee laxity. Fourteen percent (three) of the twenty-two patients with a hamstring graft had a mild pivot shift, and 27% (six) had a moderate pivot shift. Only 14% (three) of the twenty-two patients with a bone-patellar tendon-bone graft had a mild pivot shift, and none had a moderate pivot shift. At the same follow-up interval, the patients in whom a hamstring graft had been used had significantly lower peak knee-flexion strength than those who had a bone-patellar tendon-bone graft (p = 0.039). In contrast, the two treatments produced similar outcomes in terms of patient satisfaction, activity level, and knee function (ability to perform a one-legged hop, bear weight, squat, climb stairs, run in place, and duckwalk).
Conclusions: After three years of follow-up, the objective results of anterior cruciate ligament replacement with a bone-patellar tendon-bone autograft were superior to those of replacement with a two-strand semitendinosus-gracilis graft with regard to knee laxity, pivot-shift grade, and strength of the knee flexor muscles. However, the two groups had comparable results in terms of patient satisfaction, activity level, and knee function.
TL;DR: In this article, the authors tested two models of family economic problems and adolescent psychological adjustment using adolescents' survey data and information regarding school lunch program enrollment, the associations among family SES, perceived economic strain, family conflict, and coping responses were examined in a sample of 364 adolescents from rural New England.
Abstract: This study tested two models of family economic problems and adolescent psychological adjustment Using adolescents’ survey data and information regarding school lunch program enrollment, the associations among family SES, perceived economic strain, family conflict, and coping responses were examined in a sample of 364 adolescents from rural New England Two theoretical models were tested using structural equation modeling — one tested coping as a mediator of the stress – psychopathology relation and the other tested coping as a moderator Results revealed that family economic hardship was related to aggression and anxiety/depression primarily through two proximal stressors: perceived economic strain and conflict among family members Family conflict partially mediated the relation between economic strain and adolescent adjustment, and coping further mediated the relation between family conflict and adjustment These analyses identified two types of coping that were associated with fewer anxiety/depression and aggression problems in the face of these stressors — primary and secondary control coping Although primary and secondary control coping were associated with fewer adjustment problems, youth who were experiencing higher amounts of stress tended to use less of these potentially helpful coping strategies and used more of the potentially detrimental disengagement coping The models did not differ according to the age or gender of the adolescents, nor whether they lived with two parents or fewer No support was found for coping as a moderator of stress Implications of these findings and suggestions for future research involving coping with economic stressors are reviewed
TL;DR: The data suggest that the principal biological consequences of endogenously produced and unrepaired free radical-damaged DNA bases are mutations.
TL;DR: Tissue factor-induced blood coagulation was studied in 20 individuals, for varying periods of time during 54 months, in contact pathway-inhibited whole blood at 37 degrees C and evaluated in terms of the activation of various substrates to illustrate that most thrombin (96%) is formed well after clotting occurs.
TL;DR: hs-CRP is significantly elevated in patients dying suddenly with severe coronary artery disease, both with and without acute coronary thrombosis, and correlates with immunohistochemical staining intensity and numbers of thin cap atheroma.
Abstract: Background— Elevations in serum C-reactive protein measured by high-sensitivity assay (hs-CRP) have been associated with unstable coronary syndromes. There have been no autopsy studies correlating hs-CRP to fatal coronary artery disease. Methods and Results— Postmortem sera from 302 autopsies of men and women without inflammatory conditions other than atherosclerosis were assayed for hs-CRP. There were 73 sudden deaths attributable to atherothrombi, 71 sudden coronary deaths with stable plaque, and 158 control cases (unnatural sudden deaths and noncardiac natural deaths without conditions known to elevate CRP). Atherothrombi were classified as plaque ruptures (n=55) and plaque erosion (n=18); plaque burden was estimated in each heart. Total cholesterol, high-density lipoprotein cholesterol, diabetes, smoking history, and body mass index were also determined. Immunohistochemical stains for CRP and numbers of thin cap atheromas per heart were quantitated in coronary deaths with hs-CRP in the highest and low...
TL;DR: The model accounts for the formation, expression, and propagation of the vitamin K-dependent procoagulant complexes, and most experimentally observable parameters are captured, and the pathology that results in enhanced or deficient thrombin generation is accurately described.
TL;DR: Elevated factor VIII and von Willebrand factor levels were common, independent, and dose-dependent risk factors for venous thromboembolism, and an elevated factor VII level was a possible risk factor.
Journal Article•
TL;DR: There is some agreement among authors with regard to the risk factors for ankle-ligament injury; however, considerable controversy remains and future research is needed to develop a consensus on all ankle-injury risk factors.
Abstract: OBJECTIVE: To review the prospective studies of ankle-ligament-injury risk factors. DATA SOURCES: We searched MEDLINE from 1978 to 2001 using the terms ankle, ligament, injury, risk factor, and epidemiology. DATA SYNTHESIS: The results included many studies on the treatment and prevention of ankle injuries. There were, however, very few prospective studies focusing on identifying the risk factors that predispose an athlete to ankle-ligament trauma. CONCLUSIONS/RECOMMENDATIONS: There is some agreement among authors with regard to the risk factors for ankle-ligament injury; however, considerable controversy remains. Although female athletes are at significantly greater risk of suffering a serious knee sprain, such as disruption of the anterior cruciate ligament, this does not appear to be the case for ankle-ligament sprains. Therefore, sex does not appear to be a risk factor for suffering an ankle-ligament sprain. Athletes who have suffered a previous sprain have a decreased risk of reinjury if a brace is worn, and the consensus is that generalized joint laxity and anatomical foot type are not risk factors for ankle sprains. However, the literature is divided with regard to whether or not height, weight, limb dominance, ankle-joint laxity, anatomical alignment, muscle strength, muscle-reaction time, and postural sway are risk factors for ankle sprains. Future research is needed on this topic to develop a consensus on all ankle-injury risk factors. This will allow future intervention studies to be designed that will reduce the incidence and severity of this common injury.
TL;DR: This paper summarizes the work in the field of elastography over the past decade, and discusses the basic principles and limitations that are involved in the production ofElastography of biological tissues.
Abstract: Elastography is a method that can ultimately generate several new kinds of images, called elastograms. As such, all the properties of elastograms are different from the familiar properties of sonograms. While sonograms convey information related to the local acoustic backscatter energy from tissue components, elastograms relate to its local strains, Young's moduli or Poisson's ratios. In general, these elasticity parameters are not directly correlated with sonographic parameters, i.e. elastography conveys new information about internal tissue structure and behavior under load that is not otherwise obtainable. In this paper we summarize our work in the field of elastography over the past decade. We present some relevant background material from the field of biomechanics. We then discuss the basic principles and limitations that are involved in the production of elastograms of biological tissues. Results from biological tissues in vitro and in vivo are shown to demonstrate this point. We conclude with some observations regarding the potential of elastography for medical diagnosis.
TL;DR: In this article, the authors examined associations of depressive symptoms with inflammation and coagulation factors in persons aged > 65 years, and found that depression was associated with elevated C-reactive protein (CRP), white blood cell (WBC) count, total platelet count, and albumin.
Abstract: Depression is associated with increased cardiovascular disease, but the underlying mechanisms are not well understood. This study examines associations of depressive symptoms with inflammation and coagulation factors in persons aged > 65 years. Blood samples were obtained from 4,268 subjects free of cardiovascular disease (age 72.4 +/- 5.5 years, 2,623 women). Inflammation markers were C-reactive protein (CRP), white blood cell (WBC) count, total platelet count, and albumin; coagulation factors included factors VIIc and VIIIc and fibrinogen. Depression was assessed with the Center for Epidemiologic Studies Depression scale, and states of energy depletion with a validated exhaustion index. Statistical adjustments were made for risk factors (age, sex, race, systolic blood pressure, smoking status, diabetes mellitus) and physical measures of frailty (isometric handgrip, timed 15-feet walk test, activity level). Depression was associated with elevated CRP (3.31 +/- 0.10 vs 3.51 +/- 0.21 mg/L), WBC (6.14 +/- 0.03 vs 6.43 +/- 0.11 10(6)/L), fibrinogen (319 +/- 1 vs 326 +/- 3 mg/dl), and factor VIIc (124.6 +/- 0.6% vs 127.2 +/- 1.3%; all p 65 years.
TL;DR: This article summarizes literature on silica-induced accelerated silicosis, chronic silicaosis, silico-tuberculosis, bronchogenic carcinoma, and immune-mediated diseases and the role of ROS in these processes is briefly discussed.