University of Vermont

About: University of Vermont is a education organization based out in Burlington, Vermont, United States. It is known for research contribution in the topics: Population & Poison control. The organization has 17592 authors who have published 38251 publications receiving 1609874 citations. The organization is also known as: UVM & University of Vermont and State Agricultural College.

Regulation of myocardial Ca2+-ATPase and phospholamban mRNA expression in response to pressure overload and thyroid hormone.

Abstract: The sarcoplasmic reticulum (SR) and the contractile protein myosin play an important role in myocardial performance. Both of these systems exhibit plasticity--i.e., quantitative and/or qualitative reorganization during development and in response to stress. Recent studies indicate that SR Ca2+ uptake function is altered in adaptive cardiac hypertrophy and failure. The molecular basis (genetic and phenotypic) for these changes is not understood. In an effort to determine the underlying causes of these changes, we characterized the rabbit cardiac Ca2+-ATPase phenotype by molecular cloning and ribonuclease A mapping analysis. Our results show that the heart muscle expresses only the slow-twitch SR Ca2+-ATPase isoform. Second, we quantitated the steady-state mRNA levels of two major SR Ca2+ regulatory proteins, the Ca2+-ATPase and phospholamban, to see whether changes in mRNA content might provide insight into the basis for functional modification in the SR of hypertrophied hearts. In response to pressure overload hypertrophy, the relative level of the slow-twitch/cardiac SR Ca2+-ATPase mRNA was decreased to 34% of control at 1 week. The relative Ca2+-ATPase mRNA level increased to 167% of control after 3 days of treatment with thyroid hormone. In contrast, in hypothyroid animals, the relative Ca2+-ATPase mRNA level decreased to 51% of control at 2 weeks. The relative level of phospholamban mRNA was decreased to 36% in 1-week pressure overload. Hyperthyroidism induced a decrease to 61% in the phospholamban mRNA level after 3 days of treatment, while hypothyroidism had virtually no effect on phospholamban mRNA levels. These data indicate that the expression of SR Ca2+-ATPase and phospholamban mRNA may not be coordinately regulated during myocardial adaptation to different physiological conditions.

Use of Emergency Medical Services in Acute Myocardial Infarction and Subsequent Quality of Care Observations From the National Registry of Myocardial Infarction 2

Abstract: Background— National practice guidelines strongly recommend activation of the 9-1-1 Emergency Medical Systems (EMS) by patients with symptoms consistent with an acute myocardial infarction (MI). We examined use of the EMS in the United States and ascertained the factors that may influence its use by patients with acute MI. Methods and Results— From June 1994 to March 1998, the National Registry of Myocardial Infarction 2 enrolled 772 586 patients hospitalized with MI. We excluded those who transferred in, arrived at the hospital >6 hours from symptom onset, or who were in cardiogenic shock. We compared baseline characteristics and initial management for patients who arrived by ambulance versus self-transport. EMS was used in 53.4% of patients with MI, a proportion that did not vary significantly over the 4-year study period. Nonusers of the EMS were on average younger, male, and at relatively lower risk on presentation. In addition, payer status was significantly associated with EMS use. Use of EMS was in...

Complications in Surgical Patients

Abstract: Hypothesis Complications are common in hospitalized surgical patients. Provider error contributes to a significant proportion of these complications. Design Surgical patients were concurrently observed for the development of explicit complications. All complications were reviewed by the attending surgeon and other members of the service and evaluated for the severity of sequelae (major or minor) and for whether the complication resulted from medical error (avoidable) or not. Setting University teaching hospital with a level I trauma designation. Patients All inpatients (operative or nonoperative) from 4 different surgical services: general surgery, combined general surgery and trauma, vascular surgery, and cardiothoracic surgery. Main Outcome Measures Total complication rate (number of complications divided by the number of patients) and the number of patients with complications. Complications were separated into those with major or minor sequelae and the proportion of each type that were due to medical error (avoidable). Rates of complications in a recent Institute of Medicine report were used as a criterion standard. Results The data for the respective groups (general surgery, vascular surgery, combined general surgery and trauma, and cardiothoracic surgery) are as follows. The number of patients was 1363, 978, 914, and 1403; number of complications, 413, 409, 295, and 378; total complication rate, 30.3%, 42.4%, 32.3%, and 26.9%; minor complication rate, 13.3%, 19.9%, 13.5%, and 13.0% (percentage of minor complications that were avoidable, 37.4%, 59.0%, 51.2%, and 49.5%); major complication rate, 16.2%, 21.1%, 18.1%, and 12.9% (percentage of major complications that were avoidable, 53.4%, 60.7%, 38.8%, and 38.7%); and mortality rate, 1.83%, 3.33%, 2.28%, and 3.34% (percentage of mortality that was avoidable, 28.0%, 44.1%, 19.0%, and 25.0%). Conclusions Despite mortality rates that compare favorably with national benchmarks, a prospective examination of surgical patients reveals complication rates that are 2 to 4 times higher than those identified in an Institute of Medicine report. Almost half of these adverse events were judged contemporaneously by peers to be due to provider error (avoidable). Errors in care contributed to 38 (30%) of 128 deaths. Recognition that provider error contributes significantly to adverse events presents significant opportunities for improving patient outcomes.

Compression-induced changes in intervertebral disc properties in a rat tail model.

Abstract: Study design An Ilizarov-type apparatus was applied to the tails of rats to assess the influence of immobilization, chronically applied compression, and sham intervention on intervertebral discs of mature rats. Objectives To test the hypothesis that chronically applied compressive forces and immobilization cause changes in the biomechanical behavior and biochemical composition of rat tail intervertebral discs. Summary of background data Mechanical factors are associated with degenerative disc disease and low back pain, yet there have been few controlled studies in which the effects of compressive forces on the structure and function of the disc have been isolated. Methods The tails of 16 Sprague-Dawley rats were instrumented with an Ilizarov-type apparatus. Animals were separated into sham, immobilization, and compression groups based on the mechanical conditions imposed. In vivo biomechanical measurements of disc thickness, angular laxity, and axial and angular compliance were made at 14-day intervals during the course of the 56-day experiment, after which discs were harvested for measurement of water, proteoglycan, and collagen contents. Results Application of pins and rings alone (sham group) resulted in relatively small changes of in vivo biomechanical behavior. Immobilization resulted in decreased disc thickness, axial compliance, and angular laxity. Chronically applied compression had effects similar to those of immobilization alone but induced those changes earlier and in larger magnitudes. Application of external compressive forces also caused an increase in proteoglycan content of the intervertebral discs. Conclusions The well-controlled loading environment applied to the discs in this model provides a means of isolating the influence of joint-loading conditions on the response of the intervertebral disc. Results indicate that chronically applied compressive forces, in the absence of any disease process, caused changes in mechanical properties and composition of tail discs. These changes have similarities and differences in comparison with human spinal disc degeneration.

25 Years of Family Business Review: Reflections on the Past and Perspectives for the Future

Abstract: Since its launch in 1988, the Family Business Review (FBR) has played an integral role in the establishment and development of the field of family business studies. This field is distinguished from its sister disciplines by its singular focus on the paradoxes caused by the involvement of family in business. Today, scholars worldwide recognize both the ubiquity of family enterprises and the complexity of issues faced by these enterprises. However, this has not always been the case. While the field has made impressive progress in terms of the 3Rs of research— Relevance, Reach, and Rigor—much exciting work remains to be done. This introduction to the special issue celebrating the 25th anniversary of FBR discusses the progress the field and the journal have made in the past quarter century and some of the challenges that are waiting for resolution in the future. Family firms represent the predominant form of business organization in the world (LaPorta, Lopez-de-Silanes, & Shleifer, 1999). These heterogeneous and complex enterprises offer a challenging array of issues to study and are beginning to receive substantial scholarly attention. For the past 25 years, FBR has been a catalyst in establishing family business studies as a legitimate field of investigation—a mission defined by its founding editor Ivan Lansberg in its first issue (Lansberg & Gersick, 1993). FBR is currently supported by approximately 200 scholars who are serving as its editors, advisory and review board members, and ad hoc reviewers. With an impact factor of 2.426, it ranks among the top 20 journals in the business category of the Social Science Citation Index. More than 200 submissions from around the world compete for approximately 20 article slots in FBR annually. No wonder there is a “collective sense that significant progress has been made” (Litz, Pearson, & Litchfield, 2012) and that scholars are “united in their appreciation of what has been achieved to date” (Craig & Salvato, 2012). While family enterprise research is moving forward and gaining momentum today, such was not always the case. In this introduction to the special issue celebrating the 25th anniversary of FBR, we pay tribute to the visionaries who laid the foundation for the field of family business studies and contributed substantially to the consulting profession devoted to these enterprises. To accomplish this purpose we provide a brief history of FBR and the owner of the journal, the Family Firm Institute (FFI), followed by observations on the field’s domain and notable developments regarding the progression of family business studies in terms of three 3Rs of research: relevance, reach, and rigor (cf. Sharma, 2010a). Our aim is to provide an overview of the major developments in the past two and half decades, while offering some suggestions on how the future aspirations of the journal and its stakeholders might be achieved. This introductory article draws heavily from three sources: (a) our own experiences as consumers and producers of knowledge related to family enterprises, (b) previous editorials and review articles published in FBR and other venues (e.g., Bird, Welsch, Astrachan, & Pistrui,