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.

Climate change impacts on bumblebees converge across continents

Abstract: For many species, geographical ranges are expanding toward the poles in response to climate change, while remaining stable along range edges nearest the equator. Using long-term observations across Europe and North America over 110 years, we tested for climate change–related range shifts in bumblebee species across the full extents of their latitudinal and thermal limits and movements along elevation gradients. We found cross-continentally consistent trends in failures to track warming through time at species’ northern range limits, range losses from southern range limits, and shifts to higher elevations among southern species. These effects are independent of changing land uses or pesticide applications and underscore the need to test for climate impacts at both leading and trailing latitudinal and thermal limits for species.

Prophylactic versus selective use of surfactant in preventing morbidity and mortality in preterm infants

Abstract: Background Surfactant therapy is effective in improving the outcome of very preterm infants. Trials have studied a wide variety of surfactant preparations used either to prevent or treat respiratory distress syndrome (RDS). In animal models, prophylactic surfactant leads to more homogeneous distribution and less evidence of lung damage. However, administration requires intubation and treatment of infants who will not go on to develop RDS. This is of particular concern with the advent of improved approaches to providing continuous distending pressure, particularly in the form of nasal continuous positive airway pressure (NCPAP). Objectives To compare the effect of prophylactic surfactant administration with surfactant treatment of established RDS in very preterm infants at risk of RDS. Search methods We updated the search of the Cochrane Central Register of Controlled Trials (The Cochrane Library), MEDLINE, EMBASE, CINAHL, and clinical trials.gov register in December 13, 2011. Selection criteria Randomized and quasi-randomized controlled trials that compared the effects of prophylactic surfactant administration with surfactant treatment of established RDS in preterm infants at risk of RDS. Data collection and analysis Data regarding clinical outcomes were extracted from the reports of the clinical trials by the review authors. Data analysis was done in accordance with the standards of the Cochrane Neonatal Review Group. Main results We identified 11 studies that met inclusion criteria (nine without routine application of continuous positive air way pressure (CPAP) in the selective treatment group; two with routine application of CPAP in the selective treatment group). The meta-analysis of studies conducted prior to the routine application of CPAP demonstrated a decrease in the risk of air leak and neonatal mortality associated with prophylactic administration of surfactant. However, the analyses of studies that allowed for routine stabilization on CPAP demonstrated a decrease in the risk of chronic lung disease or death in infants stabilized on CPAP. When all studies were evaluated together, the benefits of prophylactic surfactant could no longer be demonstrated. Authors' conclusions Although the early trials of prophylactic surfactant administration to infants judged to be at risk of developing RDS compared with selective use of surfactant in infants with established RDS demonstrated a decreased risk of air leak and mortality, recent large trials that reflect current practice (including greater utilization of maternal steroids and routine post delivery stabilization on CPAP) do not support these differences and demonstrate less risk of chronic lung disease or death when using early stabilization on CPAP with selective surfactant administration to infants requiring intubation.

Effect of age on in vivo rates of mitochondrial protein synthesis in human skeletal muscle

Abstract: A progressive decline in muscle performance in the rapidly expanding aging population is causing a dramatic increase in disability and health care costs. A decrease in muscle endurance capacity due to mitochondrial decay likely contributes to this decline in muscle performance. We developed a novel stable isotope technique to measure in vivo rates of mitochondrial protein synthesis in human skeletal muscle using needle biopsy samples and applied this technique to elucidate a potential mechanism for the age-related decline in the mitochondrial content and function of skeletal muscle. The fractional rate of muscle mitochondrial protein synthesis in young humans (24 +/- 1 year) was 0.081 +/- 0.004%.h-1, and this rate declined to 0.047 +/- 0.005%.h-1 by middle age (54 +/- 1 year; P < 0.01). No further decline in the rate of mitochondrial protein synthesis (0.051 +/- 0.004%.h-1) occurred with advancing age (73 +/- 2 years). The mitochondrial synthesis rate was about 95% higher than that of mixed protein in the young, whereas it was approximately 35% higher in the middle-aged and elderly subjects. In addition, decreasing activities of mitochondrial enzymes were observed in muscle homogenates (cytochrome c oxidase and citrate synthase) and in isolated mitochondria (citrate synthase) with increasing age, indicating declines in muscle oxidative capacity and mitochondrial function, respectively. The decrease in the rates of mitochondrial protein synthesis is likely to be responsible for this decline in muscle oxidative capacity and mitochondrial function. These changes in muscle mitochondrial protein metabolism may contribute to the age-related decline in aerobic capacity and muscle performance.

Dose and Dose Intensity as Determinants of Outcome in the Adjuvant Treatment of Breast Cancer

Abstract: Background: Both total dose and dose intensity of adjuvant chemotherapy are postulated to be important variables in the outcome for patients with operable breast cancer. The Cancer and Leukemia Group B study 8541 examined the effects of adjuvant treatment using conventional-range dose and dose intensity in female patients with stage II (axillary lymph node-positive) breast cancer. Methods: Within 6 weeks of surgery (radical mastectomy, modified radical mastectomy, or lumpectomy), 1550 patients with unilateral breast cancer were randomly assigned to one of three treatment arms: high-, moderate-, or low-dose intensity. The patients received cyclophosphamide, doxorubicin, and 5fluorouracil on day 1 of each chemotherapy cycle, with 5fluorouracil administration repeated on day 8. The highdose arm had twice the dose intensity and twice the drug dose as the low-dose arm. The moderate-dose arm had two thirds the dose intensity as the high-dose arm but the same total drug dose. Disease-free survival and overall survival were primary end points of the study. Results: At a median follow-up of 9 years, disease-free survival and overall survival for patients on the moderate- and high-dose arms are superior to the corresponding survival measures for patients on the low-dose arm (two-sided P<.0001 and two-sided P = .004, respectively), with no difference in disease-free or overall survival between the moderate- and the high-dose arms. At 5 years, overall survival (average ± standard error) is 79% ± 2% for patients on the high-dose arm, 77% ± 2% for the patients on the moderate-dose arm, and 72% ± 2% for patients on the low-dose arm; disease-free survival is 66% ± 2%, 61% ± 2%, and 56% ± 2%, respectively. Conclusion: Within the conventional dose range for this chemotherapy regimen, a higher dose is associated with better disease-free survival and overall survival. [J Natl Cancer Inst 1998;90:

Pathogenetic and prognostic significance of altered coagulation and fibrinolysis in acute lung injury/acute respiratory distress syndrome

Abstract: Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are life-threatening disorders characterized by severe inflammation in the lungs and frequent occurrence of multiple organ failure (1). Despite numerous randomized controlled trials of therapies aimed at modulating the inflammatory response in ALI/ARDS (2), the only therapy that has been proven to reduce mortality is a protective ventilatory strategy (3). Although mortality from ALI/ARDS has declined in clinical trials, epidemiologic studies that include all patients with ALI/ARDS still report mortality rates >50% (4). Insight into the pathophysiological derangements that characterize early clinical ALI/ARDS may help to guide the development of new therapies for this devastating disorder. The degree of alterations in coagulation and fibrinolysis may be an important pathogenetic and prognostic determinant of mortality in ALI/ARDS. Although altered coagulation and fibrinolysis, both systemically and in the alveolar compartment, were first described in patients with ARDS some years ago (5-7), the relationship of procoagulant to proinflammatory events in causing organ injury has been better appreciated recently (8, 9). Alterations in coagulation and fibrinolysis proteins have not been systematically studied in large numbers of well-characterized patients with ALI/ARDS using the standard definitions (10) that are now used in most clinical trials. We previously measured circulating levels of the endogenous anticoagulant protein C (11) and the fibrinolysis inhibitor plasminogen activator inhibitor-1 (PAI-1) (12) in patients with ALI/ARDS in two small single-center pilot studies. Compared with control patients with acute cardiogenic pulmonary edema, levels of plasma protein C were low and levels of plasma PAI-1 were high in ALI/ARDS. Based on these preliminary findings, we hypothesized that in a large multicenter study, low circulating levels of protein C and high levels of PAI-1 would be present and would have a major impact on the risk of death and other major outcomes in ALI/ARDS. In addition, because prognostic indices in lung injury have limited value when based on a single biomarker alone (13), we determined whether the combination of protein C and PAI-1 would have a higher prognostic value for important clinical outcomes. Understanding the relationship of alterations in coagulation and fibrinolysis proteins on the pathogenesis and prognosis of ALI could be a valuable step toward the development of new therapeutic strategies to target these pathways in this important cause of acute respiratory failure.