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Biomedical subjects

B McIntosh

Publications and source records attributed to B McIntosh.

17 recordsLinked to original sources

Strategic options for sustainable water management at new developments: the application of a simulation model to explore potential water savings.

Research on appropriate technologies and infrastructures to support water reuse has progressed rapidly over recent decades and there are now a wide range of source--treatment--reuse options for planners to choose from. Although the economics of water reuse schemes favours application to new developments rather than retrofit projects, there are few studies which have sought to address strategic option selection issues for large developments. The potential advantages of using treatment and reuse systems in new developments require an understanding of the relationships between a wide variety of social, environmental, technological, and operational factors. The operational effectiveness and economic efficiency of specific technology choices will vary as a function of network configuration, wastewater characteristics, how different technologies respond to dynamic loading (variability of feed strength and flow) and potential spiking, as well as equipment reliability, climate and household behaviour. Using a commercially available software package, the study reports the design and implementation of a low resolution simulation tool to explore sustainable water management options for a live case study site in the south of England (a peri-urban development of 4,500 new homes) with particular reference to opportunities for rainwater harvesting, and water reuse.

Climate↗

Cardiac rehabilitation for community-based patients with myocardial infarction: factors predicting discharge recommendation and participation.

Although there is substantial evidence that cardiac rehabilitation is beneficial for post myocardial infarction (MI) patients, such programs are currently under utilized. This study examined systematic criteria predicting physician referral to and patients' participation in cardiac rehabilitation programs. Patients discharged for MI were interviewed in-hospital and at 6-12 weeks post discharge to determine referral, participation, and completion. Stepwise logistic regression analyzed factors associated with rehabilitation. Factors associated with referral to rehab were catheterization (p < 0.001), bypass surgery (p < 0.01), cardiologist/cardiac surgeon appointment (p < 0.02), and age (p < 0.01). Participation was increased for those with bypass surgery (p < 0.001), and referral to cardiologist or cardiac surgeon (p < 0.001). Type of provider significantly influences referral to and participation in cardiac rehabilitation. This suggests that encouragement plays a strong role in attendance for rehabilitation. The same strong encouragement should be given to the broader range of MI patients who stand to benefit from cardiac rehabilitation.

Adult↗

Cloning and characterization of a novel human histone deacetylase, HDAC8.

Histone deacetylases (HDACs) are a growing family of enzymes implicated in transcriptional regulation by affecting the acetylation state of core histones in the nucleus of cells. HDACs are known to have key roles in the regulation of cell proliferation [Brehm, Miska, McCance, Reid, Bannister and Kouzarides (1998) Nature (London) 391, 597-600], and aberrant recruitment of an HDAC complex has been shown to be a key step in the mechanism of cell transformation in acute promyelocytic leukaemia [Grignani, De Matteis, Nervi, Tomassoni, Gelmetti, Cioce, Fanelli, Ruthardt, Ferrara, Zamir et al. (1998) Nature (London) 391, 815-818; Lin, Nagy, Inoue, Shao, Miller and Evans (1998), Nature (London) 391, 811-814]. Here we present the complete nucleotide sequence of a cDNA clone, termed HDAC8, that encodes a protein product with similarity to the RPD3 class (I) of HDACs. The predicted 377-residue HDAC8 product contains a shorter C-terminal extension relative to other members of its class. After expression in two cell systems, immunopurified HDAC8 is shown to possess trichostatin A- and sodium butyrate-inhibitable HDAC activity on histone H4 peptide substrates as well as on core histones. Expression profiling reveals the expression of HDAC8 to various degrees in every tissue tested and also in several tumour lines. Mutation of two adjacent histidine residues within the predicted active site severely decreases activity, confirming these residues as important for HDAC8 enzyme activity. Finally, linkage analysis after radiation hybrid mapping has localized HDAC8 to chromosomal position Xq21.2-Xq21.3. These results confirm HDAC8 as a new member of the HDAC family.

Amino Acid Sequence↗

The use of angiotensin-converting enzyme inhibitors in patients with acute myocardial infarction in community hospitals. Michigan State University Inter-Institutional Collaborative Heart (MICH) Study Group.

BACKGROUND: Previous studies documenting underutilization of angiotensin-converting enzyme inhibitors (ACEIs) in acute myocardial infarction (AMI) have been limited to Medicare populations. HYPOTHESIS: This study examines ACEI prescription rates and predictors in a community sample of hospitalized patients with AMI. METHODS: The charts of 1163 community patients with AMI, prospectively identified at admission between January 1, 1994, and April 30, 1995, were reviewed. RESULTS: Only 64 of 158 (40%) patients considered ideal candidates for ACEI prescription were discharged with a prescription for an ACEI. In a multivariate logistic regression model, prior ACEI utilization [adjusted odds ration (OR) = 3.26; 95% confidence interval (CI) = 2.05-5.20], presence of congestive heart failure (OR = 2.33; CI = 1.50-3.61) and black race (OR = 2.20; CI = 1.34-3.64) were identified as positive predictors of ACEI prescription. Conversely, lack of left ventricular ejection fraction (LVEF) measurement (OR = 0.46; CI = 0.28-0.75), LVEF > 40 ( OR = 0.27; CI = 0.18-0.40), and acute renal failure (OR = 0.08; CI = 0.01-0.44) were negative predictors. Women were also less likely to be discharged with an ACEI prescription (OR = 0.71; CI = 0.48-1.05). Furthermore, women were significantly less likely to have LVEF measured prior to discharge than were males (77 vs. 85%, p = 0.001). CONCLUSION: This study underscores the need for improvement in the utilization of ACEI in eligible patients with AMI. It also identifies opportunities for improvement in prescription rates, especially in women.

Adult↗

Initiation of protein synthesis with fluorophore-Met-tRNA(f) and the involvement of IF-2.

The complicity of initiation factor 2 (IF-2) in causing the observed low incorporation of N-terminal fluorophore from fluorophore-methionyl-tRNA(f) during protein synthesis in an in vitro coupled transcription/translation system was investigated. The low incorporation in comparison to formyl-methionine was not due to the lack of interaction of fluorophore-Met-tRNA(f) with IF-2. Fluorescence measurements of cascade yellow-, eosin-, pyrene-, or coumarin-Met-tRNA(f) determined that all were capable of binding IF-2 at 4 mM Mg(2+) and 37 degrees C. Filter binding assays conducted in the absence of magnesium ions on fMet-tRNA(f), eosin-Met-tRNA(f), and cascade yellow-Met-tRNA(f) confirmed the previously reported value for the dissociation constant of fMet-tRNA(f) of about 1 microM and placed the binding constants for the two fluorophore derivatives about three-fold higher. Binding of the fluorophore-Met-tRNA(f) species to salt-washed ribosomes showed a more significant decrease compared to fMet-tRNA(f). Stimulation in the amount of tRNA bound to the ribosomes upon the addition of IF-2 was observed in each case. All ribosome-bound cascade yellow-Met-tRNA(f) and eosin-Met-tRNA(f) were as puromycin-reactive as fMet-tRNA(f). Cumulatively, the effects observed for the fluorophore-Met-tRNA species in partial reactions of initiation may account for the reduced incorporation of these probes at the N terminus of polypeptides.

Codon, Initiator↗

Shyness and sociotropy: additive and interactive relations in predicting interpersonal concerns.

Sociotropy (an aspect of interpersonal dependence) and sociability (affiliative need) were examined as moderator variables of the relationship between shyness and interpersonal concerns in two studies. In Study 1, sociotropy, but not sociability, predicted unique variance in three indices of interpersonal concerns through both direct and interactive relations with shyness. An initial analysis in Study 2 showed that sociotropy, but not sociability, was predictive of participants' perceived competence in situations that involved initiation of conversations and assertion. In the second part of Study 2, sociotropy accounted for significant increments in variance when predicting cognitive and affective manifestations of distress related to simulated conversation and assertion situations, while sociability did not. Study 2 results suggest that sociotropy operates primarily in an additive manner with shyness in predicting interpersonal concerns, rather than moderating the relation between shyness and interpersonal concerns. Differences in the results of the two studies and implications for future research are discussed.

Adolescent↗

Surgical decompression of ductal obstruction in patients with chronic pancreatitis.

BACKGROUND: Recurrent acute pancreatitis often leads to chronic obstructive ductal disease requiring operative decompression. METHODS: From 1983 through 1998, 124 patients with ductal obstruction underwent lateral pancreaticojejunostomy (78 patients), distal pancreatectomy with end-to-side pancreaticojejunostomy (27 patients), distal pancreatectomy with placement of a pancreas with a filleted duct within a jejunal limb (15 patients), or pancreaticoduodenectomy (4 patients). Preoperative symptoms included abdominal and back pain (99%), nausea with vomiting (99%), and diarrhea with weight loss (11%). Associated conditions included hypertension (20%) and diabetes mellitus (12%). Endoscopy in 106 patients demonstrated distal stricture (37%), proximal stricture (36%), pseudocyst (30%), chain of lakes (15%), calcification and debris (19%), and bile duct stricture (8%). RESULTS: Two patients died, one of an unrecognized esophageal perforation during intubation and the other of leakage of a 1-layer pancreaticojejunostomy. Thirty-six patients developed 53 complications including intra-abdominal abscess (7 patients) and bleeding requiring reoperation in 1 patient. Pain relief was complete in 61 patients, substantial in 39 patients, moderate in 11 patients, minimal in 8 patients, and nonexistent in 3 patients with multiple stones and narrow duct. Ten patients died, with 6 deaths as a result of pancreatic cancer Two other patients may have died of pancreatic cancer. CONCLUSIONS: Lateral pancreaticojejunostomy is the procedure of choice in most patients. Recurrent pancreatitis usually follows alcoholic binges. Long-term follow-up must assess for pancreatic cancer.

Adult↗

Sensitivity to grammatical morphemes in children with specific language impairment.

Grammatical morphemes, such as articles and auxiliary verbs, provide potentially useful information to language learners. However, children with specific language impairment (SLI) frequently fail to produce grammatical morphemes, raising questions about their sensitivity to them. To address this issue, two experiments were conducted in which 3- to 5-year-old children with SLI and with normally developing language (NL) heard sentences asking them to identify a picture corresponding to a named target word. The target occurred in either a grammatical sentence or one with an incorrectly used grammatical morpheme. In Experiment 1, the picture representing the target occurred with three unrelated distractor pictures. In Experiment 2, distractor sets included pictures that were semantically related to the target. In both studies, the SLI group chose fewer correct pictures when the target followed an incorrectly used morpheme. In Experiment 2, the SLI group chose more semantically related than unrelated distractors. These results suggest that children with SLI are sensitive to grammatical morphemes and that their incorrect picture choices may reflect a failure to maintain the target in memory.

Child↗

The effect of testing time on students' performance for the subject examination for internal medicine.

The authors tested the hypothesis that increasing the allotted testing time from two to four hours for the National Board of Medical Examiners medicine subject examination would increase the score on this examination when given as part of the clerkship evaluation. One-hundred six students who completed their medicine clerkships between September 1991 and August 1992 (group 1) were compared with 96 students who completed their clerkships between September 1992 and August 1993 (group 2). The mean medicine subject examination score for group 1 was 462 +/- 86, vs 518 +/- 108 for group 2 (p = 0.0003). Regression analysis using the medicine subject examination score as the dependent variable and all baseline characteristics, group assignment, and time of year the test was taken as independent variables demonstrated significant interactions only for United States Medical Licensing Examination (USMLE) Step 1 score (R2 = 0.48, beta weight = 0.68, p = 0.0000) and group assignment (R2 = 0.05, beta weight = 0.18, p = 0.002). The authors conclude that increased testing time for the medicine subject examination from two to four hours is associated with a significant increase in scores; however, scores on the preclinical USMLE Step 1 showed a stronger association.

Adult↗

Sequence analysis of a cDNA clone encoding the C-terminal end of human complement factor H.

Peptide sequencing of the complement system regulatory protein, factor H, permitted the synthesis of a mixed sequence oligonucleotide probe. Human liver cDNA libraries were screened and factor H-specific clones selected. No full-length clone was obtained, but the largest available clone, R2a, was found to encode the C-terminal 657 amino acids of factor H. The derived amino acid sequence consists of 10 contiguous internally homologous segments, each about 60 amino acids long. Sequences homologous to these are found in several other complement and non-complement proteins. Such sequences are likely to represent a particular type of tertiary structure subunit.

Amino Acid Sequence↗

The cloning and nucleotide sequence of cDNA for an amplified glutamine synthetase gene from the Chinese hamster.

The nucleotide sequence for a glutamine synthetase (GS) mRNA from gene-amplified Chinese hamster (CHO) cells was determined from recombinant cDNA clones obtained from both pBR322 and lambda gt10 libraries and by primer extension. The sequence obtained contains about 1400 bp corresponding to a minor species of mRNA terminated by a poly A sequence. The mRNA contains 146 nucleotides of 5'-noncoding region, 1119 bp of coding sequence, and 108 bp of 3'-noncoding sequence with a 32 bp poly(A) tail. The polyadenylation site used shows little homology with efficient polyadenylation sites, but has considerable complementarity with U4 RNA. The predicted amino acid sequence, starting from an initiation codon with the preferred sequence surrounding it, indicates that Chinese hamster GS has high homology with published bovine brain GS peptides and enabled an ordering of these peptides. There is homology between the mammalian GS enzymes and glutamine synthetases obtained from plants and cyanobacteria but no obvious homology between the CHO cell GS sequence and that of other ATP hydrolysing enzymes.

Animals↗

Mianserin kinetics in depressed patients.

We studied mianserin kinetics after a single (60 mg) dose in eight inpatients suffering from depression. There was a considerable interpatient variability in plasma levels. Mean peak plasma levels (+/- SEM) were 114 +/- 26 ng/ml and were reached between 1 and 3 hr. The decline of mianserin levels in plasma was biphasic. The mean elimination t 1/2 was 21.6 +/- 3.1 hr and ranged from 10.7 to 40.8 hr. The estimated first-pass loss ranged from 26% to 48% (mean, 37%) and was lower than that reported for tertiary amine tricyclic antidepressants. The mean apparent volume of distribution (15.7 +/- 2.2 l/kg; 9.7 to 28.8 l/kg) was in the range of that for imipramine but somewhat lower than for maprotiline. Apparent total body clearance ranged from 0.33 to 0.81 l/hr/kg (mean +/- SEM, 0.52 +/- 0.05 l/hr/kg) and was of the order of that after maprotiline. Our results indicate that mianserin kinetics are in most respects similar to those of tertiary amine tricyclic antidepressants (e.g., imipramine) and the tetracyclic maprotiline.

Adult↗

Handling of highly infectious material in a clinical pathology laboratory and in a viral diagnostic unit.

The handling of potentially lethal and highly infective material in a routine clinical pathology laboratory and in a viral diagnostic unit is detailed. Extensive precautions were taken at each step of the receiving, processing and disposal cycle. Disposable protective clothing and apparatus were used whenever possible. Laboratory tests were limited to those essential for the clinical management and diagnosis. Technologists who handled infective material were limited to minimal numbers of experienced, non-pregnant, informed volunteers. They wore special protective clothing, including gloves, caps, gowns and masks. When possible, specimens were handled under special protective hoods. Potentially infective material was processed through automated apparatus, and care was taken to prevent contamination of its exterior. The effluent from the machines was collected into viricidal agents (glutaraldehyde, sodium hypochlorite). After processing, the machines were flushed extensively with viricidal solution. This procedure has caused no damage to the automated equipment and has been adopted as a routine laboratory safety measure. The protective procedures adopted were successful in that there was no outbreak of the viral infection among the associated laboratory workers.

Animals↗

Injury patterns in recreational rock climbers.

We studied 39 recreational rock climbers to determine the incidence and pattern of injuries sustained in the sport at their level. Eleven climbers (26%), who climbed beyond the sport level, had sustained a major injury from a fall. Thirty-five climbers (89%) sustained at least one significant injury. Fifty percent of the injuries involved the hand or wrist. Only seven climbers (19%) had evidence of a digital pulley injury (climber's finger). Four climbers (11%) had evidence of a carpal tunnel syndrome. Twenty climbers (50%) had tendinitis in an upper extremity on physical examination.

Accidental Falls↗

How government policy decisions affect seniors' quality of life: findings from a participatory policy study carried out in Toronto, Canada.

Toronto seniors explored how government policy decisions were influencing their health and well-being. In this participatory policy study, emphasis was upon the lay and critical knowledge of highly informed seniors. Focus groups and interviews revealed that all three levels of governments were seen as not listening to seniors' voices. In nine key policy areas identified as influencing seniors' quality of life--hearing seniors' voices, housing, acute illness care, long-term care, income supports, transportation and mobility, promoting healthy lifestyles, access to information, and hearing voices from cultural communities--many concerns were raised. The gap between government rhetoric and government action on seniors' issues merits public health attention.

Aged↗