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Biomedical subjects

D Wheeler

Publications and source records attributed to D Wheeler.

At least 19 recordsLinked to original sources

Auditory integration training and other sound therapies for autism spectrum disorders: a systematic review.

OBJECTIVES: To determine the effectiveness of auditory integration training (AIT) or other methods of sound therapy in people with autism spectrum disorders (ASD). STUDY DESIGN: A systematic review was carried out of randomised controlled trials (RCTs) of adults or children with ASD. Meta-analysis was attempted. RESULTS: Six RCTs of AIT, including one crossover trial, were identified, with a total of 171 participants aged 3-39 years. 17 different outcome measures were used, with only two outcome measures used by three or more studies. Meta-analysis was not possible owing to very high heterogeneity or presentation of data in unusable forms. Three studies did not show any benefit of AIT over control conditions. Three studies reported improvements at 3 months in the AIT group for total mean scores of the Aberrant Behaviour Checklist (ABC), which is of questionable validity. Of these, one study also reported improvements at 3 months in the AIT group for ABC subgroup scores. No significant adverse effects of AIT were reported. CONCLUSION: At present there is not sufficient evidence to support its use.

Acoustic Stimulation↗

What is soil organic matter worth?

The conservation and restoration of soil organic matter are often advocated because of the generally beneficial effects on soil attributes for plant growth and crop production. More recently, organic matter has become important as a terrestrial sink and store for C and N. We have attempted to derive a monetary value of soil organic matter for crop production and storage functions in three contrasting New Zealand soil orders (Gley, Melanic, and Granular Soils). Soil chemical and physical characteristics of real-life examples of three pairs of matched soils with low organic matter contents (after long-term continuous cropping for vegetables or maize) or high organic matter content (continuous pasture) were used as input data for a pasture (grass-clover) production model. The differences in pasture dry matter yields (non-irrigated) were calculated for three climate scenarios (wet, dry, and average years) and the yields converted to an equivalent weight and financial value of milk solids. We also estimated the hypothetical value of the C and N sequestered during the recovery phase of the low organic matter content soils assuming trading with C and N credits. For all three soil orders, and for the three climate scenarios, pasture dry matter yields were decreased in the soils with lower organic matter contents. The extra organic matter in the high C soils was estimated to be worth NZ$27 to NZ$150 ha(-1) yr(-1) in terms of increased milk solids production. The decreased yields from the previously cropped soils were predicted to persist for 36 to 125 yr, but with declining effect as organic matter gradually recovered, giving an accumulated loss in pastoral production worth around NZ$518 to NZ$1239 ha(-1). This was 42 to 73 times lower than the hypothetical value of the organic matter as a sequestering agent for C and N, which varied between NZ$22,963 to NZ$90,849 depending on the soil, region, discount rates, and values used for carbon and nitrogen credits.

Agriculture↗

Indoor air quality for poor families: new evidence from Bangladesh.

Poor households in Bangladesh depend heavily on wood, dung and other biomass fuels for cooking. This paper provides a detailed analysis of the implications for indoor air pollution (IAP), drawing on new 24-h monitoring data for respirable airborne particulates (PM10). A stratified sample of 236 households was selected in Dhaka and Narayanganj, with a particular focus on fuel use, cooking locations, structural materials, ventilation practices, and other potential determinants of exposure to IAP. At each household, PM10 concentrations in the kitchen and living room were monitored for a 24-h period during December, 2003-February, 2004. Concentrations of 300 microg/m3 or greater are common in our sample, implying widespread exposure to a serious health hazard. A regression analysis for these 236 households was then conducted to explore the relationships between PM10 concentrations, fuel choices and a large set of variables that describe household cooking and ventilation practices, structure characteristics and building materials. As expected, our econometric results indicate that fuel choice significantly affects indoor pollution levels: natural gas and kerosene are significantly cleaner than biomass fuels. However, household-specific factors apparently matter more than fuel choice in determining PM10 concentrations. In some biomass-burning households, concentrations are scarcely higher than in households that use natural gas. Our results suggest that cross-household variation is strongly affected by structural arrangements: cooking locations, construction materials, and ventilation practices. A large variation in PM10 was also found during the 24-h cycle within households. For example, within the 'dirtiest' firewood-using household in our sample, readings over the 24-h cycle vary from 68 to 4864 microg/m3. Such variation occurs because houses can recycle air very quickly in Bangladesh. After the midday meal, when ventilation is common, air quality in many houses goes from very dirty to reasonably clean within an hour. Rapid change also occurs within households: diffusion of pollution from kitchens to living areas is nearly instantaneous in many cases, regardless of internal space configuration, and living-area concentrations are almost always in the same range as kitchen concentrations. By implication, exposure to dangerous indoor pollution levels is not confined to cooking areas. To assess the broader implications for poor Bangladeshi households, we extrapolate our regression results to representative 600 household samples from rural, peri-urban and urban areas in six regions: Rangpur in the north-west, Sylhet in the north-east, Rajshahi and Jessore in the west, Faridpur in the center, and Cox's Bazar in the south-east. Our results indicate great geographic variation, even for households in the same per capita income group. This variation reflects local differences in fuel use and, more significantly, construction practices that affect ventilation. For households with per capita income <US Dollars 1.00/day, rural PM10 concentrations vary from 410 microg/m3 in Cox's Bazar to 202 microg/m3 in Faridpur. In urban areas, concentrations for such households differ by almost 100 microg/m3 between the highest areas, Jessore and Rajshahi, and the lowest, Sylhet. Practical Implications Our analysis suggests that poor families may not have to wait for clean fuels or clean stoves to enjoy significantly cleaner air. Within our sample household population, some arrangements are already producing relatively clean conditions, even when 'dirty' biomass fuels are used, such as simple changes in ventilation characteristics of housing (construction materials, space configurations, cooking locations and placement of doors and windows) and ventilation behavior (keeping doors and windows open after cooking). As these arrangements are already within the means of poor families, the scope for cost-effective improvements may be larger than is commonly believed.

Air Pollutants↗

Differential effects of everyday stress on the episodic memory test performances of young, mid-life, and older adults.

This research explored the differential association of everyday stress with the episodic memory test performances of young, mid-life, and older adults. Participants included 98 community-dwelling adults ranging in age from 19-89 years. Everyday stress was assessed via the Perceived Stress Scale and the Elder Life Stress Inventory. A brief battery of episodic memory tasks was administered which included tests of Logical Memory, Verbal Paired Associates, Digit Symbol Substitution, and Digit Symbol Incidental Learning. Results suggest that everyday hassles and irritations as well as the accumulation of challenging life events may exacerbate age-related decline on episodic memory tests that require greater executive resources and more integrated and elaborative processing. The functional relationship between affective status and risk for dementia is discussed, and consideration of individual differences in everyday stress is suggested so as to allow more sensitive interpretation of episodic memory tests commonly used to discern mild cognitive impairment.

Adult↗

Sequencing and mapping hemoglobin gene clusters in the Australian model dasyurid marsupial Sminthopsis macroura.

Comparing globin genes and their flanking sequences across many species has allowed globin gene evolution to be reconstructed in great detail. Marsupial globin sequences have proved to be of exceptional significance. A previous finding of a beta(beta)-like omega(omega) gene in the alpha(alpha) cluster in the tammar wallaby suggested that the alpha and beta cluster evolved via genome duplication and loss rather than tandem duplication. To confirm and extend this important finding we isolated and sequenced BACs containing the alpha and beta loci from the distantly related Australian marsupial Sminthopsis macroura. We report that the alpha gene lies in the same BAC as the beta-like omega gene, implying that the alpha-omega juxtaposition is likely to be conserved in all marsupials. The LUC7L gene was found 3' of the S. macroura alpha locus, a gene order shared with humans but not mouse, chicken or fugu. Sequencing a BAC contig that contained the S. macroura beta globin and epsilon globin loci showed that the globin cluster is flanked by olfactory genes, demonstrating a gene arrangement conserved for over 180 MY. Analysis of the region 5' to the S. macroura epsilon (epsilon) globin gene revealed a region similar to the eutherian LCR, containing sequences and potential transcription factor binding sites with homology to eutherian hypersensitive sites 1 to 5. FISH mapping of BACs containing S. macroura alpha and beta globin genes located the beta globin cluster on chromosome 3q and the alpha locus close to the centromere on 1q, resolving contradictory map locations obtained by previous radioactive in situ hybridization.

Animals↗

Auditory integration training and other sound therapies for autism spectrum disorders.

BACKGROUND: Autism spectrum disorders (ASD) are a heterogeneous group of disorders encompassing Autistic Disorder, Asperger's Disorder, Semantic-Pragmatic disorder and Pervasive Developmental Disorder Not Otherwise Specified. Auditory integration therapy (AIT) was developed as a technique for improving abnormal sound sensitivity in individuals with behavioural disorders including autism. Other sound therapies bearing similarities to AIT include the Tomatis Method and Samonas Sound Therapy. OBJECTIVES: To determine the effectiveness of AIT or other methods of sound therapy in individuals with ASD. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (Cochrane Library Issue 2, 2003), MEDLINE (1966 - February 2002), EMBASE (1980 - February 2002), CINAHL (1982 - December 2001), PsycINFO (1887 - February 2002), ERIC (1965 - December 2001) and LILACS (1982 - March 2002). Reference lists of articles identified electronically were searched for further relevant publications. SELECTION CRITERIA: Randomised controlled trials of adults or children with ASD. Treatment was auditory integration therapy (AIT) or other sound therapies involving listening to music modified by filtering and modulation. Control groups could be no treatment, waiting list, usual therapy or placebo equivalent. Outcomes sought were changes in core and associated features of ASD, auditory processing, quality of life and adverse events. DATA COLLECTION AND ANALYSIS: All outcome data reported in included papers were continuous. Initial intention was to undertake meta-analyses using mean difference and standard deviation to take into account differences between treatment and control groups at baseline. These data were not available. Instead, point estimates and standard errors were calculated from t-test scores and post intervention means. Meta-analysis was attempted but deemed inappropriate at present. MAIN RESULTS: No trials assessing sound therapies other than AIT were found. Six RCTs of AIT, including one cross-over trial, were identified with a total of 171 individuals aged 3-39 years. Four trials had fewer than 20 participants. Allocation concealment was inadequate for all of the studies. Seventeen different outcome measures were used. Only two outcomes were used by three or more studies: Aberrant Behaviour Checklist (ABC) (5) and Fisher's Auditory Problems Checklist (FAPC) (3). Meta-analysis was not possible due to very high heterogeneity (Aberrant Behaviour Checklist subscores), or presentation of data in unusable forms. Three studies (Bettison 1996, Zollweg 1997, Mudford 2000) did not demonstrate benefit of AIT over control conditions. The remaining trials (Veale 1993, Rimland 1995, Edelson 1999) reported improvements at 3 months for the AIT group based on improvements of total mean scores for the ABC, which is of questionable validity. Rimland 1995 also reported improvements at 3 months in the AIT group for ABC subgroup scores. No significant adverse effects of AIT were reported. REVIEWER'S CONCLUSIONS: More research is needed to inform parents', carers' and practitioners' decision making about this therapy for individuals with autism spectrum disorders.

Acoustic Stimulation↗

Antibiotics and surgery for vesicoureteric reflux: a meta-analysis of randomised controlled trials.

AIMS: To evaluate the benefits and harms of treatments for vesicoureteric reflux in children. METHODS: Meta-analyses of randomised controlled trials using a random effects model. Main outcome measures were incidence of urinary tract infection (UTI), new or progressive renal damage, renal growth, hypertension, and glomerular filtration rate. RESULTS: Eight trials involving 859 evaluable children comparing long term antibiotics with surgical correction of reflux (VUR) and antibiotics (seven trials) and antibiotics compared with no treatment (one trial) were identified. Risk of UTI by 1-2 and 5 years was not significantly different between surgical and medical groups (relative risk (RR) by 2 years 1.07; 95% confidence interval (CI) 0.55 to 2.09, RR by 5 years 0.99; 95% CI 0.79 to 1.26). Combined treatment resulted in a 60% reduction in febrile UTI by 5 years (RR 0.43; 95% CI 0.27 to 0.70) but no concomitant significant reduction in risk of new or progressive renal damage at 5 years (RR 1.05; 95% CI 0.85 to 1.29). In one small study no significant differences in risk for UTI or renal damage were found between antibiotic prophylaxis and no treatment. CONCLUSION: It is uncertain whether the identification and treatment of children with VUR confers clinically important benefit. The additional benefit of surgery over antibiotics alone is small at best. Assuming a UTI rate of 20% for children with VUR on antibiotics for five years, nine reimplantations would be required to prevent one febrile UTI, with no reduction in the number of children developing any UTI or renal damage.

Adolescent↗

Influenza vaccine effectiveness in preventing hospitalizations and deaths in persons 65 years or older in Minnesota, New York, and Oregon: data from 3 health plans.

This study developed methods and determined the impact of influenza vaccination on elderly persons in 3 large health plans: Kaiser Permanente Northwest, HealthPartners, and Oxford Health Plans. Data for the 1996-1997 and 1997-1998 seasons were extracted from administrative databases. Subjects were health plan members > or = 65 years old. Comorbid conditions collected from the preceding year were used for risk adjustment with logistic regression. The virus-vaccine match was excellent for year 1 and fair for year 2. Both years, during peak and total periods, vaccination reduced all causes of death and hospitalization for pneumonia and influenza: hospitalizations were reduced by 19%-20% and 18%-24% for years 1 and 2, respectively, and deaths were reduced by 60%-61% and 35%-39% for the same periods. These results show that all elderly persons should be immunized annually for influenza. The methods used in this study are an efficient cost-effective way to study vaccine impact and similar questions.

Age Factors↗

Superconformal electrodeposition in submicron features.

Superconformal electrodeposition is explained based on a local growth velocity that increases with coverage of a catalytic species adsorbed on the copper-electrolyte interface. For dilute concentration of the catalyst precursor in the electrolyte, local coverage in fine features changes more due to interface area change than by accumulation from the electrolyte, yielding superconformal growth. The model is supported by experiments and simulations of copper deposition in 350-100 nm wide features, helping to explain the influence of adsorbates on roughness evolution.

Journal Article↗

An orphaned mammalian beta-globin gene of ancient evolutionary origin.

Mammals possess multiple, closely linked beta-globin genes that differ in the timing of their expression during development. These genes have been thought to be derived from a single ancestral gene, by duplication events that occurred after the separation of the mammals and birds. We report the isolation and characterization of an atypical beta-like globin gene (omega-globin) in marsupials that appears to be more closely related to avian beta-globin genes than to other mammalian beta-globin genes, including those previously identified in marsupials. Phylogenetic analyses indicate that omega-globin evolved from an ancient gene duplication event that occurred before the divergence of mammals and birds. Furthermore, we show that omega-globin is unlinked to the previously characterized beta-globin gene cluster of marsupials, making this the first report of an orphaned beta-like globin gene expressed in a vertebrate.

Amino Acid Sequence↗

MADD victim impact panels and stages-of-change in drunk-driving prevention.

OBJECTIVE: To assess the additional effects of Mothers Against Drunk Driving (MADD) Victim Impact Panels (VIPs) over the effects of a DWI (driving while intoxicated) school, on (1) moving individuals through the stages-of-change toward not drinking while driving and (2) drunk-driving recidivism. METHOD: A randomized experiment with 813 (75% male) DWI offenders in New Mexico measured progress through the stages-of-change at pretest, posttest, 1-year follow-up and 2-year follow-up. In addition, drunk-driving recidivism over 2 years was measured from state driving records. Individuals were randomly assigned to a DWI school or a DWI school plus a MADD VIP. RESULTS: No significant difference in movement through the stages-of-change, or in recidivism, occurred between respondents in the DWI-school-only treatment, and those in the DWI school plus VIP treatment. CONCLUSIONS: There was no additional effect of the MADD VIP, a relatively emotional intervention, over that of the DWI school, a relatively informational approach, on DWI behavior (whether measured by stages-of-change or by DWI rearrest data) over the 2-year period following the two interventions.

Adult↗

Premature cardiovascular disease in chronic renal failure.

There is a remarkable lack of reliable information about the determinants of risk of cardiovascular disease (CVD) among patients with chronic renal failure. Indeed, such patients have often been deliberately excluded from randomised trials of treatments of CVD, perhaps because of concerns about drug safety. But the absolute risk of CVD among them may be large, so the potential absolute benefits of treatments may also be large, and may well exceed any increased hazards. Hence, as well as further investigation of the underlying mechanisms of cardiac disease, it would be helpful to have some large-scale randomised trials in a wide range of renal patients of interventions (such as cholesterol-lowering drugs, antihypertensives, aspirin, B-vitamins, and antioxidant vitamins) that are of proven or suspected benefit in other settings. If safe and effective treatments can be identified, and started early in the natural history of renal failure, the exceptionally high risk of CVD experienced by these patients could be decreased before and after end-stage renal failure has occurred.

Acute-Phase Proteins↗

Nurse management of patients with minor illnesses in general practice: multicentre, randomised controlled trial.

OBJECTIVE: To assess the acceptability and safety of a minor illness service led by practice nurses in general practice. DESIGN: Multicentre, randomised controlled trial. SETTING: 5 general practices in south east London and Kent representing semi-rural, suburban, and urban settings. PARTICIPANTS: 1815 patients requesting and offered same day appointments by receptionists. INTERVENTION: Patients were assigned to treatment by either a specially trained nurse or a general practitioner. Patients seen by a nurse were referred to a general practitioner when appropriate. MAIN OUTCOME MEASURES: The general satisfaction of the patients as measured by the consultation satisfaction questionnaire. Other outcome measures included the length of the consultation, number of prescriptions written, rates of referral to general practitioners, patient's reported health status, patient's anticipated behaviour in seeking health care in future, and number of patients who returned to the surgery, visits to accident and emergency, and out of hours calls to doctors. RESULTS: Patients were very satisfied with both nurses and doctors, but they were significantly more satisfied with their consultations with nurses (mean (SD) score of satisfaction 78.6 (16. 0) of 100 points for nurses v 76.4 (17.8) for doctors; 95% confidence interval for difference between means -4.07 to -0.38). Consultations with nurses took about 10 minutes compared with about 8 minutes for consultations with doctors. Nurses and doctors wrote prescriptions for a similar proportion of patients (nurses 481/736 (65.4%) v doctors 518/816 (63.5%)). 577/790 (73%) patients seen by nurses were managed without any input from doctors. CONCLUSION: Practice nurses seem to offer an effective service for patients with minor illnesses who request same day appointments.

Acute Disease↗

CPT-EIA assays for the detection of vancomycin resistant vanA and vanB genes in enterococci.

Cycling Probe Technology (CPT) was combined with a colorimetric enzyme-immuno assay (EIA) to develop two assays for the detection of vanA and vanB genes in vancomycin resistant enterococci (VRE). The CPT-EIA assay employs a gene-specific fluorescein labeled DNA-RNA-DNA probe that gets cleaved within the probe : target duplex. The cleaved DNA probe fragments dissociate from the target, making it available for further cycling. Following the separation of cleaved probe fragments, anti-fluorescein-horseradish peroxidase antibodies are used for the detection of uncleaved probes. The two CPT-EIA assays were used to screen a collection of 440 clinical isolates (Modrusan et al., 1999). All of the 154 VanA and 131 VanB isolates were correctly identified in the vanA and vanB CPT-EIA, respectively. The VanA and VanB isolates were differentiated from vancomycin sensitive enterococci (VSE) and also from the VanC isolates. In addition, an accurate VRE detection in the CPT-EIA assay was shown with cultures grown on eight different media.

Anti-Bacterial Agents↗

A comparison of methods currently used in clinical practice to estimate familial breast cancer risks.

BACKGROUND: With the identification of genes predisposing to hereditary breast cancer, the accurate and consistent estimation of a woman's risk of developing breast cancer based on her family history is of paramount importance if national service guidelines are to be developed. PATIENTS AND METHODS: The residual lifetime risk of developing breast cancer was estimated for 200 women attending a breast cancer genetic assessment clinic by three different methods currently in use in the UK. Risks were computed on the basis of the Cancer and Steroid Hormone (CASH) study data and were classified as 'low/moderate' (<20%) or 'high' (>20%). These risk categories are representative of those currently used to allocate surveillance and genetic testing. Risks were then compared to estimates derived by other methods used in current clinical practice, including those of Houlston and Murday. RESULTS: The CASH data-based method ascribed 27% to the high risk category, as compared to 53% for the combined Houlston and Murday methods. A method based on the number of affected relatives alone ascribed only 14% to the high risk category. Overall, 108 (54%) women were placed in the same risk category by all three methods. CONCLUSIONS: This study demonstrates that there is a significant degree of variability between methods currently used to estimate breast cancer risk which has serious implications for individual patient management, service provision and multicentre studies evaluating the benefits of genetic testing for breast cancer susceptibility.

Adult↗

Sequence and evolution of a hexamerin from the ant Camponotus festinatus.

In the ant Camponotus festinatus, two different hexamerins accumulate stage-specifically during the late larval period and at various times in adults. These hexamerins serve as storage proteins and play important roles in brood nourishment and colony founding. We report an analysis of the cDNA sequence of C. festinatus hexamerin 2 (CfeHex2). The native protein contains 732 amino acids, which are moderately enriched in aromatic amino acids, aspartate and asparagine. Phylogenetic analyses show a close relationship of CfeHex2 to a putative toxin of the braconid wasp, Bracon hebetor. The divergence of Formicidae and Braconidae hexamerins was calculated to have begun 187 MYA, an estimate consistent with currently accepted phylogeny of insect orders.

Amino Acid Sequence↗