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K Boyce

Publications and source records attributed to K Boyce.

16 recordsLinked to original sources

Automated tissue analysis--a bioinformatics perspective.

OBJECTIVES: Recent progress in automated tissue analysis (tissomics) provides reproducible phenotypical characterization of histological specimens. We introduce informatics tools to cluster and correlate quantitative tissue profiles with gene expression data. The great potential of synergies between tissue analysis and bioinformatics and its perspectives in medical research and computational diagnostics are discussed. METHODS: Key enablers in microscopic imaging and machine vision are reviewed to perform a high-throughput tissue analysis. Methodologies are described and results are demonstrated that support a combined analysis of tissue with gene expression profiles whereby the consideration of individual responses is key. RESULTS: Comprehensive histomorphometric profiles, extracted using machine vision, provide information regarding the components and heterogeneity of a tissue in a reproducible format amenable to data mining and analysis. Tissue quantitative information can be placed in synergetic context with bioinformatics data, such as gene expression profiles, for a more comprehensive stratification of individual responses. From a bioinformatics point of view tissue data are co-variants that support the identification of candidate genes relevant in tissue injury or disease. CONCLUSIONS: Progress in automated analytics enables the generation of quantitative data about tissue previously limited to visual histopathology. Such reproducible data sets can be statistically correlated and clustered throughout the continuum of bioinformatics. The combined approach supports a system-wide view of biology and has a potential to accelerate developments for a personalized computational diagnosis.

Automation↗

Comparison of dry ice-baited centers for disease control and New Jersey light traps for measuring mosquito abundance in California.

Mosquito catch in New Jersy light traps (NJLTs) has been declining in recent years, compromising the sensitivity of the California mosquito monitoring program. Centers for Disease Control traps (CDCTs) operated without light and augmented with dry ice have been considered for replacement or augmentation. To provide information on comparative sensitivity and ability to measure abundance over time and space, catch of mosquitoes in NJLTs was compared to catch in CDCTs operated concurrently at 8-10 sites within the Coachella Valley, Kern, San Joaquin County, and Sacramento-Yolo Mosquito and Vector Control Districts. The CDCTs always collected more female mosquitoes than did NJLTs; however, differences in sensitivity varied markedly over time and space precluding the calculation of a universal conversion factor. Regressions of the catch of female Culex tarsalis in CDCTs as a function of catch in NJLTs within districts indicated that the slopes varied markedly, again precluding the derivation of a universal function. Therefore, we recommend that mosquito surveillance programs replace or supplement NJLTs with systematically operated CDCTs to enhance sampling sensitivity for females of most mosquito species. However, both trap types should be operated concurrently at several sites within each district to derive regression functions to convert historical relative abundance data from NJLTs to equivalent counts in CDCTs for retrospective analyses.

Aedes↗

Patterns of avian seroprevalence to western equine encephalomyelitis and Saint Louis encephalitis viruses in California, USA.

Temporal and spatial changes in the enzootic activity of western equine encephalomyelitis (WEE) and St. Louis encephalitis (SLE) viruses were monitored at representative wetland study sites in the Coachella, San Joaquin, and Sacramento valleys of California from 1996 to 1998 using three methods: (1) virus isolation from pools of 50 host-seeking Culex tarsalis Coquillett females, (2) seroconversions in flocks of 10 sentinel chickens, and (3) seroprevalence in wild birds collected by mist nets and grain baited traps. Overall, 74 WEE and one SLE isolates were obtained from 222,455 Cx. tarsalis females tested in 4,988 pools. In addition, 133 and 40 seroconversions were detected in 28 chicken flocks, and 143 and 27 of 20,192 sera tested from 149 species of wild birds were positive for antibodies to WEE and SLE, respectively. WEE was active in all three valleys, whereas SLE only was detected in Coachella Valley. Seroconversions in sentinel chickens provided the most sensitive indication of enzootic activity and were correlated with seroprevalence rates in wild birds. Avian seroprevalence rates did not provide an early warning of pending enzootic activity in chickens, because positive sera from after hatching year birds collected during spring most probably were the result of infections acquired during the previous season. Few seroconversions were detected among banded recaptured birds collected during spring and early summer. Age and resident status, but not sex, were significant risk factors for wild bird infection, with the highest seroprevalence rates among after hatching year individuals of permanent resident species. Migrants (with the exception of mourning doves) and winter resident species rarely were positive. House finches, house sparrows, Gambel's quail, California quail, common ground doves, and mourning doves were most frequently positive for antibodies. The initial detection of enzootic activity each summer coincided closely with the appearance of hatching year birds of these species in our study areas, perhaps indicating their role in virus amplification. Bird species most frequently positive roosted or nested in elevated upland vegetation, sites where Cx. tarsalis host-seeking females hunt most frequently. These serosurveys provided important background information for planned host competence and chronic infection studies.

Animals↗

Comparative effectiveness of three adult mosquito sampling methods in habitats representative of four different biomes of California.

The effectiveness of New Jersey (NJ) light, dry ice baited, and gravid female traps for collecting adult mosquitoes was compared at representative habitats in the Coachella, San Joaquin, and Sacramento valleys and the Los Angeles basin of California. The NJ light traps effectively sampled Anopheles freeborni, Culex tarsalis, Psorophora columbiae, and several Aedes when abundance was high in rural areas with minimal competitive illumination. Dry ice-baited encephalitis virus surveillance or CDC style traps collected significantly more females of most species at most localities than did NJ light traps, regardless of background illumination. The Cummings modification of the Reiter gravid female trap baited with a bulrush (Schoenoplectus) infusion was the best method for collecting Culex pipiens complex females in most habitats. In the Los Angeles basin, gravid traps baited with bulrush infusion collected, on average, 4.5 times more Culex quinquefasciatus females than did traps baited with the Reiter infusion. The bulrush infusion in combination with the Cummings trap design seemed to provide resting site cues and collected males as well as empty and bloodfed females. Mosquito surveillance programs in California should include the systematic operation of dry ice-baited and gravid female traps to improve surveillance sensitivity for selected species in appropriate habitats.

Animals↗

Conduction velocity in the tricuspid valve-inferior vena cava isthmus is slower in patients with type I atrial flutter compared to those without a history of atrial flutter.

INTRODUCTION: In human type I atrial flutter, the electrophysiologic substrate is unclear. In order to determine if slow conduction is mechanistically important, we evaluated conduction velocity in the tricuspid valve-inferior vena cava (TV-IVC) isthmus, right atrial free wall, and interatrial septum in patients with and without a history of atrial flutter undergoing electrophysiologic study. METHODS AND RESULTS: Nine patients with (group 1) and nine without a history of type 1 atrial flutter (group 2) were studied. Conduction time (msec) in the right atrial free wall, TV-IVC isthmus (bidirectional), and interatrial septum was measured during pacing in sinus rhythm at cycle lengths of 600, 500, 400, and 300 msec from the low lateral right atrium and coronary sinus ostium. Conduction velocity (cm/sec) was calculated by dividing the distance between pacing electrodes and sensing electrodes (cm) by the conduction time (sec). Conduction velocity was slower in the TV-IVC isthmus in group 1 (range 37 +/- 8 to 42 +/- 8 cm/sec) versus group 2 (range 50 +/- 8 to 55 +/- 9 msec) at all pacing cycle lengths (P < 0.05). However, conduction velocity was not different in the right atrial free wall or interatrial septum between groups 1 and 2. Conduction velocity was also slower in the TV-IVC isthmus than in the right atrial free wall and interatrial septum in group 1 patients, at all pacing cycle lengths (P < 0.05). Atrial flutter cycle length correlated with total atrial conduction time (r > or = 0.832, P < 0.05). CONCLUSION: Slow conduction in the TV-IVC isthmus may be mechanistically important for the development of human type I atrial flutter.

Aged↗

The relation between atrial fibrillation wavefront characteristics and accessory pathway conduction.

Although the source-sink relationship for impulse propagation in cardiac tissues has been demonstrated in vitro, there has been no verification of this hypothesis in humans. Accordingly, eight patients undergoing surgical division of their accessory pathways were studied. A 56-channel (7 x 8) bipolar plaque electrode array was placed over the atrioventricular groove on the accessory pathway and atrial fibrillation electrically induced. 10 episodes of QRS transition from consecutively preexcited to nonpreexcited complexes were analyzed. This showed that consecutively preexcited QRS complexes were always associated with uniform large atrial wavefronts. Immediately prior to QRS transition, four general types of changes were observed: (a) premature invasion by secondary wavefronts creating local conduction block (n = 5); (b) wavefront collision leading to wavefront curvature (n = 2); (c) transition from a uniform large atrial wavefront to multiple fractionated small wavefronts (n = 1); and (d) uniform atrial wavefronts "marching" into the accessory pathway refractory period (n = 2). We conclude that local atrial wavefront characteristics are important factors influencing impulse propagation through the accessory pathway. The findings that local wavefront collision, curvature, or fractionation often precede loss of accessory pathway conduction support the notion that source-sink relationship is an important determinant of the safety factor for impulse propagation in the human heart.

Adolescent↗

Interaction between accessory pathways resulting in inability to induce reciprocating tachycardia.

A 44-year old male with Wolff-Parkinson-White syndrome presented with atrial fibrillation. The patient was found at the electrophysiological study to have two accessory pathways, one concealed and the other conducting exclusively in the anterograde direction. After radiofrequency catheter ablation of the anterograde conducting pathway, orthodromic reciprocating tachycardia, which previously could not be induced despite an aggressive protocol, was easily induced. Ablation of the concealed pathway resulted in termination of the tachycardia and suppression of inducibility. We propose that interaction between the two accessory pathways resulted in an inability to induce reciprocating tachycardia.

Adult↗

Radiofrequency modification of atrioventricular conduction by selective ablation of the low posterior septal right atrium in a patient with atrial fibrillation and a rapid ventricular response.

A case is presented of a 58-year-old woman with atrial fibrillation and uncontrolled ventricular responses up to 180 beats/min despite therapy with digoxin. Radiofrequency energy was applied to the low posteroseptal right atrium in an attempt to modify "slow fiber" conduction. This resulted in a decrease in ventricular rate from 125 to 50 beats/min. Follow-up Holter monitor demonstrated an average heart rate of 64 beats/min (range 43-112). On exercise tolerance test, the maximum heart rate was 126. Modification of the low posterosepta right atrium may prove to be an alternative to AV node or His bundle ablation and pacemaker implantation in patients with poorly controlled atrial fibrillation and rapid ventricular response. The mechanism by which this approach was effective may be ablation of slow conducting AV nodal fibers with a short refractory period.

Atrial Fibrillation↗

Radiofrequency catheter ablation for the treatment of human type 1 atrial flutter. Identification of a critical zone in the reentrant circuit by endocardial mapping techniques.

BACKGROUND: Recent studies of human type 1 atrial flutter demonstrated reentry in the right atrium and an area of slow conduction in the low posteroseptal right atrium. Direct-current catheter ablation of this area has been only moderately successful in preventing recurrence. Therefore, we performed endocardial activation mapping and entrainment pace mapping during atrial flutter to determine the critical site for radiofrequency ablation of this arrhythmia. METHODS AND RESULTS: Twelve consecutive patients (seven men and five women; age, 21-73 years) with type 1 atrial flutter (mean cycle length, 253 +/- 39 msec) underwent right atrial endocardial activation and entrainment pace mapping using standard transvenous catheter techniques to localize the atrial flutter reentrant circuit, the area of slow conduction, and the exit site from the area of slow conduction. Upon identifying appropriate sites, radiofrequency energy (16-29 W) was applied via a 4-mm tipped catheter. Activation mapping of atrial flutter revealed a counterclockwise reentrant wave front originating just inferior or posterior to the coronary sinus ostium, proceeding superiorly in the atrial septum to the right atrial free wall, then inferiorly toward the tricuspid annulus and finally medially between the inferior vena cava and the tricuspid annulus, where low-amplitude fragmented electrical activity was noted. Entrainment pace mapping from this area produced an exact P wave match to atrial flutter on 12-lead ECG with a long (greater than 40 msec) stimulus-to-P interval indicating slow conduction, whereas pacing just inferior or posterior to the coronary sinus ostium produced an exact P wave match with a short stimulus-to-P interval (less than 40 msec), presumably identifying the exit site from the area of slow conduction. Radiofrequency energy (one to 14 applications) was effective in terminating and preventing reinduction of atrial flutter in 10 patients. In two patients, atrial flutter was not terminated during radiofrequency energy application but during subsequent pacing attempts. Sites where ablation was successful, located just inferior or posterior to the coronary sinus ostium, were characterized by discrete electrograms with activation times of -20 to -50 msec before P wave onset and exact entrainment pace maps with a stimulus-to-P interval of 20 to 40 msec, consistent with the exit site from the area of slow conduction. Follow-up (mean, 16 +/- 9 weeks; range, 2-31 weeks) revealed recurrence of the original atrial flutter in two patients, one of whom underwent repeat ablation without further recurrence, self-limited infrequent recurrence of a new atrial flutter or atrial fibrillation in three suppressed by beta-blocker or digoxin, and no recurrence in seven. CONCLUSIONS: 1) Radiofrequency energy applied to a critical area in the atrial flutter reentrant circuit, inferior or posterior to the coronary sinus ostium, will terminate and prevent arrhythmia reinduction. 2) Long-term follow-up in a larger series of patients will be required to confirm efficacy of this technique, although short-term results look promising.

Adult↗

Antibiotic use in the nursing home. Physician practice patterns.

Antibiotic usage patterns were studied in two nonproprietary nursing homes that included 720 intermediate care and skilled nursing home beds. Medical records of residents receiving antibiotics were reviewed every fourth month for 1 year. Of 181 antibiotic prescriptions written for indications other than prophylaxis, 41% were for presumed urinary tract infections, 35% for respiratory tract infections, and 14% for skin/soft-tissue infections. The majority of antibiotic prescriptions (54%) were made by telephone order. Cultures were obtained in 60% of suspected infections; two thirds of cultures were of the urine. Antibiotics were changed during the course of therapy in only 12% of cases. Eighty-one percent of residents treated with antibiotics improved or were cured, 9.5% were hospitalized or died, and an additional 9.5% failed to improve but remained in the nursing home. Fever was present in 48% of cases prior to treatment, but had no predictive value for patient outcome. We conclude that antibiotic treatment in the nursing home is often initiated in the absence of fever, culture information, or examination of the patient. Empiric prescription of antibiotics in this setting generally is associated with favorable clinical course.

Aged↗

Peritonitis caused by Alcaligenes denitrificans subsp. xylosoxydans: case report and review of the literature.

We report the third human case of peritonitis caused by Alcaligenes denitrificans subsp. xylosoxydans and review the English literature regarding community-acquired and nonsocomial infection and colonization that results from this bacterium. The biochemical and genetic characteristics supporting the pathogenic potential of A. denitrificans subsp. xylosoxydans are reviewed, and the antimicrobial susceptibility profile of the organism is summarized.

Adult↗

Acquisition of simple motor imitative behavior in mentally retarded and nonretarded children.

The effects of social reinforcement and population on two simple motor tasks which were embedded within a contingently reinforced imitation task were explored. A Social Reinforcement Type x Population interaction was observed, where the nonretarded children performed at higher levels under informative social reinforcement (right-correct) and at lower levels under affective social reinforcement (good-fine); the opposite was observed for the retarded children. In addition, one motor response was imitated to a higher degree than the other response.

Adolescent↗