Biomedical subjects
Publications and source records attributed to M L Nelson.
This paper describes the development of an interdisciplinary, interinstitutional seminar in palliative care for South Dakota students in medicine, nursing, pharmacy, chaplaincy, and social work. Student outcomes from six seminars conducted during 2001-2004 are reported, and recommendations for future educational efforts are outlined.
When ovulation is induced with gonadotrophin-releasing hormone (GnRH) in anoestrous ewes, a proportion of animals fail to form normal (full-lifespan) corpora lutea (CL). Progesterone treatment before GnRH prevents luteal inadequacy. It remains uncertain whether a similar effect, achieved with medroxyprogesterone acetate (MAP) from intravaginal sponges, is mediated by influences on growing ovarian follicles and/or secretion of gonadotrophic hormones, before and after GnRH treatment. Two experiments were performed, on 13 and 11 anoestrous Western white-faced ewes, respectively. Seven and six ewes, respectively, received MAP-containing sponges (60 mg) for 14 days; the remaining ewes served as untreated controls. To test the effect of timing of GnRH administration after pre-treatment with MAP-releasing sponges, GnRH injections (250 ng every 2h for 24h followed by a bolus injection of 125 microg of GnRH i.v.) were given either immediately (Experiment 1) or 24h after sponge removal in the treated ewes (Experiment 2). Ovarian follicular dynamics (follicles reaching >or=5mm in size) and development of luteal structures were monitored using transrectal ultrasonography. In Experiment 1, the mean ovulation rate (0.7+/-0.3 and 1.0+/-0.4) and proportion of ovulating ewes (57 and 67%, respectively) did not vary (P>0.05) between MAP-treated and control ewes. Normal (full-lifespan) CL were detected in 29% of treated and 67% of control ewes (P>0.05). In Experiment 2, the mean ovulation rate (2.3+/-0.2 and 1.2+/-0.6; P<0.05) and percentage of ewes with normal (full-lifespan) CL (100 and 40%, respectively; P<0.10) were greater in the treated compared to control ewes. In Experiment 1, the mean peak concentration of the GnRH-induced LH surge was lower (P<0.05) in MAP-treated than in control ewes. There were no significant differences between MAP-treated and control ewes in the characteristics of follicular waves, mean daily serum FSH concentrations, and secretory parameters of LH/FSH, based on intensive blood sampling conducted 1 day before sponging and 1 day before sponge removal. It is concluded that treatment with MAP has no effect on the tonic secretion of LH/FSH or follicular wave development in anoestrous ewes. However, the GnRH-stimulated LH discharge was attenuated in the ewes that received MAP-impregnated sponges for 14 days and were treated with GnRH immediately after sponge withdrawal. Ovulatory response and CL formation were increased when GnRH was administered 24 h after sponge removal.
To measure the effects of dietary fat on feedlot performance, carcass characteristics, and beef appearance, moisture binding, shelf life, and palatability, 168 crossbred beef steers (317 +/- 1.0 kg) were allotted randomly, within weight blocks, to a randomized complete block design with a 3 x2 + 1 factorial arrangement of dietary treatments. Main effects were level of yellow restaurant grease (RG; 0, 3, or 6%) and level of alfalfa hay (AH; 3.5 or 7%), with the added treatment of 6% tallow and 7% AH in barley-based diets containing 15% potato by-product and 7% supplement fed for 165 d (all dietary levels on a DM basis). Dietary treatment did not (P >0.10) affect DMI, LM area, beef brightness, or beef texture. Level of RG linearly increased (P <0.05) ADG from 1.48 to 1.60 kg/d, diet NE(m) from 2.4 to 2.6 Mcal/kg, diet NE(g) from 1.7 to 1.9 Mcal/kg, and internal fat from 2.1 to 2.4%. Level of RG linearly increased (P <0.05) G:F from 0.184 to 0.202, but decreased (P <0.05) beef firmness score from 3.0 to 2.8 and fat luster score from 3.1 to 2.8. Level of AH did not (P >0.10) affect any of the measurements; however, AH interacted with level of RG on fat thickness and yield grade (linear; P <0.05), as well as marbling score and percentage of carcasses grading USDA Choice (quadratic; P <0.05). Fat thickness and yield grade increased with increasing RG level in 3.5%, but not in 7%, AH diets. In steers fed 3.5% RG, marbling scores and percentage of carcasses grading Choice were greatest when fed with 3.5% AH, and least when fed 7% AH. Steers fed tallow had lower marbling scores (P = 0.01) and percentage of carcasses grading Choice (P = 0.066) than those fed RG. Retail storage attributes, including visual and instrumental color, decreased during storage (P <0.01), but were not (P >0.10) affected by diet. Trained sensory panel scores for initial tenderness increased quadratically (P = 0.07) as dietary RG increased, but diet did not (P >0.10) affect drip loss, cooking loss, or trained sensory panel scores for sustained tenderness, initial and sustained juiciness, and beef flavor. Therefore, RG increased diet energy, improved performance, and increased carcass fatness; however, dietary fat and AH did not affect most measurements of water retention, color stability, or palatability of beef.
One hundred sixty-eight crossbred steers (317.1 +/- 1.0 kg) were used to evaluate the effects of supplemental fat in finishing diets on the fatty acid composition, including the 9,11 isomer of conjugated linoleic acid, of beef. Steers were allotted within three weight blocks to a randomized complete block design with a 3 x 2 + 1 factorial arrangement of dietary treatments. Main effects were level of yellow restaurant grease (RG; 0, 3, and 6%), and level of alfalfa hay (AH; 3.5 and 7%) with an added treatment containing 6% tallow (T) and 7% AH in barley-based diets containing 15% potato by-product and 7% supplement (all dietary levels are on a DM basis) fed for an average of 165 d. Fatty acids of the LM and s.c. fat from four randomly selected steers per pen were quantified using GC after methylation with sodium methoxide. Dietary treatment did not (P > 0.10) affect total fatty acid (FA) content of the LM (143 +/- 5.2 mg/g) or fat (958 +/- 7.9 mg/g). Myristic acid increased linearly (P < 0.01) with increasing RG from 3.1 to 3.7 +/- 0.1 g/100 g of FA in muscle. Stearic acid increased linearly (P < 0.05) as RG increased in the diet, from 11.4 to 12.9 +/- 0.4 g/100 g of FA in LM and from 9.9 to 12.2 +/- 0.3 g/100 g of FA in fat. Compared with T, steers fed 6% RG had more (P < 0.05) oleic acid in LM (42.7 vs. 40.3 +/- 0.5 g/100g FA) and in fat (43.0 vs. 40.9 +/- 0.5 g/100g FA). The cis-9, trans-11 conjugated linoleic acid (CLA) increased quadratically (P < 0.01) with increasing dietary RG in LM from 0.45 to 0.64 to 0.62 +/- 0.03 g/100 g of FA and increased in fat from 0.61 to 0.84 to 0.83 +/- 0.04 g/100 g of FA. Moreover, cis-9, trans-11 CLA was higher (P < 0.05) in fat from steers fed RG compared with T (0.81 vs. 0.69 +/- 0.04 g/100 g of FA), and tended to be higher (P = 0.07) in muscle (0.62 vs. 0.54 +/- 0.03 g/100 g of FA. Feeding yellow restaurant grease increased content of cis-9, trans-11 CLA in beef without an increase total FA content.
As part of a larger study, the aortic arch and its branches were removed en bloc at autopsy from men of Japanese ancestry born in Hawaii. Of the 193 arterial trees examined, 182 (94.3%) had a typical branching pattern (e.g., brachiocephalic trunk, left common carotid, and left subclavian arteries, in that order). Two specimens had only two branches arising from the aortic arch, a common trunk uniting the brachiocephalic and left common carotid arteries and a left subclavian artery. Nine individuals (4.6%) had four branches off the aortic arch; in eight of these cases (4.1%), the left vertebral artery originated directly off the aortic arch just proximal to, or as a common trunk with, the left subclavian artery. A unique aortic arch branching pattern was found in one of these men. The four arteries arising from the arch of the aorta were, in sequence: right subclavian, left subclavian, right common carotid, and left common carotid. The literature on aortic arch variations is reviewed and the possible embryonic development of these branching patterns and their clinical significance is discussed briefly.
OBJECTIVE: To determine whether hypoxia induces refractive changes in subjects who have had laser in situ keratomileusis (LASIK) refractive surgery. DESIGN: Prospective paired eye clinical trial. PARTICIPANTS: There were 20 LASIK subjects (40 eyes) and 20 myopic non-LASIK controls (40 eyes). INTERVENTION: Each subject had one eye exposed to ocular surface hypoxia (humidified nitrogen) by use of an airtight goggle system at sea level for 2 hours. The other eye was simultaneously exposed to humidified, compressed air (21% oxygen) with the same airtight goggle system. MAIN OUTCOME MEASURES: Keratometry, cycloplegic refraction, and pachymetry were compared before and after exposure by use of repeated measures analysis of variance. RESULTS: A significant myopic shift (P: < 0.01) occurred in LASIK corneas exposed to hypoxia compared with myopic control subjects. A significant increase in corneal thickening occurred symmetrically in both LASIK and control subjects exposed to hypoxia. There was a trend toward corneal steepening (keratometry) in LASIK subjects, but this was not statistically significant. CONCLUSIONS: These results suggest that ocular surface hypoxia induces a myopic shift in LASIK subjects.
The relationships between the development of antral follicles (growing from 3 to > or = 5 mm diameter), hormone secretion (luteinizing hormone (LH), follicle-stimlating hormone (FSH), oestradiol and progesterone), ovulation and the formation of luteal structures in response to gonadotrophin-releasing hormone (GnRH) were examined in 24 anoestrous Western White Face ewes (May-July). Ewes were monitored by transrectal ovarian ultrasonography for 34 days, commencing 15 days before the administration of GnRH. Following treatment with GnRH, 83% (20/24) of ewes ovulated. Twenty-five per cent of all ewes (6/24) subsequently had normal (full-life span) corpora lutea (CL), 37% (9/24) had inadequate CL, 17% (4/24) had both normal and inadequate CL, 17% (including three of four anovular ewes and one ewe with inadequate CL) formed luteinized follicles and only 4% (1/24) did not ovulate or produce any luteal structure. None of the variables of follicular growth (follicles reaching > or = 5 mm diameter) differed between follicles that either ovulated or failed to ovulate and there was no evident correlation between the age or stage of development of ovulatory sized antral follicles and the type of luteal structure formed, except for luteinized unovulated follicles; these follicles all emerged within 3 days of GnRH injection. Mean serum concentrations of FSH and oestradiol before treatment did not differ (P>0.05) between ewes with different ovarian responses, but peaks of fluctuations in serum concentrations of FSH in daily samples were higher in ewes that produced normal CL compared with ewes with inadequate CL. After GnRH treatment, oestradiol secretion was higher in ewes that formed luteinized unovulated follicles than in all ewes with inadequate CL (P<0.05). The peak concentration of the GnRH-induced LH surge was higher and the interval from GnRH to peak LH discharge was shorter in ewes with inadequate CL compared with ewes that had normal CL after ovulation (P<0.05). In conclusion, ovulatory sized antral follicles at a similar stage of their life span can give rise to either normal or inadequate CL and a proportion of these follicles do not ovulate in response to GnRH in seasonally anoestrous ewes. This suggests differences in ovarian follicular responsiveness to gonadotrophic stimuli. Both the amplitude of episodic elevations in daily serum FSH concentrations and the characteristics of the pre-ovulatory LH surge may be important for luteogenesis following ovulation.
A balance trial was conducted to titrate the effects of tallow on the energy metabolism of wethers fed barley finishing diets. Six dietary levels of tallow (0, 2, 4, 6, 8, or 10%) in a barley finishing diet were fed to six crossbred wethers (35+/-1.1 kg) in a randomized complete block design. Diets were 73% barley, 10% tallow and(or) bentonite, 10% alfalfa pellets, and 7% supplement. There was no effect of tallow level on OM intake (1,103.1+/-51 g/d), OM digestibility (84+/-0.9%), GE digestibility (83+/-1.1%), or cell solubles digestibility (84.2+/-1.2%). The level of tallow quadratically decreased ADF digestibility (P < 0.05), methane emissions, and methane energy as a percentage of GE P < 0.01). There were linear increases in dietary GE (megacalories per kilogram of OM [P < 0.01]), dietary DE (megacalories per kilogram of OM [P < 0.05]), and dietary ME (megacalories per kilogram of OM [P < 0.01]), as dietary tallow increased. Numbers of ruminal protozoa (Entodinium spp. and Polyplastron sp.) decreased linearly (P < 0.05) with increased level of tallow. The energy value of tallow (calculated by difference) was low. The total-tract fatty acid digestibility of tallow was calculated by linear regression, without intercept, after accounting for the fatty acids digested from the base diet (0% tallow fed to a wether in a period). Fatty acids of the same carbon length were pooled for the regression analysis. All linear regressions were significant (P < 0.10) indicating no effect of tallow level on fatty acid digestibility. Lauric acid had low digestibility. The high digestibility of all C16 (89%) and C18 (104%) fatty acids suggests an effect of tallow on endogenous and microbial fatty acid excretion. Fatty acid digestibility was probably a minor contributor to the low energy content of tallow, calculated by difference, in these diets.
The Healing Web is a transformative nursing model, bridging gaps between nursing education and practice, baccalaureate and associate degree education, and public and private educational institutions. It is an educational prototype in which nursing students experience collaborative clinical practice in a differentiated practice model. Based on the Healing Web framework, it was hypothesized that the educational partnership model would influence specific student competencies (i.e., caring abilities, leadership skills, assertiveness, and professional nursing behaviors). Students in the Healing Web program scored higher in caring knowing, caring courage, leadership, and assertiveness than their counterparts who participated in traditional clinical experiences. Students identified collaboration, partnership with students and staff, and learning to value different nursing roles as primary benefits of the experience. Findings support the contribution of Healing Web experiences to selected student outcomes, but the research is limited by instrumentation, small numbers, and the question of adequate "dosage." Future research will emphasize qualitative methods to explicate significant concepts more completely.
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Cigarette smoking behavior is influenced by both personality traits and inherited factors. Previous research showed that neuroticism-a broad personality domain that includes anxiety, depression, impulsiveness and vulnerability-increases the risk of being a smoker, primarily because of difficulty in quitting. Neuroticism has also been associated with the 5-HTTLPR, a functional polymorphism in the promoter for the serotonin transporter gene. We used population and family-based methods to analyze the joint effects of the 5-HTTLPR and neuroticism on smoking behavior in a population of 759 never, current, and former smokers, all members of sib-pairs. Our main finding is that smoking behavior is influenced by an interaction between neuroticism and 5-HTTLPR genotype. Specifically, neuroticism was positively correlated with current smoking and negatively associated with smoking cessation in individuals and siblings with poorly transcribed 5-HTTLPR-S genotypes, but not in those with the more highly expressed 5-HTTLPR-L genotype. Individuals with both a 5-HTTLPR-S genotype and a high level of neuroticism had the greatest difficulty in quitting smoking. These data, if replicated, suggest that smoking behavior is more strongly influenced by the combination of the serotonin transporter gene and neuroticism than by either factor alone, and that personality scores and 5-HTTLPR genotype may predict the clinical efficacy of certain smoking cessation drugs.
PURPOSE: The effectiveness of a disposable liner designed for a 2-piece colostomy appliance pouch was evaluated. DESIGN: Randomized, crossover trial with follow-up surveys. SETTING AND SUBJECTS: Nineteen participants were recruited from the Mayo Clinic in Scottsdale, Arizona, and the surrounding community. INSTRUMENTS: A Daily Colostomy Care Evaluation Record and tally sheet of times for ostomy care were designed by the authors. METHODS: Participants, acting as their own controls, were randomly assigned to use either an unlined or a lined appliance for 9 days. On day 10, participants switched to the opposite regimen, which was maintained through day 18. They recorded the time required for daily colostomy care and perceptions of the lined and unlined appliances. The volume of ostomy supplies and cost were recorded at baseline, 1, 3, and 5 to 9 months after the initial trial. RESULTS: Odor, bother, perceived severity of leakage, and partner acceptance were better with unlined than lined appliances. Half of the participants were using a liner > or =75% of the time 3 months after the trial. There was no difference in cost when lined versus unlined ostomy systems were compared. Participants who chose to use the liners indicated high satisfaction. Problems noted included an inadequate seal with the liner (58%), inadequate liner size (16%), retention of flatus by the liner (11%), and difficulty removing the full liner (11%). CONCLUSIONS: The study supports recommending liners to patients who have a modest amount of fecal output or flatus. However, patients who are unable to manipulate the seal or have a large output volume are unlikely to find the liners a convenience. Satisfaction with the liners was sufficient to warrant investigation and design of a lined device with an improved design, greater capacity, and tighter seal.
To measure effects of diet on feedlot performance, carcass characteristics, and beef appearance, 144 crossbred beef steers (333+/-.44 kg) were allotted within weight block (3) to a randomized complete block design with a 2 x 3 factorial arrangement of dietary treatments. Main effects were grain (barley or corn) and level of potato by-product (PB) (0, 10, or 20% of diet DM). Steers were fed diets containing 83% concentrate (grain plus PB), 10% supplement, and 7% alfalfa on a DM basis for an average of 130 d. Level of PB quadratically affected (P < .10) DM intake and gain such that steers fed 10% PB ate more and gained faster. Corn-fed steers were more (P < .05) efficient (5.8 vs 6.3 kg DM/kg gain) and had more (P < .05) kidney, pelvic, and heart fat (2.2 vs 2.0%) than barley-fed steers. A grain x PB interaction was detected (P < .10) for marbling score, which was minimized in steers fed barley diets (small 0) but maximized in those fed corn diets (small 30) at 10% PB. Diet did not affect beef firmness or beef color score. Barley-fed beef had whiter fat (P < .05) than corn-fed beef (2.6 vs 2.9 on a 1 to 7 scale); however, fat luster score was not affected by diet. Small differences were noted in fatty acid profile, purge, drip loss, and muscle pH. No differences were noted in color measurements due to dietary treatment over 7 d of retail shelf life. Overall, differences were small and probably not biologically important. These results indicate that these diets had minimal effects on beef appearance and carcass characteristics, meat composition, and water retention properties.
The objective of this study was to evaluate the effects of barley- or corn-based diets containing 0, 10, or 20% potato by-product (DM basis) on Warner-Bratzler shear force and palatability of beef. One hundred forty-four crossbred beef steers (333+/-.44 kg) were allotted within weight block (3) to a randomized complete block design with a 2 x 3 factorial arrangement of dietary treatments. Main effects were grain (barley or corn) and level of potato by-product (0, 10, or 20% of diet DM). There were a total of 18 pens with eight steers per pen and three pens per treatment. Steers were fed diets containing 83% concentrate (grain plus potato by-product), 10% supplement, and 7% alfalfa (DM basis) for an average of 130 d. Longissimus muscle cuts were used for Warner-Bratzler shear force determination (four steers per pen) and evaluation (two steers per pen) by a 10-member trained laboratory panel, a professional flavor/texture profile panel, and by consumer panels. Diet did not affect (P > .10) Warner-Bratzler shear force or trained laboratory panel tenderness, juiciness, and flavor intensity scores. Flavor/texture profile panel scores indicated feeding a corn-based diet as opposed to barley-based diet produced a more appropriate well-balanced and well-blended beef flavor and texture. However, the magnitudes of the differences were relatively small, and flavor and texture amplitude ratings for both barley- and corn-fed beef were well above average. Beef from steers fed 10 or 20% potato by-product had lower (P < .05) incidences of inappropriate aromatics and aftertastes, which may have a slightly beneficial effect on beef flavor, but flavor amplitude was not affected (P > .05) by level of potato. Moreover, consumer panel overall acceptability scores were not affected by diet. Thus, feedlot diets containing corn or barley with or without potato by-product should result in palatable beef products.
Dopaminergic genes are likely candidates for heritable influences on cigarette smoking. In an accompanying article, Lerman et al. (1999) report associations between allele 9 of a dopamine transporter gene polymorphism (SLC6A3-9) and lack of smoking, late initiation of smoking, and length of quitting attempts. The present investigation extended their study by examining both smoking behavior and personality traits in a diverse population of nonsmokers, current smokers, and former smokers (N = 1,107). A significant association between SLC6A3-9 and smoking status was confirmed and was due to an effect on cessation rather than initiation. The SLC6A3-9 polymorphism was also associated with low scores for novelty seeking, which was the most significant personality correlate of smoking cessation. It is hypothesized that individuals carrying the SLC6A3-9 polymorphism have altered dopamine transmission, which reduces their need for novelty and reward by external stimuli, including cigarettes.
Active efflux is a useful strategy by which bacteria evade growth inhibition by antibiotics. Certain semisynthetic tetracycline (TC) analogs, substituted at the 13th carbon at C-6 on ring C of the TC molecule, blocked TC efflux as revealed in everted membrane vesicles from class B TC-resistant (Tcr) Escherichia coli (M. L. Nelson, B. H. Park, J. S. Andrews, V. A. Georgian, R. C. Thomas, and S. B. Levy, J. Med. Chem. 36:370-377, 1993). A representative C-13-substituted analog, 13-cyclopentylthio-5-OH-TC (13-CPTC), was shown to competitively inhibit TC translocation by the Tet(B) protein, blocking the uptake of TC into vesicles and therefore the efflux of TC from whole cells. Against Tcr E. coli, 13-CPTC, when used in combination with doxycycline, produced synergistic inhibition of growth. 13-CPTC was shown to increase the uptake of [3H]TC into the resistant cells. 13-CPTC alone was a potent growth inhibitor against TC-susceptible (Tcs) and Tcr Staphylococcus aureus and enterococci specifying class K or class L efflux-dependent TC resistance mechanisms or, unexpectedly, the class M ribosomal protection mechanism. These findings indicate that derivatives of TC, identified by their ability to block the Tet(B) efflux protein, can restore TC activity against Tcr bacteria bearing either of the two known resistance mechanisms. Blocking drug efflux and increasing intracellular drug concentrations constitute an effective approach to reversing TC resistance and may be generally applicable to other antibiotics rendered ineffective by efflux proteins.
Clinics associated with psychology training programs have potential to generate important research data. The expectation that research be experimental in nature has limited the pursuit of research in training clinics. This type of efficacy study is not feasible in most clinics, where too much variation occurs as a result of training and administrative demands. Numerous process-outcome studies have been effectively conducted in training clinics. This article reviews some of these studies, identifies problems related to research in training clinics, and makes recommendations for the development of an enhanced research agenda for training clinics.
PURPOSE: To describe the manifestations of infectious crystalline keratopathy caused by Candida guilliermondii in a corneal transplant performed for pseudophakic bullous keratopathy. METHOD: Case report. RESULTS: Candida guilliermondii was identified as the causative organism of an indolent infectious crystalline keratopathy. Incisional lamellar biopsy provided diagnostic culture and histopathologic results. Histopathology showed aggregates of yeast elements between corneal stromal lamellae, without inflammation. The infection progressed despite a 6-week course of topical amphotericin B and an additional 6-week course of topical and oral fluconazole. Repeat penetrating keratoplasty resulted in clear graft, with no recurrent infection. CONCLUSIONS: Fungal keratopathy should be included in the differential diagnosis of infectious crystalline keratopathy. Numerous Candida species have been isolated in addition to the most common causative bacterial organism, Streptococcus viridans. Candida guilliermondii is yet one more causative agent of infectious crystalline keratopathy. Candida guilliermondii, a rare human pathogen, was resistant to medical therapy in this case.