Biomedical subjects

Melanie L Bell

Publications and source records attributed to Melanie L Bell.

11 recordsLinked to original sources

PubMed2006

Accuracy and reliability of observational motion analysis in identifying shoulder symptoms.

INTRODUCTION: Aberrations in shoulder movement patterns are believed to be associated with the presence of shoulder symptoms. However, the detection of movement aberrations has not been rigorously investigated. It is possible that manipulative physiotherapists use the clinical history to prejudge the existence of aberrations, rather than the actual observation of the movement pattern itself. There is a need to determine whether physiotherapists, in the absence of a clinical history, can relate observed anomalies of shoulder movement to the presence of symptoms and to determine the reliability for observation of such anomalous shoulder movement. METHODS: The sample comprised of 9 symptomatic subjects recruited from four physiotherapy clinics in Christchurch, New Zealand and a further 11 asymptomatic subjects recruited from Christchurch's general population. They were videotaped performing shoulder flexion, abduction, and scapular plane abduction. The video-recordings were evaluated by 11 manipulative physiotherapists who did not know which subjects were symptomatic and who were thus required to judge the symptomatic status as: asymptomatic, symptomatic left, symptomatic right or symptomatic both. Additionally, each physiotherapist completed a survey on each of the 20 subjects regarding the type of movement anomaly that was perceived (e.g. too much scapular elevation, too little glenohumeral movement, etc). Classification accuracy (percentage of correct responses) and agreement (kappa) among physiotherapists were computed. RESULTS: Out of the 220 responses by the physiotherapists regarding symptomatic status, 58% were correct, with 68% asymptomatic, 71% symptomatic left and 30% symptomatic right subjects correctly classified. Reliability analysis showed kappa statistics for all subjects was 0.23, for asymptomatic subjects 0.22, symptomatic left 0.34, and symptomatic right 0.17. Only five subjects had two or more evaluators agree on the type of anomalous movement. CONCLUSIONS: Although movement analysis is considered an integral part of a physiotherapist's skill this research has shown that a sample of experienced manipulative physiotherapists had difficulty in determining the symptomatic status of patients with clinically diagnosed shoulder complaints by movement analysis alone.

Adult↗

PubMed2006

Carbohydrate balance predicts weight and fat gain in adults.

BACKGROUND: The prevention and treatment of obesity is a public health challenge. OBJECTIVE: We investigated the effects of dietary composition, insulin sensitivity (S(I)), and energy balance on predicted changes in body composition. DESIGN: In a randomized crossover design study, 39 normal-weight (n = 23), overweight (n = 8), and obese (n = 8) men and women (aged 25-36 y) each followed a 15-d isocaloric high-fat (HF; 50% fat) and high-carbohydrate [HC; 55% carbohydrate (CHO)] diet with a 4-6-wk washout period during the first year. During each treatment, energy balance was measured while the subjects were inactive by using indirect calorimetry on day 15, and S(I) was measured by using a euglycemic clamp study (40 mU . m(-2) . min(-1)) on day 16. Weight and body composition were then measured annually for 4 y. The outcomes for fat mass, percentage body fat, and weight were measured by using a linear 2-stage mixed model. RESULTS: CHO balance (day 15) and S(I) (day 16) on the HC diet were highly and significantly correlated (r = 0.55, P < 0.001). On the HC diet, the subjects who had a higher positive CHO balance (day 15) gained less fat mass (P < 0.001), percentage body fat (P = 0.006), and weight (P = 0.024) over time. When adjusted for S(I), CHO balance remained a significant predictor of changes in fat mass (P = 0.021) and percentage body fat (P = 0.025). CONCLUSIONS: On a HC diet, the subjects who had a higher positive CHO balance on day 15 while they were inactive gained less fat mass during 4 y, a predictive effect independent of S(I). As suggested in rodents, the capacity to expand the glycogen pool might reduce energy intake and protect against fat and weight gain.

Adipose Tissue↗

PubMed2006

Air travel and fatal pulmonary embolism.

Although long-distance air travel is commonly regarded as a risk factor for venous thromboembolism, the risk of clinically important events has not been well defined. We estimated the absolute risk of dying from pulmonary embolism following long-distance air travel in a national population-based descriptive study of 121 men and women who were aged 15-59 years (the age range in which the majority of international arrivals are found) and whose underlying cause of death was certified as codes 415.1, 451, or 453 of the International Classification of Diseases (ninth revision). Eleven cases had undertaken long-distance air travel in the four weeks before the onset of the fatal episode. The estimated risks of fatal pulmonary embolism following a flight of at least three hours' duration were 0.5 (95% CI 0.2-1.2) and 0.6 (95% CI 0.2-1.4) per million arrivals for overseas visitors and New Zealand residents, respectively. For air travel of more than eight hours' duration, the risk in New Zealand residents was 1.3 (95% CI 0.4-3.0) per million arrivals. We also conducted a case-control study based on those cases who were normally resident in New Zealand and registered on the electoral roll (n = 99). For each case, four controls matched for sex, age, and electorate, were randomly selected from the electoral roll. In the key analysis (based on 88 cases and 334 controls), the adjusted odds ratio for travellers who had flown for more than eight hours was 7.9 (95% CI 1.1-55.1) compared with those who did not undertake a long-distance flight. Long-distance air travellers have a higher risk of dying from pulmonary embolism than non-travellers, but the absolute risk in people aged 15-59 years appears to be very small.

Adolescent↗

PubMed2005

Effects of indomethacin and celecoxib on renal function in athletes.

INTRODUCTION: Strenuous exercise induces a marked reduction in renal hemodynamics. Prostaglandins (PG) play an important role in maintaining renal integrity in the face of hemodynamic changes. Inhibition of cyclooxygenase (COX) and thus PG formation can further compromise renal perfusion. The role of selective COX-2 inhibition on renal hemodynamics during exercise has not been investigated. METHODS: Twelve healthy males (22-47 yr) took part in a randomized placebo controlled study investigating the effects of nonselective COX inhibition (indomethacin) and COX-2 selective inhibition (celecoxib) on renal hemodynamics during exercise. Renal blood flow (RBF), glomerular filtration rate (GFR), and free water clearance were measured using standard clearance techniques. Each experimental session was performed at least a week apart. The medications were taken for 36 h before study with the last dose at 0700 h on the day of study. Following baseline studies, each participant exercised for 30 min at 80% of their maximal aerobic power. Renal function was monitored for 2 h post-recovery. RESULTS: RBF and GFR fell by 40% after exercise with no significant difference between placebo, indomethacin, or celecoxib. Indomethacin (-2.43 +/- 0.95 mL x min(-1), P < 0.007) and celecoxib (-3.88 +/- 0.94 mL x min(-1), P < 0.0001) significantly reduced free water clearance compared with placebo during recovery. CONCLUSION: This study has confirmed that selective and nonselective COX inhibition can induce significant inhibition of free water clearance, indicating that these acute changes are regulated predominantly via COX-2. Acute cerebral edema with hyponatremia has been reported after major endurance sporting events. Identifiable risk factors include excessive hydration and use of NSAID. Impaired free water clearance during exercise potentiated by COX inhibition provides a pathophysiological explanation for these observations.

Adult↗

PubMed2004

Resistant starch consumption promotes lipid oxidation.

BACKGROUND: Although the effects of resistant starch (RS) on postprandial glycemia and insulinemia have been extensively studied, little is known about the impact of RS on fat metabolism. This study examines the relationship between the RS content of a meal and postprandial/post-absorbative fat oxidation. RESULTS: 12 subjects consumed meals containing 0%, 2.7%, 5.4%, and 10.7% RS (as a percentage of total carbohydrate). Blood samples were taken and analyzed for glucose, insulin, triacylglycerol (TAG) and free fatty acid (FFA) concentrations. Respiratory quotient was measured hourly. The 0%, 5.4%, and 10.7% meals contained 50 muCi [1-14C]-triolein with breath samples collected hourly following the meal, and gluteal fat biopsies obtained at 0 and 24 h. RS, regardless of dose, had no effect on fasting or postprandial insulin, glucose, FFA or TAG concentration, nor on meal fat storage. However, data from indirect calorimetry and oxidation of [1-14C]-triolein to 14CO2 showed that addition of 5.4% RS to the diet significantly increased fat oxidation. In fact, postprandial oxidation of [1-14C]-triolein was 23% greater with the 5.4% RS meal than the 0% meal (p = 0.0062). CONCLUSIONS: These data indicate that replacement of 5.4% of total dietary carbohydrate with RS significantly increased post-prandial lipid oxidation and therefore could decrease fat accumulation in the long-term.

Journal Article↗

PubMed2004

Cell contact-dependent mechanisms specify taste bud pattern during a critical period early in embryonic development.

After gastrulation, the pharyngeal endoderm is specified to give rise to taste receptor organs without further signaling from other embryonic tissues. We hypothesized that intercellular signaling might be responsible for the specification of taste buds. To test if and when this signaling was occurring, intercellular contacts were transiently disrupted in cultures of pharyngeal endoderm from axolotl embryos, and the number, size, and distribution of taste buds analyzed. Disruption of cell contacts at progressive time points, from neurula to late tail bud stages, revealed a critical period, during mid-tail bud stages, when disruption of cell contacts resulted in a significant increase in taste bud number and size. The spatial distribution of taste buds was also altered; taste buds were more clustered in explants disrupted during the critical period. These effects were not due to general alterations in mitosis and apoptosis. Rather, at least three aspects of taste bud patterning, i.e., number, size, and distribution, are governed by mechanisms dependent on normal cell contacts during a concise time window. Furthermore, our findings are consistent with specification of taste buds by means of lateral inhibitory signaling, which we hypothesize results from cell contact-dependent or short-range diffusible signals.

Ambystoma↗

PubMed2004

Commercially available pedometers: considerations for accurate step counting.

BACKGROUND: Many commercially available pedometers undercount, especially at slower speeds. We examined the effects of age, obesity, and self-selected walking speed on pedometer accuracy. We also compared the accuracy of piezoelectric and spring-levered pedometers at slow walking speeds. METHODS: Study 1: 259 subjects walked on a motorized treadmill at two self-selected walking speeds. Steps were counted using a spring-levered pedometer. Study 2: 32 subjects walked on a motorized treadmill at slow walking (1.0-2.6 MPH) speeds. Steps were counted using spring-levered and piezoelectric pedometers. RESULTS: Study 1: self-selected walking speed and pedometer accuracy decreased with increasing age, weight, and body mass index (BMI). Accuracy was 71% below 2.0 MPH, 74-91% between 2.0 and 3.0 MPH, and 96% above 3.0 MPH. Decreased accuracy was best predicted by increasing age. Study 2: between 1.8 and 2.0 MPH, the accuracy of the piezoelectric pedometer (>97%) exceeded that of the spring-levered pedometers (52-95%). Even at 1.0 MPH, accuracy of the piezoelectric pedometer (56.4 +/- 33.8%) was superior to the spring-levered pedometers (7-20%). CONCLUSION: Accuracy of all pedometers tested exceeded 96% at speeds 3.0 MPH, but decreased at slower walking speeds. In individuals that naturally ambulate at slower walking speeds (e.g., elderly), we recommend the use of more sensitive (e.g., piezoelectric) pedometers.

Adult↗

PubMed2004

Mixed models for the analysis of replicated spatial point patterns.

The statistical methodology for the analysis of replicated spatial point patterns in complex designs such as those including replications is fairly undeveloped. A mixed model is developed in conjunction with maximum pseudolikelihood and generalized linear mixed modeling by extending Baddeley and Turner's (2000, Australian and New Zealand Journal of Statistics 42, 283-322) work on pseudolikelihood for single patterns. A simulation experiment is performed on parameter estimation. Fixed- and mixed-effect models are compared, and in some respects the mixed model is found to be superior. An example using the Strauss process for modeling neuron locations in post-mortem brain slices is shown.

Brain↗

PubMed2003

Disruption of sonic hedgehog signaling alters growth and patterning of lingual taste papillae.

Taste buds on the anterior part of the tongue develop in conjunction with epithelial-mesenchymal specializations in the form of gustatory (taste) papillae. Sonic hedgehog (Shh) and Bone Morphogenetic Protein 4 (BMP4) are expressed in developing taste papillae, but the roles of these signaling molecules in specification of taste bud progenitors and in papillary morphogenesis are unclear. We show here that BMP4 is not expressed in the early tongue, but is precisely coexpressed with Shh in papillary placodes, which serve as a signaling center for both gustatory and papillary development. To elucidate the role of Shh, we used an in vitro model of mouse fungiform papillary development to determine the effects of two functional inhibitors of Shh signaling: anti-Shh (5E1) antibody and cyclopamine. Cultured E11.5 tongue explants express Shh and BMP4(LacZ) in a pattern similar to that of intact embryos, localizing to developing papillary placodes after 2 days in culture. Tongues cultured with 5E1 antibody continue to express these genes in papillary patterns but develop more papillae that are larger and closer together than in controls. Tongues cultured with cyclopamine have a dose-dependent expansion of Shh and BMP4(LacZ) expression domains. Both antibody-treated and cyclopamine-treated tongue explants also are smaller than controls. Taken together, these results suggest that, although Shh is not involved in the initial specification of papillary placodes, Shh does play two key roles during pmcry development: (1) as a morphogen that directs cells toward a nonpapillary fate, and (2) as a mitogen, causing expansion of the interplacodal epithelium and underlying mesenchyme.

Animals↗

PubMed2003

Short-term triglyceride lowering with fenofibrate improves vasodilator function in subjects with hypertriglyceridemia.

OBJECTIVE: The objective of this study was to investigate the effects of lowering plasma triglycerides (TGs) on endothelial function and gain insight into the role played by free fatty acids (FFAs) in hypertriglyceridemia-associated vascular dysfunction. METHODS AND RESULTS: Eleven hypertriglyceridemic subjects without coronary artery disease, diabetes, elevated low-density lipoprotein cholesterol, tobacco use, or hypertension were studied using a randomized, double-blinded, crossover design (fenofibrate and placebo, 14 days). After each regimen, forearm blood flow was assessed by plethysmography in response to arterial acetylcholine, nitroprusside, and verapamil infusion. Hourly plasma TGs, FFA, glucose, and insulin were measured during a 24-hour feeding cycle to characterize the metabolic environment. Changes in plasma FFA after intravenous heparin were used to estimate typical FFA accumulation in the luminal endothelial microenvironment. Fenofibrate lowered plasma TG (P<0.001), total cholesterol (P<0.01), and apolipoprotein B (P<0.01) without altering high-density lipoprotein or low-density lipoprotein cholesterol concentrations. Forearm blood flow in response to acetylcholine (P<0.0001), nitroprusside (P<0.001), and verapamil (P<0.0001) improved after fenofibrate. Fenofibrate lowered 24-hour (P<0.0001) and post-heparin (P<0.001) TG and tended to lower 24-hour (P=0.054) and post-heparin (P=0.028) FFA. CONCLUSIONS: Vascular smooth muscle function significantly improves after lowering plasma TG without changes in confounding lipoproteins or insulin resistance. The data raise additional questions regarding the role of FFA in hypertriglyceridemia-associated vascular dysfunction.

Adult↗

PubMed2002

Differences in resting metabolic rate between white and African-American young adults.

OBJECTIVE: A reported lower resting metabolic rate (RMR) in African-American women than in white women could explain the higher prevalence of obesity in the former group. Little information is available on RMR in African-American men. RESEARCH METHODS AND PROCEDURES: We assessed RMR by indirect calorimetry and body composition by DXA in 395 adults ages 28 to 40 years (100 African-American men, 95 white men, 94 African-American women, and 106 white women), recruited from participants in the Coronary Artery Risk Development in Young Adults (CARDIA), Birmingham, Alabama, and Oakland, California, field centers. RESULTS: Using linear models, fat-free mass, fat mass, visceral fat, and age were significantly related to RMR, but the usual level of physical activity was not. After adjustment for these variables, mean RMR was significantly higher in whites (1665.07 +/- 10.78 kcal/d) than in African Americans (1585.05 +/- 11.02 kcal/d) by 80 +/- 16 kcal/d (p < 0.0001). The ethnic x gender interaction was not significant (p = 0.9512), indicating that the difference in RMR between African-American and white subjects was similar for men and women. DISCUSSION: RMR is approximately 5% higher in white than in African-American participants in CARDIA. The difference was the same for men and women and for lean and obese individuals. The prevalence of obesity is not higher in African-American men than in white men. Because of these reasons, we believe that RMR differences are unlikely to be a primary explanation for why African-American women are more prone to obesity than white women.

Adipose Tissue↗