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Biomedical subjects

R Jones

Publications and source records attributed to R Jones.

At least 37 records · Page 2Linked to original sources

An introductory guide to survey research in anaesthesia.

Surveys allow convenient and inexpensive research. Surveys include mail-out questionnaires, email questionnaires, telephone interviews, and personal interviews. Despite a widespread perception that surveys are easy to conduct, good surveys need rigorous design, implementation and analysis. This requires substantial planning, time and effort. The most important step in designing a survey is to clearly define the question(s) the survey aims to answer The target population, measured variables and types of associations being investigated should be specific and unambiguous. Investigators should concentrate on what they 'need to know' rather than what would be 'nice to know'. During development surveys should be piloted to identify problems. The main goal when implementing a survey is to maximize the response rate to avoid misleading results. Evidence-based strategies, including brief personalized surveys with stamped return envelopes, can be used to maximize the response rate. A poorly conducted survey can lead to misleading or invalid conclusions and may undermine participation in subsequent surveys by the target population.

Anesthesiology↗

The planning of rural health research: rurality and rural population issues.

Rurality and rural population issues require special consideration when planning both qualitative and quantitative health research in rural areas. The objective of this article was to explore the issues that require attention when planning the research. This is the first of two articles and focus on issues that require consideration when undertaking rural health research. The diversity of study populations, the feasibility of a research topic, the selection of a research team, and the cultural traditions of Indigenous communities, are all aspects of rural health research planning that require attention. Procedures such as identifying the characteristics of the population, the selection of measures of rurality appropriate for the research topic, the use of local liaison persons, decisions on the use of 'insider' or 'outsider' researchers, and the identification of skills resources available, increase the quality of the research outcomes. These issues are relevant to both qualitative and quantitative research. Procedures are available to address issues of particular concern in developing appropriate methods for rural health research. While we have concentrated on Australian issues and solutions, rural localities in other countries may face similar issues. Attention to rurality and rural situations when planning rural health research, results in studies that support the continued improvement of health in rural communities.

Adult↗

The conducting and reporting of rural health research: rurality and rural population issues.

Rurality and rural population issues require consideration when conducting and reporting on rural health research. A first article focused on the planning stage of the research. The objective of this article is to explore conducting and reporting issues that require attention when undertaking rural health research. The privacy of participants, the collection of data, the cultural traditions of Indigenous communities, the dissemination of results, and giving something back to the community, are all aspects of conducting and reporting rural health research that require attention. Procedures such as identifying the characteristics of the population, attention to safety issues when collecting data, the use of local liaison persons and acknowledging the ownership of intellectual property, increase the quality of the research outcomes. They are issues that are relevant to both qualitative and quantitative research methods. Procedures are available to address issues of particular concern in developing appropriate methods for rural health research. While we have concentrated on Australian issues, and possible solutions, rural localities in many other countries may face similar issues. In any rural setting, paying attention to issues that may affect the conducting and reporting of rural health research will hopefully result in studies that support the continued improvement of health in rural communities.

Australia↗

Ciprofloxacin suppresses bacterial overgrowth, increases fasting insulin but does not correct low acylated ghrelin concentration in non-alcoholic steatohepatitis.

BACKGROUND: Insulin resistance and oxidative stress induced by products of small intestinal bacterial activity are putative factors in the pathogenesis of non-alcoholic steatohepatitis. Acylated ghrelin is the biologically active form of an orexigenic gastric hormone that modifies insulin sensitivity and body composition. AIM: To investigate the effect of ciprofloxacin on small intestinal bacterial activity, ethanol, ghrelin and insulin in non-alcoholic steatohepatitis patients. METHODS: Twelve non-alcoholic steatohepatitis patients and 11 controls were studied before and after ciprofloxacin 500 mg b.d. for 5 days. After an overnight fast, 75 g glucose was ingested and blood was sampled every 20 min for 120 min. Acylated and total ghrelin, ethanol and insulin were measured. Small intestinal bacterial activity was detected by glucose hydrogen breath test. RESULTS: Mean (range) integrated plasma acylated ghrelin which was 102 (21-241) and 202 (88-366) pg/mL . 2 h in non-alcoholic steatohepatitis and controls respectively (P = 0.015). This difference persisted after correction for body mass index and was unaffected by ciprofloxacin treatment. One of six non-alcoholic steatohepatitis patients positive for small intestinal bacterial activity remained positive after ciprofloxacin. In contrast, the one healthy control positive for small intestinal bacterial activity remained positive after ciprofloxacin (P = 0.025). Ethanol was detected in two subjects in each group, becoming immeasurable after ciprofloxacin. In non-alcoholic steatohepatitis patients median (range) fasting insulin increased from 113 (10-223) to 152 (32-396) pmol/L (P < 0.02), after ciprofloxacin. This was accompanied by similar changes in insulin resistance. CONCLUSIONS: Small intestinal bacterial activity is common in non-alcoholic steatohepatitis. Low acylated ghrelin in non-alcoholic steatohepatitis cannot be attributed to small intestinal bacterial activity. Changes in fasting insulin and ethanol following ciprofloxacin suggest that these parameters may be influenced by small intestinal bacterial activity.

Adult↗

Effect of forage legumes and anthelmintic treatment on the performance, nutritional status and nematode parasites of grazing lambs.

Recent studies in New Zealand and the UK have shown that certain forages reduce parasitic infection in sheep. The aim of this experiment was to investigate the effects of legume forages compared to ryegrass on interactions between production, nutritional status and nematodes in grazing lambs. Twenty-four male lambs per forage treatment, half of which were treated with anthelmintics on Day 0, grazed monocultures of lucerne (Medicago sativa), red clover (Trifolium pratense) and white clover (Trifolium repens) and were compared with lambs grazing perennial ryegrass (Lolium perenne). Individual faecal egg counts (FEC) and liveweight were determined every 7 days for 56 days, after which half the lambs were slaughtered to determine total nematode intensities (TNI). Results showed that lambs grazed on red or white clover, but not lucerne, had lower pooled mean FEC and improved liveweight performance compared to lambs grazing ryegrass. Lambs treated with anthelmintics had higher TNI compared to lambs not treated, due to a trend for more adult nematodes in lambs grazing lucerne and treated with anthelmintics than all other lambs, except those grazing red clover and also given anthelmintics. Lambs grazing white clover tended to have fewer adult nematodes than lambs grazing other forages. Examination of the nematode species showed a change in female T. circumcincta occurred in all lambs following anthelmintic treatment and that the forage species grazed by lambs affected individual parasite species. Lambs grazing white clover had fewer male and adult T. circumcincta compared to lambs grazing other forages, and lambs grazing lucerne had fewer adult T. circumcincta compared to lambs grazing ryegrass or red clover. Data on small intestine TNI showed that lambs grazing lucerne and given anthelmintics had more male adult nematodes than other lambs, except those grazing red clover and treated with anthelmintics. Results indicate that lucerne and red clover both increase the re-infection of grazing lambs with Trichostrongylus species compared to ryegrass following anthelmintic treatment. In conclusion, legume forages have the potential to contribute to the control of abomasal but not small intestine nematode parasites in finishing lamb systems.

Abomasum↗

A comparison of three modelling approaches for quantitative risk assessment using the case study of Salmonella spp. in poultry meat.

A comprehensive review of both the scientific literature and industry practices was undertaken to identify and quantify all sources of contamination throughout the entire poultry meat production chain by Salmonella spp. This information was used to develop a quantitative risk assessment (QRA) model for Salmonella in the production chain from the breeder farm to the chilled carcass. This was subsequently used as the basis on which to compare the merits of three approaches to QRA modelling in such systems. The original model used a Bayesian Network (BN). The second method was a Markov chain Monte Carlo (MCMC) approach, a numerical Bayesian technique which retained a similar network structure but allowed further development, such as the separation of variability and uncertainty. The third method was a more detailed simulation model. The BN responds immediately to changes, such as entering evidence, because it does not use simulation and can propagate information from any point in the network to all others by Bayesian inference. However, it requires all the variables to be discrete, which introduces errors if continuous variables have to be discretized. These errors can accumulate. The MCMC approach does not require discrete variables while retaining some of the properties of the BN model, such as the ability to draw inferences from evidence. Finally, the simulation offers greater flexibility, such as consideration of the individual carcass, but may be more complex to implement as a result and sacrifices the ability to propagate evidence.

Animals↗

Internal carotid blood flow and cerebral hemispheric perfusion in patients with subarachnoid haemorrhage: a study of the quantix/NDtrade mark system and CT perfusion technology.

OBJECTIVE: To assess whether carotid blood flow measurements predict abnormalities in cerebral hemispheric perfusion. DESIGN: The Quantix/NDTM system was used to measure carotid artery blood flow in nine patients with subarachnoid haemorrhage who underwent CT perfusion scanning. RESULTS: No significant correlation was found between internal carotid artery blood flow and ipsilateral cerebral hemispheric perfusion (013, p>0.05) but there was a statistically significant correlation between total internal carotid and global cerebral perfusion (0.63, p<0.05). CONCLUSIONS: This is the first report comparing the Quantix/NDTM system with CT perfusion. Our data do not show a statistically significant correlation between extracranial blood flow and cerebral hemispheric perfusion. This is in contrast to two previous studies where Quantix/NDTM measurements were compared with measurements of cerebral perfusion using the Xenon clearance technique.

Carotid Artery, Internal↗

Review: what do we mean by GERD?--definition and diagnosis.

Gastro-oesophageal reflux disease (GERD) is a condition in which the gastro-oesophageal reflux provokes symptoms or complications. Since the majority of patients with heartburn do not have mucosal breaks, expressions such as 'endoscopy-negative reflux disease' (ENRD), 'non-erosive reflux disease' (NERD), or even 'reflux-like dyspepsia' and 'functional heartburn' are frequently employed despite the lack of consensus concerning their exact meaning. Moreover, definition of a disease does not mean that precise diagnostic criteria exist. Diagnostic approaches to GERD differ considerably between primary and secondary care. The primary care physician's role is to decide, on the basis of symptoms and clinical examination, if it is likely that the patient has some serious problem which requires urgent investigation and intervention. In practice, a symptom-based diagnosis can often be made reliably because heartburn and regurgitation are very specific for GERD. The secondary care physician has to make a full evaluation of an already highly-selected patient and, as far as possible, to make a comprehensive, accurate diagnosis, using whatever investigative tools are required. However, there is no 'gold standard' for the diagnosis of GERD and 24-hour pH monitoring lacks sensitivity in NERD. Recently, impedance-pH monitoring has been introduced and promising results have been reported. However, this new technology needs further validation and technical improvement before being employed in routine clinical investigation.

Bilirubin↗

Impact of antiretroviral choice on hypercholesterolaemia events: the role of the nucleoside reverse transcriptase inhibitor backbone.

BACKGROUND: The use of highly active antiretroviral therapy (HAART) has profoundly altered the life expectancy of individuals infected with HIV. Metabolic abnormalities associated with antiretrovirals and cumulative exposure to combination antiretroviral therapy, including dyslipidaemia and insulin resistance, have been linked to an increased risk of myocardial infarction. METHODS: Longitudinal data from a large prospectively collected clinical database were analysed. All patients who commenced first antiretroviral therapy (ART) [two nucleoside reverse transcriptase inhibitors (NRTIs)+one nonnucleoside reverse transcriptase inhibitor (NNRTI) or one active protease inhibitor (PI)] since 1996 were identified. Patients with elevated cholesterol levels [>5.5 mmol/L (215 mg/dL)] prior to therapy initiation were excluded. Quantitative data were categorized into quartiles and presented stratified by individuals developing abnormal levels of cholesterol during first-line HAART. Event time was defined as time from commencing first-line ART to either development of cholesterol level >6.5 mmol/L (254 mg/dL) or switch of first-line therapy. The Kaplan-Meier product limit survival method was used to estimate time to abnormal cholesterol level, and the chi2 test was used for comparisons between drug classes. Cox's proportional hazards regression analysis was used to identify factors predicting a likelihood of raised cholesterol level. RESULTS: A total of 1664 patients were included in the study: 57.1% on two NRTIs+one NNRTI, 38.4% on two NRTIs+one PI, and 4.4% on two NRTIs+a boosted PI regimen. Regimens containing stavudine or PIs were associated with a significantly higher event risk and earlier time to event. No differences between efavirenz and nevirapine or between didanosine and lamivudine were observed. In 28 patients exposed to the combination of tenofovir+lamivudine+efavirenz, there were no episodes of elevated cholesterol level. CONCLUSION: Dyslipidaemia has emerged as an important issue in HIV-infected individuals receiving antiretroviral therapy. This study demonstrates that age at start of therapy, baseline cholesterol level, stavudine use and PI use are all associated with increased risk of hypercholesterolemia on initial therapy. Both NRTI and NNRTI/PI choice influence risk of hypercholesterolaemia.

Adult↗

Misregulation of poly(ADP-ribose) polymerase-1 activity and cell type-specific loss of poly(ADP-ribose) synthesis in the cerebellum of aged rats.

Protein modification by ADP-ribose polymers is a common regulatory mechanism in eukaryotic cells and is involved in several aspects of brain physiology and physiopathology, including neurotransmission, memory formation, neurotoxicity, ageing and age-associated diseases. Here we show age-related misregulation of poly(ADP-ribose) synthesis in rat cerebellum as revealed by: (i) reduced poly(ADP-ribose) polymerase-1 (PARP-1) activation in response to enzymatic DNA cleavage, (ii) altered protein poly(ADP-ribosyl)ation profiles in isolated nuclei, and (iii) cell type-specific loss of poly(ADP-ribosyl)ation capacity in granule cell layer and Purkinje cells in vivo. In particular, although PARP-1 could be detected in virtually all granule cells, only a fraction of them appeared to be actively engaged in poly(ADP-ribose) synthesis and this fraction was reduced in old rat cerebellum. NAD(+), quantified in tissue homogenates, was essentially the same in the cerebellum of young and old rats suggesting that in vivo factors other than PARP-1 content and/or NAD(+) levels may be responsible for the age-associated lowering of poly(ADP-ribose) synthesis. Moreover, PARP-1 expression was substantially down-regulated in Purkinje cells of senescent rats.

Aging↗

HIV and hepatitis C co-infection.

HIV/HCV co-infection is emerging as a major cause of morbidity and mortality in the 21st century. This editorial reviews the prevalence of co-infection, the factors involved in acquisition of HCV, and the influence of co-infection on disease progression. We examine the results of the major co-infection trials including APRICOT, ACTG 5071 and RIBAVIC. These trials, in association with emerging evidence for future therapies currently undergoing investigation, have led to increased hope of treatment success in co-infected individuals.

Anti-HIV Agents↗

Assessment of the efficacy of total lymphocyte counts as predictors of AIDS defining infections in HIV-1 infected people.

BACKGROUND: The CD4 count is a dominant prognostic and predictive factor in HIV infection. This study assessed the utility of the total lymphocyte count (TLC) in place of the CD4 count to predict the development of AIDS defining opportunistic infections (ADOI). METHODS: The Chelsea and Westminster cohort was used to identify those people with a first episode of an ADOI. Corresponding CD4 and TLCs were recorded before diagnosis or at the time of first prescribing prophylaxis; patients without an AIDS defining opportunistic infection were defined as being at "risk" and receiver operating characteristic (ROC) curves were used to display the results of sensitivity and the false positive error rate of total lymphocyte and CD4 count groups. RESULTS: A significant linear correlation was seen between the log(10) CD4 count and log(10) TLC (Pearson's correlation coefficient = 0.70, p<0.001). The finer cut off value for TLC where false positive error rate is minimum and sensitivity maximum was 1500-2000 cells/mm(3). Patients with TLC 1000-1500 cells/mm(3) were estimated to be at 40% increased risk of developing an ADOI. The cut off value for CD4 counts measured 200 cells/mm(3) above which the risk developing an ADOI decreased. Patients with a CD4 count of 150-200 cells/mm(3) were at a 34% increased risk of developing an ADOI. The area under the ROC curve for TLC was 10% lower than that for CD4 count. CONCLUSIONS: The TLC is minimally less reliable than the CD4 count as a predictor of ADOIs. In the absence of expensive equipment for CD4 measurement, the TLC is a useful test.

AIDS-Related Opportunistic Infections↗

Gold color in onions (Allium cepa): a natural mutation of the chalcone isomerase gene resulting in a premature stop codon.

Unusual gold-colored onions were selected from a F3 family originating from a cross between US-type yellow and Brazilian yellow onions. HPLC analysis showed that the gold onions contained a significantly reduced amount of quercetin, the most abundant flavonoid in onions. This result indicated that an early step in the flavonoid biosynthesis pathway might be abnormal in these onions. The expression of flavonoid synthesis genes isolated from onions was examined in gold onions and compared to that in onions of other colors by RT-PCR. The results showed that all genes were transcribed in gold onions as in red onions. In order to identify any critical mutations in flavonoid synthesis genes encoding enzymes involved in early steps of the pathway, the genomic sequence of chalcone isomerase (CHI) was obtained. A premature stop codon and a subsequent single base-pair addition causing a frameshift were identified in the coding region of the CHI gene in the gold onions. Co-segregation of the mutant allele of the CHI gene and the gold phenotype was investigated in the original F2 segregating population. Genotyping of three color groups (red, yellow and gold) of F2 onions revealed perfect co-segregation of the mutant CHI allele with the gold phenotype. All tested gold F2 onions were homozygous for the mutant CHI allele. This perfect co-segregation implies that the presence of a premature stop codon in the gold CHI gene results in an inactive CHI. Inactivation of CHI results in a block in the flavonoid biosynthesis pathway and the accumulation of chalcone derivatives, including a yellow pigment which might be responsible for the gold color in onions.

Amino Acid Sequence↗

Degradation of boron-doped Czochralski-grown silicon solar cells.

The formation mechanism and properties of the boron-oxygen center responsible for the degradation of Czochralski-grown Si(B) solar cells during operation is investigated using density functional calculations. We find that boron traps an oxygen dimer to form a bistable defect with a donor level in the upper half of the band gap. The activation energy for its dissociation is found to be 1.2 eV. The formation of the defect from mobile oxygen dimers, which are shown to migrate by a Bourgoin mechanism under minority carrier injection, has a calculated activation energy of 0.3 eV. These energies and the dependence of the generation rate of the recombination center on boron concentration are in good agreement with observations.

Journal Article↗

A comparison of the CD4 response to antiretroviral regimens in patients commencing therapy with low CD4 counts.

OBJECTIVE: To compare the immunological response to highly active antiretroviral therapy (HAART) in treatment-naive patients with a baseline CD4 count of <200 cells/mm(3). DESIGN AND METHODS: We identified treatment-naive human immunodeficiency virus (HIV-1)-infected individuals who had commenced HAART since 1996 and who had a starting CD4 count of <200 cells/mm(3). Immunological success was defined as achieving a CD4 count of >200 cells/mm(3) and treatments were compared using univariate and multivariate Cox's proportional hazards models in order to establish whether protease inhibitor (PI)-based regimens were significantly different to regimens based on non-nucleoside reverse transcriptase inhibitors (NNRTIs). Both regimens utilize a nucleoside analogue (NA) backbone. RESULTS: A total of 599 patients were identified. When the variables were entered into a multivariate analysis, no significant differences between HAART regimens were found. We showed that compared with efavirenz regimens a two NA plus one PI regimen was not significantly less likely to achieve immunological success (adjusted HR: 0.65, 95% CI 0.41-1.03, P=0.07). Two NA and boosted PI (adjusted HR: 1.33, 95% CI 0.81 to 2.16) or two NA and nevirapine (adjusted HR: 0.93, 95% CI 0.67-1.29) regimens were also not significantly different from efavirenz-based regimens, based on the endpoint of immunological success. CONCLUSION: PI-, boosted PI- and NNRTI-based HAART regimens are not significantly different in achieving increased CD4 counts in individuals who commence therapy with a low CD4 count.

Adult↗

Effect of coal mine dust and clay extracts on the biological activity of the quartz surface.

Modification of the quartz surface by aluminium salts and metallic iron have been shown to reduce the biological activity of quartz. This study aimed to investigate the ability of water soluble extracts of coal mine dust (CMD), low aluminium clays (hectorite and montmorillonite) and high aluminium clays (attapulgite and kaolin) to inhibit the reactivity of the quartz surface. DQ12 induced significant haemolysis of sheep erythrocytes in vitro and inflammation in vivo as indicated by increases in the total cell numbers, neutrophil cell numbers, MIP-2 protein and albumin content of bronchoalveolar lavage (BAL) fluid. Treatment of DQ12 with CMD extract prevented both haemolysis and inflammation. Extracts of the high aluminium clays (kaolin and attapulgite) prevented inhibition of DQ12 induced haemolysis, and the kaolin extract inhibited quartz driven inflammation. DQ12 induced haemolysis by coal mine dust and kaolin extract could be prevented by pre-treatment of the extracts with a cation chellator. Extracts of the low aluminium clays (montmorillonite and hectorite) did not prevent DQ12 induced haemolysis, although the hectorite extract did prevent inflammation. These results suggest that CMD, and clays both low and rich in aluminium, all contain soluble components (possibly cations) capable of masking the reactivity of the quartz surface.

Administration, Inhalation↗