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Biomedical subjects

S M Moore

Publications and source records attributed to S M Moore.

At least 19 recordsLinked to original sources
PubMed2007

Creation of a CT Image Library for the Lung Screening Study of the National Lung Screening Trial.

The CT Image Library (CTIL) of the Lung Screening Study (LSS) network of the National Lung Screening Trial (NLST) consists of up to three annual screens using CT imaging from each of 17,308 participants with a significant history of smoking but no evidence of cancer at trial enrollment (Fall 2002-Spring 2004). Screens performed at numerous medical centers associated with 10 LSS-NLST screening centers are deidentified of protected health information and delivered to the CTIL via DVD, external hard disk, or Internet/Virtual Private Network transmission. The collection will be completed in late 2006. The CTIL is of potential interest to clinical researchers and software developers of nodule detection algorithms. Its attractiveness lies in its very specific, well-defined patient population, scanned via a common CT protocol, and in its collection of evenly spaced serial screens. In this work, we describe the technical details of the CTIL collection process from screening center retrieval through library storage.

Clinical Protocols↗
PubMed2005

One-dimensional and three-dimensional models of cerebrovascular flow.

The Circle of Willis is a ring-like structure of blood vessels found beneath the hypothalamus at the base of the brain. Its main function is to distribute oxygen-rich arterial blood to the cerebral mass. One-dimensional (1D) and three-dimensional (3D) computational fluid dynamics (CFD) models of the Circle of Willis have been created to provide a simulation tool which can potentially be used to identify at-risk cerebral arterial geometries and conditions and replicate clinical scenarios, such as occlusions in afferent arteries and absent circulus vessels. Both models capture cerebral haemodynamic autoregulation using a proportional-integral (PI) controller to modify efferent artery resistances to maintain optimal efferent flow rates for a given circle geometry and afferent blood pressure. The models can be used to identify at-risk cerebral arterial geometries and conditions prior to surgery or other clinical procedures. The 1D model is particularly relevant in this instance, with its fast solution time suitable for real-time clinical decisions. Results show the excellent correlation between models for the transient efferent flux profile. The assumption of strictly Poiseuille flow in the 1D model allows more flow through the geometrically extreme communicating arteries than the 3D model. This discrepancy was overcome by increasing the resistance to flow in the anterior communicating artery in the 1D model to better match the resistance seen in the 3D results.

Blood Flow Velocity↗
PubMed2001

Randomized trial of a home recovery intervention following coronary artery bypass surgery.

For this study a randomized clinical trial was designed to test the effects of an early home recovery information intervention on physical functioning, psychological distress, and symptom frequency 1 month following coronary artery bypass graft surgery (CABG). Recovery outcomes were compared between two groups: those receiving an audiotape of information on expected physical sensations and their management (Cardiac Home Information Program [CHIP]) in addition to the usual care, and those receiving the usual cardiac discharge information protocol. A nonprobability sample of 180 patients (84 women and 96 men; mean age = 62 years) was equally distributed between the two study groups. When controlling for age, comorbidity, and cardiac functional status, the results showed positive effects on physical functioning in women and psychological distress, vigor and fatigue in men. Consistent with other studies, women had worse physical functioning and more symptom frequency than men. These findings indicate that the CHIP intervention is an effective method to prepare CABG patients for home recovery.

Activities of Daily Living↗
PubMed2001

Eliciting exercise preferences in cardiac rehabilitation: initial evaluation of a new strategy.

Cardiac rehabilitation (CR) programs may be more effective in promoting long-term exercise if participants are helped to devise exercise programs that are individually tailored to their exercise preferences. This paper describes an initial evaluation of 'CHOICE' (Creating better Health Orientation by Improving Communication about Exercise experiences), an instrument designed to elicit cardiac patients' exercise preferences. In individual interviews with 16 women, CHOICE was used to help participants select exercise features that were important to them for maintaining long-term exercise. Exercise preferences were then summarized on individual preference forms. Study participants in this pilot study had no problems in selecting exercise features contributing to exercise maintenance and could easily discriminate between their relative importance. Further, there were large variations in the importance participants placed on different exercise features. This suggests the need for eliciting patients' exercise preferences so exercise programs can be individually designed. In conclusion, CHOICE is an applicable instrument for eliciting exercise preferences.

Aged↗
PubMed2001

HeartCare: an Internet-based information and support system for patient home recovery after coronary artery bypass graft (CABG) surgery.

HeartCare is an Internet-based information and support service for patients recovering at home from coronary artery bypass graft (CABG) surgery. The system is designed to meet the nursing challenges in health information to support needs of CABG patients. HeartCare (a) provides information and support, tailored to patients' individual and changing recovery needs during CABG recovery, (b) makes recovery information more accessible for timely use by patients, and (c) extends the scope of nursing services to CABG patients from hospital through home. An ongoing randomized controlled study is underway to evaluate the clinical outcomes of patients' use of the HeartCare system and to examine its acceptance as a usable resource for postCABG patients who have limited previous computer experience.

Adult↗
PubMed2001

Induction of Epstein-Barr virus kinases to sensitize tumor cells to nucleoside analogues.

The presence of Epstein-Barr virus (EBV) in the tumor cells of some EBV-associated malignancies may facilitate selective killing of these tumor cells. We show that treatment of an EBV(+) Burkitt's lymphoma cell line with 5-azacytidine led to a dose-dependent induction of EBV lytic antigen expression, including expression of the viral thymidine kinase (TK) and phosphotransferase (PT). Azacytidine treatment for 24 h modestly sensitized the cell line to all nucleosides tested. To better characterize EBV TK with regard to various nucleoside analogues, we expressed EBV TK in stable cell clones. Two EBV TK-expressing clones were moderately sensitive to high doses of acyclovir and penciclovir (PCV) (62.5 to 500 microM) and to lower doses of ganciclovir (GCV) and bromovinyldeoxyuridine (BVdU) (10 to 100 microM) compared to a control clone and were shown to phosphorylate GCV. Similar experiments in a transient overexpression system showed more killing of cells transfected with the EBV TK expression vector than of cells transfected with the control mutant vector (50 microM GCV for 4 days). A putative PT was also studied in the transient transfection system and appeared similar to the TK in phosphorylating GCV and conferring sensitivity to GCV, but not in BVdU- or PCV-mediated cell killing. Induction of EBV kinases in combination with agents such as GCV merits further evaluation as an alternative strategy to gene therapy for selective killing of EBV-infected cells.

Acyclovir↗
PubMed2001

Exposure of hooded capuchin monkeys (Cebus apella cay) to a rabid bat at a zoological park.

On 27 May 1999, a big brown bat (Eptesicus fuscus) was discovered on an island exhibit at the Denver Zoo that contained a troop of 15 hooded capuchin monkeys (Cebus apella cay). The monkeys were attacking the bat when it was discovered. The bat was collected and humanely euthanatized without direct handling and submitted to the Colorado Department of Public Health and Environment Virology Laboratory for rabies evaluation. The monkeys had not been vaccinated against rabies virus. The next day, the laboratory confirmed that the bat was positive for rabies. The recommendations from the Colorado Department of Public Health and Environment and the Centers for Disease Control and Prevention were to euthanatize the monkeys or quarantine them and comply with the human nonvaccinated postexposure protocol. A 1-ml dose of a killed rabies vaccine was administered i.m. in the hip on each of days 2, 7, 12, 19, and 33 postexposure, and a single dose of human rabies immune globulin was administered i.m. 5 days postexposure. Blood was collected under anesthesia in order to evaluate the immune response after rabies vaccination from six monkeys 5 days postexposure, six monkeys 19 days postexposure (five of the six monkeys were the same monkeys bled 5 days postexposure), 15 monkeys 67 days postexposure, and 13 monkeys approximately 1 yr postexposure. All of the monkeys developed and maintained levels of rabies virus neutralizing antibody above 0.05 IU/ml by 67 days postexposure. Although a serologic titer of 0.05 IU/ml indicates an adequate human response after rabies vaccination, no similar information is available for nonhuman primates. To date, none of the monkeys has succumbed to rabies.

Animals↗
PubMed2000

Adult dogs receiving a rabies booster dose with a recombinant adenovirus expressing rabies virus glycoprotein develop high titers of neutralizing antibodies.

Retired greyhound dogs, with low or absent antibody titers to rabies virus following previous vaccinations with commercially available vaccines, were immunized either subcutaneously or intramuscularly with a replication-defective recombinant adenovirus expressing the rabies virus glycoprotein termed Adrab.gp. Immunized animals developed high titers (geometric mean titers of 2630 and 5329) of viral neutralizing antibodies (VNA) against rabies virus by 10 days after vaccination. The antibody titers were even higher (geometric mean titers of 19349 and 122086) by 21 days after vaccination. The results indicate that the recombinant adenovirus expressing rabies virus glycoprotein is capable of inducing antibody immune responses in dogs and therefore may be developed as a rabies virus vaccine for dogs.

Adenoviruses, Human↗
PubMed2000

The influence of uncertainty in illness, stress appraisal, and hope on coping in survivors of breast cancer.

On the basis of Mishel's uncertainty in illness theory, Lazarus and Folkman's stress on appraisal and coping, and Herth's perspective of hope, this cross-sectional, correlational study was designed to examine the influence of uncertainty, stress appraisal, and hope on coping in 71 survivors of breast cancer. Uncertainty was measured by the Mishel Uncertainty in Illness: Community Scale, stress appraisal by the Stress Appraisal Index, hope by the Herth Hope Index, and coping by the Ways of Coping Questionnaires (WCQ).

Adaptation, Psychological↗
PubMed1999

Extracellular matrix proteins protect small cell lung cancer cells against apoptosis: a mechanism for small cell lung cancer growth and drug resistance in vivo.

Resistance to chemotherapy is a principal problem in the treatment of small cell lung cancer (SCLC). We show here that SCLC is surrounded by an extensive stroma of extracellular matrix (ECM) at both primary and metastatic sites. Adhesion of SCLC cells to ECM enhances tumorigenicity and confers resistance to chemotherapeutic agents as a result of beta1 integrin-stimulated tyrosine kinase activation suppressing chemotherapy-induced apoptosis. SCLC may create a specialized microenvironment, and the survival of cells bound to ECM could explain the partial responses and local recurrence of SCLC often seen clinically after chemotherapy. Strategies based on blocking beta1 integrin-mediated survival signals may represent a new therapeutic approach to improve the response to chemotherapy in SCLC.

Amino Acid Chloromethyl Ketones↗
PubMed1999

Family-centered care after acute myocardial infarction.

The experience of a cardiac event is a significant source of stress for both patients and their family members. The acute phase after myocardial infarction reflects a crisis for patients and family members as they attempt to reconcile the affect of the event and adapt to the uncertainties associated with hospitalization and the initial recovery process. This article reviews empirical research available to cardiovascular nurses that may guide family-centered care during the acute phase after myocardial infarction. Directions for practice and research focus on cardiovascular nursing interventions that address family needs after an acute myocardial infarction. The experience of an acute myocardial infarction is a source of stress for both patients and their family members and may be viewed as a crisis that significantly disrupts family functioning and dynamics. The trajectory of cardiovascular disease involves multiple adjustments by patients and family members as they attempt to reconcile the affect of the event and adapt to the uncertainties associated with the acute phase of illness. Efforts by patients and family members to manage the stressors associated with the acute phase of cardiovascular illness are often associated with alterations in physiologic and psychologic functioning.

Caregivers↗
PubMed1998

The presence of a constitutively active phosphoinositide 3-kinase in small cell lung cancer cells mediates anchorage-independent proliferation via a protein kinase B and p70s6k-dependent pathway.

Small cell lung cancer (SCLC) is characterized by early and widespread metastases. Anchorage-independent growth is pivotal to the ability of tumor cells to survive and metastasize in vivo and, under in vitro conditions, allows transformed cells to form colonies in semisolid medium. Here, we report that of five SCLC cell lines tested, all exhibited high basal constitutive phosphoinositide 3-kinase (PI 3-kinase) activity, which results in high basal protein kinase B (PKB) and ribosomal p70 S6 kinase activity (p70s6k). Inhibition of PI 3-kinase activity markedly inhibited SCLC cell proliferation in liquid culture as a result of stimulating apoptosis and promoting cell cycle delay in G1. Furthermore, PI 3-kinase inhibition reduced basal SCLC cell colony formation in agarose semisolid medium that could not be overcome by the addition of neuropeptide growth factors. Thus, constitutive PI 3-kinase activity in SCLC cells plays an important role in promoting the growth and anchorage independence of SCLC. This is not due to activating ras mutations or increased basal src or focal adhesion kinase activity. These data represent the first description of constitutively activated PI 3-kinase/PKB in any human cancer. Constitutive activation of these integrin-dependent signaling events provides a molecular explanation for the anchorage-independent growth of SCLC cells and may account for the nonadherent phenotype and highly metastatic nature of this aggressive cancer. Up-regulation of the PI 3-kinase/PKB pathway may, therefore, represent a novel target for therapeutic intervention in SCLC.

Androstadienes↗
PubMed1998

Using PDSA (Plan-Do-Study-Act) to establish academic-community partnerships: the Cleveland experience.

The Schools of Medicine and Nursing at Case Western Reserve University and the Program in Health Administration at Cleveland State University have created an interdisciplinary course in continuous improvement that emphasizes learning through experience, accommodates a large number of students, and has created new partnerships with Cleveland area health care organizations. An approach that respects these partners as customers and refines the relationships with serial tests of change (e.g., PDSA) has contributed significantly to this program's success.

Community-Institutional Relations↗
PubMed1998

Platelet-derived growth factor-BB and thrombin activate phosphoinositide 3-kinase and protein kinase B: role in mediating airway smooth muscle proliferation.

Proliferation of airway smooth muscle results from persistent inflammatory cytokine and growth factor stimulation and is a critical component of airway luminal narrowing in chronic asthma. Using primary cultures of bovine tracheal smooth muscle (BTSM) cells to examine the signaling basis of cell proliferation, platelet-derived growth factor (PDGF)-BB and thrombin (which act through distinct receptor types) were found to induce DNA synthesis in BTSM cells. Mitogen-induced DNA synthesis could be completely inhibited by LY294002, a selective phosphoinositide 3-kinase (PtdIns 3-kinase) inhibitor. Exposure of BTSM cells to PDGF-BB or thrombin resulted in rapid activation of PtdIns 3-kinase and accumulation of phosphoinositide-3,4,5-trisphosphate. Protein kinase B, a novel signaling protein kinase, was identified in BTSM cells and was activated by PDGF-BB and thrombin in a PtdIns 3-kinase-dependent manner; this may underlie mitogen-stimulated activation of p70(s6k). PD98059, a mitogen-activated protein kinase kinase 1 inhibitor, also partially inhibited PDGF-BB- and thrombin-stimulated DNA synthesis, indicating a modulatory role for mitogen-activated protein kinase in proliferation. GF109203X, Ro 31-8220, calphostin C, and chelerythrine (selective protein kinase C inhibitors) had no effect on PDGF-BB- or thrombin-stimulated DNA synthesis, suggesting that, despite abolishment of mitogen-stimulated protein kinase C activity, cell proliferation stimulated by PDGF-BB and thrombin is protein kinase C-independent. These data demonstrate that the PtdIns 3-kinase/protein kinase B pathway represents a key signaling route in airway smooth muscle proliferation, with the mitogen-activated protein kinase kinase 1/mitogen-activated protein kinase cascade providing a complementary signal required for the full mitogenic response.

3-Phosphoinositide-Dependent Protein Kinases↗
PubMed1998

Designing HeartCare: custom computerized home care for patients recovering from CABG surgery.

With the current trend toward discharge of cardiac artery bypass graft (CABG) patients from the hospital after 5 days, clinicians must make effective use of existing computer technology to provide more efficiently the services once available during the patient's lengthier hospital stay. This paper describes the design of the HeartCare initiative, a computerized cardiac recovery service designed to provide home-care support for patients in the first three months following CABG surgery. Capitalizing on the expansion in health resources on the Internet, and building on the lessons from the ComputerLink projects, HeartCare will employ the World Wide Web platform in the generation of personalized in-home computerized access to recovery resources. Key implementation decisions include selection of WebTV/ as the home-based device, and application of Metadata to organizing health-related knowledge resources on the WWW.

Computers↗
PubMed1997

An examination of adolescent risk-taking using a story completion task.

The aim of the study was to assess whether risk-taking as described in complete the story tasks written by adolescents could be predicted by the perceived consequences of the behaviours portrayed in the stories. The study involved analysis of story themes in terms of portrayal of participation in risky behaviour and the nature of story outcomes. Links between story elements were assessed and comparisons made of these projectively-based findings with previous self-report research. Participants were 570 adolescents aged 12 to 17 from secondary schools in Melbourne, Australia. Responses to four complete the story stimuli were coded according to whether story protagonists participated in the hypothetical risk posed, and in terms of the behavioural outcomes presented. Adolescents were more likely to write stores accepting negative than positive risks, and to expect short-term rather than long-term consequences. Perceived short-term consequences of risk-taking behaviour were predictive of risk participation, however long-term consequences were not. The study provided data about adolescent risk-taking which mirrored and extended the findings of self-report studies.

Adolescent↗
PubMed1997

Gambling activities of young Australians: developing a model of behaviour.

As more gambling venues open in Australia, youth gambling as problem behaviour has been identified. The aim of this study was to assess youth gambling in a population with easy access to gambling, and to evaluate the adequacy of a model for predicting adolescent gambling frequency and problem gambling. The model comprised a combination of the Theory of Reasoned Action (TRA) (Ajzen & Fishbein, 1980), personality variables (venturesomeness, impulsiveness), and cognitive bias variables derived from Weinstein's (1980) propositions concerning unrealistic optimism about future life events. A sample of 1017 school- and university-based adolescents indicated relatively low frequencies of gambling and low scores on the problem gambling scale, with males scoring higher than females on both measures. The TRA was supported with about 30% of the variance of each of gambling behaviour and problem gambling accounted for by intentions, attitudes, and subjective norms. Personality factors added significantly to the prediction of gambling. The cognitive bias variables, although independently not statistically significant, further contributed to prediction.

Journal Article↗