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Nelson RM, Shedlock M, Kaczmarek C, Gahrs J, MacLaughlin H. Comparison of motor unit action potentials using monopolar vs. concentric needle electrodes in the middle deltoid and abductor digiti minimi muscles. ELECTROMYOGRAPHY AND CLINICAL NEUROPHYSIOLOGY 2003; 43:459-64. [PMID: 14717026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
UNLABELLED Electromyography readings are analyzed noting abnormalities in the parameters of amplitude, duration, and number of phases. Previous studies have demonstrated variability between monopolar needle electrodes (MNEs) and concentric needle electrodes (CNEs) in regard to the above parameters. We hypothesized that a difference in measured parameters would be observed due to the physical differences between the needles. Twenty-three subjects participated in this study. Five readings were recorded from the middle deltoid and the abductor digiti minimi muscles using the MNE, and five readings were recorded using the CNE. A minimal isometric contraction of the tested muscle in the subjects dominant arm was performed. A significant difference was found in amplitudes recorded by the MNE and CNE in both muscles. A significant difference was found in the ADM, and not in the deltoid, with regard to duration. The difference found in the number of phases was clinically insignificant. DISCUSSION The MNE detected larger amplitudes and durations because of its larger recording territory. The duration may also be affected by the distance between the active/reference electrodes.
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Nelson RM, Cauley T, Fink M, Lauretani C, Simonson T. Comparison of motor unit action potential characteristics and hand dominance using monopolar needle electrodes in the abductor pollicis brevis and abductor digiti minimi muscles. ELECTROMYOGRAPHY AND CLINICAL NEUROPHYSIOLOGY 2003; 43:17-22. [PMID: 12613136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
This study examined specific electrical characteristics of voluntary single motor unit action potentials (SMUAPs): amplitude, duration, phase change, and rate of rise. These characteristics, which were detected from two intrinsic muscles of the hand--the abductor pollicis brevis and the abductor digiti minimi--were compared to hand dominance. Forty subjects participated in the study. Five characteristics were detected from each muscle using the quadrant technique while the subject produced a minimal isometric contraction. Based on results of an ANOVA [two-factor with replication] test, our study revealed no significant difference between muscles in the dominant and non-dominant hands. Descriptive statistics for each muscle characteristic are presented. This study has identified parameters for SMUAP characteristics detected in non-impaired individuals ranging in age from 20 to 43 years. The normative parameters serve as a valuable base from which one may examine potential neuronal damage from cumulative trauma disorders.
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Soderblom LA, Becker TL, Bennett G, Boice DC, Britt DT, Brown RH, Buratti BJ, Isbell C, Giese B, Hare T, Hicks MD, Howington-Kraus E, Kirk RL, Lee M, Nelson RM, Oberst J, Owen TC, Rayman MD, Sandel BR, Stern SA, Thomas N, Yelle RV. Observations of comet 19P/Borrelly by the miniature integrated camera and spectrometer aboard Deep Space 1. Science 2002; 296:1087-91. [PMID: 11934989 DOI: 10.1126/science.1069527] [Citation(s) in RCA: 182] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The nucleus of the Jupiter-family comet 19P/Borrelly was closely observed by the Miniature Integrated Camera and Spectrometer aboard the Deep Space 1 spacecraft on 22 September 2001. The 8-kilometer-long body is highly variegated on a scale of 200 meters, exhibiting large albedo variations (0.01 to 0.03) and complex geologic relationships. Short-wavelength infrared spectra (1.3 to 2.6 micrometers) show a slope toward the red and a hot, dry surface (</=345 kelvin, with no trace of water ice or hydrated minerals), consistent with approximately 10% or less of the surface actively sublimating. Borrelly's coma exhibits two types of dust features: fans and highly collimated jets. At encounter, the near-nucleus coma was dominated by a prominent dust jet that resolved into at least three smaller jets emanating from a broad basin in the middle of the nucleus. Because the major dust jet remained fixed in orientation, it is evidently aligned near the rotation axis of the nucleus.
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Abstract
Ethical conflict in the clinical setting generally arises in situation of uncertainty, ambiguity, and complexity. This report discusses 4 cases of conflict between clinicians, between clinicians and patient, and between clinicians and family. Presented in enough detail for the reader to appreciate the extent and nature of the conflict, these cases are difficult and in many ways unresolved. Some conflicts may be inevitable and would not be prevented by even the most conscientious clinician. The authors discuss various approaches and resources that may prevent or ameliorate conflict. However, no easy answers are offered, but the importance of open communication of differing viewpoints in an atmosphere of trust and respect are emphasized.
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Nelson RM. New rules for gene-transfer trials. IRB 2001; 23:11. [PMID: 12737176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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Nelson RM. Nontherapeutic research, minimal risk, and the Kennedy Krieger lead abatement study. IRB 2001; 23:7-11. [PMID: 12737175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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Green AR, Hainsworth AH, Misra A, Debens TA, Jackson DM, Murray TK, Nelson RM, Cross AJ. The interaction of AR-A008055 and its enantiomers with the GABA(A) receptor complex and their sedative, muscle relaxant and anticonvulsant activity. Neuropharmacology 2001; 41:167-74. [PMID: 11489453 DOI: 10.1016/s0028-3908(01)00053-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AR-A008055 [(+/-)-1-(4-methyl-5-thiazolyl)-1-phenylmethylamine] is structurally related to clomethiazole and has been used to probe the mechanism of the neuroprotective effect of clomethiazole. Clomethiazole, (+/-)-AR-A008055 and (S)-(-)-AR-A008055 all displaced [35S]-t-butyl-bicyclophosphorothionate ([35S]TBPS) from rat cerebral cortex tissue (IC50 values: GABA, 8.1+/-0.04 microM; clomethiazole, 130+/-30 microM; (+/-)-AR-A008055, 494+/-7 microM; (S)-(-)-AR-A008055, 221+/-14 microM. (R)-(+)-AR-A008055 was without significant effect (IC50>1000 microM). None of the compounds interacted with NMDA or AMPA receptors or with sodium or calcium (N, P/Q) channels. Brain penetration of both enantiomers following their i.p. administration was excellent, with brain and plasma concentrations being similar. Clomethiazole dose-dependently inhibited spontaneous locomotor activity in rats and was approximately 10 times more sedative than either enantiomer of AR-A008055. Clomethiazole was more potent than (S)-(-)-AR-A008055 in the "pull-up" test (muscle relaxation) and in producing loss of righting reflex, while (R)-(+)-AR-A008055 had little effect. The time animals remained on a Rota-rod was of the order: clomethiazole<(S)-(-)-AR-A008055<(R)-(+)-AR-A008055. (S)-(-)-AR-A008055 (210 micromol/kg) raised seizure threshold to pentylenetetrazole (i.v.) by 119+/-21%. The (R)-(+)- enantiomer was not anticonvulsant. Overall, (S)-(-)-AR-A008055 exhibited a similar pharmacology to clomethiazole. However, its sedative and muscle relaxant effects were substantially less than clomethiazole, emphasising that these properties are not directly related to neuroprotective efficacy. The current data suggest that the proposed GABA uptake inhibitory property of (R)-(+)-AR-A008055 fails to produce significant sedative, myorelaxant or anticonvulsant activity.
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Nelson RM, Hainsworth AH, Lambert DG, Jones JA, Murray TK, Richards DA, Gabrielsson J, Cross AJ, Green AR. Neuroprotective efficacy of AR-A008055, a clomethiazole analogue, in a global model of acute ischaemic stroke and its effect on ischaemia-induced glutamate and GABA efflux in vitro. Neuropharmacology 2001; 41:159-66. [PMID: 11489452 DOI: 10.1016/s0028-3908(01)00052-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We have investigated the neuroprotective properties of AR-A008055 [(+/-)-1-(4-methyl-5-thiazolyl-1-phenyl-methylamine], a novel compound structurally related to clomethiazole. Administration (i.p.) of (+/-)-AR-A008055 60 min after 5 min of global cerebral ischaemia in gerbils produced a dose-dependent protection of the hippocampus from damage. Both enantiomers [(R)-(+)-AR-A008055 and (S)-(-)- AR-A008055] at 600 micromol/kg produced similar protection to that following clomethiazole (600& micromol/kg) and both produced similar and sustained neuroprotection, at 4, 7 and 21 days post-insult. When infused intravenously over a 2-h period, both enantiomers produced concentration-dependent neuroprotection, with the enantiomers providing similar protection at every plasma concentration (50-200 nmol/ml). The efficacy of (S)-(-)-AR-A008055 was similar to clomethiazole, but it was slightly less potent. Ischaemia-induced glutamate efflux from rat brain cortical prisms in vitro was inhibited by both isomers (100 microM). The inhibitory effect of (R)-(+)-AR-A008055 was blocked by bicuculline (10 microM) and picrotoxin (100 microM), while the effect of (S)-(-)-AR-A008055 was only antagonised by picrotoxin. This indicated that (S)-(-)-AR-A008055, like clomethiazole, is able to open the GABA(A)-chloride channel in the absence of endogenous GABA. (R)-(+)-AR-A008055 was more potent than (S)-(-)-AR-A008055 in enhancing the concentration of GABA in the medium following 30 min exposure of tissue to the ischaemic conditions, suggesting that it is an effective GABA uptake inhibitor. This action may explain both its effect on glutamate efflux in vitro and its neuroprotective effect in vivo.
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Nelson RM. Protocol 126 and "The Hutch". IRB 2001; 23:14-6. [PMID: 11789524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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Leuschen MP, Nelson RM. Effects of asphyxia on telencephalic microvessels of premature beagle pups. J Perinatol 2001; 7:93-9. [PMID: 3505618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The authors identified alterations in the brain microvasculature of the premature Beagle pup that could be attributed to asphyxia and potentially associated with the etiology of intraventricular hemorrhage (IVH). Beagle pups were delivered by cesarean section six days before their predicted whelping date and exposed to an alternating protocol of asphyxial episodes known to produce IVH. Data from the telencephalic microvasculature at both the germinal matrix (an area susceptible to IVH) and the borderzone cerebral cortex (an area rarely involved in hemorrhage) were analyzed. The germinal matrix microvessels responded differently to asphyxia than the cortical vessels. The germinal matrix microvessels maintained junctional complexes and intraluminal microvilli, and increased in cross-sectional luminal area following asphyxia; however, total vessel cross-sectional area did not change. After the asphyxial insult, cortical microvessels no longer exhibited intraluminal microvilli and increased in both total cross-sectional area and luminal area. The number of junctional complexes in cross-sections of cortical vessels was significantly reduced due at least in part to the narrowing of the endothelial cell lateral borders. The data provide indirect evidence to substantiate vasodilation speculated to be due to an increased cerebral blood flow to telencephalic vessels (both the germinal matrix and cerebral cortex) following asphyxia. The data also suggest differential rates of maturation between germinal matrix and cortical microvessels.
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George RY, Bodnar G, Gerlach SL, Nelson RM. Buffer zones promoting oligotrophication in golf course runoffs: fiddler crabs as estuarine health indicators. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2001; 44:591-598. [PMID: 11804155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Nitrogen pollution above a threshold level induces a eutrophication process in coastal creek ecosystems and consequently impacts on the water quality. The remedy for this scenario is the introduction of methods to enhance oligotrophication by means of constructed wetlands and buffer zones. This paper discusses new data on nitrogen flux and population changes in the primary consumers in the Bradley Creek ecosystem, adjacent to the Duck Haven Golf Course in southeastern North Carolina. In 1998-99, over different seasons, density distribution of the field populations of the fiddler crab Uca minax, was monitored as an indicator of environmental health. A control site at Whiskey Creek, adjacent to the University Center for Marine Sciences, was monitored in the same period since this site is not influenced by any golf course nutrient flux. The results pointed out that threshold level for optimum population density in Spartina grandiflora salt marsh is 0.1 mg/L of nitrates. A dense crab population, adjacent to the golf course with a buffer zone, was indicative of restoration of the estuarine ecosystem. A model, involving the use of constructed wetlands for oligotrophication, is being prepared on the basis of studies conducted by the University of South Alabama for a stormwater wetland constructed adjacent to the university's golf course.
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Billore SK, Singh N, Ram HK, Sharma JK, Singh VP, Nelson RM, Dass P. Treatment of a molasses based distillery effluent in a constructed wetland in central India. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2001; 44:441-448. [PMID: 11804132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
A field-scale 4-celled, horizontal subsurface constructed wetland (CW) was installed to evaluate removal efficiencies of wastewater constituents in an industrial distillery effluent. Total and dissolved solids, NH4-N, TKN, P and COD were measured. This CW design provides four serial cells with synthetic liners and a river gravel base. The first two unplanted cells provide preliminary treatment. Specific gravel depths and ensuing biofilm growth provides anaerobic treatment in Cell 1 and anaerobic treatment in Cell 2. Cell 3 was planted with Typha latifolia with an inserted layer of brick rubble (for phosphorus removal). Locally grown reed, Phragmites karka was planted in Cell 4. COD was reduced from 8420 mg/l 3000 from Cell 1 to the outlet of Cell 4. Likewise other parameters: total and dissolved solids, ammonium and total nitrogen, and total P, indicated declining trends at the 4-celled CW effluent. This study reveals how high strength distillery wastewater strongly impacts morphology, aeration anatomy in the chiseled plant tissues, reed growth; and composition of the biofilm in the specialized substratum. The reliability of a CW for organic and nutrients reduction, in association with a poorly performing conventional system is discussed. There is an immense potential for appropriately designed constructed wetlands to improve high strength wastewaters in India.
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Nelson RM, Calo G, Guerrini R, Hainsworth AH, Green AR, Lambert DG. Nociceptin/orphanin FQ inhibits ischaemia-induced glutamate efflux from rat cerebrocortical slices. Neuroreport 2000; 11:3689-92. [PMID: 11117473 DOI: 10.1097/00001756-200011270-00020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Nociceptin/orphanin FQ (NC), the endogenous ligand for the G-protein coupled nociceptin receptor (NCR), has a modulatory role in various physiological processes including neurotransmitter release. We have examined the effects of NC, the analogues NC(1-13)NH2 and [F/G]NC(1-13)NH2 and the competitive antagonist [Nphe1]NC(1-13)NH2 (Nphe1) on glutamate efflux during an acute simulated ischaemic challenge in rat cerebrocortical slices. The increase in glutamate efflux seen with ischaemia was inhibited by NC (EC50 250 nM). At micromolar concentrations, the analogues were found to have a similar effect on glutamate efflux compared to NC. In all cases, inhibition of glutamate efflux was abolished by Nphe1 (30 microM). These results suggest a neuroprotective action for NC.
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Romanski SA, Nelson RM, Jensen MD. Meal fatty acid uptake in adipose tissue: gender effects in nonobese humans. Am J Physiol Endocrinol Metab 2000; 279:E455-62. [PMID: 10913047 DOI: 10.1152/ajpendo.2000.279.2.e455] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We tested for gender differences in dietary fatty acid metabolism in 12 nonobese men and 12 nonobese women using the meal fatty acid tracer/adipose tissue biopsy study design. In addition to determining body composition, measurements of regional adipose tissue lipoprotein lipase activity, blood flow, and fat cell size were performed to place the meal fatty acid kinetic studies in perspective. Twenty-four hours after ingesting the test meal, the concentration of meal fatty acids was greater (P < 0.05) in abdominal subcutaneous than in thigh adipose tissue in both men (0. 61 +/- 0.12 vs. 0.45 +/- 0.09 mg/g) and women (0.59 +/- 0.10 vs. 0. 43 +/- 0.05) but was not different between men and women. A greater percentage of dietary fat was stored in subcutaneous adipose tissue in women than in men (38 +/- 3 vs. 24 +/- 3%, respectively, P < 0. 05), and a greater portion of meal fatty acid disposal was unaccounted for in men. Significant gender differences in regional adipose tissue blood flow after meal ingestion were noted; the differences were in the direction that could support greater nutrient storage in lower body fat in women.
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Romanski SA, Nelson RM, Jensen MD. Meal fatty acid uptake in human adipose tissue: technical and experimental design issues. Am J Physiol Endocrinol Metab 2000; 279:E447-54. [PMID: 10913046 DOI: 10.1152/ajpendo.2000.279.2.e447] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The adipose tissue uptake of dietary fat has been studied using fatty acid radiotracers incorporated into a meal, followed by adipose tissue biopsies. A number of experimental design issues, including the use of isotopic tracers to measure meal fatty acid oxidation and plasma appearance of tracer, as well as the heterogeneity of adipose tissue fatty acid uptake, have been addressed. We examined these questions in a study of 24 volunteers (12 men and 12 women) who consumed a meal containing [(3)H]triolein and [(14)C]triolein. Slight differences in the purity of [(3)H]triolein vs. [(14)C]triolein were found, which could affect the apparent adipose tissue uptake of meal fatty acids. The adipose tissue triglyceride specific activity from bilateral biopsy sites agreed well, implying that a unilateral biopsy is satisfactory for measuring tracer uptake. Meal fatty acid oxidation measured using [(3)H]triolein and [(14)C]triolein was well correlated (r = 0.79, P < 0.0001). The peak tracer appearance in plasma chylomicrons occurred 1 h after the ingestion of a second, unlabeled meal. Our findings have implications for the experimental design of future meal fatty acid tracer/adipose tissue biopsy studies.
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Nelson RM, Green AR, Lambert DG, Hainsworth AH. On the regulation of ischaemia-induced glutamate efflux from rat cortex by GABA; in vitro studies with GABA, clomethiazole and pentobarbitone. Br J Pharmacol 2000; 130:1124-30. [PMID: 10882398 PMCID: PMC1572159 DOI: 10.1038/sj.bjp.0703398] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Prisms of adult rat cortex were maintained in vitro in either aerobic conditions (control) or conditions simulating an acute ischaemic challenge (hypoxia with no added glucose). Endogenous glutamate efflux increased with time in ischaemic conditions, being 2.7 fold higher than control efflux at 45 min. Returning prisms to control solution after 20 min of simulated ischaemia resulted in glutamate efflux returning to near-control values. Endogenous GABA efflux in ischaemic conditions also increased, being 4.5 fold higher than control efflux at 45 min. Ischaemia-induced glutamate efflux was not accompanied by increased lactate dehydrogenase efflux and was unaltered by omitting calcium from the extra-cellular solution and adding EGTA (0.1 mM). Both GABA and the GABA-mimetic clomethiazole inhibited ischaemia-induced glutamate efflux, with IC(50) values of 26 and 24 microM respectively. The maximum inhibition by either drug was 60 - 70%. Bicuculline (10 microM) abolished the inhibitory effect of GABA (100 microM) but not clomethiazole (100 microM). Picrotoxin (100 microM) abolished the action of both GABA and clomethiazole. Pentobarbitone inhibited glutamate efflux at 100 - 300 microM (maximal inhibition: 39%). Bicuculline (10 microM) abolished this effect. These data suggest that ischaemia-induced glutamate efflux from rat cerebral cortex is calcium-independent and not due to cell damage up to 45 min. The inhibitory effect of GABA, clomethiazole and pentobarbitone on ischaemia-induced glutamate efflux appears to be mediated by GABA(A) receptors. The results suggest that clomethiazole, unlike pentobarbitone, is able to activate the GABAA receptor-linked chloride channel directly and not merely potentiate the effect of endogenous GABA.
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Al-Obaidi SM, Nelson RM, Al-Awadhi S, Al-Shuwaie N. The role of anticipation and fear of pain in the persistence of avoidance behavior in patients with chronic low back pain. Spine (Phila Pa 1976) 2000; 25:1126-31. [PMID: 10788858 DOI: 10.1097/00007632-200005010-00014] [Citation(s) in RCA: 184] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A correlative design using stepwise regression analysis. OBJECTIVE To explore the variation in spinal isometric strength that can be accounted for by anticipation of pain, sensory perception of pain, functional disability belief, and the fear-avoidance belief in chronic low back pain patients. SUMMARY OF THE BACKGROUND DATA Several biobehavioral factors contribute to the persistence of pain behavior in chronic patients. Recent studies suggest a need to explore the relation between reduced physical performance and the sensory and cognitive perception of pain. METHODS Sixty-three patients with chronic low back pain 20 to 56 years of age participated in this study. Visual Analogs Scales, the Fear-Avoidance Belief questionnaire, and the Disability Belief questionnaire were used to measure the sensory and cognitive dimensions of pain. Spinal isometric strength was measured by the Medx lumbar extension machine. RESULTS Analysis of variance and the stepwise regression analysis demonstrated that anticipation of pain and the fear-avoidance belief about physical activity significantly predicted variation in the spinal isometric strength deficit P < 0. 001. True pain experienced during the testing and answers to the Disability Belief questionnaire were not related. CONCLUSION The results of this study strongly support the hypothesis that spinal physical capacity in chronicity is not explained solely by the sensory perception of pain. The anticipation of pain and the fear-avoidance belief about physical activities were the strongest predictors of the variation in physical performance.
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Randolph AG, Zollo MB, Egger MJ, Guyatt GH, Nelson RM, Stidham GL. Variability in physician opinion on limiting pediatric life support. Pediatrics 1999; 103:e46. [PMID: 10103338 DOI: 10.1542/peds.103.4.e46] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE We conducted this study to investigate how physicians in a pediatric intensive care unit (ICU) currently make decisions to withdraw and withhold life support. Consultation with the patient's primary caregiver often precedes decisions about withdrawal and limitation of life support in chronically ill patients. In these scenarios, the patient's primary caregiver was the pediatric oncologist. To evaluate the influence of subspecialty training, we compared the attitudes of the pediatric intensivists and the oncologists using scenarios describing critically ill oncology patients. DESIGN Cross-sectional survey. Each physician was randomly assigned 4 of 8 potential case scenarios. SETTING A total of 29 American pediatric ICUs. PARTICIPANTS Pediatric intensive care and oncology attendings and fellows. INTERVENTION Systematic manipulation of patient characteristics in two hypothetical case scenarios describing 6-year-old female oncology patients presenting to the ICU after the institution of mechanical ventilator support for acute respiratory failure. Cases 1 through 4 described a patient who, before admission, had a 99% projected 1-year probability of survival from her underlying cancer and suffered from severe neurologic disabilities. Cases 5 through 8 described a patient who was neurologically normal before admission and had a <1% chance of surviving longer than 1 year because of her underlying cancer. Each physician was randomly assigned 2 cases from cases 1 through 4 and 2 cases from cases 5 through 8. Within each of these case scenarios, parental preferences (withdraw or advance support or look for guidance from the caregivers) and probability of survival (5% vs 40%) were manipulated. Before distribution, the survey instrument was pilot-tested and underwent a rigorous assessment for clinical sensibility. PRIMARY OUTCOME MEASURES Physicians ratings of the importance of 10 factors considered in the decision to withdraw life support, and their decisions about the appropriate level of care to provide. Respondents were offered five management options representing five levels of care: 1) discontinue inotropes and mechanical ventilation but continue comfort measures; 2) discontinue inotropes and other maintenance therapy but continue mechanical ventilation and comfort measures; 3) continue with current management but add no new therapeutic intervention; 4) continue with current management, add additional inotropes, change antibiotics and the like as needed, but do not start dialysis; and 5) continue with full aggressive management and plan for dialysis if necessary. Respondents also were asked whether they would obtain an ethics consultation. RESULTS A total of 270 physicians responded to our survey (165 of 198 potentially eligible pediatric intensivists and 105 of 178 pediatric oncologists for response rates of 83% and 59%, respectively). The respondents considered the probability of ICU survival and the wishes of the parents regarding the aggressiveness of care most important in the decision to limit life-support interventions. No clinically important differences were found when the responses of oncologists were compared with those of intensivists. In six of eight possible scenarios, the same level of intensity of care was chosen by less than half of all respondents. In three scenarios, >/=10% of respondents chose full aggressive management as the most appropriate level of care, whereas another >/=10% chose comfort measures only when viewing the same scenario. The most significant respondent factors affecting choices were professional status (attending vs fellow) and the self-rated importance of functional neurologic status. The majority of respondents (83%) believed that the intensive care and the oncology staff were usually in agreement at their institution about the level of intervention to recommend to the parents. (ABSTRACT TRUNCATED)
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DeBacker TK, Nelson RM. Variations on an Expectancy-Value Model of Motivation in Science. CONTEMPORARY EDUCATIONAL PSYCHOLOGY 1999; 24:71-94. [PMID: 10072310 DOI: 10.1006/ceps.1998.0984] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Relationships among motivational variables from goal theory and expectancy-value theory were investigated in this correlational study of high school students. Self-report surveys of motivation in science were collected during biology classes from 69 males and 80 females. Outcome measures were effort, persistence, and achievement. Gender differences were noted in the pattern of zero-order correlations. Internal motivation variables were related to achievement in males but not females. Regression analyses indicated that the motivation variables explained large proportions of variance in the outcomes. However, the contribution of individual variables differed by gender. Most notable was perceived ability, which contributed significantly to predicting outcome measures for females but not males. Findings suggest that interventions may need to focus on different motivational aspects depending on gender. Copyright 1999 Academic Press.
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Ambrose WP, Semin DJ, Robbins DL, Van Orden A, Kashem MA, Hamilton SA, Nelson RM, Jett JH, Keller RA. Detection system for reaction-rate analysis in a low-volume proteinase-inhibition assay. Anal Biochem 1998; 263:150-7. [PMID: 9799526 DOI: 10.1006/abio.1998.2786] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
High-throughput screening of large combinatorial chemical libraries in biochemical assays will benefit from reduced reagent volume and increased speed of measurement. Standard assays typically are performed in 96-well microtiter plates having 200-microL well volumes and up to an hour of incubation time. In this paper, we demonstrate a technique for precise and rapid measurement of the progress of an enzymatic reaction and its inhibition with reduced volume and time (for this work, the assay was mixed at the 200-microL level and detected in 2-microL volumes with minutes of total assay time). Directly measuring the enzyme activity in the small volume format yields a precise value for the median inhibitory concentration (IC50) of an inhibitor compound. The model assay is the endoproteolytic cleavage of a small fluorogenic peptide by human neutrophil collagenase (MMP-8). The fluorogenic peptide was labeled at one end with a UV/blue fluorophore (N-methylanthranilyl) and at the other end with a quencher (dinitrophenol). To generate inhibition data, a hydroxamate peptide analog inhibitor of collagenase, actinonin, was included in the reaction. The experiments were performed using ultraviolet laser illumination (325 nm wavelength) and parallel fluorescence detection by a cooled, charge-coupled-device camera system to increase sensitivity and speed. The assay volume was reduced to 2 microL for data collection, and the total time for mixing, incubation, and measurement was less than 6 min. For comparison to a standard format, the same assay was performed in a 96-well microtiter plate in 200 microL using 30 min of incubation and measurement in a microtiter plate fluorimeter. Median inhibitory concentrations (IC50) for actinonin of 73 +/- 16 and 100 +/- 14 nM were obtained in the 2- and 200-microL assays, respectively. One concern with assay miniaturization and increases in throughput is a potential loss of precision and accuracy. Laser excitation and parallel detection of fluorescence is a promising approach for increased speed and reduced cost without loss of precision for proteinase inhibition assays.
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Williams JH, Ward CW, Spangenburg EE, Nelson RM. Functional aspects of skeletal muscle contractile apparatus and sarcoplasmic reticulum after fatigue. J Appl Physiol (1985) 1998; 85:619-26. [PMID: 9688740 DOI: 10.1152/jappl.1998.85.2.619] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
This study examined the effects of fatigue on the functional aspects of the contractile apparatus and sarcoplasmic reticulum (SR). Frog semitendinosus muscles were stimulated to fatigue, and skinned fibers or a homogenate fraction was prepared from both fatigued and rested contralateral muscles. In fatigued fibers, maximal Ca2+-activated force of the contractile apparatus was unaltered, whereas maximal actomyosin-ATPase activity was depressed by 20%. The Ca2+ sensitivity of force was increased, whereas that of actomyosin-ATPase was not altered. Also, the rate constant for tension redevelopment was decreased at submaximal Ca2+ concentration. These latter findings suggest that fatigue slows the dissociation of force-generating myosin cross bridges. Ca2+ uptake and Ca2+-ATPase activity of the SR were depressed by 46 and 21%, respectively, in the fatigued muscles. Fatigue also reduced the rates of SR Ca2+ release evoked by AgNO3 and 4-chloro-m-cresol by 38 and 45%, respectively. During fatigue, the contractile apparatus and SR undergo intrinsic functional alterations. These changes likely result in altered force production and energy consumption by the intact muscle.
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Fath MA, Wu X, Hileman RE, Linhardt RJ, Kashem MA, Nelson RM, Wright CD, Abraham WM. Interaction of secretory leukocyte protease inhibitor with heparin inhibits proteases involved in asthma. J Biol Chem 1998; 273:13563-9. [PMID: 9593692 DOI: 10.1074/jbc.273.22.13563] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Protease inhibition by secretory leukocyte protease inhibitor (SLPI) is accelerated by the sulfated polysaccharides. The nature of the SLPI-polysaccharide interaction, explored with affinity chromatography, indicated that this interaction was sensitive to the charge and type of polysaccharide. Dextran and chondroitin had the lowest affinity for SLPI, followed by dermatan, heparan, and dextran sulfates. While heparin bound SLPI tightly, the highest affinity heparin chains unexpectedly contained a lower level of sulfation than more weakly interacting chains. Heparin oligosaccharides, prepared using heparin lyase I were SLPI-affinity fractionated. Surprisingly, undersulfated heparin oligosaccharides bound SLPI with the highest affinity, suggesting the importance of free hydroxyl groups for high affinity interaction. Isothermal titration calorimetry was used to determine the thermodynamics of SLPI interaction with a low molecular weight heparin, an undersulfated decasaccharide and a tetrasaccharide. The studies showed 12-14 saccharide units, corresponding to molecular weight of approximately 4,800, were required for a 1:1 (SLPI:heparin) binding stoichiometry. Furthermore, an undersulfated decasaccharide was able to bind SLPI tightly (Kd approximately 13 nM), resulting in its activation and the inhibition of neutrophil elastase and pancreatic chymotrypsin. The in vitro assessment of heparin and the decasaccharide and tetrasaccharide using stopped-flow kinetics suggested that heparin was the optimal choice to study SLPI-based in vivo protease inhibition. SLPI and heparin were co-administered by inhalation in therapy against antigen-induced airway hyperresponsiveness in a sheep bronchoprovocation model. Heparin, in combination with SLPI demonstrated in vivo efficacy reducing early and late phase bronchoconstriction. Heparin also increased the therapeutic activity of SLPI against antigen-induced airway hyperresponsiveness.
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