Publication productivity in academic family medicine departments

BACKGROUND AND OBJECTIVES

The purpose of this study was to quantify research publication productivity of family medicine departments in selected family medicine and interdisciplinary journals.

METHODS

A 5-year journal search was conducted to identify original research articles published by family medicine department faculty. Publication productivity of all departments was ranked, and regression analysis was used to identify predictors of publication productivity.

RESULTS

The departments leading in publication productivity published more than 25 articles over the 5-year period. The number of faculty and mean dollar value of family medicine department establishment grants were the strongest predictors of publication productivity. When adjusted for departmental size, some departments were found to have high publication productivity per faculty member, even though total numbers of departmental publications were low in comparison to other departments.

CONCLUSIONS

This study identified one way of comparing departments in terms of publication productivity. Large departments, and those with more developmental grant support, have the highest publication productivity.

Shock-induced Analgesia in the cockroach (Periplaneta americana)

For 3 consecutive days cockroaches (Periplaneta americana) received escapable, inescapable, or no shock in an escape task. 24 hr. later minimum shock which initiated movement was identified. Reliably higher shocks were needed to initiate movement in the inescapably shocked roaches. In a second experiment the analgesia induced by inescapable shock was blocked by the opiate antagonist naloxone. The results are discussed in relation to the escape deficit and analgesia commonly seen following exposure to inescapable shock in a variety of species.

The freedom and the responsibility of investigator-initiated research

Since World War II, scientific inquiry and research have been based on the premise that the more investigator-initiated research is conducted, the more automatic benefits for society are created. It is finally becoming clear to many that this belief is neither rational, true, nor healthy; in short, we as a society have been indiscriminately embracing whatever we are able to do instead of doing those things that will take society where it needs to go. Trickle-down science and technology do not work any better than the famous trickle-down economics worked. The author praises the accomplishments of scientific research but gives several examples, including those involving health care, of the widening gap that unguided science and technology have helped to foster between the advantaged and disadvantaged populations in most of the world, including the United States. He proposes that while investigator-initiated research is crucial, it must be done in the context of strategic paths and a set of values that direct it toward achieving the goals for the nation and the world that must be reached if the planet and its increasing population are to survive. He emphasizes that such strategic paths provide the compass; they do not control the journey. For example, he is not saying that biomedical researchers should be directed to specific experiments, but rather that as researchers they must realize the moving from remediation to prevention is a primary national and international goal for human health.(ABSTRACT TRUNCATED AT 250 WORDS)

High-Temperature XAS Study of Fe 2 SiO 4 Liquid: Reduced Coordination of Ferrous Iron

X-ray absorption spectroscopy (XAS) of Fe(2+) in Fe(2)SiO(4) liquid at 1575 kelvin and 10(-4) gigapascal (1 bar) shows that the Fe(2+) -O bond length is 1.98 +/- 0.02 angstroms compared with approximately 2.22 angstroms in crystalline Fe(2)SiO(4) (fayalite) at the melting point (1478 kelvin), which indicates a decrease in average Fe(2+) coordination number from six in fayalite to four in the liquid. Anharmonicity in the liquid was accounted for using a data analysis procedure. This reduction in coordination number is similar to that observed on the melting of certain ionic salts. These results are used to develop a model of the medium-range structural environment of Fe(2+) in olivine-composition melts, which helps explain some of the properties of Fe(2)SiO(4) liquid, including density, viscosity, and the partitioning of iron and nickel between silicate melts and crystalline olivines. Some of the implications of this model for silicate melts in the Earth's crust and mantle are discussed.

Systematic desensitization of oral hypersensitivity in a patient with a closed head injury

A 36-year-old man who had sustained a closed head injury displayed extreme fear of being stimulated in the oral cavity, of being presented with foods, and of swallowing. The patient's fear increased his muscle tone and hypersensitivity in the facial and oral area, thereby preventing assessment of his dysphagia. We describe the use of systematic desensitization to alleviate the patient's fear thus allowing successful completion of a videofluoroscopic barium swallow examination.

Do rainbow trout and Atlantic salmon discriminate kin?

The purpose of this study was to determine if juvenile Atlantic salmon (Salmo salar) and rainbow trout (Oncorhynchus mykiss) can discriminate kin from non-kin, since other salmonid species (coho salmon (Oncorhynchus kisutch) and Arctic charr (Salvelinus alpinus)) have been shown to possess this ability. When tested in water conditioned by conspecifics (kin and non-kin) and heterospecifics in a two-choice tank, both rainbow trout and Atlantic salmon demonstrated a significant preference for kin over non-kin and heterospecifics, indicating that these species possess kin-discrimination abilities. This ability appears to be widespread among salmonid fishes.

Neutrophil CR3 expression and specific granule exocytosis are controlled by different signal transduction pathways

Neutrophils express receptors (CR3) for the complement fragment C3bi. CR3 expression can be increased by exposure of the cells to chemotactic factors such as FMLP or to the calcium ionophore A23187. It has been suggested that CR3 moieties are stored in the membrane bounding either the secondary or the tertiary (gelatinase containing) granules. To help define the mechanisms mediating CR3 up-regulation, the effects of several inhibitors upon CR3 expression and secondary granule exocytosis were investigated. Pertussis toxin inhibited FMLP-induced (but not A23187-induced) CR3 expression and exocytosis, indicating that an early step in FMLP-induced CR3 expression is activation of a pertussis toxin-sensitive G protein. However, CR3 expression and exocytosis appeared to be controlled by separate mechanisms distal to G protein activation because 1) DBcAMP and the protein kinase inhibitor H-7 inhibited or stimulated exocytosis, respectively, without affecting CR3 expression; 2) the calmodulin (chlorpromazine and trifluoperazine) and myosin L chain kinase (ML9) inhibitors had greater effects on exocytosis than on CR3 expression; and 3) the kinetics of CR3 expression and exocytosis differed markedly. Thus, although G protein activation is a common early step in both processes, there is a bifurcation of the two processes distally. The mechanisms mediating CR3 up-regulation and tertiary granule exocytosis were also investigated. Extracellular Ca2+ was essential for tertiary granule exocytosis, but not for CR3 up-regulation. We conclude that because the mechanisms controlling CR3 up-regulation and exocytosis diverge soon after the binding of a chemotactic ligand to its receptor, that at least the bulk of increased CR3 expression is not simply a by-product of secondary and tertiary granule exocytosis but is the result of the mobilization of CR3 moieties from an intracellular pool of uncertain identity.

Neutrophil CR3 expression and specific granule exocytosis are controlled by different signal transduction pathways

Neutrophils express receptors (CR3) for the complement fragment C3bi. CR3 expression can be increased by exposure of the cells to chemotactic factors such as FMLP or to the calcium ionophore A23187. It has been suggested that CR3 moieties are stored in the membrane bounding either the secondary or the tertiary (gelatinase containing) granules. To help define the mechanisms mediating CR3 up-regulation, the effects of several inhibitors upon CR3 expression and secondary granule exocytosis were investigated. Pertussis toxin inhibited FMLP-induced (but not A23187-induced) CR3 expression and exocytosis, indicating that an early step in FMLP-induced CR3 expression is activation of a pertussis toxin-sensitive G protein. However, CR3 expression and exocytosis appeared to be controlled by separate mechanisms distal to G protein activation because 1) DBcAMP and the protein kinase inhibitor H-7 inhibited or stimulated exocytosis, respectively, without affecting CR3 expression; 2) the calmodulin (chlorpromazine and trifluoperazine) and myosin L chain kinase (ML9) inhibitors had greater effects on exocytosis than on CR3 expression; and 3) the kinetics of CR3 expression and exocytosis differed markedly. Thus, although G protein activation is a common early step in both processes, there is a bifurcation of the two processes distally. The mechanisms mediating CR3 up-regulation and tertiary granule exocytosis were also investigated. Extracellular Ca2+ was essential for tertiary granule exocytosis, but not for CR3 up-regulation. We conclude that because the mechanisms controlling CR3 up-regulation and exocytosis diverge soon after the binding of a chemotactic ligand to its receptor, that at least the bulk of increased CR3 expression is not simply a by-product of secondary and tertiary granule exocytosis but is the result of the mobilization of CR3 moieties from an intracellular pool of uncertain identity.

Evidence for multinuclear metal-ion complexes at solid/water interfaces from X-ray absorption spectroscopy

Metals dissolved in natural waters often become sorbed onto oxide or clay minerals, so that prediction of their chemical behaviour and transport properties requires knowledge of the structure and bonding of metal species at the solid/water interface. For many sorption systems, X-ray absorption spectroscopy (XAS) can be used to determine the identity and number of nearest-neighbour atoms and interatomic distances in aqueous complexes on solid surfaces, and thus to identify the dominant type of surface complex and the partitioning mechanism. Here we describe an XAS study of divalent cobalt (Co(II)) complexes sorbed on three different solids, gamma-Al2O3, rutile (TiO2) and kaolinite (Al2Si2O5(OH)4). We find direct evidence for the presence of multinuclear sorption complexes at surface coverages below one monolayer of Co(II) atoms. Our spectroscopic data reveal distinct differences in the number of coordinating atoms and interatomic distances in the surface complexes formed on each of the solids at the same sorption density. These results suggest that different oxide and clay surfaces influence the structure and properties of aqueous surface complexes, and therefore must be accounted for in models of metal-ion sorption.

Immunization against learned helplessness in the cockroach (Periplaneta americana)

Cockroaches exposed to one day of escapable shock prior to three days of inescapable shock did not become helpless on a shuttlebox-escape task. Like dogs and rats, cockroaches are immunized against learned helplessness by prior experience with escapable shock.

Stimulation of rat hepatocyte fibronectin production by monocyte-conditioned medium is due to interleukin 6

In this report, conditioned media from LPS-stimulated monocytes increased rat hepatocyte production of fibronectin (Fn) in a dose-dependent manner. Preincubation of the conditioned media with anti-IL-6, but not with anti-IL-1 alpha, anti-IL-1 beta, or anti-TNF, completely neutralized the Fn-stimulating activity. 10-100 pg/ml of rIL-6 was sufficient to increase Fn production. Neither IL-1 nor TNF had an effect on Fn production. The Fn-stimulating activity of IL-6 could be specifically neutralized only with anti-IL-6, but not with anti-IL-1 or anti-TNF. The increased Fn produced was shown to be of the plasma rather than the cellular form. These results demonstrate that IL-6 is the factor in monocyte-conditioned media that stimulates Fn production, and that IL-6 is the monokine tested with such activity.

Coagulation increases neutrophil CR1 and CR3 expression: primary role for platelet-derived growth factor

Neutrophil receptors for C3b(CR1) and C3bi(CR3) mediate a number of functions important for infection control and tissue repair, such as adherence, aggregation, orientation in chemotactic gradients, and phagocytosis of opsonized particles. We studied the effect of the coagulation of whole blood on the induction of neutrophil complement receptor (CR) expression in vitro. Neutrophils incubated in serum for 1 hour at 37 degrees C increased the expression of CR1 3.43-fold and CR3 3.06-fold compared with incubation in buffer (p less than 0.001). In contrast, incubation in plasma did not induce such an increase. The serum factor responsible for this CR-inducing effect appeared to be a platelet constituent, because (1) serum derived from platelet-rich plasma, but not platelet-poor plasma, contained the CR-inducing factor; (2) pretreatment with aspirin inhibited the adenosine diphosphate-induced expression of this factor in platelet-rich plasma; (3) the CR-inducing factor was also contained in supernatants derived from frozen/thawed platelets; (4) pure platelet-derived growth factor (PDGF) induced CR expression to the same extent as did whole serum; and (5) the CR-inducing activity of serum and platelet supernatants was inhibited by incubation with antibody against PDGF but not by antibody against C5. Thus, a platelet component that is probably PDGF appears to be the major CR-inducing factor generated during in vitro coagulation and may play a vital role in mediating the neutrophil response to tissue injury and inflammation.

Learned helplessness in the cockroach (Periplaneta americana)

For 3 consecutive days cockroaches (Periplaneta americana) were exposed to either escapable, inescapable, or no shock in an escape task. Twenty-four hours later they were tested in a shuttlebox escape task. There were reliable differences between escapable and inescapable animals and between inescapable and control animals in both escape latencies and the number of failures to escape.

Induction of hepatocyte synthesis of fibronectin by a non-interleukin-1 monokine

Plasma fibronectin concentrations initially decrease and then markedly increase following injury and during inflammation. Although hepatocytes are known to be the major source of plasma fibronectin, the stimulus controlling its production is not known. The present study investigated the role of interleukin-1 (Il-1) and LPS-induced monocyte supernatants in stimulating hepatocyte fibronectin synthesis in vitro. Hepatocytes exposed to monocyte supernatants significantly increased their production of fibronectin and fibrinogen. Albumin production was suppressed. Both LPS-induced and noninduced monocyte supernatants increased hepatocyte fibronectin and fibrinogen synthesis, and decreased albumin synthesis. However, only LPS-induced monocyte supernatants contained Il-1 activity. Pure Il-1 had no effect on hepatocyte fibronectin synthesis. Molecular sizing of the monocyte supernatants containing the Fibronectin Stimulating Factor (FSF) yielded active fractions in the 30-40 kD range. These fractions did not contain Il-1 activity. We conclude that a non-Il-1 monokine, Fibronectin Stimulating Factor (FSF), stimulates hepatocyte production of fibronectin. FSF is presumably the monokine responsible for stimulating hepatocyte fibronectin production in vivo following injury and during inflammation. Based on these results, and the time-course of fibronectin levels seen following injury and during inflammation, it seems reasonable to consider fibronectin as one of the acute-phase proteins.

Neutrophil CR3 induction by platelet supernatants is due to platelet-derived growth factor

Recently, serum was shown to contain a factor that increased expression of the complement receptor CR3 on neutrophil membranes. This factor was localized to platelet granules and was released during coagulation. This study was undertaken to identify this factor in platelet granules. Platelet supernatants containing granule contents were incubated with neutrophils, and CR3 expression was determined by flow cytometry. Incubation with platelet supernatants induced more than a twofold increase in the amount of CR3 expressed on the neutrophil membrane (p = 0.05). Anti-platelet-derived growth factor (anti-PDGF) Fab, when preincubated with the platelet supernatants, completely inhibited this CR3-inducing activity. Pure PDGF induced a dose-response increase in CR3, whereas platelet factor 4 had no effect. PDGF was active in concentrations well within the physiologic range. These data indicate that PDGF is responsible for the CR3-inducing activity of platelet supernatants. PDGF may well be an important regulator of neutrophil adherence and phagocytic function in areas of tissue injury.

Coagulation augments neutrophil C3b receptors via formation of a protein(s) unrelated to fibrinolysis or C5 activation

The present study investigated the effect of coagulation on neutrophil complement receptors (CRs) 1 and 3, which are specific for the opsonins C3b and C3bi. Incubation of neutrophils in autologous serum, but not in plasma, increased the mean (+/- SD) expression of CR1 (x3.43 +/- 0.93) and CR3 (x3.07 +/- 0.86), in comparison with incubation in buffer. Serum also increased neutrophil superoxide production in response to opsonized zymosan from 0.48 +/- 0.21 to 1.05 +/- 0.25 nmol/10(6) cells/min. Similarly, calcium conversion of platelet-rich plasma (but not platelet-poor plasma) to serum also increased both CR1 and CR3 expression. This finding, as well as the fact that freeze-thawed platelet-rich plasma (but not platelet-poor plasma) increased CR expression, indicated that platelet constituents were the origin of this CR-inducing activity. Other nonplatelet factors formed during coagulation, such as C5a, fibrinogen degradation products, kallikrein, and factor XIIa, were shown not to be responsible for this CR-inducing activity.

In Situ X-ray Absorption Study of Surface Complexes: Selenium Oxyanions on agr-FeOOH

A novel application of x-ray absorption spectroscopy has provided structural information for ions sorbed at oxide-water interfaces. As an example, in situ extended x-ray absorption fine structure (EXAFS) measurements of adsorbed selenate and selenite ions at ah alpha-FeOOH(goethite)-water interface have been performed; these measurements show that selenate forms a weakly bonded, outer-sphere complex and that selenite forms a strongly bonded, inner-sphere complex. The selenite ion is bonded directly to the goethite surface in a bidentate fashion with two iron atoms 3.38 angstroms from the selenium atom. Adsorbed selenate has no iron atom in the second coordination shell of selenium, which indicates retention of its hydration sphere upon sorption. This method provides direct structural information for adsorbed species at solid-liquid interfaces.

Neutrophil chemiluminescence and opsonic fibronectin levels following blunt trauma

Trauma is known to result in depression of opsonic fibronectin levels as well as abnormalities in neutrophil function. Neutrophil oxidative metabolism, important for bactericidal activity, has not been investigated following injury. Since fibronectin has been reported to increase neutrophil chemiluminescence (CL), we examined the relationship between neutrophil oxidative metabolism (as measured by chemiluminescence) and opsonic fibronectin levels following blunt trauma. Sera from 11 nonseptic and 9 eventually septic-trauma patients were studied. Normal neutrophils incubated in septic-trauma serum had decreased CL responses compared to incubation in nonseptic serum (P less than 0.0001). This difference was apparent immediately after injury, prior to the onset of sepsis. This depression was due to the presence of a serum suppressor of neutrophil chemiluminescence and not to the absence of a serum factor. This suppressor has been partially characterized as a protein of greater than 30,000 Da. Opsonic fibronectin levels were also depressed in septic-trauma sera compared to nonseptic-trauma sera (P less than 0.0001). However, no correlation could be demonstrated between the CL response and opsonic fibronectin levels. Addition of fibronectin to buffer increased the CL response, while addition of fibronectin to nonseptic-trauma serum had no effect. In contrast, addition of fibronectin to septic-trauma sera actually decreased the CL response (P less than 0.05), perhaps by forming complexes with abnormal proteins and interfering with membrane-particle interaction.

Synthesis of eosinophil-associated enzymes in HL-60 promyelocytic leukemia cells

Eosinophils derived from HL-60 cells share many of the abnormalities of granule histochemistry and morphology frequently seen in eosinophils of patients with certain malignancies, especially those seen in acute myelomonocytic leukemia with abnormal eosinophils (FAB class M4eo). In order to understand the pathogenesis of these abnormalities, four enzymes, characteristic of the eosinophil, were studied in HL-60 promyelocytic leukemia cells at various stages of eosinophilic differentiation. Using biochemical and ultrahistochemical techniques, the following differences from normal eosinophil development were demonstrated. First, both myeloperoxidase and eosinophil peroxidase coexisted in the population of maturing HL-60 eosinophils. Second, the granules formed from the condensation of material in vacuoles which were derived from dilated segments of the endoplasmic reticulum; the role of the Golgi apparatus in processing of peroxidase appeared minimal. Third, low levels of lysophospholipase and arylsulfatase were present in the cells compared to normal eosinophils. Finally, crystallizations resembling precursor structures of Auer rods appeared in the granules of about 5% of the cells. These findings suggest that several disorders of the control of protein synthesis and processing exist in HL-60 eosinophils which may be responsible for the abnormal granule morphology and histochemistry.

Trauma serum suppresses superoxide production by normal neutrophils

The effect of trauma serum on superoxide production by normal neutrophils was studied in 47 serum samples from 18 patients with multiple trauma. Ten patients became septic and eight patients remained nonseptic. Incubation in trauma serum significantly suppressed superoxide production by normal neutrophils compared with incubation in normal serum: 3.6 +/- 1.44 vs 4.04 +/- 1.64 nmole of superoxide produced by 10(6) neutrophils (mean +/- SD). There was no difference in the suppressive effect between septic and nonseptic trauma serum samples. The chemiluminescence response of normal neutrophils was likewise suppressed following incubation in trauma serum compared with incubation in normal serum. The chemiluminescence response correlated with superoxide reduction of cytochrome C. In addition, the chemiluminescence response was significantly less in septic-trauma serum than in nonseptic-trauma serum. Suppressive serum was found to inhibit the neutrophil-membrane depolarization response to latex particles, as measured by flow cytometry. We conclude that trauma serum suppresses superoxide production by normal neutrophils, and that such suppression can be detected reliably using the clinically applicable technique of chemiluminescence. A normal chemiluminescence response excludes serum-mediated suppression of neutrophil superoxide production. In addition, chemiluminescence may be of value in detecting altered resistance to sepsis following injury, while superoxide determinations do not seem to be helpful in this regard. The mechanism of action of the suppressor may involve reversible inhibition of membrane depolarization necessary for the production of bactericidal oxygen species.

Animal welfare legislation

In the article "Rates of elementary reactions: Measurement and applications" by F. Kaufman (25 Oct., p. 393), the equation in column 2 on page 394 should have read: [See formula in Source Pdf.]

Arteriography and selective embolisation in the control of life-threatening haemorrhage following facial fractures

Bleeding after serious facial fractures may be of such life-threatening proportions that it is sometimes impossible to control it by traditional methods. Super-selective arteriography allows accurate localisation of the bleeding site and immediate embolisation of the offending vessel is a highly effective manoeuvre. Two clinical cases are reported.

National Nutrition Monitoring System: a congressional perspective

A national nutrition monitoring system can serve as a basic epidemiological tool necessary to examine the linkages between food consumption patterns, nutritional status, and health status. The major component of the 1981 Joint Implementation Plan for a Comprehensive National Nutrition Monitoring System (NNMS) includes the interlocking of the study design and data analysis of the National Health and Nutrition Examination Survey and the Nationwide Food Consumption Survey to begin in 1987. Congress needs the information from the NNMS to formulate and evaluate the consequences of nutrition and health policies, regulations, and programs.

Development of membrane-potential responsiveness by myeloid leukemia cells during neutrophilic differentiation

The ability of a myeloid leukemia cell line (HL-60) to undergo membrane electrical potential changes was followed during neutrophilic differentiation induced by 2 compounds. Membrane-potential changes were induced with 12-O-tetradecanoylphorbol 13-acetate (TPA) or formyl-methionyl-leucyl-phenylalanine (FMLP) and were monitored by flow cytometry. The magnitude of the membrane-potential response to TPA increased in a more uniform manner as the population of cells matured than did acquisition of mature morphology or ability to undergo the respiratory burst in response to TPA. The response to TPA and FMLP of HL-60 cells, maximally induced to differentiate by dimethylsulfoxide, closely resembled that of neutrophils. Thus, HL-60 cells may be a useful tool in the study of the relation between membrane depolarization and subsequent cellular activation.

Characterization of deoxyribonuclease activities derived from control and inflammation-associated mouse peritoneal macrophages

Native DNAase (deoxyribonuclease) activities derived from mouse peritoneal cavity and peripheral blood components were separated, detected, and characterized by electrophoresis into polyacrylamide gels containing DNA, followed by incubation of the gels, and staining of the substrate to reveal only the DNAase activities. Resident peritoneal macrophages contained 12 DNAase-II-like activities that were characteristic of that cell type, whereas lymphocytes and granulocytes each contained five DNAases. Induction of inflammation by peritoneal injection of thioglycollate resulted in changes in macrophage DNAase expression, including: increased total DNAase activity, a decrease in the number of activities from 12 to 11, increased activity of a specific subset of the enzymes, and a change in the apparent size of a specific subset of the enzymes. Electrophoretic and enzymic properties and sensitivity to endo-beta-N-acetylglucosaminidase H indicated that the macrophage activities probably represented charge variants of one or two parent peptide chains.

Isoelectric focusing--polynucleotide/polyacrylamide-gel electrophoresis. A technique to separate and characterize nuclease activities

Individual native nuclease activities from human leucocytes are separated by using two-dimensional gel electrophoresis in an apparatus that allows the simultaneous running of 28 gels. Proteins are separated by isoelectric focusing in a disc gel, followed by electrophoresis into a slab gel containing DNA. Protein denaturants are avoided in the second dimension by the use of a running pH well above the optimal pH for DNAase (deoxyribonuclease) activity. Electrophoresed gels are incubated in appropriate buffers to activate nuclease activity. After staining for intact DNA, the positions of active enzymes, unobscured by the presence of other proteins, are revealed as colourless spots in a reddish-purple field. The technique is easy to use and is sensitive to 50pg of DNAase I. Versatility is provided by the use of either acidic or basic electrophoresis running buffers and by the use of specific gel incubation conditions to reveal different sets of enzyme activities. Two DNAases active at pH 7.4 in the presence of Mg2+ and Ca2+, and sixteen DNAases active at acidic pH and not requiring metals, are detected. Treatment of the human enzymes with specific glycosidases reveals that many of the human DNAases are glycoproteins containing negatively charged moieties and may be derived from modification of parent activities.