Howell Laboratories (United States)

The effect of propranolol (0.1 mg/kg intravenously followed by 320 mg given over 27 hour orally) on serum levels of creatine kinase enzyme was studied in a randomized trial involving 95 patients seen within 12 hours of onset of symptoms of uncomplicated myocardial infarction. In 15 patients who were treated with propranolol within 4 hours of onset, and who eventually developed pathological Q waves, peak measured enzyme levels were 27% (P less than 0.0125) lower than in 19 control patients who were also seen within 4 hours of the onset but had no specific treatment. Total calculated enzyme appearance was also lower in the treated patients (reduced 25%, P less than 0.05) as was the calculated rate of the appearance (33%, P less than 0.005). No significant difference was found for treated compared with control patients entering the trial more than 4 hours after the onset of chest pain. This evidence suggests that propranolol may reduce the size of uncomplicated infarctions if it is given intravenously within 4 hours of the onset.

BACKGROUND: High tension in an anterior cruciate ligament graft adversely affects both the graft and the knee; however, it is unknown why high graft tension in flexion occurs in association with a posterior femoral tunnel. The purpose of the present study was to determine the effect of the angle of the femoral and tibial tunnels in the coronal plane and incremental excision of the posterior cruciate ligament on the tension of an anterior cruciate ligament graft during passive flexion. METHODS: Eight cadaveric knees were tested. The angle of the tibial tunnel was varied to 60 degrees, 70 degrees, and 80 degrees in the coronal plane with use of three interchangeable, low-friction bushings. The femoral tunnel, with a 1-mm-thick posterior wall, was drilled through the tibial tunnel bushing with use of the transtibial technique. After the graft had been tested in all three tibial bushings with one femoral tunnel, the femoral tunnel was filled with bone cement and the tunnel combinations were tested. Lastly, the graft was replaced in the 80 degrees femoral and tibial tunnels, and the tests were repeated with excision of the lateral edge of the posterior cruciate ligament in 2-mm increments. Graft tension, the flexion angle, and anteroposterior laxity were recorded in a six-degrees-of-freedom load-application system that passively moved the knee from 0 degrees to 120 degrees of flexion. RESULTS: The graft tension at 120 degrees of flexion was affected by the angle of the femoral tunnel and by incremental excision of the posterior cruciate ligament. The highest graft tension at 120 degrees of flexion was 169 +/- 9 N, which was detected with the graft in the 80 degrees femoral and 80 degrees tibial tunnels. The lowest graft tension at 120 degrees of flexion was 76 +/- 8 N, which was detected with the graft in the 60 degrees femoral and 60 degrees tibial tunnels. The graft tension of 76 N at 120 degrees of flexion with the graft in the 60 degrees femoral and 60 degrees tibial tunnels was closer to the tension in the intact anterior cruciate ligament. Excision of the lateral edge of the posterior cruciate ligament in 2 and 4-mm increments significantly lowered the graft tension at 120 degrees of flexion without changing the anteroposterior position of the tibia. CONCLUSIONS: Placing the femoral tunnel at 60 degrees in the coronal plane lowers graft tension in flexion. Our results suggest that high graft tension in flexion is caused by impingement of the graft against the posterior cruciate ligament, which results from placing the femoral tunnel medially at the apex of the notch in the coronal plane.

BACKGROUND: Around the world, beans and rice are commonly consumed together as a meal. With type 2 diabetes increasing, the effect of this traditional diet pattern on glycemic response has not been studied fully. METHODS: We evaluated the glycemic response of bean and rice traditional meals compared to rice alone in adults with type 2 diabetes. Seventeen men and women with type 2 diabetes controlled by metformin (n = 14) or diet/exercise (n = 3) aged 35-70 years participated in the randomized 4 × 4 crossover trial. The white long grain rice control, pinto beans/rice, black beans/rice, red kidney beans/rice test meals, matched for 50 grams of available carbohydrate, were consumed at breakfast after a 12 hour fast. Capillary blood glucose concentrations at baseline and at 30 minute intervals up to 180 minutes postprandial were collected. MANOVA for repeated measures established glucose differences between treatments. Paired t tests identified differences between bean types and the rice control following a significant MANOVA. RESULTS: Postprandial net glucose values were significantly lower for the three bean/rice treatments in contrast to the rice control at 90, 120 and 150 minutes. Incremental area under the curve values were significantly lower for the pinto and black bean/rice meals compared to rice alone, but not for kidney beans. CONCLUSIONS: Pinto, dark red kidney and black beans with rice attenuate the glycemic response compared to rice alone. Promotion of traditional foods may provide non-pharmaceutical management of type 2 diabetes and improve dietary adherence with cultural groups.

Thalidomide enhances rituximab-mediated, antibody-dependent, cell-mediated cytotoxicity. We therefore conducted a phase 2 study using thalidomide and rituximab in symptomatic Waldenstrom macroglobulinemia (WM) patients naive to either agent. Intended therapy consisted of daily thalidomide (200 mg for 2 weeks, then 400 mg for 50 weeks) and rituximab (375 mg/m(2) per week) dosed on weeks 2 to 5 and 13 to 16. Twenty-five patients were enrolled, 20 of whom were untreated. Responses were complete response (n = 1), partial response (n = 15), and major response (n = 2), for overall and major response rate of 72% and 64%, respectively, on an intent-to-treat basis. Median serum IgM decreased from 3670 to 1590 mg/dL (P < .001), whereas median hematocrit rose from 33.0% to 37.6% (P = .004) at best response. Median time to progression for responders was 38 months. Peripheral neuropathy to thalidomide was the most common adverse event. Among 11 patients experiencing grade 2 or greater neuropathy, 10 resolved to grade 1 or less at a median of 6.7 months. Thalidomide in combination with rituximab is active and produces long-term responses in WM. Lower doses of thalidomide (ie, <or= 200 mg/day) should be considered given the high frequency of treatment-related neuropathy in this patient population. This trial is registered at www.clinicaltrials.gov as #NCT00142116.

BACKGROUND AND PURPOSE: On the basis of phase II trials, we considered that transcranial laser therapy could have neuroprotective effects in patients with acute ischemic stroke. METHODS: We studied transcranial laser therapy in a double-blind, sham-controlled randomized clinical trial intended to enroll 1000 patients with acute ischemic stroke treated ≤24 hours after stroke onset and who did not undergo thrombolytic therapy. The primary efficacy measure was the 90-day functional outcome as assessed by the modified Rankin Scale, with hierarchical Bayesian analysis incorporating relevant previous data. Interim analyses were planned after 300 and 600 patients included. RESULTS: The study was terminated on recommendation by the Data Monitoring Committee after a futility analysis of 566 completed patients found no difference in the primary end point (transcranial laser therapy 140/282 [49.6%] versus sham 140/284 [49.3%] for good functional outcome; modified Rankin Scale, 0-2). The results remained stable after inclusion of all 630 randomized patients (adjusted odds ratio, 1.024; 95% confidence interval, 0.705-1.488). CONCLUSIONS: Once the results of the interim futility analysis became available, all study support was immediately withdrawn by the capital firms behind PhotoThera, and the company was dissolved. Proper termination of the trial was difficult but was finally achieved through special efforts by former employees of PhotoThera, the CRO Parexel and members of the steering and the safety committees. We conclude that transcranial laser therapy does not have a measurable neuroprotective effect in patients with acute ischemic stroke when applied within 24 hours after stroke onset. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01120301.

Abstract Cyanobacterial blooms have substantial direct and indirect negative impacts on freshwater ecosystems including releasing toxins, blocking light needed by other organisms, and depleting oxygen. There is growing concern over the potential for climate change to promote cyanobacterial blooms, as the positive effects of increasing lake surface temperature on cyanobacterial growth are well documented in the literature; however, there is increasing evidence that cyanobacterial blooms are also being initiated and persisting in relatively cold‐water temperatures (&lt; 15°C), including ice‐covered conditions. In this work, we provide evidence of freshwater cold‐water cyanobacterial blooms, review abiotic drivers and physiological adaptations leading to these blooms, offer a typology of these lesser‐studied cold‐water cyanobacterial blooms, and discuss their occurrence under changing climate conditions.

ABSTRACT We investigate how the deterioration of household balance sheets affects worker productivity, and in turn economic downturns. Specifically, we compare the output of innovative workers who experienced differential declines in housing wealth during the financial crisis but were employed at the same firm and lived in the same metropolitan area. We find that, following a negative wealth shock, innovative workers become less productive and generate lower economic value for their firms. The reduction in innovative output is not driven by workers switching to less innovative firms or positions. These effects are more pronounced among workers at greater risk of financial distress.

Code symbols are treated as vectors in an r-dimensional vector space F/sup r/ over a field F. Given any (n, k) linear block code over F with minimum distance d, it is possible to derive an (n, k) code with symbols over F/sup r/, also with minimum distance d, which can correct any pattern of d-2 or fewer symbol errors for which the symbol errors as vectors are linearly independent. This is about twice the bound on the number of errors guaranteed to be correctable. Furthermore, if the error vectors are linearly dependent and d-2 or fewer in number, the existence of dependence can always be detected. A decoding techinque is described for which complexity increases no greater than as n/sup 3/, for any choice of code. For the two applications considered, situations are described where the probability of the error patterns being linearly dependent decreases exponentially with r.< <ETX xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">&gt;</ETX>

On May 4-5, 1993, a policy conference was held in San Diego, California, under the sponsorship of the North American Society of Pacing and Electrophysiology (NASPE) to identify the fundamental goals of antibradycardia pacemaker follow-up, evaluate the effectiveness with which it achieves those goals, and formulate specific recommendations as to how it can be made more effective. The conference addressed clinical, administrative, and educational objectives, focusing on existing and potential resources for follow-up testing and the appropriate frequency of their application. The training of physicians and associated professionals engaged in follow-up also was addressed, as were regulatory and reimbursement issues. This report summarizes the conclusions and recommendations arrived at during the conference and subsequently approved by the NASPE Board of Trustees.

OBJECTIVE: Healthcare systems are being challenged to manage increasing numbers of nonhealing wounds. Wound dressings are one of the first lines of defense in wound management, and numerous options exist. The oxidized regenerated cellulose (ORC)/collagen dressing may offer healthcare providers a robust and cost-effective tool for use in a variety of wounds. DESIGN: A multidisciplinary panel meeting was convened to discuss the use of ORC/collagen dressings in wound care and provide practice recommendations. A literature search was conducted to provide a brief review of the peer-reviewed studies published between January 2000 and March 2016 to inform the meeting. SETTING: A 2-day panel meeting convened in February 2017. PARTICIPANTS: Healthcare providers with experience using ORC/collagen dressings. This multidisciplinary panel of 15 experts in wound healing included podiatrists, wound care specialists (doctors, certified wound care nurses, and research scientists), and an orthopedist. RESULTS: The literature search identified 58 articles, a majority of which were low levels of evidence (69.3% were level 3 or lower). Panel members identified wound types, such as abrasions, burns, stalled wounds, diabetic foot ulcers, and pressure injuries, where ORC/collagen dressing use could be beneficial. Panel members then provided recommendations and technical pearls for the use of ORC/collagen dressings in practice. Barriers to ORC/collagen dressing use were discussed, and potential resolutions were offered. CONCLUSIONS: An ORC/collagen dressing can be a critical tool for clinicians to help manage a variety of wounds. Clinical and economic studies comparing standard-of-care dressings and plain collagen dressings to ORC/collagen dressings are needed.

Although the value of human capital is not captured on company balance sheets, it may account for about half of the gap between a company's market value and book value. Yet, many companies do not focus comparable scrutiny on human capital management as compared with other large assets, nor do they systematically measure its output (ie, productivity). Methods are emerging to enable employers to assess productivity losses, including absenteeism and presenteeism, and to understand the associated costs (ie, direct medical costs, total productivity loss). This will permit employers to assess the value of programs to enhance health and productivity. We contend that the effective workforce is probably decreased by 5% to 10% because of health problems. We believe that employers who increase their investments in healthy human capital now will emerge tomorrow as the companies leading the gains in US productivity.

Journal Article "RHINO", AN ALLELE OF HAIRLESS IN THE HOUSE MOUSE Get access ALMA HOWARD ALMA HOWARD *Finney-Howell Research Fellow Search for other works by this author on: Oxford Academic PubMed Google Scholar Journal of Heredity, Volume 31, Issue 11, November 1940, Pages 467–470, https://doi.org/10.1093/oxfordjournals.jhered.a104815 Published: 01 November 1940

To determine the efficacy of 21-day therapy with azithromycin and doxycycline in the treatment of experimental infection with Chlamydophila psittaci in cockatiels (Nymphicus hollandicus), 30 birds randomly assigned to 3 treatment groups and 1 control group were inoculated with C psittaci by combined intranasal and ocular routes. Morbidity, mortality, and results of polymerase chain reaction testing confirmed that infection was successful. Birds in group 1 (n = 8) received azithromycin at 40 mg/kg PO q48h for 21 days; in group 2 (n = 8), doxycycline at 35 mg/kg PO q24h for 21 days; in group 3 (n = 8), doxycycline at 35 mg/kg PO q24h for 45 days; and, in group 4 (controls; n = 6), no treatment. Six birds died either before or within 2 days of initiating treatment: 4 in the 3 treatment groups and 2 in the control group. Clinical signs resolved and mortality ceased 2-6 days after treatment was initiated in all treatment groups, whereas birds in the control group exhibited clinical signs for the duration of the study. Plasma doxycycline concentrations were measured during the treatment period and exceeded 1 microg/mL at all time points. The absence of clinical signs and mortality in the treatment groups, even after inducing an immunocompromised state with dexamethasone (3 mg/kg IM q24h for 5 days), starting on day 70 postinoculation, suggested that treatment resulted in elimination of the pathogen. After euthanasia of the remaining 24 birds, 23 of the carcasses were submitted for necropsy. Spleen and liver samples from the birds in all treatment and control groups were polymerase chain reaction negative for C psittaci nucleic acid, and organisms were not detected by Gimenez stain. No gross or histologic differences were observed in the livers and spleens of treated and untreated infected birds. Lesions consistent with avian chlamydiosis (hystiocytosis) were seen in all birds and were considered residual. In this study, a 21-day course of either doxycycline or azithromycin was effective in eliminating C psittaci infection in experimentally inoculated cockatiels. Additional studies are necessary to evaluate the efficacy of these treatments in naturally infected cockatiels as well as other species of birds.

OBJECTIVE: The effect of physical activity resumption on functional recovery following concussion is poorly understood. We sought to examine the relationship between physical activity resumption timing and gait stability 2 months following concussion. SETTING: Motion analysis laboratory. PARTICIPANTS: Twenty-nine individuals who sustained a concussion and were subsequently allowed to return to preinjury levels of physical activity within 2 months postinjury. DESIGN: Prospective cohort study. MAIN MEASURES: The return-to-activity day (RTA-day) was identified as the first day postinjury that each participant was medically cleared to resume regular physical activity. Whole-body center-of-mass (COM) motion during single-task and dual-task walking was assessed 2 months postinjury. Correlation coefficients were calculated between the RTA-day and single/dual-task gait stability as well as symptom severity measurements 2 months postinjury. RESULTS: Dual-task medial-lateral COM displacement (r = -0.52, P = .004) and peak medial-lateral COM velocity (r = -0.37, P = .048) were significantly correlated with RTA-day. Dual-task peak forward velocity and single-task gait stability measures were not significantly correlated with RTA-day. CONCLUSIONS: The time of RTA-day clearance, within a 2 months postinjury period, is significantly correlated with dual-task medial-lateral gait stability measured at the end of that period, suggesting that frontal plane gait stability recovery is sensitive to the timing of RTA-day.

Sensory systems adapt to persistent stimulation. In the transmembrane receptors of bacterial chemotaxis, adaptation is mediated by methylation at specific glutamyl residues in the cytoplasmic domain. Methylation counteracts effects of ligand binding on functional activities of that domain. Both ligand binding and adaptational modification are thought to act through conformational changes. As characterized for Escherichia coli chemoreceptors, a mechanistically crucial feature of the ligand-induced conformational change is piston sliding towards the cytoplasm of a signalling helix in the periplasmic/transmembrane domain. Adaptational modification could counteract this signalling movement by blocking its influence on the cytoplasmic domain or by reversing it. To investigate, we characterized effects of adaptational modification on the position of the signalling helix in chemoreceptor Trg using rates of disulphide formation between introduced cysteines. We utilized an intact cell procedure in which receptors were in their native, functional state. In vivo rates of disulphide formation between diagnostic cysteine pairs spanning a signalling helix interface changed as a function of adaptational modification. Strikingly, those changes were opposite those caused by ligand occupancy for each diagnostic pair tested. This suggests that adaptational modification resets the receptor complex to its null state by reversal of the conformational change generated by ligand binding.

besity is a worldwide problem, not just an issue for industri- alized nations. Therefore, we need to examine opportunities for prevention and treatment from a global perspective.

A simple method is developed for calculation of reflectance of homogeneous multiple layer coatings for the case of normal incidence. The derivation is based upon a vectorial representation of the reflectance of a single or more coating layers, found by a summation of the infinite series of multiple reflections within each layer. Presence of absorption and dispersion may be accounted for in the formulas.

Effective administrative authority involves willing rather than forced compliance; hence, a major concern of school principals should be to find strategies to increase the zone of acceptance among teachers. This research investigates the leadership behavior of principals and the personal characteristics of teachers as both are related to elementary teachers' professional zone of acceptance. Data from 46 elementary schools support the hypothesis that a large professional zone of acceptance for elementary teachers is nurtured by a principal's leadership style that combines both structure and consideration. The personal characteristics of individual teachers, however, were not as strongly related to zone of acceptance as predicted.

BACKGROUND: Self-management plays an important role in improving quality of life among patients with breast cancer. Self-management behaviors change with treatment periods, and the trajectory varies in patients with different demographic and psychosocial characteristics. However, the trajectory patterns and the predictive factors have not been fully studied. OBJECTIVES: The aim of this study was to identify the trajectory patterns of self-management behaviors in Chinese patients with breast cancer and their predictive factors. METHODS: A total of 128 patients with breast cancer were recruited. Demographic and disease-related information, self-management behaviors, self-efficacy, coping modes, emotional distress, and social support were investigated across 5 time points. Growth mixture modeling was used to identify the trajectory patterns of self-management behaviors. Logistic regression was used to determine the predictors for membership. RESULTS: The best-fit growth mixture modeling revealed a 2-class model; model fit indices were all in acceptable ranges. Class 1 and 2 were named as the group of "stable" (34.38%) and the group of "sharply decreased" (65.62%), respectively, based on the tendency of change. Modified radical mastectomy, avoidance coping mode, anxiety, and low self-efficacy level were predictors of the patients' membership to the sharply decreased group. CONCLUSION: Our study proved the heterogeneity of self-management behaviors and the influencing effect of treatment and psychosocial factors on the development of self-management behaviors in Chinese patients with breast cancer. IMPLICATIONS FOR PRACTICE: Health professionals should pay more attention to patients who are at higher risk of developing a poor self-management pattern. Targeted interventions should be developed across subpopulations and treatment periods accordingly.

Objective: To (1) quantify the diagnostic accuracy of the vestibular/oculomotor screening (VOMS), and (2) determine the recovery of vestibular and oculomotor impairments exhibited by concussed athletes compared with nonconcussed athletes using the VOMS. Setting: Clinical assessment laboratory. Participants: Amateur athletes who were diagnosed with sport-related concussion by emergency department physicians, and non-concussed, control athletes. Design: Prospective, longitudinal study. Main Measures: Participants were assessed 1 week following sport-related concussion, upon clearance to return-to-sporting activity, and 2 weeks following return-to-sporting activity by a study investigator who administered the VOMS. We calculated test sensitivity, specificity, and positive and negative predictive values to estimate the diagnostic accuracy of the VOMS. We performed a mixed-design analysis of variance to assess differences in VOMS symptom scores reported by concussed athletes compared with control athletes. Results: Fifty concussion participants and 50 control participants completed the study. The VOMS demonstrated sensitivity and specificity of 96% and 46%, respectively, and produced positive and negative predictive values of 64% and 92%, respectively. The concussion group exhibited a significantly greater symptom provocation change score from baseline than the control group for all test domains of the VOMS only in the first week following concussion. Conclusion: The VOMS may be most useful as a clinical screening tool to rule out, rather than confirm, the presence of sport-related concussion. The VOMS may be appropriate to inform the recovery of vestibular and oculomotor impairments exhibited by concussed individuals over time.