Postprandial blood glucose and its relation to diabetic gastroparesis--a comparison of two methods

A group of 44 individuals were re-evaluated at a median follow up time of 19 years after radiotherapy for childhood cancer involving some part of the vertebral column. The median age at diagnosis was 2.6 years. The diagnosis included Wilms' tumour (n = 24), neuroblastoma (n = 9) and other solid tumours (n = 11). Scoliosis with or without kyphosis was the most common spinal deformity and was found in 40/44 patients. The apex of the major curvature was on the lumbar vertebral body 1-3 in 23 cases. The kyphosis and lordosis were greater in the subjects with tumour other than Wilms' (P = 0.04 both). Of the subjects restudied, 35 had detectable local soft tissue atrophy in the region of irradiation. Scoliotic deformity often enhanced cosmetic handicap/defect. Five subjects reported some symptoms related to the back; they had more severe scoliotic and kyphotic deformity (P = 0.02). Spinal abnormalities were common in these survivors, but subjective complaints were unusual.     

Nurse-midwifery service model in an academic environment

Chiral high performance liquid chromatography was used for the enantiometric separation of leucovorin. The optimal separation conditions recommended after optimizing the mobile phase composition, flow rate, and temperature are described. Achiral reversed-phase chromatographic method was applied for the simultaneous separation of methotrexate and leucovorin in clinical samples. Column-switching system including achiral short pre-column and chiral analytical column based on immobilized bovine serum albumin were used for simultaneous determination of leucovorin and methotrexate patients treated at the National Cancer Institute.     

Development of a model angiography informed consent form based on a multiinstitutional survey of current forms

PURPOSE: To develop an informative consent form for angiography that can be read and understood by a patient with an eighth-grade level of education. MATERIALS AND METHODS: Consent forms from 125 medical centers were evaluated with RightWriter 4.0 software. The readability index, a measure of educational grade level needed to understand a document, was determined for each form. Features of forms and discussion of complications were evaluated. A model consent form was developed. RESULTS: Analysis of 27 consent forms revealed a mean readability index of 14.2; to adequately understand the documents, an average of 2.2 years of college were required. Alternatives to the procedure were listed in 14 forms (52%). All consent forms listed potential complications, but only 15 (56%) identified specific numeric risks, and attempts to classify complications according to severity were made in only five (18%). CONCLUSION: An angiography consent form has been developed that can be understood with an eight-grade level of education. It should allow patients to more easily understand the procedure and its risks, benefits, and alternatives. It remains the obligation of the physician to tailor the discussion for each procedure to meet the needs of each patient.     

Invited review: Advances and applications of random regression models: From quantitative genetics to genomics

An important goal in animal breeding is to improve longitudinal traits; that is, traits recorded multiple times during an individual's lifetime or physiological cycle. Longitudinal traits were first genetically evaluated based on accumulated phenotypic expression, phenotypic expression at specific time points, or repeatability models. Until now, the genetic evaluation of longitudinal traits has mainly focused on using random regression models (RRM). Random regression models enable fitting random genetic and environmental effects over time, which results in higher accuracy of estimated breeding values compared with other statistical approaches. In addition, RRM provide insights about temporal variation of biological processes and the physiological implications underlying the studied traits. Despite the fact that genomic information has substantially contributed to increase the rates of genetic progress for a variety of economically important traits in several livestock species, less attention has been given to longitudinal traits in recent years. However, including genomic information to evaluate longitudinal traits using RRM is a feasible alternative to yield more accurate selection and culling decisions, because selection of young animals may be based on the complete pattern of the production curve with higher accuracy compared with the use of traditional parent average (i.e., without genomic information). Moreover, RRM can be used to estimate SNP effects over time in genome-wide association studies. Thus, by analyzing marker associations over time, regions with higher effects at specific points in time are more likely to be identified. Despite the advances in applications of RRM in genetic evaluations, more research is needed to successfully combine RRM and genomic information. Future research should provide a better understanding of the temporal variation of biological processes and their physiological implications underlying the longitudinal traits.     

Genetic parameters for a multiple-trait multiple-lactation random regression test-day model in Italian Holsteins

The objectives of this study were to estimate variance components for test-day milk, fat, and protein yields and average daily SCS in 3 subsets of Italian Holsteins using a multiple-trait, multiple-lactation random regression test-day animal model and to determine whether a genetic heterogeneous variance adjustment was necessary. Data were test-day yields of milk, fat, and protein and SCS (on a log₂ scale) from the first 3 lactations of Italian Holsteins collected from 1992 to 2002. The 3 subsets of data included 1) a random sample of Holsteins from all herds in Italy, 2) a random sample of Holsteins from herds using a minimum of 75% foreign sires, and 3) a random sample of Holsteins from herds using a maximum of 25% foreign sires. Estimations of variances and covariances for this model were achieved by Bayesian methods using the Gibbs sampler. Estimated 305-d genetic, permanent environmental, and residual variance was higher in herds using a minimum of 75% foreign sires compared with herds using a maximum of 25% foreign sires. Estimated average daily heritability of milk, fat, and protein yields did not differ among subsets. Heritability of SCS in the first lactation differed slightly among subsets and was estimated to be the highest in herds with a maximum of 25% foreign sire use (0.19 ± 0.01). Genetic correlations across lactations for milk, fat, and protein yields were similar among subsets. Genetic correlations across lactations for SCS were 0.03 to 0.08 higher in herds using a minimum of 75% or a maximum of 25% foreign sires, compared with herds randomly sampled from the entire population. Results indicate that adjustment for heterogeneous variance at the genetic level based on the percentage of foreign sire use should not be necessary with a multiple-trait random regression test-day animal model in Italy.     

Genetic analysis of milk urea nitrogen and lactose and their relationships with other production traits in Canadian Holstein cattle

The objective of this research was to estimate heritabilities of milk urea nitrogen (MUN) and lactose in the first 3 parities and their genetic relationships with milk, fat, protein, and SCS in Canadian Holsteins. Data were a random sample of complete herds (60,645 test day records of 5,022 cows from 91 herds) extracted from the edited data set, which included 892,039 test-day records of 144,622 Holstein cows from 4,570 herds. A test-day animal model with multiple-trait random regression and the Gibbs sampling method were used for parameter estimation. Regression curves were modeled using Legendre polynomials of order 4. A total of 6 separate 4-trait analyses, which included MUN, lactose, or both (yield or percentage) with different combinations of production traits (milk, fat and protein yield, fat and protein percentages, and somatic cell score) were performed. Average daily heritabilities were moderately high for MUN (from 0.384 to 0.414), lactose kilograms (from 0.466 to 0.539), and lactose percentage (from 0.478 to 0.508). Lactose yield was highly correlated with milk yield (0.979). Lactose percentage and MUN were not genetically correlated with milk yield. However, lactose percentage was significantly correlated with somatic cell score (−0.202). The MUN was correlated with fat (0.425) and protein percentages (0.20). Genetic correlations among parities were high for MUN, lactose percentage, and yield. Estimated breeding values (EBV) of bulls for MUN were correlated with fat percentage EBV (0.287) and EBV of lactose percentage were correlated with lactation persistency EBV (0.329). Correlations between lactose percentage and MUN with fertility traits were close to zero, thus diminishing the potential of using those traits as possible indicators of fertility.     

Estimation of genetic parameters for concentrations of milk urea nitrogen

The objective of this study was to use field data collected by dairy herd improvement programs to estimate genetic parameters for concentrations of milk urea nitrogen (MUN). Edited data were 36,074 test-day records of MUN and yields of milk, fat, and protein obtained from 6102 cows in Holstein herds in Ontario, Canada. Data were divided into three sets, for the first three lactations. Two analyses were performed on data from each lactation. The first procedure used ANOVA to estimate the significance of the effects of several environmental factors on MUN. Herd-test-day effects had the most significant impact on MUN. Effects of stage of lactation were also important, and MUN levels tended to increase from the time of peak yield until the end of lactation. The second analysis used a random regression model to estimate heritabilities and genetic correlations of MUN and the yield traits. Heritability estimates for MUN in lactations one, two, and three were 0.44, 0.59, and 0.48, respectively. Heritabilities for the yield traits were of a similar magnitude. Little relationship was observed between MUN and yield. Raw phenotypic correlations were all <0.10 (absolute value). Genetic correlations with production traits were close to zero in lactations one and three and only slightly positive in lactation two. The results indicate that selection on MUN is possible, but relationships between MUN and other economically important traits such as metabolic disease and fertility are needed.