Survival in Cats with Naturally Occurring Chronic Kidney Disease (2000–2002)

Duration of survival of cats with naturally occurring chronic kidney disease (CKD) is poorly characterized. Hypothesis : Stage of kidney disease based on serum creatinine concentration (SCr) at the time of diagnosis and after correction of prerenal azotemia is strongly associated with duration of survival in cats. Animals : Two hundred and eleven client-owned cats with naturally occurring CKD evaluated between April 2000 and January 2002. Methods : Retrospective case review of 733 cats with SCr > 2.3 mg/dL. Examination of the medical records identified 211 cats that met all other inclusion and exclusion criteria for this study. Clinical characteristics, clinicopathologic data, and survival times were extracted from the medical record. Owners and referring veterinarians were contacted by phone to obtain follow-up if it was not documented in the record. Kaplan-Meier survival curves were performed to determine survival times for International Renal Interest Society (IRIS) stage both at diagnosis and at baseline (ie, after correction of prerenal azotemia). Results : Median survival for cats in IRIS stage IIb at the time of diagnosis was 1,151 days (range 2–3,107), and was longer than survival in stage III (median 778, range 22–2,100) or stage IV (median 103, range 1–1,920) ( P -value < .0001). P -value for effect of stage at diagnosis was <.0001. Conclusions and Clinical Importance : IRIS stage of CKD based on serum creatinine at the time of diagnosis is strongly predictive of survival in cats with naturally occurring CKD.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75440/1/j.1939-1676.2008.0163.x.pd

A Prospective Evaluation of Two Defibrillation Safety Margin Techniques in Patients with Low Defibrillation Energy Requirements

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75077/1/j.1540-8167.1998.tb00865.x.pd

Effect of Ventricular Shock Strength on Cardiac Hemodynamics

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75115/1/j.1540-8167.1998.tb00118.x.pd

Differential Effect of Adenosine on Anterograde and Retrograde Fast Pathway Conduction in Patients with Atrioventricular Nodal Reentrant Tachycardia

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72925/1/j.1540-8167.1998.tb00121.x.pd

Validation of key behaviourally based mental health diagnoses in administrative data: suicide attempt, alcohol abuse, illicit drug abuse and tobacco use

<p>Abstract</p> <p>Background</p> <p>Observational research frequently uses administrative codes for mental health or substance use diagnoses and for important behaviours such as suicide attempts. We sought to validate codes (<it>International Classification of Diseases, 9^thedition, clinical modification </it>diagnostic and E-codes) entered in Veterans Health Administration administrative data for patients with depression versus a gold standard of electronic medical record text ("chart notation").</p> <p>Methods</p> <p>Three random samples of patients were selected, each stratified by geographic region, gender, and year of cohort entry, from a VHA depression treatment cohort from April 1, 1999 to September 30, 2004. The first sample was selected from patients who died by suicide, the second from patients who remained alive on the date of death of suicide cases, and the third from patients with a new start of a commonly used antidepressant medication. Four variables were assessed using administrative codes in the year prior to the index date: suicide attempt, alcohol abuse/dependence, drug abuse/dependence and tobacco use.</p> <p>Results</p> <p>Specificity was high (≥ 90%) for all four administrative codes, regardless of the sample. Sensitivity was ≤75% and was particularly low for suicide attempt (≤ 17%). Positive predictive values for alcohol dependence/abuse and tobacco use were high, but barely better than flipping a coin for illicit drug abuse/dependence. Sensitivity differed across the three samples, but was highest in the suicide death sample.</p> <p>Conclusions</p> <p>Administrative data-based diagnoses among VHA records have high specificity, but low sensitivity. The accuracy level varies by different diagnosis and by different patient subgroup.</p

Amino-terminal dimerization of an erythropoietin mimetic peptide results in increased erythropoietic activity

AbstractBackground: Erythropoietin (EPO), the hormone involved in red blood cell production, activates its receptor by binding to the receptor's extracellular domain and presumably dimerizing two receptor monomers to initiate signal transduction. EPO-mimetic peptides, such as EMP1, also bind and activate the receptor by dimerization. These mimetic peptides are not as potent as EPO, however. The crystal structure of the EPO receptor (EBP) bound to EMP1 reveals the formation of a complex consisting of two peptides bound to two receptors, so we sought to improve the biological activity of EPO-mimetic peptides by constructing covalent dimers of EMP1 and other peptide mimetics linked by polyethylene glycol (PEG).Results: The potency of the PEG-dimerized EPO peptide mimetics both in vitro and in vivo was improved up to 1,000-fold compared to the corresponding peptide monomers. The dinners were constructed using peptide monomers which have only one reactive amine per molecule, allowing us to conclude that the increase in potency can be attributed to a structure in which two peptides are linked through their respective amino termini to the difunctional PEG molecule. In addition, an inactive peptide was converted into a weak agonist by PEG-induced dimerization.Conclusions: The potency of previously isolated peptides that are modest agonists of the EPO receptor was dramatically increased by PEG-induced dimerization. The EPO receptor is thought to be dimerized during activation, so our results are consistent with the proposed 2:2 receptor : peptide stoichiometry. The conversion of an inactive peptide into an agonist further supports the idea that dimerization can mediate receptor activation

Long-Term Evaluation of the Ventricular Defibrillation Energy Requirement

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74692/1/j.1540-8167.1998.tb00132.x.pd

Martial arts as a mental health intervention for children? Evidence from the ECLS-K

<p>Abstract</p> <p>Background</p> <p>Martial arts studios for children market their services as providing mental health outcomes such as self-esteem, self-confidence, concentration, and self-discipline. It appears that many parents enroll their children in martial arts in hopes of obtaining such outcomes. The current study used the data from the Early Childhood Longitudinal Study, Kindergarten class of 1998-1999, to assess the effects of martial arts upon such outcomes as rated by classroom teachers.</p> <p>Methods</p> <p>The Early Childhood Longitudinal Study used a multistage probability sampling design to gather a sample representative of U.S. children attending kindergarten beginning 1998. We made use of data collected in the kindergarten, 3^rdgrade, and 5^thgrade years. Classroom behavior was measured by a rating scale completed by teachers; participation in martial arts was assessed as part of a parent interview. The four possible combinations of participation and nonparticipation in martial arts at time 1 and time 2 for each analysis were coded into three dichotomous variables; the set of three variables constituted the measure of participation studied through regression. Multiple regression was used to estimate the association between martial arts participation and change in classroom behavior from one measurement occasion to the next. The change from kindergarten to third grade was studied as a function of martial arts participation, and the analysis was replicated studying behavior change from third grade to fifth grade. Cohen's f²effect sizes were derived from these regressions.</p> <p>Results</p> <p>The martial arts variable failed to show a statistically significant effect on behavior, in either of the regression analyses; in fact, the f²effect size for martial arts was 0.000 for both analyses. The 95% confidence intervals for regression coefficients for martial arts variables have upper and lower bounds that are all close to zero. The analyses not only fail to reject the null hypothesis, but also render unlikely a population effect size that differs greatly from zero.</p> <p>Conclusion</p> <p>The data from the ECLS-K fail to support enrolling children in martial arts to improve mental health outcomes as measured by classroom teachers.</p

Opportunities for advances in climate change economics

There have been dramatic advances in understanding the physical science of climate change, facilitated by substantial and reliable research support. The social value of these advances depends on understanding their implications for society, an arena where research support has been more modest and research progress slower. Some advances have been made in understanding and formalizing climate-economy linkages, but knowledge gaps remain [e.g., as discussed in (1, 2)]. We outline three areas where we believe research progress on climate economics is both sorely needed, in light of policy relevance, and possible within the next few years given appropriate funding: (i) refining the social cost of carbon (SCC), (ii) improving understanding of the consequences of particular policies, and (iii) better understanding of the economic impacts and policy choices in developing economies