bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceptions of Well-Being in Sexual Ill Health: What Role does Age Play?
Authors: Hinchliff Sharron , Gott Merryn
Published: September 2004

This article explores the ways in which age can mediate the impact of sexual health problems on psychological well-being, and reports a qualitative interview study with 69 participants (aged 31-92). Data were analysed using ‘Framework’ and the following themes identified. Participants self-defined their sexual health problems, and these included tiredness, erectile dysfunction and menopause. Older participants reported more physical conditions of a long-term nature and younger participants experienced more shorter-term problems. The effect these had on the sufferer varied with regard to perceived aetiology and longevity of the problem, for instance older participants perceived some problems as age-related which buffered impact on well-being. The findings are discussed in relation to their implications for health care and policy development.
Verbalization of Emotion in Chronic Pain Patients and their Psychological Adjustment
Authors: Herbette Gwénola , Rimé Bernard
Published: September 2004

Little attention has been paid to the issue of emotional verbalization in people undergoing chronic situations. We addressed this issue in the present study focusing on chronic pain patients. Our study investigated the verbalization of their health-related emotions, as well as the role of interpersonal variables on patients’ disclosure, and their relation to their psychological adjustment. Results indicate that chronic pain patients talk more frequently about their illness with their intimates. Yet, the medical staff represents a favored sharing target as it elicits the highest satisfaction degree. Results also reveal that others’ social constraint behavior and lack of credibility of sufferers’ health status negatively predict patients’ psychological adjustment. Therefore, the social environment appears to play a significant part in patients’ well-being.
The Role of Social Support in Coping with Daily Pain among Patients with Rheumatoid Arthritis
Authors: Holtzman Susan , Newth Sarah , Delongis Anita
Published: September 2004

Using a daily process methodology, the current study examined the role of social support in coping and pain severity among patients with rheumatoid arthritis (RA). Seventy-three adults with RA completed a structured record twice daily for one week on pain severity, pain coping, satisfaction with support and disappointment in support. Findings suggested that support influenced pain indirectly, by encouraging the use of specific coping strategies, as well as impacting coping effectiveness. Satisfaction with support was associated with adaptive and maladaptive coping, while disappointment was associated with maladaptive coping. Findings highlight the importance of close others in promoting adaptive coping strategies.
Toward a Political Economy Model for Comparative Analysis of the Role of Strategic Human Resource Development Leadership
Authors: Yorks Lyle
Published: September 2004

This article presents a conceptual framework for a political economy approach for studying the role of human resource development (HRD) leadership in organizations and understanding the linkage between an organization’s political-economic context and HRD programs and practice. This conceptual framework provides an integrative model for comparative analysis across organizations. It also brings the role of opportunistic advocacy to the forefront of discourse involving HRD practice. A political economy approach contextualizes the literature on performance improvement and emphasizes the role of HRD agency. This article provides a foundation for the conceptual framework, drawing on the seminal literature in strategy and organizational sociology. Examples of initial categories for a grounded theory of HRD from a political economy perspective are provided.
Toward a Theoretical Model of Employee Turnover: A Human Resource Development Perspective
Authors: Peterson Shari L.
Published: September 2004

This article sets forth the Organizational Model of Employee Persistence, influenced by traditional turnover models and a student attrition model. The model was developed to clarify the impact of organizational practices on employee turnover from a human resource development (HRD) perspective and provide a theoretical foundation for research on that topic. What is unique about this unified longitudinal model in which organizational factors that impact human resources are the focal point is that these organizational factors are hypothesized to be symbiotically and reciprocally linked to key individual variables—intention, goals, commitment, and satisfaction. Implications include evaluating HRD practices on the basis of reduced costs of turnover, thus enhancing the strategic role of HRD in organizations.
Business Models for Training and Performance Improvement Departments
Authors: Carliner Saul
Published: September 2004

Although typically applied to entire enterprises, the concept of business models applies to training and performance improvement groups. Business models are “the method by which firm[s] build and use [their] resources to offer…value.” Business models affect the types of projects, services offered, skills required, business processes, and type of respect accorded the training and performance improvement group. Six business models characterize training and performance improvement groups: (a) consulting firm—a group from outside an organization that advises on strategic and performance issues and implements them; (b) internal profit center—an internal group that offers services such as performance consulting and classroom and e-learning courses for a fee and makes a profit; (c) internal cost center—an internal group that provides classroom and e-learning courses and related administration at cost; (d) leveraged expertise—a small internal group of trainers who identify training needed, train subject matter experts to provide it, and handle related logistics; (e) development shop—an external group that develops training programs on contract; and (f) course marketers—an organization that builds courses.
Modeling Work-Related Learning on the Basis of Intentionality and Developmental Relatedness: A Noneducational Perspective
Authors: Doornbos Anja J. , Bolhuis Sanneke , Simons P. Robert-Jan
Published: September 2004

A model of work-related learning based on intentionality and developmental relatedness is proposed here. A shift is called for from an educational perspective on work-related learning to a noneducational perspective in which learning is construed as largely implicit and spontaneous. That is, work-related learning can happen both deliberately and spontaneously as direct or indirect result of work-related interactions. Work-related learning often occurs in messy real-life situations, is influenced by various power and social relations, and results in individual learning outcomes as well as shared understandings. The proposed model can help human resource development professionals better understand how learning and work are interrelated. It can also help such professionals take individual and work characteristics more carefully into consideration.
Iterative class discovery and feature selection using Minimal Spanning Trees
Authors: Varma Sudhir , Simon Richard
Published: September 2004

Background

Clustering is one of the most commonly used methods for discovering hidden structure in microarray gene expression data. Most current methods for clustering samples are based on distance metrics utilizing all genes. This has the effect of obscuring clustering in samples that may be evident only when looking at a subset of genes, because noise from irrelevant genes dominates the signal from the relevant genes in the distance calculation.

Results

We describe an algorithm for automatically detecting clusters of samples that are discernable only in a subset of genes. We use iteration between Minimal Spanning Tree based clustering and feature selection to remove noise genes in a step-wise manner while simultaneously sharpening the clustering.

Evaluation of this algorithm on synthetic data shows that it resolves planted clusters with high accuracy in spite of noise and the presence of other clusters. It also shows a low probability of detecting spurious clusters. Testing the algorithm on some well known micro-array data-sets reveals known biological classes as well as novel clusters.

Conclusions

The iterative clustering method offers considerable improvement over clustering in all genes. This method can be used to discover partitions and their biological significance can be determined by comparing with clinical correlates and gene annotations. The MATLAB© programs for the iterative clustering algorithm are available from http://linus.nci.nih.gov/supplement.html
Integrated analysis of metabolic phenotypes in Saccharomyces cerevisiae
Authors: Duarte Natalie C , Palsson Bernhard Ø , Fu Pengcheng
Published: September 2004

Background

The yeast Saccharomyces cerevisiae is an important microorganism for both industrial processes and scientific research. Consequently, there have been extensive efforts to characterize its cellular processes. In order to fully understand the relationship between yeast's genome and its physiology, the stockpiles of diverse biological data sets that describe its cellular components and phenotypic behavior must be integrated at the genome-scale. Genome-scale metabolic networks have been reconstructed for several microorganisms, including S. cerevisiae, and the properties of these networks have been successfully analyzed using a variety of constraint-based methods. Phenotypic phase plane analysis is a constraint-based method which provides a global view of how optimal growth rates are affected by changes in two environmental variables such as a carbon and an oxygen uptake rate. Some applications of phenotypic phase plane analysis include the study of optimal growth rates and of network capacity and function.

Results

In this study, the Saccharomyces cerevisiae genome-scale metabolic network was used to formulate a phenotypic phase plane that displays the maximum allowable growth rate and distinct patterns of metabolic pathway utilization for all combinations of glucose and oxygen uptake rates. In silico predictions of growth rate and secretion rates and in vivo data for three separate growth conditions (aerobic glucose-limited, oxidative-fermentative, and microaerobic) were concordant.

Conclusions

Taken together, this study examines the function and capacity of yeast's metabolic machinery and shows that the phenotypic phase plane can be used to accurately predict metabolic phenotypes and to interpret experimental data in the context of a genome-scale model.
Opioid modulation of GABA release in the rat inferior colliculus
Authors: Tongjaroenbungam Walaiporn , Jongkamonwiwat Nopporn , Cunningham Joanna , Phansuwan-Pujito Pansiri , Dodson Hilary C , Forge Andrew , Govitrapong Piyarat , Casalotti Stefano O
Published: September 2004

Background

The inferior colliculus, which receives almost all ascending and descending auditory signals, plays a crucial role in the processing of auditory information. While the majority of the recorded activities in the inferior colliculus are attributed to GABAergic and glutamatergic signalling, other neurotransmitter systems are expressed in this brain area including opiate peptides and their receptors which may play a modulatory role in neuronal communication.

Results

Using a perfusion protocol we demonstrate that morphine can inhibit KCl-induced release of [3H]GABA from rat inferior colliculus slices. DAMGO ([D-Ala(2), N-Me-Phe(4), Gly(5)-ol]-enkephalin) but not DADLE ([D-Ala2, D-Leu5]-enkephalin or U69593 has the same effect as morphine indicating that μ rather than δ or κ opioid receptors mediate this action. [3H]GABA release was diminished by 16%, and this was not altered by the protein kinase C inhibitor bisindolylmaleimide I. Immunostaining of inferior colliculus cryosections shows extensive staining for glutamic acid decarboxylase, more limited staining for μ opiate receptors and relatively few neurons co-stained for both proteins.

Conclusion

The results suggest that μ-opioid receptor ligands can modify neurotransmitter release in a sub population of GABAergic neurons of the inferior colliculus. This could have important physiological implications in the processing of hearing information and/or other functions attributed to the inferior colliculus such as audiogenic seizures and aversive behaviour.
Is remission of depressive symptoms in primary care a realistic goal? A meta-analysis
Authors: Dawson Marliese Y , Michalak Erin E , Waraich Paul , Anderson J Ellen , Lam Raymond W
Published: September 2004

Background

A primary goal of acute treatment for depression is clinical remission of symptoms. Most meta-analyses of remission rates involve randomized controlled trials (RCTs) using patients from psychiatric settings, but most depressed patients are treated in primary care. The goal of this study was to determine remission rates obtained in RCTs of treatment interventions for Major Depressive Disorder (MDD) conducted in primary care settings.

Methods

Potentially relevant studies were identified using computerized and manual search strategies up to May 2003. Criteria for inclusion included published RCTs with a clear definition of remission using established outcome measures.

Results

A total of 13 studies (N = 3202 patients) meeting inclusion criteria were identified. Overall remission rates for active interventions ranged between 50% and 67%, compared to 32% for pill placebo conditions and 35% for usual care conditions.

Conclusions

Remission rates in primary care studies of depression are at least as high as for those in psychiatric settings. It is a realistic goal for family physicians to target remission of symptoms as an optimal outcome for treatment of depression.
A new method for determination of varicella-zoster virus immunoglobulin G avidity in serum and cerebrospinal fluid
Authors: Kneitz Ralf-Herbert , Schubert Jörg , Tollmann Franz , Zens Wolfgang , Hedman Klaus , Weissbrich Benedikt
Published: September 2004

Background

Avidity determination of antigen-specific immunoglobulin G (IgG) antibodies is an established serological method to differentiate acute from past infections. In order to compare the avidity of varicella-zoster virus (VZV) IgG in pairs of serum and cerebrospinal fluid (CSF) samples, we developed a new technique of avidity testing, the results of which are not influenced by the concentration of specific IgG.

Methods

The modifications introduced for the new VZV IgG avidity method included the use of urea hydrogen peroxide as denaturing reagent, the adaptation of the assay parameters in order to increase the sensitivity for the detection of low-level VZV IgG in CSF, and the use of a new calculation method for avidity results. The calculation method is based on the observation that the relationship between the absorbance values of the enzyme immunoassays with and without denaturing washing step is linear. From this relationship, a virtual absorbance ratio can be calculated. To evaluate the new method, a panel of serum samples from patients with acute and past VZV infection was tested as well as pairs of serum and CSF.

Results

For the serum panel, avidity determination with the modified assay gave results comparable to standard avidity methods. Based on the coefficient of variation, the new calculation method was superior to established methods of avidity calculation.

Conclusions

The new avidity method permits a meaningful comparison of VZV IgG avidity in serum and CSF and should be of general applicability for easy determination of avidity results, which are not affected by the concentration of specific IgG.
A human in vitro model system for investigating genome-wide host responses to SARS coronavirus infection
Authors: Ng Lisa FP , Hibberd Martin L , Ooi Eng-Eong , Tang Kin-Fai , Neo Soek-Ying , Tan Jenny , Krishna Murthy Karuturi R , Vega Vinsensius B , Chia Jer-Ming , Liu Edison T , Ren Ee-Chee
Published: September 2004

Background

The molecular basis of severe acute respiratory syndrome (SARS) coronavirus (CoV) induced pathology is still largely unclear. Many SARS patients suffer respiratory distress brought on by interstitial infiltration and frequently show peripheral blood lymphopenia and occasional leucopenia. One possible cause of this could be interstitial inflammation, following a localized host response. In this study, we therefore examine the immune response of SARS-CoV in human peripheral blood mononuclear cells (PBMCs) over the first 24 hours.

Methods

PBMCs from normal healthy donors were inoculated in vitro with SARS-CoV and the viral replication kinetics was studied by real-time quantitative assays. SARS-CoV specific gene expression changes were examined by high-density oligonucleotide array analysis.

Results

We observed that SARS-CoV was capable of infecting and replicating in PBMCs and the kinetics of viral replication was variable among the donors. SARS-CoV antibody binding assays indicated that SARS specific antibodies inhibited SARS-CoV viral replication. Array data showed monocyte-macrophage cell activation, coagulation pathway upregulation and cytokine production together with lung trafficking chemokines such as IL8 and IL17, possibly activated through the TLR9 signaling pathway; that mimicked clinical features of the disease.

Conclusions

The identification of human blood mononuclear cells as a direct target of SARS-CoV in the model system described here provides a new insight into disease pathology and a tool for investigating the host response and mechanisms of pathogenesis.
Comparison of glucose tolerance in renal transplant recipients and hemodialysis patients
Authors: Argani Hassan , Noorazarian Alireza , Rahbaninobar Mohammad , Noori Mohammad , Khosroshahi Hamid T
Published: September 2004

Background

Impaired glucose tolerance is a risk factor for atherosclerosis in hemodialysis patients and renal transplant recipients.

Methods

To check the relationship of impaired glucose tolerance with the other atherosclerotic risk factors, fasting blood sugar and the standard two hour glucose tolerance test, serum tryglyceride, serum cholesterol, cyclosporine through level (in renal tranpslant recipients) and hemoglobin A1C were measured in 55 stable renal transplant recipients, 55 hemodialysis patients and 55 healthy controls with similar demographic characteristics. Patients with diabetes mellitus and propranolol consumers were excluded. The mean age and female to male ratio were 39 +/- 7 years and 23/22, respectively.

Results

Four of the renal transplant recipients and twelve of the hemodialysis patients had impaired glucose tolerance. Significant linear correlation was observed with body mass index and IGT only in hemodialysis patients (r = 0.4, p = 0.05). Glucose tolerance also had a significant correlation with triglyceride levels (217.2 +/- 55 mg/dl in hemodialysis patients vs. 214.3 +/- 13 mg/dl in renal transplant recipients and 100.2 +/- 18 mg/dl in control groups, p = 0.001). The glucose tolerance had significant relationship with higher serum cholesterol levels only in the renal transplant recipients (269.7 +/- 54 in renal transplant recipients vs. 199.2 +/- 36.6 mg/dl in hemodialysis and 190.5 +/- 34 mg/dl in control groups, p = 0.0001). In the renal transplant recipients, a linear correlation was observed with glucose tolerance and both the serum cyclosporine level (r = 0.9, p = 0.001) and the hemoglobin A1C concentration (6.2 +/- 0.9 g/dl). The later correlation was also observed in the hemodialysis patients (6.4 +/- 0.7 g/dl; r = 67, p = 0.001).

Conclusions

We conclude that although fasting blood sugar is normal in non-diabetic renal transplant and hemodialysis patients, impaired glucose tolerance could be associated with the other atherosclerotic risk factors.
Non-Invasive monitoring of diaphragmatic timing by means of surface contact sensors: An experimental study in dogs
Authors: Fiz José Antonio , Jané Raimon , Torres Abel , Morera Josep , Galdiz Batxi , Gea Joaquín , Grassino Alejandro
Published: September 2004

Background

Non-invasive monitoring of respiratory muscle function is an area of increasing research interest, resulting in the appearance of new monitoring devices, one of these being piezoelectric contact sensors. The present study was designed to test whether the use of piezoelectric contact (non-invasive) sensors could be useful in respiratory monitoring, in particular in measuring the timing of diaphragmatic contraction.

Methods

Experiments were performed in an animal model: three pentobarbital anesthetized mongrel dogs. The motion of the thoracic cage was acquired by means of a piezoelectric contact sensor placed on the costal wall. This signal is compared with direct measurements of the diaphragmatic muscle length, made by sonomicrometry. Furthermore, to assess the diaphragmatic function other respiratory signals were acquired: respiratory airflow and transdiaphragmatic pressure. Diaphragm contraction time was estimated with these four signals. Using diaphragm length signal as reference, contraction times estimated with the other three signals were compared with the contraction time estimated with diaphragm length signal.

Results

The contraction time estimated with the TM signal tends to give a reading 0.06 seconds lower than the measure made with the DL signal (-0.21 and 0.00 for FL and DP signals, respectively), with a standard deviation of 0.05 seconds (0.08 and 0.06 for FL and DP signals, respectively). Correlation coefficients indicated a close link between time contraction estimated with TM signal and contraction time estimated with DL signal (a Pearson correlation coefficient of 0.98, a reliability coefficient of 0.95, a slope of 1.01 and a Spearman's rank-order coefficient of 0.98). In general, correlation coefficients and mean and standard deviation of the difference were better in the inspiratory load respiratory test than in spontaneous ventilation tests.

Conclusion

The technique presented in this work provides a non-invasive method to assess the timing of diaphragmatic contraction in canines, using a piezoelectric contact sensor placed on the costal wall.
Phenotypic plasticity of fine root growth increases plant productivity in pine seedlings
Authors: Wu Rongling , Grissom James E , McKeand Steven E , O'Malley David M
Published: September 2004

Background

The plastic response of fine roots to a changing environment is suggested to affect the growth and form of a plant. Here we show that the plasticity of fine root growth may increase plant productivity based on an experiment using young seedlings (14-week old) of loblolly pine. We use two contrasting pine ecotypes, "mesic" and "xeric", to investigate the adaptive significance of such a plastic response.

Results

The partitioning of biomass to fine roots is observed to reduce with increased nutrient availability. For the "mesic" ecotype, increased stem biomass as a consequence of more nutrients may be primarily due to reduced fine-root biomass partitioning. For the "xeric" ecotype, the favorable influence of the plasticity of fine root growth on stem growth results from increased allocation of biomass to foliage and decreased allocation to fine roots. An evolutionary genetic analysis indicates that the plasticity of fine root growth is inducible, whereas the plasticity of foliage is constitutive.

Conclusions

Results promise to enhance a fundamental understanding of evolutionary changes of tree architecture under domestication and to design sound silvicultural and breeding measures for improving plant productivity.
How patient-physician encounters in critical medical situations affect trust: results of a national survey
Authors: Shenolikar Rahul A , Balkrishnan Rajesh , Hall Mark A
Published: September 2004

Background

Patients' trust in physicians and in the medical profession is vital for a successful patient-physician relationship. Trust is especially salient in critical medical situations, such as serious side-effects, hospitalizations, and diagnoses of serious medical conditions, but most trust studies have been done with the general population or in routine primary care settings. This study examines the association between patient-physician encounters in such critical medical situations and patients' trust in their physician and in the medical profession in general.

Methods

A random national telephone survey was conducted using validated multi-item questionnaire measuring trust and satisfaction with physicians and with the medical profession. A seven item questionnaire measured the patient-physician encounters in critical medical situations. A total of 1117 subjects aged 20 years and older with health insurance were included for analyses. Spearman rank order correlations were used to determine the association of encounter variables with trust in physicians and the medical profession.

Results

Prescription of medications by primary care physicians that patients believed might have side effects was negatively correlated with trust in physician (ρ = -0.12, p < 0.001, n = 1045) in multivariate analysis. A primary care physician evaluating the patient for a condition the patient believed was serious was positively correlated with trust in physician (ρ= 0.08, p < 0.01). Being hospitalized was positively correlated with trust in the medical profession (ρ = 0.12, p < 0.01, n = 475).

Conclusion

Hospitalization, perceived seriousness of condition, and concerns about the risks of medications were found to be associated with patient trust in physicians or the medical profession. These findings highlight the salience of trust in serious physician-patient encounters and the role that patient vulnerability plays in determining patient trust.
Setting priorities in health care organizations: criteria, processes, and parameters of success
Authors: Gibson Jennifer L , Martin Douglas K , Singer Peter A
Published: September 2004

Background

Hospitals and regional health authorities must set priorities in the face of resource constraints. Decision-makers seek practical ways to set priorities fairly in strategic planning, but find limited guidance from the literature. Very little has been reported from the perspective of Board members and senior managers about what criteria, processes and parameters of success they would use to set priorities fairly.

Discussion

We facilitated workshops for board members and senior leadership at three health care organizations to assist them in developing a strategy for fair priority setting. Workshop participants identified 8 priority setting criteria, 10 key priority setting process elements, and 6 parameters of success that they would use to set priorities in their organizations. Decision-makers in other organizations can draw lessons from these findings to enhance the fairness of their priority setting decision-making.

Lessons learned in three workshops fill an important gap in the literature about what criteria, processes, and parameters of success Board members and senior managers would use to set priorities fairly.
The effects of moderate alcohol supplementation on estrone sulfate and DHEAS in postmenopausal women in a controlled feeding study
Authors: Mahabir Somdat , Baer David J , Johnson Laura L , Dorgan Joanne F , Campbell William , Brown Ellen , Hartman Terryl J , Clevidence Beverly , Albanes Demetrius , Judd Joseph T , Taylor Philip R
Published: September 2004

Background

We have demonstrated that moderate alcohol consumption (15 g/d, 30 g/d) for 8 weeks resulted in significantly increased levels of serum estrone sulfate and DHEAS in 51 postmenopausal women in a randomized, placebo-controlled trial. We now report on the relationships between serum estrone sulfate and dehydroepiandrosterone sulfate (DHEAS) levels after 4 weeks of moderate alcohol supplementation, and compare the results to the 8 weeks data to elucidate time-to-effect differences.

Methods

Postmenopausal women (n = 51) consumed 0 (placebo), 15 (1 drink), and 30 (2 drinks) g alcohol (ethanol)/ day for 8 weeks as part of a controlled diet in a randomized crossover design. Blood samples were drawn at baseline, at 4 weeks and at 8 weeks. Changes in estrone sulfate and DHEAS levels from placebo to 15 g and 30 g alcohol per day were estimated using linear mixed models.

Results and Discussion

At week 4, compared to the placebo, estrone sulfate increased an average 6.9% (P = 0.24) when the women consumed 15 g of alcohol per day, and 22.2% (P = 0.0006) when they consumed 30 g alcohol per day. DHEAS concentrations also increased significantly by an average of 8.0% (P < 0.0001) on 15 g of alcohol per day and 9.2% (P < 0.0001) when 30 g alcohol was consumed per day. Trend tests across doses for both estrone sulfate (P = 0.0006) and DHEAS (P < 0.0001) were significant. We found no significant differences between the absolute levels of serum estrone sulfate at week 4 versus week 8 (P = 0.32) across all doses. However, absolute DHEAS levels increased from week 4 to week 8 (P < 0.0001) at all three dose levels.

Conclusions

These data indicate that the hormonal effects due to moderate alcohol consumption are seen early, within 4 weeks of initiation of ingestion.
Nutritional care of Danish medical inpatients: Effect on dietary intake and the occupational groups' perspectives of intervention
Authors: Lassen Karin O , Kruse Filip , Bjerrum Merete , Jensen Lillian , Hermansen Kjeld
Published: September 2004

Background

Many patients do not eat and drink sufficiently during hospitalisation. The clinical consequences of this under nutrition include lassitude, an increased risk of complications and prolonged convalescence. The aim of the study was 1) to introduce intervention targeting nutritional care for medical inpatients, 2) to investigate the effect of this intervention, and 3) to investigate the occupational groups' attitudes towards nutritional intervention and nutritional care in general.

Methods

The design was to determinate the extent to which the protein and energy requirements of medical inpatients were met before and after intervention. Dietary protein and energy intakes were assessed by 72-hour weighed food records. A total number of 108 medical patients at four bed sections and occupational groups in the two intervention bed sections, Aarhus University Hospital, Denmark participated. The intervention included introduction and implementation of nursing procedures targeting nutritional care during a five-month investigation period using standard food produced at the hospital. The effect of intervention for independent groups of patients were tested by one-way analysis of variance. After the intervention occupational groups were interviewed in focus groups.

Results

Before the intervention hospital food on average met 72% of the patients' protein requirement and 85% of their energy requirement. After intervention hospital food satisfied 85% of the protein and 103% of the energy requirements of 14 patients in one intervention section and 56% of the protein and 76% of the energy requirement of 17 patients in the other intervention section. Hospital food satisfied 61% of the protein and 75% of the energy requirement in a total of 29 controls. From the occupational groups' point of view lack of time, lack of access to food, and lack of knowledge of nutritional care for patients were identified as barriers to better integration of nutritional care into the overall care provision.

Conclusion

There was ample room for improving the extent to which standard hospital food satisfies patients' protein and energy requirements, but implementation of procedures addressing nutritional care were difficult, especially at bed sections with a large staff turnover.
Food and nutrient intake in relation to mental wellbeing
Authors: Hakkarainen Reeta , Partonen Timo , Haukka Jari , Virtamo Jarmo , Albanes Demetrius , Lönnqvist Jouko
Published: September 2004

Background

We studied food consumption and nutrient intake in subjects with depressed mood, anxiety and insomnia as indices of compromised mental wellbeing.

Methods

The study population consisted of 29,133 male smokers aged 50 to 69 years who entered the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study in 1985–1988. This was a placebo-controlled trial to test whether supplementation with alpha-tocopherol or beta-carotene prevents lung cancer. At baseline 27,111 men completed a diet history questionnaire from which food and alcohol consumption and nutrient intake were calculated. The questionnaire on background and medical history included three symptoms on mental wellbeing, anxiety, depression and insomnia experienced in the past four months.

Results

Energy intake was higher in men who reported anxiety or depressed mood, and those reporting any such symptoms consumed more alcohol. Subjects reporting anxiety or depressed mood had higher intake of omega-3 fatty acids and omega-6 fatty acids.

Conclusions

Our findings conflict with the previous reports of beneficial effects of omega-3 fatty acids on mood.
Analysis of cardiac signals using spatial filling index and time-frequency domain
Authors: Faust Oliver , Acharya U Rajendra , Krishnan SM , Min Lim Choo
Published: September 2004

Background

Analysis of heart rate variation (HRV) has become a popular noninvasive tool for assessing the activities of the autonomic nervous system (ANS). HRV analysis is based on the concept that fast fluctuations may specifically reflect changes of sympathetic and vagal activity. It shows that the structure generating the signal is not simply linear, but also involves nonlinear contributions. These signals are essentially non-stationary; may contain indicators of current disease, or even warnings about impending diseases. The indicators may be present at all times or may occur at random in the time scale. However, to study and pinpoint abnormalities in voluminous data collected over several hours is strenuous and time consuming.

Methods

This paper presents the spatial filling index and time-frequency analysis of heart rate variability signal for disease identification. Renyi's entropy is evaluated for the signal in the Wigner-Ville and Continuous Wavelet Transformation (CWT) domain.

Results

This Renyi's entropy gives lower 'p' value for scalogram than Wigner-Ville distribution and also, the contours of scalogram visually show the features of the diseases. And in the time-frequency analysis, the Renyi's entropy gives better result for scalogram than the Wigner-Ville distribution.

Conclusion

Spatial filling index and Renyi's entropy has distinct regions for various diseases with an accuracy of more than 95%.
A novel method of cultivating cardiac myocytes in agarose microchamber chips for studying cell synchronization
Authors: Kojima Kensuke , Kaneko Tomoyuki , Yasuda Kenji
Published: September 2004

We have developed a new method that enables agar microstructures to be used to cultivate cardiac myocyte cells in a manner that allows their connection patterns to be controlled. Non-contact three-dimensional photo-thermal etching with a 1064-nm infrared focused laser beam was used to form the shapes of agar microstructures. This wavelength was selected as it is not absorbed by water or agar. Identical rat cardiac myocytes were cultured in adjacent microstructures connected by microchannels and the interactions of asynchronous beating cardiac myocyte cells observed. Two isolated and independently beating cardiac myocytes were shown to form contacts through the narrow microchannels and by 90 minutes had synchronized their oscillations. This occurred by one of the two cells stopping their oscillation and following the pattern of the other cell. In contrast, when two sets of synchronized beating cells came into contact, those two sets synchronized without any observable interruptions to their rhythms. The results indicate that the synchronization process of cardiac myocytes may be dependent on the community size and network pattern of these cells.
Predicting declines in physical function in persons with multiple chronic medical conditions: What we can learn from the medical problem list
Authors: Bayliss Elizabeth A , Bayliss Martha S , Ware John E , Steiner John F
Published: September 2004

Background

Primary care physicians are caring for increasing numbers of persons with comorbid chronic illness. Longitudinal information on health outcomes associated with specific chronic conditions may be particularly relevant in caring for these populations. Our objective was to assess the effect of certain comorbid conditions on physical well being over time in a population of persons with chronic medical conditions; and to compare these effects to that of hypertension alone.

Methods

We conducted a secondary analysis of 4-year longitudinal data from the Medical Outcomes Study. A heterogeneous population of 1574 patients with either hypertension alone (referent) or one or more of the following conditions: diabetes, coronary artery disease, congestive heart failure, respiratory illness, musculoskeletal conditions and/or depression were recruited from primary and specialty (endocrinology, cardiology or mental health) practices within HMO and fee-for-service settings in three U.S. cities. We measured categorical change (worse vs. same/better) in the SF-36® Health Survey physical component summary score (PCS) over 4 years. We used logistic regression analysis to determine significant differences in longitudinal change in PCS between patients with hypertension alone and those with other comorbid conditions and linear regression analysis to assess the contribution of the explanatory variables.

Results

Specific diagnoses of CHF, diabetes and/or chronic respiratory disease; or 4 or more chronic conditions, were predictive of a clinically significant decline in PCS.

Conclusions

Clinical recognition of these specific chronic conditions or 4 or more of a list of chronic conditions may provide an opportunity for proactive clinical decision making to maximize physical functioning in these populations.
Health-related quality of life as a predictor of pediatric healthcare costs: A two-year prospective cohort analysis
Authors: Seid Michael , Varni James W , Segall Darron , Kurtin Paul S
Published: September 2004

Background

The objective of this study was to test the primary hypothesis that parent proxy-report of pediatric health-related quality of life (HRQL) would prospectively predict pediatric healthcare costs over a two-year period. The exploratory hypothesis tested anticipated that a relatively small group of children would account for a disproportionately large percent of healthcare costs.

Methods

317 children (157 girls) ages 2 to 18 years, members of a managed care health plan with prospective payment participated in a two-year prospective longitudinal study. At Time 1, parents reported child HRQL using the Pediatric Quality of Life Inventory™ (PedsQL™ 4.0) Generic Core Scales, and chronic health condition status. Costs, based on health plan utilization claims and encounters, were derived for 6, 12, and 24 months.

Results

In multiple linear regression equations, Time 1 parent proxy-reported HRQL prospectively accounted for significant variance in healthcare costs at 6, 12, and 24 months. Adjusted regression models that included both HRQL scores and chronic health condition status accounted for 10.1%, 14.4%, and 21.2% of the variance in healthcare costs at 6, 12, and 24 months. Parent proxy-reported HRQL and chronic health condition status together defined a 'high risk' group, constituting 8.7% of the sample and accounting for 37.4%, 59.2%, and 62% of healthcare costs at 6, 12, and 24 months. The high risk group's per member per month healthcare costs were, on average, 12 times that of other enrollees' at 24 months.

Conclusions

While these findings should be further tested in a larger sample, our data suggest that parent proxy-reported HRQL can be used to prospectively predict healthcare costs. When combined with chronic health condition status, parent proxy-reported HRQL can identify an at risk group of children as candidates for proactive care coordination.
Skipping the co-expression problem: the new 2A "CHYSEL" technology
Authors: de Felipe Pablo
Published: September 2004

The rapid progress in the field of genomics is increasing our knowledge of multi-gene diseases. However, any realistic hope of gene therapy treatment for those diseases needs first to address the problem of co-ordinately co-expressing several transgenes. Currently, the use of internal ribosomal entry sites (IRESs) is the strategy chosen by many researchers to ensure co-expression. The large sizes of the IRESs (~0.5 kb), and the difficulties of ensuring a well-balanced co-expression, have prompted several researchers to imitate a co-expression strategy used by many viruses: to express several proteins as a polyprotein. A small peptide of 18 amino acids (2A) from the foot-and-mouth disease virus (FMDV) is being used to avoid the need of proteinases to process the polyprotein. FMDV 2A is introduced as a linker between two proteins to allow autonomous intra-ribosomal self-processing of polyproteins. Recent reports have shown that this sequence is compatible with different sub-cellular targeting signals and can be used to co-express up to four proteins from a single retroviral vector. This short peptide provides a tool to allow the co-expression of multiple proteins from a single vector, a useful technology for those working with heteromultimeric proteins, biochemical pathways or combined/synergistic phenomena.
Co-administration of a DNA vaccine encoding the prostate specific membrane antigen and CpG oligodeoxynucleotides suppresses tumor growth
Authors: Ren Jiaqiang , Zheng Li , Chen Qi , Li Hua , Zhang Lin , Zhu Hongguang
Published: September 2004

Background

Prostate-specific membrane antigen (PSMA) is a well characterized prostate-specific tumor associated antigen. Its expression is elevated in prostate carcinoma, particularly in metastatic and recurrent lesions. These observations suggest that PSMA can be used as immune target to induce tumor cell-specific recognition by the host and, consequently tumor rejection. We utilized a DNA-based vaccine to specifically enhance PSMA expression. An immune modulator, such as CpG oligodeoxynucleotides which promote Th1-type immune responses was combined to increase the efficacy of tumor recognition and elimination.

Methods

A eukaryotic expression plasmid pCDNA3.1-PSMA encoding full-length PSMA was constructed. C57BL/6 mice were immunized with endotoxin-free pCDNA3.1-PSMA alone or in combination with CpG oligodeoxynucleotides by intramuscular injection. After 4 immunizations, PSMA specific antibodies and cytotoxic T lymphocyte reactivity were measured. Immunized C57BL/6 mice were also challenged subcutaneously with B16 cells transfected with PSMA to evaluate suppression of tumor growth.

Results

Vaccine-specific cytotoxic T lymphocytes reactive with B16 cells expressing PSMA could be induced with this treatment schedule. Immune protection was observed in vaccinated mice as indicated by increased tumor growth in the control group (100%) compared with the groups vaccinated with DNA alone (66.7%) or DNA plus CpG oligodeoxynucleotides (50%) respectively. Average tumor volume was smaller in vaccinated groups and tumor-free survival time was prolonged by the vaccination.

Conclusion

The current findings suggest that specific anti-tumor immune response can be induced by DNA vaccines expressing PSMA. In addition, the suppression of in vivo growth of tumor cells expressing PSMA was augmented by CpG oligodeoxynucleotides. This strategy may provide a new venue for the treatment of carcinoma of prostate after failure of standard therapy.
Combination of histopathological and electromyographic patterns can help to evaluate functional outcome of critical ill patients with neuromuscular weakness syndromes
Authors: Kerbaul François , Brousse Muriel , Collart Frédéric , Pellissier Jean-François , Planche Denis , Fernandez Carla , Gouin François , Guidon Catherine
Published: September 2004

Introduction

The aim of the study was to describe patterns of neuromuscular weakness using a combination of electromyography and histology, and to evaluate functional outcome in patients following complicated cardiovascular surgery.

Methods

Fifteen adults requiring long-term mechanical ventilation (>15 days) following cardiovascular surgery associated with postoperative complications were prospectively included. Electrophysiological and histological analyses (muscle and nerve) were performed when failure to wean from mechanical ventilation associated with peripheral neuromuscular weakness was noticed. Functional disability was evaluated 12 months after surgery.

Results

Six patients had a predominantly axonal neuropathy, six presented with myopathy, and three patients had a combination of axonal neuropathy and myopathy. All of them presented with acute tetraparesis and failure to wean from mechanical ventilation. All of the study patients who received corticosteroids exhibited a myopathic pattern (with or without axonopathic changes) but never an axonopathic pattern only. Only two of the eight survivors at 12 months were not ambulatory. These two patients had no detectable compound muscle action potential on electrophysiological examination.

Conclusion

The combination of electromyographic evaluation and neuromuscular histological abnormalities could help to identify the type and severity of neuromuscular weakness, in turn helping to evaluate the patient's potential functional prognosis.
Activation of cytotoxic lymphocytes by interferon-α: role of oxygen radical-producing mononuclear phagocytes
Authors: Hansson Markus , Romero Ana , Thorén Fredrik , Hermodsson Svante , Hellstrand Kristoffer
Published: September 2004

A significant part of the therapeutic benefit of interferon-α (IFN-α) therapy in malignant diseases and in chronic viral infections is assumed to result from activation of lymphocytes with natural killer (NK) and T cell phenotype. In tumor tissue and in chronically infected tissue, the function and viability of these lymphocytes are frequently impaired. Mononuclear phagocyte (MP)-derived reactive oxygen species (ROS) have been proposed to contribute to the lymphocyte suppression in these tissues. Here, we report that three types of human cytotoxic lymphocytes of relevance to immunoactivation by IFN-α, CD3ɛ+/8+/56– T cells, CD3ɛ–/56+ NK cells, and CD3ɛ+/56+ NK/T cells became anergic to IFN-α induction of the cell-surface activation marker CD69 after exposure to autologous MPs in vitro. In addition to their incapacity to express CD69, cytotoxic lymphocytes acquired features characteristic of apoptosis after incubation with MPs. The lymphocyte apoptosis and nonresponsiveness to IFN-α were prevented by two inhibitors of reduced nicotinamide adenine dinucleotide phosphate oxidase-dependent formation of ROS in MPs, histamine dihydrochloride and diphenylene ionodonium, as well as by catalase, a scavenger of ROS. We conclude that MP-derived ROS may negatively affect IFN-α-induced immunostimulation and propose that ROS inhibitors or scavengers may be useful to improve lymphocyte activation during treatment with IFN-α.
Frequency-domain stable state-space system identification
Authors: Isapour A. , Sadati N. , Ranjbar Ali Mohammad
Published: September 2004

Due to possible distortion contained in frequency-domain data, system identification methods based on data-matching alone do not guarantee stable models. This is a model of a linear system from its frequency response data. It is an improvement and an extension of previous work. The method first identifies a matrix-fraction description of the transfer function matrix of the system from data. Then, through forming a multivariable observable or controllable canonical form, the method separates and replaces the unstable subsystem by a stable subsystem having approximately the same frequency response. Finally, it calculates the Markov parameters of the resulting model and obtains a state-space model through the Eigensystem Realization Algorithm.