bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors associated with response to lamivudine: Retrospective study in a tertiary care clinic serving patients with chronic hepatitis B
Authors: HANN HIE‐WON L , JONSSON FUNK MICHELE L , ROSENBERG DANIEL M , DAVIS RANDY
Published: February 2005

Background and Aims: Chronic hepatitis B (CHB) is an important cause of end stage liver disease and hepatocellular carcinoma. Controlled clinical trials indicate treatment with lamivudine results in positive clinical responses. The study goal was to determine if the response to lamivudine treatment (HBeAg loss, HBV DNA loss and alanine aminotransferase [ALT] reduction) differs according to pretherapy (pre‐tx) ALT levels.

Methods: This was a retrospective review of medical record data. All CHB patients at all stages of disease (including cirrhotic) with more than two visits to the clinic were included in the study (n = 719). Kaplan‐Meier survival and Cox proportional hazards were estimated.

Results: Of the total 719 HBsAg (+) patients, 317 were treated with lamivudine 150 mg or 100 mg daily. Among HBeAg positive patients, at 3 years, Kaplan‐Meier estimates of the loss of HBeAg were 40%, 57% and 61% for pre‐tx ALT < upper limit of normal (ULN), 1–2 × ULN and >2 × ULN, respectively. Similar results of HBV‐DNA loss were seen in HBeAg negative patients.

Conclusions: In this setting, we observed that pre‐tx ALT levels were not associated with response to lamivudine, but that lower platelet count and female sex in HBeAg (+) patients were important predictive factors of a favorable response to lamivudine therapy.
Short‐term recurrent abdominal pain related to Helicobacter pylori infection in children
Authors: YANG YAO‐JONG , SHEU BOR‐SHYANG , LEE SHUI‐CHENG , WU JIUNN‐JONG
Published: February 2005

Background and Aim: The causal relationship between Helicobacter pylori infection and recurrent abdominal pain in children is still under debate. This study assessed the relationship between H. pylori infection and recurrent abdominal pain (RAP) in preschool and school children.

Methods: A total of 1271 preschool and school children completed a questionnaire to define the RAP or short‐term RAP (SRAP) with pain duration from 2 weeks to 3 months. The serum samples of 118 children with RAP, 60 with SRAP and 212 control children without abdominal pain were all tested for anti‐H. pylori IgG. Children with abdominal pain and anti‐H. pylori seropositivity were followed for 1 year to assess the relationship of H. pylori infection and recurrent abdominal pain.

Results: The prevalence rates of RAP and SRAP in children were 9.8% (124/1271) and 5.5% (70/1271), respectively. Children with SRAP had a higher anti‐H. pylori seropositive rate than those with RAP (25%vs 5%, P < 0.001) and control (25%vs 9%, P = 0.001). Among children with SRAP, the epigastric pain was related to H. pylori infection (P = 0.002). One year later, 71% (15/21) of the follow‐up children (15 with SRAP, six with RAP) became symptom free regardless of the persistence of H. pylori.

Conclusion: H. pylori infection is more commonly found in children with short‐term RAP, and presentation of epigastric pain in these cases can be considered as a warning alarm to screen for H. pylori infection.
Gastric tone variations during gastric infusion of fiber‐supplemented formulas
Authors: SAVOYE GUILLAUME , BOUIN MICKAEL , HERVÉ SOPHIE , DENIS PHILIPPE , DUCROTTÉ PHILIPPE
Published: February 2005

Background and Aim: Despite gastric feeding being a common method of artificial nutritional support, little is known about the effects of enteral nutrition on fundic motor function. The objective of this study was to assess variations of fundic tone and their relation to antroduodenal motility before, during and after nasogastric feeding supplemented or not with fibers.

Method: Double‐blinded studies were performed in random order with the three different diets (2100 kJ) in eight volunteers: fiber free (FF), insoluble fiber (IF) or mixed fiber (MF). Fundic tone was recorded by barostat concomitantly with antroduodenal manometry.

Results: Before the infusion, seven spontaneous fundic relaxations occurred during the 24 studies. Concomitantly or less than 2 min before these relaxations, phase III of the migrating motor complex (MMC) with a duodenal onset was recorded. Only the 17 studies without spontaneous fundic relaxation (4 FF, 6 MF, 7 IF) were suitable for the assessment of fundic response to infusion. Disappearance of the volume waves at the beginning and during the whole infusion was observed in 11/17 studies (FF 50%, MF 66% and IF 71%, NS), but a proximal gastric relaxation following the beginning of the infusion occurred in only three individuals, one with the FF and two with IF. When it occurred, fundic relaxation was observed within 2 min and was not different from those observed spontaneously.

Conclusion: Gastric infusion of a polymeric diet, supplemented or not with fiber, did not promote fundic relaxation in most of the cases but often induced a disappearance of gastric volume waves.
Doxazosin for benign prostatic hyperplasia: An open‐label, baseline‐controlled study in Korean general practice
Authors: CHUNG BYUNG HA , HONG SUNG JOON , LEE MOO SANG
Published: February 2005

Background: Few studies have reported the treatment of benign prostatic hyperplasia (BPH) in Asian patients. We assessed the safety and efficacy of doxazosin, a selective α1‐adrenoceptor antagonist, in the treatment of Korean patients with symptomatic BPH.

Methods: Two hundred and ninety‐five men, aged 48 years or older with clinical BPH, were enrolled in a 12‐week, open‐label, baseline‐controlled, dose‐titration, multicenter study. A 2‐week, single‐blind, placebo run‐in was followed by 10 weeks of doxazosin treatment, initially administered at 1 mg/day, with upward titrations (2, 4, or 8 mg/day) at 2‐week intervals. The international prostate symptom score (IPSS) was used to assess efficacy after 4, 6, and 10 weeks of active treatment.

Results: The intent‐to‐treat (ITT) population comprised 249 patients (mean age 63.6 years). Doxazosin significantly reduced the mean total IPSS by 48%; similarly, the obstructive and irritative subscores were reduced from baseline by 51% and 39%, respectively (P < 0.001 for all scores: Wilcoxon rank sum test). In a subset analysis of 170 normotensive and 78 hypertensive patients, significant reductions in mean systolic and diastolic blood pressures relative to baseline were observed only in the hypertensive subset (P < 0.01). Similar results in mean IPSS were observed in older (≥65 years, n = 100) and younger (45–64 years, n = 140) patients, as well as between normotensive and hypertensive patients. Thirty‐nine patients reported adverse events: The most frequent were dizziness, dyspepsia, asthenia, somnolence, and dry mouth.

Conclusions: The efficacy and safety of doxazosin treatment for BPH were confirmed in this Asian population. Significant improvements in total IPSS, as well as obstructive and irritative subscores, were observed.
Single‐nucleotide polymorphisms in the 17β‐hydroxysteroid dehydrogenase genes might predict the risk of side‐effects of estramustine phosphate sodium in prostate cancer patients
Authors: SUZUKI MOTOFUMI , MUTO SATORU , HARA KAZUO , OZEKI TAKESHI , YAMADA YASUHIKO , KADOWAKI TAKASHI , TOMITA KYOICHI , KAMEYAMA SHUJI , KITAMURA TADAICHI
Published: February 2005

Background: Estramustine phosphate sodium (EMP) frequently causes side‐effects such as gastrointestinal discomfort, nausea, and edema in extremities. We analyzed single nucleotide polymorphisms (SNP) in the 17β‐hydroxysteroid dehydrogenase (HSD17B) genes, which are involved in the metabolism of EMP, to predict the risk of EMP side‐effects in prostate cancer patients.

Methods: We performed genotyping of SNP in the HSD17B genes of 44 Japanese patients with newly diagnosed prostate cancer. The association of SNP and individual EMP side‐effects was evaluated.

Results: Peripheral edema occurred more frequently in patients with C/C genotype of IMS‐JST123219 than in those with C/G genotype (OR: 5.47, 95% CI: 1.27–23.64). Haplotype analysis showed that appetite loss was associated with the G allele of IMS‐JST123219 and the T allele of IMS‐JST123218 (OR: 9.13, 95% CI: 1.15–72.76).

Conclusions: These preliminary data demonstrated that analyses of SNP in the HSD17B genes might predict the occurrence of side‐effects from EMP.
Testicular natural killer T‐cell lymphoma
Authors: BALLEREAU CHARLES , LEROY XAVIER , MORSCHHAUSER FRANCK , FANTONI JEAN‐CHRISTOPHE , LEMAITRE LAURENT , VILLERS ARNAULD , BISERTE JACQUES
Published: February 2005

Abstract  Primary testicular lymphomas account for less than 5% of all testicular neoplasms. Testicular natural killer (NK)/T‐cell lymphomas are exceptional and have a very poor prognosis. We report the case of a 30‐year‐old French Caucasian man with testicular NK/T‐cell lymphoma of the following immunophenotype: CD2+, CD3ɛ+ and CD56+. Despite intensive chemotherapy, the disease progressed rapidly, with death occurring 2 months after diagnosis.
Vascular endothelial growth factor‐C (VEGF‐C) expression predicts lymph node metastasis of transitional cell carcinoma of the bladder
Authors: SUZUKI KAZUMI , MORITA TATSUO , TOKUE AKIHIKO
Published: February 2005

Purpose: It has been found that expression of vascular endothelial growth factor‐C (VEGF‐C) in several carcinomas is significantly associated with angiogenesis, lymphangiogenesis and regional lymph node metastasis. However, VEGF‐C expression in bladder transitional cell carcinoma (TCC) has not yet been reported. To elucidate the role of VEGF‐C in bladder TCC, we examined VEGF‐C expression in bladder TCC and pelvic lymph node metastasis specimens obtained from patients who underwent radical cystectomy.

Methods: Eighty‐seven patients who underwent radical cystectomy for clinically organ‐confined TCC of the bladder were enrolled in the present study. No neoadjuvant treatments, except transurethral resection of the tumor, were given to these patients. The VEGF‐C expressions of 87 bladder tumors and 20 pelvic lymph node metastasis specimens were examined immunohistochemically and the association between VEGF‐C expression and clinicopathological factors, including angiogenesis as evaluated by microvessel density (MVD), was also examined.

Results: Vascular endothelial growth factor‐C expression was found in the cytoplasm of tumor cells, but not in the normal transitional epithelium. Vascular endothelial growth factor‐C expression was significantly associated with the pathological T stage (P = 0.0289), pelvic lymph node metastasis (P < 0.0001), lymphatic involvement (P = 0.0008), venous involvement (P = 0.0002) and high MVD (P = 0.0043). The multivariate analysis demonstrated that VEGF‐C expression and high MVD in bladder TCC were independent risk factors influencing the pelvic lymph node metastasis. Moreover, the patients with VEGF‐C‐positive tumors had significantly poorer prognoses than those with the VEGF‐C‐negative tumors (P = 0.0087) in the univariate analysis. The multivariate analysis based on Cox proportional hazard model showed that the independent prognostic factors were patient age (P = 0.0132) and pelvic lymph node metastasis (P = 0.0333).

Conclusion: The present study suggests that VEGF‐C expression is an important predictive factor of pelvic lymph node metastasis in bladder cancer patients.
Novel technique for correcting penile curvature with severe hypospadias; Ventral lengthening with tunica vaginalis flap patching
Authors: HAYASHI YUTARO , KOJIMA YOSHIYUKI , MIZUNO KENTARO , NAKANE AKIHIRO , KUROKAWA SATOSHI , KOHRI KENJIRO
Published: February 2005

Abstract  The adequate correction of penile curvature is essential for successful hypospadias surgery. We describe a novel technique to correct severe penile curvature with a tunica vaginalis flap on the penile ventrum. We applied a tunica vaginalis flap to lengthen the ventral aspect of the tunica albuginea in two boys with significant curvature and proximal hypospadias. Tunica vaginalis flap patching to the ventral aspect of the penis is safe and technically feasible. If penile curvature is severe or the penis is small in hypospadiac patients, lengthening the ventral aspect using a tunica vaginalis flap is likely to expand instead of dorsal plication or ventral graft.
Congenital prepubic sinus: A variant of dorsal urethral duplication (Stephens type 3)
Authors: USAMI MASAYUKI , HAYASHI YUTARO , KOJIMA YOSHIYUKI , MARUYAMA TETSUJI , TOZAWA KEIICHI , KOHRI KENJIRO
Published: February 2005

Abstract  A 3‐year‐old boy was admitted for yellowish discharge from a tiny opening in the midline prepubic area on the dorsal base of the penis. No other symptom related to the genitourinary tract was noted. Sinuousgraphy showed a non‐communicating sinus tract with the urinary tract. At surgical exploration, through a diamond‐shaped incision, a 4.5 cm‐long sinus was found that ended blindly as a fibrous cord at the anterior surface of the pubic symphisis. Histologically, it was lined by stratified squamous epithelium and surrounded by bundles of smooth muscle and collagen. According to Stephens’ classification, the sinus appears to be a variant of dorsal urethral duplication of Stephens type 3.
Coupling of 5‐HT1A autoreceptors to inhibition of mitogen‐activated protein kinase activation via Gβγ subunit signaling
Authors: Kushwaha Neena , Albert Paul R.
Published: February 2005

The 5‐HT1A receptor is expressed presynaptically as the primary somatodendritic autoreceptor on serotonergic raphe neurons, and postsynaptically in several brain regions. Signaling of the 5‐HT1A autoreceptor was studied in RN46A cells, a model of serotonergic raphe neurons that express endogenous 5‐HT1A receptors. In undifferentiated RN46A cells stably transfected with the wild‐type 5‐HT1A receptor, 5‐HT1A receptor activation inhibited forskolin‐induced cyclic adenosine monophosphate (cAMP) formation (by 50%), increased [Ca2+]i, and induced a novel inhibition (up to 60%) of phospho‐p42/p44‐mitogen‐activated protein kinase (MAPK). Upon differentiation of non‐transfected or 5‐HT1A‐transfected RN46A cells, agonist‐mediated inhibition of MAPK was enhanced. These actions were blocked by pretreatment with pertussis toxin indicating mediation via Gi/Go proteins and the calcium response was blocked by preactivation of protein kinase C (PKC). In cells overexpressing the Gβγ scavenger carboxyl‐terminal domain of G protein receptor kinase 2 (GRK‐CT), 5‐HT1A receptor activation inhibited cAMP formation, but coupling to calcium mobilization and inhibition of MAPK was abolished. The activity of 5‐HT1A receptors containing mutations of PKC sites in the second (i2: T149A) or third intracellular loop (i3: T229A/S253G/T343A) was tested. At comparable levels of receptor expression, the signaling of the 5‐HT1A i3 mutant was similar to the 5‐HT1A wild‐type receptor, while the i2 and quadruple (i2/i3) mutants failed to couple to Gβγ‐mediated increase in [Ca2+]i or inhibition of MAPK, but did couple to Gαi‐mediated inhibition of cAMP. Thus, the i2‐domain of the 5‐HT1A autoreceptor is crucial for coupling to Gβγ subunits and their subsequent responses (e.g. calcium mobilization and inhibition of MAPK activity).
LOCAL LINEAR FORECASTS USING CUBIC SMOOTHING SPLINES
Authors: Hyndman Rob J. , King Maxwell L. , Pitrun Ivet , Billah Baki
Published: February 2005

This paper shows how cubic smoothing splines fitted to univariate time series data can be used to obtain local linear forecasts. The approach is based on a stochastic state‐space model which allows the use of likelihoods for estimating the smoothing parameter, and which enables easy construction of prediction intervals. The paper shows that the model is a special case of an ARIMA(0, 2, 2) model; it provides a simple upper bound for the smoothing parameter to ensure an invertible model; and it demonstrates that the spline model is not a special case of Holt's local linear trend method. The paper compares the spline forecasts with Holt's forecasts and those obtained from the full ARIMA(0, 2, 2) model, showing that the restricted parameter space does not impair forecast performance. The advantage of this approach over a full ARIMA(0, 2, 2) model is that it gives a smooth trend estimate as well as a linear forecast function.
LAST ORDERS: CHOOSING POTTERY FOR FUNERALS IN ROMAN ESSEX
Authors: BIDDULPH EDWARD
Published: February 2005

Summary. This paper examines ceramic vessels from Roman‐period funerary contexts in Essex. Using correspondence analysis, it charts changes in the choice of funerary pottery and isolates the elements in pottery assemblages that unite or differentiate sites. The paper finds that the status of sites can be distinguished on ceramic grounds, reflecting cultural differences in life. Jars and beakers are characteristic of settlement cemeteries, while cups are more typical of high‐status burials. Flagons and samian ware are common between them. Underlying funerary traditions are rooted in continuity from the Late Iron Age, rather than post‐conquest change. The study also suggests that funerary pottery was selected out of the supply intended for domestic use.
The salmon vertebral body develops through mineralization of two preformed tissues that are encompassed by two layers of bone
Authors: Nordvik Kari , Kryvi Harald , Totland Geir K. , Grotmol Sindre
Published: February 2005

The teleost backbone consists of amphicoelous vertebrae and intervertebral ligaments, both of which include notochord‐derived structures. On the basis of a sequential developmental study of the vertebral column of Atlantic salmon (Salmo salar L.) from the egg stage up to early fry stage (300–2500 day‐degrees) we show that the vertebral body consists of four layers or compartments, two of which are formed through mineralization of preformed collagenous tissue (the notochordal sheath and the intervertebral ligament) and two of which are formed through ossification. The three inner layers have ordered lamellar collagen matrixes, which alternate perpendicularly from layer to layer, whereas the outer layer consists of cancellous bone with a woven matrix. The bone layers also differ in osteocyte content. In this study we describe the structural details of the layers, and their modes of formation. The results are compared with previous descriptions, and possible phylogenetic implications are discussed.
Sexually dimorphic proportions of the harbour porpoise (Phocoena phocoena) skeleton
Authors: Galatius Anders
Published: February 2005

Sexual differences in growth, allometric growth patterns and skeletal proportions were investigated by linear measurements of skeletal parts on 225 harbour porpoises (Phocoena phocoena) from the inner Danish and adjacent waters. Females show larger asymptotic sizes and extended period of growth compared with males. Measurements of the skull and flipper bones show negative allometry, whereas those of the bones of the body generally show positive allometry. There are no statistically significant intersexual differences in allometry except for the pelvic bones, where the males show stronger positive allometry. Throughout the range of individual sizes, females have significantly larger skulls and shorter vertebral columns than males for similarly sized individuals. In fully grown specimens, the condylobasal length of females makes up a smaller proportion of total length, and the vertebrae make up a larger proportion as compared with males. As these characters show negative and positive allometry, respectively, it is suggested that males finish their development at an earlier stage than females, retaining more paedomorphic proportions of the skeleton. Paedomorphosis in fully grown males relative to females is also found in the vertebral epiphyses that mature later in males than females, although the males finish growth at a younger age.
Suprapubic catheterisation: A retrospective comparison of two insertion systems
Authors: LINGARD Corinne , FOOTE Andrew J.
Published: February 2005

This study compares two suprapubic catheter insertion systems available for postoperative bladder drainage. We performed retrospective analysis of patients who underwent laparoscopic colposuspension and postoperative suprapubic catheterisation with either the Bonanno (Becton, Franklin Lakes, NJ, USA) or the Lawrence Add‐a‐Cath (Femcare, Nottingham, UK) mini‐Foley catheters (Bard, Covington, GA, USA). There were no statistically significant postoperative outcome differences between the two catheter groups. We prefer the Add‐a‐Cath mini‐Foley suprapubic catheter for its ease of insertion and fixation.
Homocysteine and Cognitive Function in a Population‐Based Study of Older Adults
Authors: Schafer Jyme H. , Glass Thomas A. , Bolla Karen I. , Mintz Margaret , Jedlicka Anne E. , Schwartz Brian S.
Published: February 2005

Objectives: To assess the relations between homocysteine levels and neurobehavioral test scores representing a broad range of cognitive domains in a population‐based study of older adults.

Design: Cross‐sectional analysis of first‐visit data of subjects in the Baltimore Memory Study, a longitudinal study.

Setting: Specific neighborhoods in Baltimore.

Participants: Participants were 1,140 randomly selected residents aged 50 to 70 with a mean age±standard deviation of 59.3±5.9; 65.9% were female, and 54.2% were white and 41.1% African‐American.

Measurements: Twenty neurobehavioral test scores in eight cognitive domains.

Results: Linear regression models revealed that homocysteine was consistently and strongly associated with worse neurobehavioral test performance, in crude analysis and after control for a large set of important covariates. Associations were observed in all eight cognitive domains assessed but were strongest and most consistent in the domains of simple motor and psychomotor speed, eye‐hand coordination/manual dexterity, and verbal memory and learning. On average, an increase in homocysteine levels from the 25th to the 75th percentile, all in the generally accepted normal range, was equivalent in its association with neurobehavioral test scores to an increase of 4.2 years of age. Logistic regression models revealed that, on average, for the neurobehavioral tests associated with homocysteine, subjects in the highest quartile of homocysteine levels were more than two times as likely to be in the lowest quartile of neurobehavioral test scores as those in the lowest quartile.

Conclusion: Higher homocysteine levels were associated with worse function across a broad range of cognitive domains, and the magnitude of the associations was large. The data suggest that homocysteine may be a potentially important modifiable cause of cognitive dysfunction.
National Estimates of Medication Use in Nursing Homes: Findings from the 1997 Medicare Current Beneficiary Survey and the 1996 Medical Expenditure Survey
Authors: Doshi Jalpa A. , Shaffer Thomas , Briesacher Becky A.
Published: February 2005

Objectives: To provide the first nationwide estimates of medication use in nursing homes (NHs) and to introduce a new data set for examining drug use in long‐term care facilities.

Design: Cross‐sectional comparison.

Setting: NH medication files from two nationally representative data sets, the 1997 Medicare Current Beneficiary Survey (MCBS) and the 1996 Medical Expenditure Panel Survey—Nursing Home Component (MEPS‐NHC).

Participants: NH residents in the MCBS (n=929, weighted n=2.0 million) and MEPS‐NHC (n=5,899, weighted n=3.1 million).

Measurements: Estimates include characteristics of facilities and residents, average number of drugs used per person per month, and the prevalence and duration of use by select therapeutic drug classes.

Results: NH residents received, on average, seven to eight medications each month (7.6 MCBS, 7.2 MEPS‐NHC). About one‐third of residents had monthly drug regimens of nine or more medications (31.8% MCBS, 32.4% MEPS‐NHC). The most commonly used medications in NHs, in descending order, were analgesics and antipyretics, gastrointestinal agents, electrolytic and caloric preparations, central nervous system agents, anti‐infective agents, and cardiovascular agents.

Conclusion: These estimates serve as examples of the first national benchmarks of prescribing patterns in NHs. This study highlights the usefulness of the MCBS as an important new resource for examining medication use in NHs.
Relationship Between Subjective Social Status and Measures of Health in Older Taiwanese Persons
Authors: Hu Peifeng , Adler Nancy E. , Goldman Noreen , Weinstein Maxine , Seeman Teresa E.
Published: February 2005

Objectives: To compare the association between subjective ladder ranking and health measures with the association between objective indices and health measures in older Taiwanese men and women.

Design: Cross‐sectional study.

Setting: A population‐representative sample of elderly and nearly elderly men and women in Taiwan.

Participants: The study included 991 participants from the Social Environment and Biomarkers of Aging Study in Taiwan.

Measurements: The information collected included demographic characteristics; subjective ladder score of SES; objective measures of SES, including education, income, and occupation; health behaviors; health‐related variables such as self‐rated health, basic activity of daily living difficulties, instrumental activity of daily living (IADL) difficulties, and physical activity difficulties; and depression score.

Results: Low ladder score was associated with poorer self‐rated health and more reported IADL and physical activity difficulties, even after adjustment for objective measures of SES and other covariates. The multiply adjusted odds ratio for a one‐quartile difference in ladder score and worse self‐rated health was 1.19 (95% confidence interval=1.06–1.33). The associations between subjective ladder ranking and health status were generally stronger in those who had 6 years or less of education than in those who received more education.

Conclusion: A simple subjective assessment of one's ranking on the social hierarchy was associated with self‐rated health and physical functional status in an older ethnic Chinese population. The associations were independent of the effects of traditional objective measures of SES, such as education, income, and occupation.
Detection of Delirium in the Intensive Care Unit: Comparison of Confusion Assessment Method for the Intensive Care Unit with Confusion Assessment Method Ratings
Authors: McNicoll Lynn , Pisani Margaret A. , Ely E. Wesley , Gifford David , Inouye Sharon K.
Published: February 2005

Objectives: To compare the Confusion Assessment Method (CAM) and CAM for the Intensive Care Unit (CAM‐ICU) methods for detecting delirium in alert, nonintubated older ICU patients.

Design: Comparison study.

Setting: Fourteen‐bed medical ICU of an 800‐bed university teaching hospital.

Participants: Twenty‐two patients aged 65 and older admitted to the ICU.

Measurements: Two blinded, trained clinician‐researchers who had undergone interrater reliability testing interviewed patients separately, usually within 10 minutes of each other (up to 120 minutes). Each researcher examined patients for the four key CAM criteria: acuteness, inattention, disorganized thinking, and altered level of consciousness. One researcher used the CAM method with the Mini‐Mental State Examination and Digit Span; the other researcher used the CAM‐ICU method with nonverbal cognitive and attention tasks.

Results: Rates of delirium were 68% according to CAM and 50% according CAM‐ICU. Comparing the two methods, agreement was 82%, with a kappa of 0.64. Using the CAM as the reference standard, the CAM‐ICU had a sensitivity of 73% (95% confidence interval (CI)=60–86) and specificity of 100% (95% CI=56–100). There were four false‐negative ratings using the CAM‐ICU. Reasons for disparate results were that the CAM used more‐detailed cognitive testing that detected more deficits (3 patients) and the time elapsed (90 minutes) between ratings in one patient with markedly fluctuating symptoms.

Conclusion: CAM and CAM‐ICU agreement was moderately high. Although the CAM‐ICU is recommended for ICU patients because of its brevity and ease of use, the standard CAM method may detect more subtle cases of delirium in nonintubated, verbal ICU patients.
Care‐Needs Certification in the Long‐Term Care Insurance System of Japan
Authors: Tsutsui Takako , Muramatsu Naoko
Published: February 2005

The introduction of Japan's long‐term care insurance (LTCI) system in April 2000 has made long‐term care an explicit and universal entitlement for every Japanese person aged 65 and older based strictly on physical and mental status. At the start of the program, more than two million seniors were expected to apply for services to approximately 3,000 municipal governments, which are the LTCI insurers. The LTCI implementation required a nationally standardized needs‐certification system to determine service eligibility objectively, fairly, and efficiently. The current computer‐aided initial needs‐assessment instrument was developed based on data collected in a large‐scale time study of professional caregivers in long‐term care institutions. The instrument was subsequently tested and validated by assessing data of 175,129 seniors involved in the national model programs before the start of LTCI. The computer‐aided initial assessment (an 85‐item questionnaire) is used to assign each applicant to one of seven need levels. The Care Needs Certification Board, a committee of medical and other professionals, reviews the results. Three years after implementation, the LTCI system and its needs‐assessment/certification system have been well accepted in Japan. Despite the overall successes, there remain challenges, including area variations, growing demands for services, and the difficulty of keeping the needs certification free of politics. The LTCI computer network that links municipalities and the central government is instrumental in continuously improving the needs‐certification system. Future challenges include promoting evidence‐based system improvements and building incentives into the system for various constituencies to promote seniors' functional independence.
Statistics on Trial
Authors: Dawid Philip
Published: February 2005

Although the concerns of Statistics and the Law might seem to have little to do with one other, they do share some fundamental common interests, such as interpretation of evidence, hypothesis testing and decision-making under uncertainty. Philip Dawid takes up questions that, though long of interest to a few scholars, have only recently become the focus of much attention.
Drug Contamination of Banknotes
Authors: Laycock Patrick
Published: February 2005

When the police or Customs and Excise seize currency they are nowadays likely to have the confiscated banknotes tested for the presence of cocaine, heroin, ecstasy and cannabis. It is an interesting statistic that there is a 99% chance that “the money in your pocket” will be contaminated with detectable amounts of cocaine. Contamination by the other drugs is apparently not so prevalent, but it is clear that banknotes in general circulation are not completely free from such contamination, albeit at a lower level. Just how low, Patrick Laycock explains, has become a source of dispute.
Career Story: Consultant Forensic Statistician
Authors: Evett Ian
Published: February 2005

Ian Evett works for the Forensic Science Service as a consultant statistician. He tells Helen Joyce about the contribution a statistician can make to analysing handwriting, glass, DNA and other forensic materials, as well as to understanding the fundamentals of evidence interpretation.
Public or Private Health Care?
Authors: Spiegelhalter David
Published: February 2005

In the early 1840s the Statistical Society of London was active in monitoring and comparing mortality rates in private licensed “mad-houses” and large public asylums. David Spiegelhalter looks at the investigations of William Farr.
DETERMINING CONSUMER VALUATION OF DIFFERENTIATED BEEF STEAK QUALITY ATTRIBUTES
Authors: FELDKAMP T.J. , SCHROEDER T.C. , LUSK J.L.
Published: February 2005

Consumer sensory analysis provides consistent and accurate consumer preference rankings for experimental meat products. However, consumer valuation of product attributes has often been overlooked. Valuations provide a monetary standard for comparison among meat products and product attributes as well as across different studies, a weakness of consumer sensory rating scales. This paper discusses the use of consumer valuation in a consumer sensory panel setting focusing on an incentive compatible method where consumers have an incentive to truthfully reveal their values for a product.
SENSORY PERCEPTION OF CURED‐SMOKED PORK LOIN FROM CARRIERS AND NONCARRIERS OF THE RN– ALLELE AND ITS RELATIONSHIP WITH TECHNOLOGICAL MEAT QUALITY
Authors: HULLBERG ANJA , JOHANSSON LISBETH , LUNDSTRÖM KERSTIN
Published: February 2005

The effects of RN genotype on the sensory perception of cured‐smoked loins were investigated in 30 female pigs crossbred with Hampshire. RN– carriers (RN–/rn+) were more tender, juicy and acidic than noncarriers (rn+/rn+). They were also more patty‐like and less salty. Further, they were more homogeneous in cured pink color and tended to have more pores than noncarriers. Despite the superior eating quality, in terms of higher tenderness and juiciness, most consumers preferred cured‐smoked loins from noncarriers. Multivariate statistical analyses showed that sensory tenderness, juiciness, acidity, number of pores and homogeneity of cured pink color were inversely related to instrumental tenderness measurements, but not well related to ultimate pH and water‐holding capacity. Instrumental tenderness measurements explained 44% of the variation in sensory tenderness, and RN genotype 41% of the variation in sensory juiciness. RN genotype best explained the variations in sensory attributes, followed by hardness.
IDENTIFICATION OF MEATS USING RANDOM AMPLIFIED POLYMORPHIC DNA (RAPD) TECHNIQUE
Authors: ARSLAN ALI , ILHAK IRFAN , CALICIOGLU MEHMET , KARAHAN MURAT
Published: February 2005

Use of a simpler, faster and reliable method for identification of species of origin in fresh and processed meat products is required to prevent unethical practices that may occur in the meat industry. The effectiveness of a random amplified polymorphic DNA (RAPD) method for identification of fresh meats from cattle, goat, sheep, camel, pork, wild swine, donkey, cat, dog, rabbit or bear origin was evaluated using a 10‐base primer (ACGACCCACG). The method was also used to determine the species in a 1 : 1 mix of raw minced meat from sheep‐pork, horse‐beef or beef‐sheep. Characteristic RAPD profiles for each species were obtained. However, efficacy of the technique in identifying species in meat mixtures varied depending on the species in the mix. These results indicate that RAPD may be useful for identification of meat samples from single species, such as intact meat samples, whereas caution should be exercised in identification of origin of species in minced meat that may consist of multiple species.
New Perspectives on Ancient Mars
Authors: Solomon Sean C. , Aharonson Oded , Aurnou Jonathan M. , Banerdt W. Bruce , Carr Michael H. , Dombard Andrew J. , Frey Herbert V. , Golombek Matthew P. , Hauck Steven A. , Head James W. , Jakosky Bruce M. , Johnson Catherine L. , McGovern Patrick J. , Neumann Gregory A. , Phillips Roger J. , Smith David E. , Zuber Maria T.
Published: February 2005

Mars was most active during its first billion years. The core, mantle, and crust formed within â¼50 million years of solar system formation. A magnetic dynamo in a convecting fluid core magnetized the crust, and the global field shielded a more massive early atmosphere against solar wind stripping. The Tharsis province became a focus for volcanism, deformation, and outgassing of water and carbon dioxide in quantities possibly sufficient to induce episodes of climate warming. Surficial and near-surface water contributed to regionally extensive erosion, sediment transport, and chemical alteration. Deep hydrothermal circulation accelerated crustal cooling, preserved variations in crustal thickness, and modified patterns of crustal magnetization.
Oxygen Ions Observed Near Saturn's A Ring
Authors: Waite J. H. , Cravens T. E. , Ip W.-H. , Kasprzak W. T. , Luhmann J. G. , McNutt R. L. , Niemann H. B. , Yelle R. V. , Mueller-Wodarg I. , Ledvina S. A. , Scherer S.
Published: February 2005

Ions were detected in the vicinity of Saturn's A ring by the Ion and Neutral Mass Spectrometer (INMS) instrument onboard the Cassini Orbiter during the spacecraft's passage over the rings. The INMS saw signatures of molecular and atomic oxygen ions and of protons, thus demonstrating the existence of an ionosphere associated with the A ring. A likely explanation for these ions is photoionization by solar ultraviolet radiation of neutral O
2
molecules associated with a tenuous ring atmosphere. INMS neutral measurements made during the ring encounter are dominated by a background signal.
NMR Structure of Mistic, a Membrane-Integrating Protein for Membrane Protein Expression
Authors: Roosild Tarmo P. , Greenwald Jason , Vega Mark , Castronovo Samantha , Riek Roland , Choe Senyon
Published: February 2005

Although structure determination of soluble proteins has become routine, our understanding of membrane proteins has been limited by experimental bottlenecks in obtaining both sufficient yields of protein and ordered crystals. Mistic is an unusual
Bacillus subtilis
integral membrane protein that folds autonomously into the membrane, bypassing the cellular translocon machinery. Using paramagnetic probes, we determined by nuclear magnetic resonance (NMR) spectroscopy that the protein forms a helical bundle with a surprisingly polar lipid-facing surface. Additional experiments suggest that Mistic can be used for high-level production of other membrane proteins in their native conformations, including many eukaryotic proteins that have previously been intractable to bacterial expression.
Simultaneous State Measurement of Coupled Josephson Phase Qubits
Authors: McDermott R. , Simmonds R. W. , Steffen Matthias , Cooper K. B. , Cicak K. , Osborn K. D. , Oh Seongshik , Pappas D. P. , Martinis John M.
Published: February 2005

One of the many challenges of building a scalable quantum computer is single-shot measurement of all the quantum bits (qubits). We have used simultaneous single-shot measurement of coupled Josephson phase qubits to directly probe interaction of the qubits in the time domain. The concept of measurement crosstalk is introduced, and we show that its effects are minimized by careful adjustment of the timing of the measurements. We observe the antiphase oscillation of the two-qubit |01〉 and |10〉 states, consistent with quantum mechanical entanglement of these states, thereby opening the possibility for full characterization of multiqubit gates and elementary quantum algorithms.
Cassini Imaging Science: Initial Results on Saturn's Rings and Small Satellites
Authors: Porco C. C. , Baker E. , Barbara J. , Beurle K. , Brahic A. , Burns J. A. , Charnoz S. , Cooper N. , Dawson D. D. , Del Genio A. D. , Denk T. , Dones L. , Dyudina U. , Evans M. W. , Giese B. , Grazier K. , Helfenstein P. , Ingersoll A. P. , Jacobson R. A. , Johnson T. V. , McEwen A. , Murray C. D. , Neukum G. , Owen W. M. , Perry J. , Roatsch T. , Spitale J. , Squyres S. , Thomas P. , Tiscareno M. , Turtle E. , Vasavada A. R. , Veverka J. , Wagner R. , West R.
Published: February 2005

Images acquired of Saturn's rings and small moons by the Cassini Imaging Science Subsystem (ISS) during the first 9 months of Cassini operations at Saturn have produced many new findings. These include new saturnian moons; refined orbits of new and previously known moons; narrow diffuse rings in the F-ring region and embedded in gaps within the main rings; exceptionally fine-scale ring structure in moderateâ to highâoptical depth regions; new estimates for the masses of ring-region moons, as well as ring particle properties in the Cassini division, derived from the analysis of linear density waves; ring particle albedos in select ring regions; and never-before-seen phenomena within the rings.
Relationship between Surface Accessibility for PpmA, PsaA, and PspA and Antibody-Mediated Immunity to Systemic Infection by
Streptococcus pneumoniae
Authors: Gor Dennis O. , Ding Xuedong , Briles David E. , Jacobs Michael R. , Greenspan Neil S.
Published: February 2005

Antibodies to capsular polysaccharide (PS) are protective against systemic infection by
Streptococcus pneumoniae
, but the large number of pneumococcal serogroups and the age-related immunogenicity of pure PS limit the utility of PS-based vaccines. In contrast, cell wall-associated proteins from different capsular serotypes can be cross-reactive and immunogenic in all age groups. Therefore, we evaluated three pneumococcal proteins with respect to relative accessibility to antibody, in the context of intact pneumococci, and their ability to elicit protection against systemic infection by encapsulated
S. pneumoniae
. Sequences encoding pneumococcal surface adhesin A (PsaA), putative protease maturation protein A (PpmA), and the N-terminal region of pneumococcal surface protein A (PspA) from
S. pneumoniae
strain A66.1 were cloned and expressed in
Escherichia coli.
The presence of genes encoding PsaA, PpmA, and PspA in 11 clinical isolates was examined by PCR, and the expression of these proteins by each strain was examined by Western blotting with antisera raised to the respective recombinant proteins. We used flow cytometry to demonstrate that PspA was readily detectable on the surface of the pneumococcal strains analyzed, whereas PsaA and PpmA were not. Consistent with these observations, mice with passively or actively acquired antibodies to PspA or type 3 PS were equivalently protected from homologous systemic challenge with type 3 pneumococci, whereas mice with passively or actively acquired antibodies to PsaA or PpmA were not effectively protected. These experiments support the hypothesis that the extent of protection against systemic pneumococcal infection is influenced by target antigen accessibility to circulating host antibodies.
Altered Gingipain Maturation in
vimA-
and
vimE
-Defective Isogenic Mutants of
Porphyromonas gingivalis
Authors: Vanterpool Elaine , Roy Francis , Sandberg Lawrence , Fletcher Hansel M.
Published: February 2005

We have previously shown that gingipain activity in
Porphyromonas gingivalis
is modulated by the unique
vimA
and
vimE
genes. To determine if these genes had a similar phenotypic effect on protease maturation and activation, isogenic mutants defective in those genes were further characterized. Western blot analyses with antigingipain antibodies showed RgpA-, RgpB-, and Kgp-immunoreactive bands in membrane fractions as well as the culture supernatant of both
P. gingivalis
W83 and FLL93, the
vimE-
defective mutant. In contrast, the membrane of
P. gingivalis
FLL92, the
vimA
-defective mutant, demonstrated immunoreactivity only with RgpB antibodies. With mass spectrometry or Western blots, full-length RgpA and RgpB were identified from extracellular fractions. In similar extracellular fractions from
P. gingivalis
FLL92 and FLL93, purified RgpB activated only arginine-specific activity. In addition, the lipopolysaccharide profiles of the
vimA
and
vimE
mutants were truncated in comparison to that of W83. While glycosylated proteins were detected in the membrane and extracellular fractions from the
vimA-
and
vimE
-defective mutants, a monoclonal antibody (1B5) that reacts with specific sugar moieties of the
P. gingivalis
cell surface polysaccharide and membrane-associated Rgp gingipain showed no immunoreactivity with these fractions. Taken together, these results indicate a possible defect in sugar biogenesis in both the
vimA
- and
vimE
-defective mutants. These modulating genes play a role in the secretion, processing, and/or anchorage of gingipains on the cell surface.
Recombinant Guinea Pig Tumor Necrosis Factor Alpha Stimulates the Expression of Interleukin-12 and the Inhibition ofMycobacterium tuberculosisGrowth in Macrophages
Authors: Cho Hyosun , Lasco Todd M. , Allen Shannon Sedberry , Yoshimura Teizo , McMurray David N.
Published: February 2005

Tumor necrosis factor alpha (TNF-α) plays an important role in the host immune response to infection with the intracellular pathogenMycobacterium tuberculosis. It is essential for the formation of protective tuberculous granulomas and regulates the expression of other cytokines which contribute to a protective immune response. Interleukin-12 (IL-12) is known to promote a Th1 response, which is essential for antimycobacterial resistance. Recombinant guinea pig TNF-α (rgpTNF-α) protein (17 kDa) was purified, and its bioactivity was confirmed by its cytotoxicity for L929 fibroblasts. High titers of polyclonal anti-gpTNF-α antibody were obtained by immunization of rabbits. Resident alveolar and peritoneal macrophages were isolated from guinea pigs and infected with either the H37Ra or H37Rv strain ofM. tuberculosis. The mRNA levels for TNF-α and IL-12 p40 were measured using real-time PCR. IL-12 p40 mRNA was up-regulated in a dose-dependent manner by rgpTNF-α alone. In infected macrophages, a lower dose of rgpTNF-α intensified the mRNA levels of TNF-α and IL-12 p40. However, higher doses of rgpTNF-α suppressed TNF-α and IL-12 p40 mRNA. The antimycobacterial activity of macrophages was assessed by metabolic labeling ofM. tuberculosiswith [3H]uracil. Resident alveolar and peritoneal macrophages treated with anti-gpTNF-α antibody to block endogenous TNF-α exhibited increased intracellular mycobacterial growth. These data suggest that the dose of TNF-α is crucial to the stimulation of optimal expression of protective cytokines and that TNF-α contributes to the control of mycobacterial replication to promote host resistance againstM. tuberculosis.
Role of the Pst System in Plaque Formation by the Intracellular Pathogen
Shigella flexneri
Authors: Runyen-Janecky L. J. , Boyle A. M. , Kizzee A. , Liefer L. , Payne S. M.
Published: February 2005

In response to the host cell environment, the intracellular pathogen
Shigella flexneri
induces the expression of numerous genes, including those in the
pst
operon which is predicted to encode a high-affinity phosphate acquisition system that is expressed under reduced phosphate conditions. An
S. flexneri pst
mutant forms smaller plaques in Henle cell monolayers than does the parental strain. This mutant exhibited normal production and localization of the
S. flexneri
IcsA protein. The
pst
mutant had the same growth rate as the parental strain in both phosphate-reduced and phosphate-replete media in vitro and during the first 3 h of growth in Henle cells in vivo. During growth in phosphate-replete media, the PhoB regulon was constitutively expressed in the
pst
mutant but not the parental strain. This suggested that the inability of the
S. flexneri pst
mutant to form wild-type plaques in Henle cell monolayers may be due to aberrant expression of the PhoB regulon. A mutation in
phoB
was constructed in the
S. flexneri pst
mutant, and the
phoB
mutation suppressed the small plaque phenotype of the
pst
mutant. Additionally, a specific mutation (R220Q) was constructed in the
pstA
gene of the
pst
operon that was predicted to eliminate Pst-mediated phosphate transport but allow normal PhoB-regulated gene expression, based on the phenotype of an
Escherichia coli
strain harboring the same mutation. Addition of this
pstA
R220Q
mutation to a
S. flexneri pst
mutant, as part of the
pst
operon, restored normal plaque formation and regulation of
phoA
expression.