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Biomedical subjects

B Randall

Publications and source records attributed to B Randall.

At least 19 recordsLinked to original sources

Grammatical categories in the brain: the role of morphological structure.

The current study addresses the controversial issue of how different grammatical categories are neurally processed. Several lesion-deficit studies suggest that distinct neural substrates underlie the representation of nouns and verbs, with verb deficits associated with damage to left inferior frontal gyrus (LIFG) and noun deficits with damage to left temporal cortex. However, this view is not universally shared by neuropsychological and neuroimaging studies. We have suggested that these inconsistencies may reflect interactions between the morphological structure of nouns and verbs and the processing implications of this, rather than differences in their neural representations (Tyler et al. 2004). We tested this hypothesis using event-related functional magnetic resonance imaging, to scan subjects performing a valence judgment on unambiguous nouns and verbs, presented as stems ('snail, hear') and inflected forms ('snails, hears'). We predicted that activations for noun and verb stems would not differ, whereas inflected verbs would generate more activation in left frontotemporal areas than inflected nouns. Our findings supported this hypothesis, with greater activation of this network for inflected verbs compared with inflected nouns. These results support the claim that form class is not a first-order organizing principle underlying the representation of words but rather interacts with the processes that operate over lexical representations.

Adult↗

Getting to the meaning of the regular past tense: evidence from neuropsychology.

Neuropsychological impairments of English past tense processing inform a key debate in cognitive neuroscience concerning the nature of mental mechanisms. Dual-route accounts claim that regular past tense comprehension deficits reflect a specific impairment of morphological decomposition (e.g., jump + ed), disrupting the automatic comprehension of word meaning accessed via the verb stem (e.g., jump). Single-mechanism accounts claim that the deficits reflect a general phonological impairment that affects perception of regular past tense offsets but which might preserve normal activation of verb semantics. We tested four patients with regular past tense deficits and matched controls, using a paired auditory semantic priming/lexical decision task with three conditions: uninflected verbs (hope/wish), regular past tense primes (blamed/accuse), and irregular past tense primes (shook/tremble). Both groups showed significant priming for verbs with simple morphophonology (uninflected verbs and irregular past tenses) but the patients showed no priming for verbs with complex morphophonology (regular past tenses) in contrast to controls. The findings suggest that the patients are delayed in activating the meaning of verbs if a regular past tense affix is appended, consistent with a dual-route account of their deficit.

Adult↗

Survey of forensic pathologists.

A survey of board-certified forensic pathologists (from a list of board-certified forensic pathologists supplied by the American Board of Pathology) was conducted to determine their current practice situations. The purpose of the survey was to provide information useful to the public in general and to those organizations that represent forensic pathologists in particular to better understand and meet the needs of the forensic pathology community. A total of 773 surveys were mailed, and 18 were returned as undeliverable. There were 337 replies (45%). Responses were as follows: In terms of age, 7% were in their 30s; 32% were in their 40s; 29% were in their 50s; 19% were in their 60s; and 13% were 70 years of age or older. In terms of gender, 79% were male and 21% were female. For pathology practice status, 72% worked more than 30 hours per week; 11% between 5 and 30 hours per week; 5% less than 5 hours per week; and 12% no longer practice pathology. For percentage of pathology practice that is forensic pathology, 69% of respondents were more than 80%; 6% were 50%-80%; 5% were 25%-50%; 8% were 5%-25%; and 12% were less than 5%. In terms of forensic pathology practice setting, 54% were employed by medical examiner or coroner systems; 13% worked under contract to medical examiner or coroner systems; 27% worked in private practice or consultation; and 6% responded as "other."

Adult↗

The 2000 Annual Report of the Regional Infant and Child Mortality Review Committee.

The 2000 Annual Report of the Regional Infant and Child Mortality Review Committee (RICMRC) is presented. Our Regional (Minneahaha, Lincoln, Turner, and McCook Counties) incidence for Sudden Infant Death (SIDS) was much lower in 2000 than seen previously in 1999 and 1998. It remains to be seen if this is a true reduction in the incidence of SIDS in our Region or simply a random fluctuation in the SIDS rate amplified by the relatively small number of Regional infant deaths. We are hopeful that the emphasis on the Back-to-Sleep program has been in part contributory towards the reduction in the number of SIDS. Accidental infant deaths in our report however emphasizes that Back-to-Sleep implies not only supine sleeping but also sleeping in a safe sleeping environment, including the avoidance of soft bedding. RICMRC serves not only as a data collection committee, but also actively engages in community education programs directed towards providing a safer environment for our children.

Accident Prevention↗

Increasing vegetable and fruit intake: randomized intervention and monitoring in an at-risk population.

High vegetable and fruit (V&F) consumption has been associated with a lower risk of several cancers. However, little is known about the ability of individuals to increase their intakes markedly. In this 1-year randomized, controlled diet intervention study of men and women with a recent history of adenomas, the intervention group (n = 100) was asked to increase V&F intake to at least eight servings per day; the control group (n = 101) continued eating their usual diet. End-point measures included V&F intake assessed by 3-day diet records, plasma carotenoids, serum lipids, urinary sodium and potassium, and body weight. The intervention group increased their daily V&F intake an average of 5.5 servings over 1 year; the control group had an average decrease of 0.5 servings per day (P < 0.001). Plasma total carotenoids, alpha-carotene, beta-carotene, beta-cryptoxanthin, and lutein/zeaxanthin were each statistically significantly elevated over baseline (11-54%) in the intervention group compared with the control group over the duration of follow-up (P < 0.001). Urinary potassium excretion was elevated 14% over baseline in the intervention group compared with no change in the control group (P < 0.001). Modest decreases in the intervention but not the control group were observed for total and low-density lipoprotein cholesterol. Plasma lycopene, triglycerides, high-density lipoprotein cholesterol, body weight, and urinary sodium were not affected by the intervention. V&F intake was significantly increased in this motivated population at higher risk of colon cancer and maintained for at least 12 months, as assessed using diet records and an ensemble of biomarkers.

Adenoma↗

The 1999 annual report of the Regional Infant and Child Mortality Review Committee.

The 1999 Annual Report of the Regional Infant and Child Mortality Review Committee (RICMRC) is presented. Our Regional (Minnehaha, Lincoln, and Turner Counties) incidence for Sudden Infant Death (SIDS) continues to significantly exceed the national rate. In this study, SIDS is strongly associated with prone sleeping and sleeping on soft surfaces or bedding. The Back-to-Sleep campaign that has been an important part of lowering the national SIDS rate appears to have been less successful in our region. The Regional Infant Child Mortality Review Committee therefore has elected to serve not only as a data collection committee, but has also actively engaged in community education programs directed towards providing a safer environment for our children.

Accident Prevention↗

Initiation of formal death investigation procedures among the Northern Plains Indians: a necessary adjunct in the study of American Indian sudden infant deaths.

The high rate of infant mortality among native peoples in the Aberdeen Service Area of the Indian Health Service (primarily North and South Dakota) prompted a multi-institutional study of this problem. The study investigators assumed that local coroners or medical examiners would be able to perform suitable death scene investigations. However, during the design portion of the study it became apparent that, with one exception, none of the participating Indian Nations had a death investigator or even a legal mandate to provide death investigation. To allow the study to go forward, and ultimately to better the community health within its service area, the Aberdeen Area Indian Health Service submitted a draft enabling coroner legislation/resolutions to the area tribes. By November of 1996, 6 of the 19 Indian Nations enacted enabling coroner legislation. To facilitate both the study and general death investigation within the area, the Aberdeen Area Indian Health Service since 1993 has held five 2-day death investigation training programs covering a variety of death investigation topics which were attended by 68 participants. Without further recognition of the need for tribal death investigation and additional funding, these gains in tribal death investigation will probably be transitory.

Cause of Death↗

Inborn defects of fatty acid oxidation: a preventable cause of SIDS.

Inborn errors of fatty acid oxidation, including medium chain acyl CoA dehydrogenase (MCAD) deficiency are readily detectable and treatable metabolic disorders in which recognition of symptoms is important. Symptoms occur when there is fasting, often associated with illness. If not diagnosed, these inborn errors of metabolism can result in sudden death classified as SIDS. These disorders can be diagnosed by ordering plasma or blood spot acylcarnitine profiles.

Acyl-CoA Dehydrogenases↗

An illustrative example of infant and child death review in South Dakota: "the 1998 annual report of the Regional Infant and Child Mortality Review Committee".

Local, regional, or state infant and child death review teams provide an excellent mechanism for identifying risk factors for infant and childhood deaths along with establishing a conduit for effecting preventive measures to reduce the number of deaths in these particularly vulnerable age groups. In 1997, a predecessor of the current Regional Infant and Child Mortality Review Committee was established in Minnehaha County as South Dakota's first non-Indian review committee for infant and childhood deaths. The 1998 Review Committee's annual report to the public is presented in this paper as an illustration of what can be expected from such a committee along with the specific public health concerns identified and their potential remedies. Especially noted in the committee's 1998 report is an alarming increase in Sudden Infant Death Syndrome (SIDS) death in the region and the educational role the Back to Sleep Campaign can play in the prevention of SIDS. The annual report serves as an example to illustrate how local review mechanisms can identify community strategies that may promote the health and well being of infants and children in their review areas.

Adolescent↗

The epidemiology of chronic fatigue in San Francisco.

Despite considerable research on chronic fatigue syndrome (CFS) and conditions associated with unexplained chronic fatigue (CF), little is known about their prevalence and demographic distribution in the population. The present study describes the epidemiology and characteristics of self-reported CF and related conditions in a diverse urban community. The study used a cross-sectional telephone screening survey of households in San Francisco, followed by interviews with fatigued and nonfatigued residents. Respondents who appeared to meet case definition criteria for CFS, based on self-reported fatigue characteristics, symptoms, and medical history, were classified as CFS-like cases. Subjects who reported idiopathic chronic fatigue (ICF) that did not meet CFS criteria were classified as ICF-like cases. Screening interviews were completed for 8,004 households, providing fatigue and demographic information for 16,970 residents. Unexplained CF was extremely rare among household residents <18 years of age, but was reported by 2% of adult respondents. A total of 33 adults (0.2% of the study population) were classified as CFS-like cases and 259 (1.8%) as ICF-like cases. Neither condition clustered within households. CFS- and ICF-like illnesses were most prevalent among women and persons with annual household incomes below $40,000, and least prevalent among Asians. The prevalence of CFS-like illness was elevated among African Americans, Native Americans, and persons engaged in clerical occupations. Although CFS-like cases were more severely ill than those with ICF-like illness, a similar symptom pattern was observed in both groups. In conclusion, conditions associated with unexplained CF occur in all sociodemographic groups but appear to be most prevalent among women, persons with lower income, and some racial minorities.

Adult↗

Chronic multisymptom illness affecting Air Force veterans of the Gulf War.

CONTEXT: Gulf War (GW) veterans report nonspecific symptoms significantly more often than their nondeployed peers. However, no specific disorder has been identified, and the etiologic basis and clinical significance of their symptoms remain unclear. OBJECTIVES: To organize symptoms reported by US Air Force GW veterans into a case definition, to characterize clinical features, and to evaluate risk factors. DESIGN: Cross-sectional population survey of individual characteristics and symptoms and clinical evaluation (including a structured interview, the Medical Outcomes Study Short Form 36, psychiatric screening, physical examination, clinical laboratory tests, and serologic assays for antibodies against viruses, rickettsia, parasites, and bacteria) conducted in 1995. PARTICIPANTS AND SETTING: The cross-sectional questionnaire survey included 3723 currently active volunteers, irrespective of health status or GW participation, from 4 air force populations. The cross-sectional clinical evaluation included 158 GW veterans from one unit, irrespective of health status. MAIN OUTCOME MEASURES: Symptom-based case definition; case prevalence rate for GW veterans and nondeployed personnel; clinical and laboratory findings among veterans who met the case definition. RESULTS: We defined a case as having 1 or more chronic symptoms from at least 2 of 3 categories (fatigue, mood-cognition, and musculoskeletal). The prevalence of mild-to-moderate and severe cases was 39% and 6%, respectively, among 1155 GW veterans compared with 14% and 0.7% among 2520 nondeployed personnel. Illness was not associated with time or place of deployment or with duties during the war. Fifty-nine clinically evaluated GW veterans (37%) were noncases, 86 (54%) mild-to-moderate cases, and 13 (8%) severe cases. Although no physical examination, laboratory, or serologic findings identified cases, veterans who met the case definition had significantly diminished functioning and well-being. CONCLUSIONS: Among currently active members of 4 Air Force populations, a chronic multisymptom condition was significantly associated with deployment to the GW. The condition was not associated with specific GW exposures and also affected nondeployed personnel.

Adult↗

Predictors of mortality from kidney cancer in 332,547 men screened for the Multiple Risk Factor Intervention Trial.

BACKGROUND: The authors examined predictors of mortality from kidney cancer in 332,547 men who were screened as part of the Multiple Risk Factor Intervention Trial. METHODS: The vital status of each member of this cohort was ascertained through 1990. Death certificates were obtained from state health departments and coded by a trained nosologist. Three hundred ninety-eight deaths due to kidney cancer occurred among the cohort of 332,547 men after an average of 16 years of follow-up. The authors used the Cox proportional hazards model to study the joint associations of age, race, income, blood pressure, cigarette smoking, and use of medication for diabetes with risk of death from kidney cancer. RESULTS: The authors observed independent associations with age, cigarette smoking status (relative risk [RR] = 2.02; 95% confidence interval [CI], 1.65-2.48), and systolic blood pressure (relative risk [RR] = 1.12 for systolic blood pressure level 10 millimeters of mercury higher; 95% CI, 1.06-1.18). The authors obtained similar results when deaths that occurred during the first 5 years were excluded. CONCLUSIONS: These findings add to the increasing body of evidence that cigarette smoking and blood pressure level are modifiable risk factors for kidney cancer in men.

Adult↗

Surveillance for chronic fatigue syndrome--four U.S. cities, September 1989 through August 1993.

PROBLEM/CONDITION: Although chronic fatigue syndrome (CFS) has been recognized as a cause of morbidity in the United States, the etiology of CFS is unknown. In addition, information is incomplete concerning the clinical spectrum and prevalence of CFS in the United States. REPORTING PERIOD COVERED: This report summarizes CFS surveillance data collected in four U.S. cities from September 1989 through August 1993. DESCRIPTION OF SYSTEM: A physician-based surveillance system for CFS was established in four U.S. metropolitan areas: Atlanta, Georgia; Wichita, Kansas; Grand Rapids, Michigan; and Reno, Nevada. The objectives of this surveillance system were to collect descriptive epidemiologic information from patients who had unexplained chronic fatigue, estimate the prevalence and incidence of CFS in defined populations, and describe the clinical course of CFS. Patients aged > or = 18 years who had had unexplained, debilitating fatigue or chronic unwellness for at least 6 months were referred by their physicians to a designated health professional(s) in their area. Those patients who participated in the surveillance system a) were interviewed by the health professional(s); b) completed a self-administered questionnaire that included their demographic information, medical history, and responses to the Beck Depression Inventory, the Diagnostic Interview Schedule, and the Sickness Impact Profile; c) submitted blood and urine samples for laboratory testing; and d) agreed to a review of their medical records. On the basis of this information, patients were assigned to one of four groups: those whose illnesses met the criteria of the 1988 CFS case definition (Group I); those whose fatigue or symptoms did not meet the criteria for CFS (Group II); those who had had an identifiable psychological disorder before onset of fatigue (Group III); and those who had evidence of other medical conditions that could have caused fatigue (Group IV). Patients assigned to Group III were further evaluated to determine the group to which they would have been assigned had psychological illness not been present, the epidemiologic characteristics of the illness and the frequency of symptoms among patients were evaluated, and the prevalence and incidence of CFS were estimated for each of the areas. RESULTS: Of the 648 patients referred to the CFS surveillance system, 565 (87%) agreed to participate. Of these, 130 (23%) were assigned to Group I; 99 (18%), Group II; 235 (42%), Group III; and 101 (18%), Group IV. Of the 130 CFS patients, 125 (96%) were white and 111 (85%) were women. The mean age of CFS patients at the onset of illness was 30 years, and the mean duration of illness at the time of the interview was 6.7 years. Most (96%) CFS patients had completed high school, and 38% had graduated from college. The median annual household income/for CFS patients was $40,000. In the four cities, the age-, sex-, and race-adjusted prevalences of CFS for the 4-year surveillance period ranged from 4.0 to 8.7 per 100,000 population. The age-adjusted 4-year prevalences of CFS among white women ranged from 8.8 to 19.5 per 100,000 population. INTERPRETATION: The results of this surveillance system were similar to those in previously published reports of CFS. Additional studies should be directed toward determining whether the data collected in this surveillance system were subject to selection bias (e.g., education and income levels might have influenced usage of the health-care system, and the populations of these four surveillance sites might not be representative of the U.S. population). ACTIONS TAKEN: In February 1997, CDC began a large-scale, cross-sectional study at one surveillance site (Wichita) to describe more completely the magnitude and epidemiology of unexplained chronic fatigue and CFS.

Adolescent↗

Commercial laboratory practice evaluation of air-dried/rehydrated cervicovaginal smears vs. traditionally-fixed smears.

Air-drying artifacts remain a significant problem in the interpretation of cervicovaginal cytologic smears. One historical, and little-used, method to combat these artifacts is to have smears submitted solely air-dried, subsequently rehydrated, fixed, and then stained as usual. Reported here is a 1992-1993 retrospective matched provider study of 6,788 air-dried/rehydrated smears and 1,691 traditionally-fixed smears. No significant differences either in the percentage of abnormalities (8.6% vs. 8.2%) or the degree of abnormality (class II, 6.9%/6.9%; class III, 1.7%/1.3%; class IV, .01%/.06%; and class V, .01%/0%) were seen between the two techniques. Cytology-biopsy correlation remained in the 98-99% range for three large providers switching from air-dried to traditionally-fixed smears. These findings strengthen our belief that the air-dried/rehydrated technique is a viable alternative to combat the usual "air-dried" artifact problem.

Air↗

Reliability and comparability of three dietary assessment methods for estimating fruit and vegetable intakes.

Although fruits and vegetables have been evaluated in numerous epidemiologic studies, few validation studies have examined fruits and vegetables. We examined the reproducibility and comparability of fruit and vegetable intakes estimated by diet records, food frequency questionnaires, and modules (brief food frequency questionnaires) in 101 control participants of a 1-year diet intervention trial. For each method, mean intakes at baseline and 3 months were generally within 0.3 serving per day for juice, fruits, vegetables, and total fruits and vegetables. In addition, Pearson correlations for the two time periods generally exceeded 0.55 for these four groups for each method. We evaluated comparability of intakes for 15 days of diet records, 1-year food frequency questionnaires, and modules, respectively. Mean total fruit and vegetable intakes were 6.3, 6.5, and 3.8 servings per day for diet records, food frequency questionnaires, and modules. For each pair-wise combination of methods, Pearson correlations exceeded 0.45 for juice, fruits, and total fruits and vegetables; correlations were lower for vegetables. Exact agreement in quintile assignment was less than 45%, however. These results indicate that estimates of fruit and vegetable intakes and disease associations may differ depending on the method used to assess fruit and vegetable intake.

Adenoma↗

Elevated postmortem tryptase in the absence of anaphylaxis.

Elevations in tryptase, a recently discovered mast cell enzyme, have been proposed as a postmortem indicator of fatal anaphylaxis. The previous studies had limited numbers of controls and thus the specificity of the test with postmortem samples was not known. Therefore, tryptase was evaluated in postmortem blood samples from 49 autopsy cases where there was no evidence of fatal anaphylaxis. The tryptase was above the normal serum threshold of 1 nanogram/mL (ng/mL) in 31 of these cases. Twenty-four cases had values in the 1 to 5 ng/mL range, two cases were between 5 and 10 ng/mL, and five were greater than 10 ng/mL. One autopsy specimen had a tryptase value of 106 ng/mL. The postmortem interval and the specimen storage condition did not appear to correlate with these elevations in tryptase. Although elevations in the postmortem tryptase remain an important supporting finding in the diagnosis of fatal anaphylaxis, it should not be used alone as the sole criterion for the postmortem diagnosis of anaphylaxis.

Adolescent↗