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Biomedical subjects

H G Miller

Publications and source records attributed to H G Miller.

At least 19 recordsLinked to original sources
PubMed1999

Monitoring the health status and impact of treatment on Americans: the Medicare Beneficiary Health Status Registry.

OBJECTIVE: A major new survey program, the Medicare Beneficiary Health Status Registry (MBHSR), has been proposed to improve the monitoring of the health status of Medicare beneficiaries. The MBHSR would collect data by mail with telephone follow up of nonrespondents to permit economical assessment of a total Registry of approximately 200,000 Medicare beneficiaries, approximately 54,000 of whom would be surveyed in any given year. (Surveys would be conducted of samples of new enrollees who would be reinterviewed every five years.) METHOD: To assess the feasibility of that approach, a field test was conducted with a probability sample (n = 1,922) that comprised approximately equal numbers of new Medicare enrollees (aged, 65) and current beneficiaries (age range, 76-80). The field test was designed to assess the quality of the data that this design would produce. FINDINGS: Results indicate that the proposed design of the MBHSR could achieve response rates of approximately 80% among both age cohorts using a survey instrument that took 30 minutes to complete. Internal reliability of Activities of Daily Living, Instrumental Activities of Daily Living, Mobility, Mental Health Index, General Health, and Prostate Symptomatology scales ranged from 0.77 to 0.93. When measurements were repeated approximately 30 days after the initial survey, moderate to high levels of cross temporal correlation (range, 0.64-0.96) were found for most indexes, with the exception of prostate symptomatology. In addition, an earlier comparison of survey responses in the MBHSR field test to Medicare payment records indicated that the MBHSR field test obtained highly accurate reports of most of the major surgeries that were recorded in Medicare claims files. CONCLUSION: The design proposed for the MBHSR is feasible. If implemented, it should produce acceptably high rates of response and data quality.

Activities of Daily Living↗
PubMed1998

CD40-tumor necrosis factor receptor-associated factor (TRAF) interactions: regulation of CD40 signaling through multiple TRAF binding sites and TRAF hetero-oligomerization.

CD40 is a TNF receptor superfamily member that provides activation signals in antigen-presenting cells such as B cells, macrophages, and dendritic cells. Multimerization of CD40 by its ligand initiates signaling by recruiting TNF receptor-associated factors (TRAFs) to the CD40 cytoplasmic domain. Recombinant human TRAF proteins overexpressed in insect cells were biochemically characterized and used to finely map TRAF binding regions in the human CD40 cytoplasmic domain. TRAF1, TRAF2, TRAF3, and TRAF6, but not TRAF4 or TRAF5, bound directly to the CD40 cytoplasmic domain. CD40 interactions with TRAF2 and TRAF3 were stronger than the interactions with TRAF1 and TRAF6. Full-length TRAF3 and TRAF5 formed hetero-oligomers, presumably through their predicted isoleucine zippers. TRAF3-TRAF5 hetero-oligomers interacted with CD40, indicating that TRAF5 can be indirectly recruited to the CD40 cytoplasmic domain. Overlapping peptides synthesized on cellulose membranes were used to map each TRAF interaction region. TRAF1, TRAF2, and TRAF3 interacted with the same region. The recognition site for TRAF6 was a nonoverlapping membrane proximal region. Using peptides with progressive deletions, a minimal TRAF1, TRAF2, and TRAF3 binding region was mapped to the PVQET sequence in the CD40 cytoplasmic domain. The minimal region for TRAF6 binding was the sequence QEPQEINF. These studies demonstrate that the CD40 cytoplasmic domain contains two nonoverlapping TRAF binding regions and suggest that TRAF1, TRAF2, and TRAF3 could bind competitively to one site. Relative affinities and competition of individual and hetero-oligomeric TRAF proteins for CD40 binding sites may contribute to receptor specificity and cell-type selectivity in CD40-dependent signaling.

Amino Acid Sequence↗
PubMed1998

Effects of interview mode on bias in survey measurements of drug use: do respondent characteristics make a difference?

Three recent empirical studies have provided strong evidence that self-administered questionnaires (SAQs), compared with interviewer questioning, substantially improve the reporting of drug use in population surveys. Specifically, SAQs appear to diminish underreporting bias. Two of these studies previously reported that this effect of interview mode varied significantly across gender, race/ethnicity, and age. Data from a randomized experiment embedded in the 1990 National Household Survey of Drug Abuse (NHSDA) field test were reanalyzed to test for those interaction effects. To better replicate prior studies, the NHSDA field test sample was restricted to people ages 18 to 45 (N = 1,877). The results of our statistical analyses generally replicated the finding of a main effect of SAQs on the reporting of drug use. However, only weak evidence was found to support the hypothesis that the advantage of SAQs varies substantially by the gender, race/ethnicity, or age of the respondent.

Adolescent↗
PubMed1997

Zenilman's anomaly reconsidered: fallible reports, ceteris paribus, and other hypotheses.

BACKGROUND AND OBJECTIVES: In the January-February, 1995 issue of Sexually Transmitted Diseases, Zenilman and colleagues reported a null association between incident sexually transmitted diseases (STDs) and self-reported condom use. That anomalous finding generated a flurry of letters to the editor, some of which were quite heated. This article reconsiders the Zenilman team's results. STUDY DESIGN: New statistical analyses were conducted to test two hypotheses that sought to account for the null association: (1) deviation from study protocol, and (2) differential risks of acquiring an incident STD among segments of the study population that varied by reported level of condom use. RESULTS: No support was found for hypotheses concerning deviation from study protocol and differential risk of acquiring an incident STD by level of condom use. Indeed, for respondents who reported multiple sexual partners, the analyses found increased rates of infection among those who reported more consistent condom use. CONCLUSIONS: Two of the most promising hypotheses for explaining Zenilman's anomalous findings are unsupported by reanalysis of the available empirical evidence. It is still possible that respondents who reported that they used condoms consistently differed from self-reported nonusers or inconsistent users in some way that altered their risk of acquiring an STD and thus obscured the protective effects of properly used condoms. Nonetheless, as Zenilman and others suggest, fallibility in self-reports of condom use remains the primary suspect as the cause of these anomalous results. Such fallibility may be particularly pronounced when self-reported behavioral data are collected in contexts that include strong educational campaigns or other norm-setting interventions.

Bias↗
PubMed1997

Monitoring trends in drug use: strategies for the 21st century.

Since the 1970s the United States and other nations have conducted regular statistical monitoring of the prevalence and patterns of drug use in their populations. Given the importance of such surveys for policymaking, their quality is a critical issue, and the biases that may affect their measurements become a major concern. An increasing volume of empirical evidence shows that the mode of administration of a survey can strongly influence the validity of respondents' reports. Compared with interviewer-administered questionnaires, self-administered forms appear to elicit more complete reporting of drug use, but the challenges they pose to the literacy skills of respondents may result in measurement biases. In addition, processes of social change may confound true shifts in drug use with changes in the willingness of respondents to report such use. The authors propose several strategies to improve monitoring of trends in drug use. Those approaches include 1) more frequent use of a survey technology--audio computer-assisted self-interviewing--that ensures full privacy for all survey respondents but does not require literacy; 2) increased use of time-series of indicators of drug use consequences built from blinded surveys of medical records; and 3) population-based surveys that collect biological specimens (e.g., hair samples). Data from the latter two sources are not subject to the same constellation of biases that afflict self-reports of drug use. Time-series of those data can be integrated with self-reports to provide a better understanding of changes over time in the prevalence and patterns of drug use.

Adolescent↗
PubMed1995

Assessing consistency of responses to questions on cocaine use.

This study examines consistency of self-reported responses to items within the questionnaire of a multi-site, prospective study of drug abuse treatment in the United States (DATOS). The analyses use data from 2842 interviewer-administered intake interviews. Questions that were logically related are paired and responses compared. The questions cover three topics: (1) age at which different types of cocaine was used, (2) reports on most recent use and (3) frequency of cocaine use during period of "heaviest" use. Responses are coded as consistent, inconsistent, or as survey administration error. The latter is related to interviewer errors such as erroneous skip pattern, out-of-range responses, "don't know" responses, missing data, or illegible responses. Contrary to expectations inconsistent responses were relatively rare in this study, with fewer than 5% (0.5-4.6%) of respondents reporting inconsistent answers for pairs of logically related questions. A careful review of responses also found few survey administration errors (0.2-1.3%).

Adult↗
PubMed1984

Penetration of clindamycin into experimental Staphylococcus aureus infections.

Inactivation of clindamycin at the site of experimental infection with Staphylococcus aureus was studied using rabbits with plastic capsules implanted in the peritoneal cavity. The mean percentage penetration of bioactive clindamycin (concentration in capsule divided by simultaneous concentration in serum times 100) into infected and noninfected capsules was 30.4 per cent and 13.0 per cent, respectively. In contrast, the mean penetration of radiolabeled clindamycin into infected capsules was 38.4 per cent. These findings indicate that the observed loss of bioactivity in infected capsules is due to intracapsular inactivation of clindamycin and not to an alteration in capsular permeability. Biologic inactivation of clindamycin was not evident after in vitro incubation of the drug with Staphylococcus aureus. These results suggest that the observed loss of bioactivity may be due to chemical modification by enzymes in the inflammatory exudate or to binding of the antibiotic to tissue components.

Animals↗
PubMed1983

Synovial fluid inhibits killing of Staphylococcus aureus by neutrophils.

Serum in the extracellular environment promotes neutrophil bactericidal activity apart from its opsonizing properties. We examined the effect of non-inflammatory osteoarthritic synovial fluid on serum-mediated neutrophil killing of Staphylococcus aureus. This was done to evaluate the effect of synovial fluid on neutrophil bactericidal activity independent of opsonin concentration. With an initial inoculum of 5 X 10(6) CFU/ml, 1.47 +/- 0.14% bacteria survived after 120 min of incubation with 10% serum and neutrophils. In contrast, 4.07 +/- 0.33% bacteria survived after incubation in serum plus synovial fluid (P less than 0.001). This inhibitory effect was directly related to the concentration of synovial fluid in the incubation mixture. Increasing the concentration of synovial fluid resulted in an increased percent survival. Studies utilizing preopsonized bacteria and radiolabeled organisms demonstrated that synovial fluid did not interfere with opsonization or phagocytosis. Intracellular bactericidal activity was assayed separately from phagocytosis by utilizing a brief ingestion period followed by the removal of extracellular bacteria by either differential centrifugation or lysostaphin treatment. The reincubation of cells and associated bacteria with serum or serum plus synovial fluid revealed that synovial fluid significantly inhibited the promoting effect of serum on neutrophil bactericidal activity. After 60 min of incubation with 10% serum, 13.0 +/- 1.2% bacteria survived, whereas 21.5 +/- 2.3% survived after incubation in serum plus synovial fluid (P less than 0.005). Superoxide production was not affected by the presence of synovial fluid. These findings suggest that the inhibitory effect of synovial fluid is due to an interaction between synovial fluid and the serum factors that promote intracellular killing.

Blood Bactericidal Activity↗
PubMed1982

Illness caused by Vibrio damsela and Vibrio hollisae.

Vibrio damsela was isolated from six wound infections in otherwise healthy persons. In five of the six cases the wounds were known to have been exposed to salt or brackish water at the time of the injury. Vibrio hollisae was isolated from an index stool culture in nine cases in which no other enteric pathogen was identified. All nine patients had diarrhoea and abdominal pain; one patient had bloody diarrhoea. Six of the nine patients were known to have eaten raw seafood in the five days before they became ill. These data suggest that both V. damsela and V. hollisae can produce diseases with distinct clinical and epidemiological characteristics.

Abdomen↗
PubMed1982

Campylobacter enteritis: a large outbreak traced to commercial raw milk.

From April 24 to May 11, 1981, an outbreak of approximately 200 cases of Campylobacter jejuni enteritis occurred in Arizona in persons who drank one brand of unpasteurized milk. Two cohort studies showed that households with members who drank raw milk reported diarrheal illness significantly more frequently than those in which no one drank raw milk (P=.003 and P=.001; relative risk 4.70 and 3.85, respectively). Of 19 serotyped C jejuni organisms isolated from persons who drank raw milk from the implicated dairy, 18 were of a single serotype.C jejuni was not detected in the milk or the milk filters cultured a week after the outbreak, but fecal excretion of Campylobacter of multiple serotypes was higher in the dairy herd that produced the implicated raw milk (48 percent) than in control herds (16 percent).

Animals↗
PubMed1980

Studies of the effects of treatment with 5-flourouracil alone and in combination with either cyclophosphamide, methotrexate, or methyl-CCNU on hepatic drug-metabolizing enzymes in murine L1210 leukemia.

Studies have been conducted on liver microsomal enzymes of B6D2F(1) mice bearing a Day 4 L1210 ascites tumor after treatment with a single intraperitoneal injection of 5-fluorouracil (FUra) alone, and in combination with either cyclophosphamide (CP), methotrexate (MTX), or methyl-CCNU (MeCCNU). FUra (200 mg/kg) alone did not alter either ethylomorphine N-demethylase, aniline hydroxylase, or neotetrazolium reductase activities as compared to untreated nontumor-bearing mice on Days 2, 4 and 6 after treatment. FUra (50 mg/kg)d plus CP (200 mg/kg) decreased neotetrazolium reductase activity 17% on Days 4 and 6 after treatment and the enzyme activity then returned to control levels on Day 8. Ethyl morphine N-demethylase and aniline hydroxylase, or neotetrazolium reductase activities on Days 1, 2, 4 and 6 after treatment. FUra (50 mg/kg) plus MeCCNU (21 mg/kg) did not affect either ethylmorphine N-demethylase or aniline hydroxylase activities on Days 1, 2, 4, 6 and 8 after treatment. However, neotetrazolium reductase activity was decreased 15% on Day 2 and then returned to control levels on Day 4. These results indicate that treatment of mice bearing the L1210 ascites tumor with an optimal single does of FUdra alone and in combination with either CP, MTX or MeCCNU does not have marked or prolonged effects on liver microsomal drug-metabolizing enzyme activities.

Animals↗
PubMedDate not supplied

Quality of treatment data. Reliability over time of self-reports given by clients in treatment for substance abuse.

This study examines the reliability over a 2-month period of self-reports of drug use, sexual behaviors, and use of treatment services provided by 2,968 clients participating in a large, multisite, prospective study of drug treatment in the United States-the Drug Abuse Treatment Outcome Study (DATOS). Analyses focus on responses to 62 pairs of logically related questions that were asked at two points in time: (1) 1 month after entry into treatment, and (2) 3 months after entry into treatment. Subjects' responses to questions asked at these two time points are assessed for logical consistency. Prior analyses of self-reports provided by DATOS clients at one point in time (entry into treatment) found surprisingly high levels of within-interview consistency in their reporting of alcohol use (Turner & Hubbard, 1995) and cocaine use (Adair, Craddock, Miller, & Turner, 1995). The crosstemporal tests of consistency reported in this article eliminate several potential sources of artifactual consistency that may have affected prior analyses, (e.g., consistency imposed by an interviewer or constructed by a respondent during the course of a single interview). Contrary to expectations, crosstemporal comparisons reveal high levels of logical consistency in clients' responses. The mean percent of substantively inconsistent responses ranges from 0.7% for questions asking about frequency of drug use to 4.4% for questions asking about sexual behaviors.

Humans↗