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PubMed2006

Serum immune responses predict rapid disease progression among children with Crohn's disease: immune responses predict disease progression.

BACKGROUND AND AIM: Crohn's disease (CD) is a heterogeneous disorder characterized by diverse clinical phenotypes. Childhood-onset CD has been described as a more aggressive phenotype. Genetic and immune factors may influence disease phenotype and clinical course. We examined the association of immune responses to microbial antigens with disease behavior and prospectively determined the influence of immune reactivity on disease progression in pediatric CD patients. METHODS: Sera were collected from 196 pediatric CD cases and tested for immune responses: anti-I2, anti-outer membrane protein C (anti-OmpC), anti-CBir1 flagellin (anti-CBir1), and anti-Saccharomyces-cerevisiae (ASCA) using ELISA. Associations between immune responses and clinical phenotype were evaluated. RESULTS: Fifty-eight patients (28%) developed internal penetrating and/or stricturing (IP/S) disease after a median follow-up of 18 months. Both anti-OmpC (p < 0.0006) and anti-I2 (p < 0.003) were associated with IP/S disease. The frequency of IP/S disease increased with increasing number of immune responses (p trend = 0.002). The odds of developing IP/S disease were highest in patients positive for all four immune responses (OR (95% CI): 11 (1.5-80.4); p = 0.03). Pediatric CD patients positive for > or =1 immune response progressed to IP/S disease sooner after diagnosis as compared to those negative for all immune responses (p < 0.03). CONCLUSIONS: The presence and magnitude of immune responses to microbial antigens are significantly associated with more aggressive disease phenotypes among children with CD. This is the first study to prospectively demonstrate that the time to develop a disease complication in children is significantly faster in the presence of immune reactivity, thereby predicting disease progression to more aggressive disease phenotypes among pediatric CD patients.

Adolescent↗
PubMed2001

Using statistical decision theory to predict speech intelligibility. II. Measurement and prediction of consonant-discrimination performance.

The speech recognition sensitivity (SRS) model [H. Müsch and S. Buus, J. Acoust. Soc. Am. 109, 2896-2909 (2001)] was tested by applying it to consonant-discrimination data collected in this study. Normally hearing listeners' abilities to discriminate among 18 consonants were measured in 58 filter conditions using two test paradigms. In one paradigm, listeners chose among all 18 stimuli. In the other, response alternatives were restricted to the correct response and eight consonants that were randomly selected among the 17 incorrect response alternatives. The effect of the number of response alternatives on performance can be described by statistical decision theory. Most filter conditions included one or more sharply filtered narrow bands of speech. Depending on the selection of bands, listeners' performance in multi-band conditions falls short of, equals, or exceeds the performance expected from multiplication of the error rates in the individual bands. The performance advantage in multi-band conditions increases with average band separation. The SRS model provides a good fit to the data and predicts the data more accurately than does the speech intelligibility index.

Adult↗
PubMed2002

Prediction of mortality from coronary heart disease among diverse populations: is there a common predictive function?

OBJECTIVES: To examine the generalisability of multivariate risk functions from diverse populations in three contexts: ordering risk, magnitude of relative risks, and estimation of absolute risk. DESIGN: Meta-analysis of prospective cohort studies. PATIENTS: Participants from various epidemiological studies. MAIN OUTCOME MEASURE: Death from coronary heart disease (CHD). RESULTS: The analysis included 105 420 men and 56 535 women 35-74 years of age and free of CHD at baseline from 16 observational studies with a total of 27 analytical groups. The area under the receiver operating characteristic curve (AUC) was used to judge the ability of the multivariate risk function to order risk correctly. AUCs ranged from 0.60 to 0.80. The AUCs differed significantly between the studies (p < 0.01) but were very similar for different risk functions applied to the same population, indicating similar ability to rank risk for different models. The magnitudes of the relative risks associated with major risk factors (age, systolic blood pressure, serum total cholesterol, smoking, and diabetes) varied significantly across studies (p < 0.05 for homogeneity). The prediction of absolute risk was not very accurate in most of the cases when a model derived from one study was applied to a different study. CONCLUSIONS: When considered qualitatively, the major risk factors are associated with CHD mortality in a diverse set of populations. However, when considered quantitatively, there was significant heterogeneity in all three aspects: ordering risk, magnitude of relative risks, and estimation of absolute risk.

Adult↗
PubMed2002

Predicting intentions versus predicting behaviors: domestic violence prevention from a theory of reasoned action perspective.

A central assumption of many models of human behavior is that intention to perform a behavior is highly predictive of actual behavior. This article presents evidence that belies this notion. Based on a survey of 1,250 Philadelphia adults, a clear and consistent pattern emerged suggesting that beliefs related to domestic violence correlate with intentions to act with respect to domestic violence but rarely correlate with reported actions (e.g., talking to the abused woman). Numerous methodological and substantive explanations for this finding are offered with emphasis placed on the complexity of the context in which an action to prevent a domestic violence incident occurs. We conclude by arguing that despite the small, insignificant relationships between beliefs and behaviors found, worthwhile aggregate effects on behavior might still exist, thus reaffirming the role of communication campaign efforts.

Adult↗
PubMed2002

Prediction of early and delayed postoperative deaths after coronary artery bypass surgery alone in Italy. Multivariate predictions based on Cox and logistic models and a chart based on the accelerated failure time model.

BACKGROUND: The aim of the multicenter OP-RISK (OPerative RISK) study was to investigate the early (28 days) and delayed (365 days) death rates following coronary artery bypass grafting (CABG) among patients representing a nationwide distribution [Centers in Northern (2), Central (1) and Southern (1) Italy] and further to define the multivariate risk factors for the early and delayed mortality after CABG. METHODS: Data were collected from 1126 patients undergoing CABG alone. Data were analyzed using Cox and logistic regression models, to accurately assess the major factors influencing survival over time after CABG. Having defined the significant factors, we constructed a chart of the absolute early risk of mortality using the accelerated failure time model. RESULTS: Using the Cox proportional hazards model and logistic regression we have demonstrated that age, preoperative ejection fraction and heart rate, and the duration of aortic cross-clamping are multivariate risk factors in the short and long term. The role of one arterial conduit was also assessed. CONCLUSIONS: The OP-RISK study produced relevant information for risk assessment and control in CABG and the results may form the basis for the objective quality assurance and accreditation of cardiac surgical institutions in Italy. Incidentally, Cox model appeared more adequate than logistic model for the assessment of the major factors influencing survival over time after CABG. The risk factors so assessed were used to construct a chart for practical predictive purposes.

Adult↗
PubMed1995

Genetics in cancer prediction, screening, and counseling: Part I, Genetics in cancer prediction and screening.

PURPOSE/OBJECTIVES: To review molecular biology and gene technology as they relate to cancer prediction and screening. DATA SOURCES: Published professional articles, texts, and proceedings; computerized data bases. DATA SYNTHESIS: Basic principles of inheritance and mutations; a discussion of proto-oncogenes, oncogenes, and anti-oncogenes; a summary of gene-mapping techniques; and a review of genes linked to familial, breast, ovarian, and colorectal cancers. CONCLUSIONS: Most human cancers are influenced genetically but are not inherited. Discoveries about cancer genes play a major role in identifying individuals and families who are likely to develop cancer. IMPLICATIONS FOR NURSING PRACTICE: Nurses need to heighten their awareness of this science and its ramifications, which ultimately will affect recommendations for early detection and screening.

Genes, Tumor Suppressor↗
PubMed1993

The ability of adolescents to predict future outcome. Part I: Assessing predictive abilities.

Because adolescents are generally viewed as "risk-takers," an assessment of planning and decision-making skills during the teenage years may reveal why this developmental group tends to engage in dangerous behaviors. One area in which these abilities have significant consequences for future outcome is pregnancy, a condition that requires a decision to either give birth or abort. Previewing, a process by which caregivers introduce infants to the physical sensations of imminent developmental change and the implications of such change on their relationship, may affect the adolescent's ability to predict upcoming change. This paper explores previewing skills during the adolescent years and how this capacity affects the teenager's orientation toward future outcomes.

Adolescent↗
PubMed1996

Predicting unpredictability: a model of women's processes of predicting battering men's violence.

This paper proposes a theoretical model of how women predict men's violence within the context of battering. The model was developed from a grounded theory study of 30 women. Participants were recruited using advertisements in free neighborhood newspapers. Interviews were conducted in small groups or individually. The analysis revealed that battered women developed sophisticated knowledge about and response patterns to their partners' violent behaviors. They identified specific changes in their partners' eyes, speech, and tone of voice and described specific situations that served as warning signs of potential violence. Once able to identify warning signs, women responded with strategies of avoidance, engagement, fleeing, and enlisting the help of others to avert or delay violent incidences. These strategies provided temporary relief but did not usually result in the cessation of violence.

Adult↗
PubMed2005

Genetic prediction of autoimmunity: initial oligogenic prediction of anti-islet autoimmunity amongst DR3/DR4-DQ8 relatives of patients with type 1A diabetes.

In this study, the combined risk for expressing anti-islet autoantibodies and type 1A diabetes (T1D) was prospectively examined in 85 sampled relatives who had the high-risk HLA genotype (DR3-DQ8 DR4-DQ2). An insulin gene polymorphism, -23 HphI, and a lymphocyte tyrosine phosphatase gene polymorphism at position 1858C>T (amino acid 620 Arg to Trp), PTPN22/LYP, were analyzed. Life tables were created evaluating time to anti-islet autoantibody development and T1D. Of relatives with the high-risk HLA type followed for 3years, 9 of 43 (28.1%) with the high-risk -23 HphI polymorphism developed anti-islet autoantibodies versus two of 36 (5.6%) relatives with the lower-risk -23 HphI genotypes (p=0.048). Of relatives with the high-risk HLA type followed for 5years, eight of 32 (25.0%) with the high-risk -23 HphI polymorphism (A/A) developed T1D versus zero of 26 (0%) relatives with the lower-risk -23 HphI genotypes (A/T and T/T) (p=0.006). The PTPN22/LYP polymorphism, with genotypes C/C, C/T, and T/T, did not show a significant difference in risk by genotype. These results highlight the multiplicative risk of combined high-risk genotypes at different loci in terms of time to autoantibody and autoimmune disease development.

Adolescent↗
PubMed2003

Gender differences in the self-rated health-mortality association: is it poor self-rated health that predicts mortality or excellent self-rated health that predicts survival?

PURPOSE: This study investigates gender differences in the association between self-rated health (SRH) and mortality. This association has been well-documented, but findings regarding gender differences are inconsistent. The specific objectives were (a) to examine these differences in a short and a long time frame, (b) to examine these differences among old and old-old people, and (c) to address the question of whether this association is based on the accuracy of poor SRH as a predictor of future decline, and/or of better SRH as a predictor of longevity. DESIGN AND METHODS: The study is based on an Israeli nationally representative sample of 622 women and 730 men who were interviewed about their SRH, as well as sociodemographic information and other measures of health, physical functioning, cognitive status, and depression. RESULTS: For both genders, SRH was associated only with shorter term mortality (within the next 4 years) and not with longer-term mortality (9 years of follow-up). This association was strongest among the old (ages 75-84) women, compared with the old men and with the old-old (85-94) women and men. A possible explanation may be related to differences in the accuracy of excellent SRH at very old age. IMPLICATIONS: The SRH-mortality association may differ among age and gender groups. Identifying the conditions under which it is more accurate will enable researchers and practitioners to know when it can be utilized. It is important to assess differences in the accuracy of poor SRH as well as of excellent SRH as predictors of future health outcomes.

Aged↗
PubMed2005

Cortisol level predicts executive and memory function in depression, symptom level predicts psychomotor speed.

OBJECTIVE: On a group level depression is related to hypercortisolism and to psychomotor retardation, executive dysfunction and memory impairment. However, intra-group heterogeneity is substantial. Why some are impaired while others remain in the normal range, is not clear. The present study aims at discerning the relative contribution of present symptom severity and hypercortisolism to impairment in the three domains of cognition. METHOD: Morning saliva cortisol was measured in 26 subjects with recurrent major depression prior to a neuropsychological examination with tests known to be sensitive to cognitive impairment in depression. RESULTS: Cortisol level correlated with executive dysfunction and post-encoding memory deficits, but not with processing speed. Depression level correlated with processing speed. These patterns remained significant after controlling for confounders through partial correlations. CONCLUSION: The association between cortisol and cognition is not an artifact of psychiatric symptom load. High level of saliva cortisol is associated with aspects of cognition that can be dissociated from psychomotor retardation, which is dependent on symptom load.

Adult↗
PubMed2004

Evaluation of a Clostridium perfringens predictive model, developed under isothermal conditions in broth, to predict growth in ground beef during cooling.

Proper temperature control is essential in minimizing Clostridium perfringens germination, growth, and toxin production. The U.S. Department of Agriculture (USDA) Food Safety and Inspection Service (FSIS) offers two options for the cooling of meat products: follow a standard time-temperature schedule or validate that alternative cooling regimens result in no more than a 1-log(10) CFU/g increase of C. perfringens and no growth of Clostridium botulinum. A mathematical model developed by Juneja et al. (Food Microbiol. 16:335-349, 1999) may be helpful in determining if the C. perfringens performance standard has been achieved, but this model has not been extensively validated. The objective of this study was to validate the Juneja 1999 model in ground beef under a variety of changing temperature and temperature abuse situations. The Juneja 1999 model consistently underpredicted growth of C. perfringens during exponential cooling of ground beef. The model also underpredicted growth of C. perfringens in ground beef cooled at two different rates. The results presented here show generally good agreement with published data on the growth of C. perfringens in similar products. The model error may be due to faster-than-expected exponential growth rates in ground beef during cooling or an error in the mathematical formulation of the model.

Animals↗