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Single-item vs multiple-item measures of stage of change in compliance with prescribed medications.

The Stage of Change construct from the Transtheoretical Model of behavioral change has been widely utilized in the assessment of various health behaviors. The majority of these tests measure the Stage of Change construct using the single-item. multiple-choice format. This study validated the use of a single-item measure in measuring readiness to comply with taking a prescribed medication. A sample of 161 subjects tested the multiple-item Stage of Change measure, then a refined multiple-item survey was tested with 59 subjects. With the latter survey, discriminating subjects at the differing stages of change dimensions was difficult. A correlation of .91 was found for stage classifications between ratings on the single-item and multiple-item scales. The use of the single-item measure seems reasonable when assessing stage of change in compliance with prescribed medication.

Adaptation, Psychological↗

[Degree of middle ear malformation in developmental defects of the I and II branchial arches].

The authors describe various grades of middle ear malformations in 22 patients with developmental defects of the first and the second branchial arch. Middle ear malformations were divided into three groups, according to Altmann's classification, on the basis of physical examination, X-ray investigations and surgeon's opinion. The analysis of the material helps in the assessment of possible anatomical and physiological benefits of surgery in each group of malformations.

Abnormalities, Multiple↗

[Gene expression profiling of multiple myeloma].

Despite the fact that multiple myeloma is a unique entity, defined by the accumulation of malignant plasma cells, a marked heterogeneity is observed among patients (regarding biological and clinical presentation, response to treatment, or survival). Current prognostic parameters are poor predictors of response to therapy and of survival in individual patients. The application and analysis of DNA microarrays to plasma cells provide an overview of gene expression programs generated by these cells in normal and pathological conditions. Genes potentially involved in transformation process have been identified by gene profiles comparison between myeloma samples, normal plasma cells from various tissues, pretumoral plasma cells and immortalized plasma cells. We can speculate that in a near future gene expression-based classification will be used as a molecular prognostic indicator.

Antigens, CD↗

Predicting hospitalisation of patients with diabetes mellitus. An application of the Bayesian discriminant analysis.

The objective of this study was to develop, and subsequently test, a Bayesian discrimination model for the purpose of identifying both the personal and the healthcare system characteristics predictive of hospitalisation for the treatment of patients with diabetes mellitus or commonly observed cormorbidities associated with the disease. First, a Bayesian classification framework was proposed. The model was then tested by using a logit regression technique in order to estimate the probability of one or more hospitalisation events among patients with diabetes. The study used claims data extracted from the Hawaii Medical Service Association (HMSA) Private Business Claims (PBS) files for the 1995 calendar year. Patients under 65 years were identified by paid claims with ICD-9-CM diagnosis codes of 250.xx which gave a sample size of 6841 patients. Age, gender, various pharmacotherapy variables, presence of hypertension, hyperlipidaemia, congestive heart failure, multiple cardiovascular diseases, any combination of commonly observed comorbidities, dialysis services and annual eye examination are highly predictive of 1 or more hospitalisation events. The model shows a predictive power of almost 90%. This study found that multivariate discriminant analysis using a logit regression model successfully identifies: (i) important explanatory variables predictive of hospitalisation; (ii) assigns patients into 1 of 2 mutually exclusive classes; and (iii) offers a benchmark for a comprehensive disease management strategy for patients with more complicated diabetes.

Bayes Theorem↗

Classification of multiple morphine and enkephalin binding sites in the central nervous system.

Detailed competitive displacement curves of 3H-labeled [D-Ala2,Met5]enkephalinamide, [D-Ala2,D-Leu5]enkephalin, and dihydromorphine by a series of opiates and enkephalins are biphasic, suggesting multiple sites. After treatment of tissue with naloxazone, the displacement of the three 3H-labeled ligands by all opiates and enkephalins tested becomes monophasic, losing the high-affinity displacement seen with low concentrations of both opiates and enkephalins. Coupled with Scatchard analysis of saturation experiments, these findings suggest a common site that binds both opiates and enkephalins equally well and with highest affinity (Kd values, less than 1 nM). Termed the mu 1 site, it corresponds to the previously described high-affinity site and appears to be the site responsible for analgesia under normal circumstances. The low-affinity binding of [3H]dihydromorphine (Kd, 3 nM) remaining after naloxazone treatment differs dramatically from low-affinity [D-Ala2,D-Leu5]-[3H]enkephalin binding (Kd, 5 nM). The mu 2 site, corresponding to the low-affinity [3H]dihydromorphine receptor sites, binds morphine (Ki, 10 nM) and dihydromorphine (Kd, 3 nM) far better than [D-Ala2,D-Leu5]enkephalin (Ki, 50 nM). Low-affinity [D-Ala2,D-Leu5]-[3H]enkephalin receptor sites bind [D-Ala2,D-Leu5]enkephalin (Ki, 5-8 nM) more potently than morphine (Ki, 71 nM) and correspond to the previously established delta receptor.

Animals↗

Global analysis of the general stress response of Bacillus subtilis.

Gene arrays containing all currently known open reading frames of Bacillus subtilis were used to examine the general stress response of Bacillus. By proteomics, transcriptional analysis, transposon mutagenesis, and consensus promoter-based screening, 75 genes had previously been described as sigma(B)-dependent general stress genes. The present gene array-based analysis confirmed 62 of these already known general stress genes and detected 63 additional genes subject to control by the stress sigma factor sigma(B). At least 24 of these 125 sigma(B)-dependent genes seemed to be subject to a second, sigma(B)-independent stress induction mechanism. Therefore, this transcriptional profiling revealed almost four times as many regulon members as the proteomic approach, but failure of confirmation of all known members of the sigma(B) regulon indicates that even this approach has not yet elucidated the entire regulon. Most of the sigma(B)-dependent general stress proteins are probably located in the cytoplasm, but 25 contain at least one membrane-spanning domain, and at least 6 proteins appear to be secreted. The functions of most of the newly described genes are still unknown. However, their classification as sigma(B)-dependent stress genes argues that their products most likely perform functions in stress management and help to provide the nongrowing cell with multiple stress resistance. A comprehensive screening program analyzing the multiple stress resistance of mutants with mutations in single stress genes is in progress. The first results of this program, showing the diminished salt resistance of yjbC and yjbD mutants compared to that of the wild type, are presented. Only a few new sigma(B)-dependent proteins with already known functions were found, among them SodA, encoding a superoxide dismutase. In addition to analysis of the sigma(B)-dependent general stress regulon, a comprehensive list of genes induced by heat, salt, or ethanol stress in a sigma(B)-independent manner is presented. Perhaps the most interesting of the sigma(B)-independent stress phenomena was the induction of the extracytoplasmic function sigma factor sigma(W) and its entire regulon by salt shock.

Bacillus subtilis↗

Cloning, expression, and cell surface localization of Paenibacillus sp. strain W-61 xylanase 5, a multidomain xylanase.

We have shown that a xylan-degrading bacterium, W-61, excretes multiple xylanases, including xylanase 5 with a molecular mass of 140 kDa. Here, we emend the previously used classification of the bacterium (i.e., Aeromonas caviae W-61) to Paenibacillus sp. strain W-61 on the basis of the nucleotide sequence of the 16S rRNA gene, and we clone and express the xyn5 gene encoding xylanase 5 (Xyn5) in Escherichia coli and study the subcellular localization of Xyn5. xyn5 encodes 1,326 amino acid residues, including a 27-amino-acid signal sequence. Sequence analysis indicated that Xyn5 comprises two family 22 carbohydrate-binding modules (CBM), a family 10 catalytic domain of glycosyl hydrolases, a family 9 CBM, a domain similar to the lysine-rich region of Clostridium thermocellum SdbA, and three S-layer-homologous (SLH) domains. Recombinant Xyn5 bound to a crystalline cellulose, Avicel PH-101, while an N-terminal 90-kDa fragment of Xyn5, which lacks the C-terminal half of the family 9 CBM, did not bind to Avicel PH-101. Xyn5 was cell bound, and the cell-bound protein was digested by exogenous trypsin to produce immunoreactive and xylanolytic fragments with molecular masses of 80 and 60 kDa. Xyn5 was exclusively distributed in the cell envelope fraction consisting of a peptidoglycan-containing layer and an associated S layer. Thus, Paenibacillus sp. strain W-61 Xyn5 is a cell surface-anchored modular xylanase possessing a functional cellulose-binding module and SLH domains. Possible cooperative action of multiple xylanases produced by strain W-61 is discussed on the basis of the modular structure of Xyn5.

Bacillaceae↗

[Health problems and factors determining the number of on-demand visits of over-users of a health centre].

OBJECTIVES: To describe the social and demographic characteristics and health problems of over-users of a health centre and to determine the number of attendances requested on demand at the general medical clinic. DESIGN: Retrospective and descriptive. Multivariate analysis: multiple linear regression. SETTING: Urban health centre. PATIENTS: Patients who requested a consultation at the health centre on at least nine occasions in 1999 (N = 7852). Random sample of 386 patients (alpha 0.05, 95% accuracy). MEASUREMENTS AND MAIN RESULTS: Dependent variable: number of on-demand consultations requested in 1999. INDEPENDENT VARIABLES: age, family size, area of residence, active or pensioner, inclusion in programmes, health problems (CIAP-2), number of drugs on repeat prescription (Anatomical Classification), short-term time off work. 57% of over-users were women (CI, 52.9-62.7%); mean age 55 (SD 18.5); family size 2.7 members (SD 1.457); 58.8% pensioners. Mean number of appointments 15 (SD 6.7). Mean habitual consumption of 1.58 medicines (SD 2.46). Inclusion in programmes: 37.7% hypertension, 16% diabetes, 17% dyslipaemia, 16% nursing clinic. Most prevalent pathologies: cardio-circulatory (43.8%), endocrino-metabolic (32%), traumatology (26.7%) and mental health (21%). The regression model included the variables of age, number of medicines and having had short-term time off. CONCLUSIONS: Over-users of our health centre are middle-aged women with chronic physical health problems and with mental health problems. The number of attendances is related to age and administrative requirements: medication and sick notes.

Female↗

Exhaustive assignment of compositional bias reveals universally prevalent biased regions: analysis of functional associations in human and Drosophila.

BACKGROUND: Compositionally biased (CB) regions are stretches in protein sequences made from mainly a distinct subset of amino acid residues; such regions are frequently associated with a structural role in the cell, or with protein disorder. RESULTS: We derived a procedure for the exhaustive assignment and classification of CB regions, and have applied it to thirteen metazoan proteomes. Sequences are initially scanned for the lowest-probability subsequences (LPSs) for single amino-acid types; subsequently, an exhaustive search for lowest probability subsequences (LPSs) for multiple residue types is performed iteratively until convergence, to define CB region boundaries. We analysed > 40,000 CB regions with > 20 million residues; strikingly, nine single-/double- residue biases are universally abundant, and are consistently highly ranked across both vertebrates and invertebrates. To home in subpopulations of CB regions of interest in human and D. melanogaster, we analysed CB region lengths, conservation, inferred functional categories and predicted protein disorder, and filtered for coiled coils and protein structures. In particular, we found that some of the universally abundant CB regions have significant associations to transcription and nuclear localization in Human and Drosophila, and are also predicted to be moderately or highly disordered. Focussing on Q-based biased regions, we found that these regions are typically only well conserved within mammals (appearing in 60-80% of orthologs), with shorter human transcription-related CB regions being unconserved outside of mammals; they are also preferentially linked to protein domains such as the homeodomain and glucocorticoid-receptor DNA-binding domain. In general, only approximately 40-50% of residues in these human and Drosophila CB regions have predicted protein disorder. CONCLUSION: This data is of use for the further functional characterization of genes, and for structural genomics initiatives.

Animals↗

Differential gene expression profiles in the steatosis/fibrosis model of rat liver by chronic administration of carbon tetrachloride.

Global gene expression profile was analyzed by microarray analysis of rat liver RNA after chronic carbon tetrachloride (CCl(4)) administration. Rats received 0.5 ml CCl(4)/kg three times a week, and the liver samples were obtained after 0, 30, 60, and 90 days of injection. Histopathologic studies of liver tissues enabled the classification of the CCl(4) effect into mild and severe fatty liver/steatosis (30 and 60 days, respectively) and fibrosis/cirrhosis (90 days) stages. The expression levels of 4,900 clones on a custom rat gene microarray were analyzed and the results were confirmed by semi-quantitative RT-PCR. Four hundred thirty-eight clones were differentially expressed with more than a 1.625-fold difference (which equals 0.7 in log2 scale) at one or more time points. Multiple genes involved in lipid metabolism and ribosome biogenesis showed differential transcript levels upon chronic CCl(4) administration, which was previously seen in acute rat model as well. In addition, a total of 149 clones were identified as fibrosis/cirrhosis-specific genes by either fold changes or Significance Analysis of Microarrays. In conclusion, we report microarray analysis results in rat liver upon chronic CCl(4) administration with a full chronological profile that not only covered fatty liver/steatosis but also later points of fibrosis/cirrhosis. These data will provide the insight of specific gene expression profiles that is implicated in the multistep process of fatty liver/steatosis and fibrosis/cirrhosis after chronic hepatotoxin exposure.

Alanine Transaminase↗

Two-dimensional elution map of GalNAc-containing N-linked oligosaccharides.

We have previously published a two-dimensional (2-D) mapping technique for N-linked oligosaccharides using pyridylaminated derivatives (PA-oligosaccharides) (N. Tomiya et al. Anal. Biochem. 171, 73-90, 1988). We now report an extension of this method to GalNAc-containing N-linked oligosaccharides. The new 2-D map was prepared from the elution data of 40 different GalNAc-containing oligosaccharides, 16 of which were obtained directly from human urinary kallidinogenase by digestion with glycopeptidase A. The other 24 oligosaccharides were derived by subsequent digestion of the 16 original oligosaccharides with beta-galactosidase or alpha-fucosidase. Each of the 40 oligosaccharide derivatives was separated by high-performance liquid chromatography using ODS-silica and amide-silica columns. The 2-D map constructed by plotting elution position of each oligosaccharide (expressed in terms of glucose units) can be useful as such in delineating the structure of an unknown oligosaccharide by direct placement of its elution positions in the 2-D map. Multiple regression analysis of the data as performed previously yielded parameters related to the contribution of each component monosaccharide unit to the elution profile. The best results were obtained when the GalNAc-containing PA-oligosaccharides were classified into an F-series (those containing Fuc alpha 6GlcNAc-PA) and a Z-series (all others), based on our previous classification method. These calculated values are useful in predicting oligosaccharide structure from known elution values as well as to predict elution volumn from a known structure. The structure of a minor GalNAc-containing oligosaccharide in human urinary kallidinogenase was elucidated using these newly calculated values.

Acetylgalactosamine↗

Multisolutional clustering and quantization algorithm (MCQ).

We have developed a novel clustering and quantization algorithm that allows the user to create multiple one-to-one correspondences between the actual data and its transformed (clustered and quantized) values, based on the user's hypothesis regarding the nature of the classification task. The types of problems for which the algorithm can be beneficial are discussed. We report experiments employing simulated and real data that suggest the proposed algorithm may be useful in neural network analysis of various phenomena in medicine and biology.

Algorithms↗

Multivariate analysis of neuronal interactions in the generalized partial least squares framework: simulations and empirical studies.

Identification of spatiotemporal interactions within/between neuron populations is critical for detection and characterization of large-scale neuronal interactions underlying perception, cognition, and behavior. Univariate analysis has been employed successfully in many neuroimaging studies. However, univariate analysis does not explicitly test for interactions between distributed areas of activity and is not sensitive to distributed responses across the brain. Multivariate analysis can explicitly test for multiple statistical models, including the designed paradigm, and allows for spatial and temporal model detection. Here, we investigate multivariate analysis approaches that take into consideration the 4D (time and space) covariance structure of the data. Principal component analysis (PCA) and independent component analysis (ICA) are two popular multivariate approaches with distinct mathematical constraints. Common difficulties in using these two different decompositions include the following: classification of the revealed components (task-related signal versus noise), overall signal-to-noise sensitivity, and the relatively low computational efficiency (multivariate analysis requires the entire raw data set and more time for model identification analysis). Using both Monte Carlo simulations and empirical data, we derived and tested the generalized partial least squares (gPLS) framework, which can incorporate both PCA and ICA decompositions with computational efficiency. The gPLS method explicitly incorporates the experimental design to simplify the identification of characteristic spatiotemporal patterns. We performed parametric modeling studies of a blocked-design experiment under various conditions, including background noise distribution, sampling rate, and hemodynamic response delay. We used a randomized grouping approach to manipulate the degrees of freedom of PCA and ICA in gPLS to characterize both paradigm coherent and transient brain responses. Simulation data suggest that in the gPLS framework, PCA mostly outperforms ICA as measured by the receiver operating curves (ROCs) in SNR from 0.01 to 100, the hemodynamic response delays from 0 to 3 TR in fMRI, background noise models of Guassian, sub-Gaussian, and super-Gaussian distributions and the number of observations from 5, 10, to 20 in each block of a six-block experiment. Further, due to selective averaging, the gPLS method performs robustly in low signal-to-noise ratio (<1) experiments. We also tested PCA and ICA using PLS in a simulated event-related fMRI data to show their similar detection. Finally, we tested our gPLS approach on empirical fMRI motor data. Using the randomized grouping method, we are able to identify both transient responses and consistent paradigm/model coherent components in the 10-epoch block design motor fMRI experiment. Overall, studies of synthetic and empirical data suggest that PLS analysis, using PCA decomposition, provides a stable and powerful tool for exploration of fMRI/behavior data.

Algorithms↗

Combinatorial motif analysis and hypothesis generation on a genomic scale.

MOTIVATION: Computer-assisted methods are essential for the analysis of biosequences. Gene activity is regulated in part by the binding of regulatory molecules (transcription factors) to combinations of short motifs. The goal of our analysis is the development of algorithms to identify regulatory motifs and to predict the activity of combinations of those motifs. APPROACH: Our research begins with a new motif-finding method, using multiple objective functions and an improved stochastic iterative sampling strategy. Combinatorial motif analysis is accomplished by constructive induction that analyzes potential motif combinations. The hypothesis is generated by applying standard inductive learning algorithms. RESULTS: Tests using 10 previously identified regulons from budding yeast and 14 artificial families of sequences demonstrated the effectiveness of the new motif-finding method. Motif combination and classification approaches were used in the analysis of a sample DNA array data set derived from genome-wide gene expression analysis. AVAILABILITY: Programs will be available as executable files upon request. CONTACT: yhu@ics.uci.eduor yhu@cse.ttu.edu.tw

Algorithms↗

Intractable epilepsy and disturbed visuomotor performance.

The factors relevant to intractability, types of epilepsy and impairment of dexterity in patients with intractable epilepsy were studied independently in different groups of patients. The factors relevant to intractable epilepsy that were disclosed in 202 patients, who required hospitalization more than twice, were as follows: strong seizure propensity, neuropsychiatric disorders including mental deterioration of various degrees, ataxia, personality changes and psychotic episodes, intolerance to antiepileptic drugs due to acute or chronic side effects, idiosyncrasy and internal disorders, self-induced seizure, misdiagnosis and mistreatment, and breakdown of family care of patients. The types of epilepsy in 224 patients with intractable epilepsy whose seizures were not adequately controlled and recurred on a monthly basis in spite of hospitalization were classified as follows: 101 patients with localization-related epilepsies or syndromes, 106 with generalized epilepsies or syndromes, 16 with undetermined epilepsies or syndromes and one with specific syndrome. In regard to partial epilepsies, frontal lobe epilepsy and partial epilepsy with multiple foci were at least partially intractable as temporal lobe epilepsy. With respect to intractable generalized epilepsies, miscellaneous symptomatic generalized epilepsies like intractable grand mal epilepsy with progressive mental retardation in childhood were as important as Lennox-Gastaut or West syndrome though it defies classification into any established syndromes. The proposed International Classification of Epileptic Syndromes and Epilepsies was found adequate for analysis of intractable epilepsy. The disturbance of fine motor performance found in 84 patients who participated in occupational therapy was investigated by test programs comprising nine subbatteries.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Determination of player potential in volleyball: coaches' rating versus game performance.

The purpose of this study was to determine if the factors which coaches feel indicated superior player potential were the same as those factors which contribute to successful competition outcome. Players from two colleges were evaluated for general and specific performance variables prior to a regular season match between the teams. A player's ability rating was the total of four coaches' ranking on a 1-to-10 scale. Multiple regression analysis to predict player ability rating selected age, vertical jump, total body movement time, and agility (R = 0.87). However, step-wise discriminant analysis to differentiate winning and losing team members selected shoulder flexibility, agility, forearm bump, and sit-and-reach flexibility. The canonical correlation between the winning-losing dichotomy and these skills was 0.74 and resulted in proper classification of 84.6% of the correct team members. It was concluded that the skills coaches consider indicative of superior ability are not necessarily the factors which dictate winning performance.

Adult↗

[Cytologic differentiation between the autonomous and autoimmune type of diffuse hyperthyroid goiter: correlation with TSH receptor antibodies, microsomal antibodies and infiltrative ophthalmopathy].

A group of 101 patients with diffuse hyperthyroid goiter has been studied. Sixty-seven patients showed significantly increased level of antibodies to the TSH receptor (TBIAb), 48 patients had positive microsomal antibodies (MAb) and 41 patients had infiltrative ophthalmopathy. On the basis of cytologic analysis of the whole group, the patients were divided into two groups. Group A (n = 51, autonomous form?) was characterized by follicular cell proliferation, while group B (n = 50, autoimmune form?) was characterized by lymphocyte infiltration or follicular cell proliferation with lymphocyte traces. Cytologic findings were correlated with autoimmunity markers (TBIAb, MAb, infiltrative ophthalmopathy); multiple correlation factor was 0.17. In conclusion, cytologic classification into autonomous and autoimmune hyperthyroidism form, except by microsomal antibodies, is not followed by other autoimmunity markers.

Adolescent↗

Alpha interferon treatment in chronic hepatitis C.

INTRODUCTION: Alpha interferon (alpha IFN) treatment normalizes serum ALT levels in at least half of all patients affected by chronic hepatitis C, but a reactivation of the disease is frequently observed after the end of therapy. Different regimens of alpha IFN therapy have been proposed but the optimal schedule is still controversial. Recently at least 6 different types of HCV have been identified and the HCV genotype has been proposed as an important factor influencing the response to alpha IFN therapy. OBJECTIVE: The aim of this study was to evaluate the efficacy of different regimens of alpha IFN in chronic hepatitis C, and to study the relationship between the response to treatment and HCV genotypes. METHODS: 160 consecutive patients affected by biopsy-proven chronic hepatitis C were randomly treated with different doses of lymphoblastoid alpha IFN [adjusted to the body surface area (m2)] and different durations of therapy, as follows: 2 MU/m2/t.i.w. for 6 or 12 months or 4 MU/m2/t.i.w. for 6 or 12 months. Biochemical and virological responses were studied: ALT levels were monitored monthly during and for at least 6 months after the end of treatment, and serum HCV RNA was assessed before and at the end of therapy, using nested RT-PCR. Biochemical responses were defined in advance as follows: non-response as maintenance of abnormal ALT levels during treatment; complete response as the normalization of ALT by the 4th month and lasting until the end of treatment; sustained response as a complete response lasting for at least 6 months after the end of therapy. The clearance of serum HCV RNA at the end of therapy was considered a virological response. In pre-treatment sera stored at-80 degrees, HCV genotyping was performed according to the method of Okamoto. The Chi square test and multiple stepwise logistic regression were used for the statistical analysis. RESULTS: A sustained biochemical response was significantly more frequent in patients treated for 12 than in patients treated for 6 months, independently of the dosage (45% vs 24% in patients treated with 2 MU/m2/tiw, and 55.5% vs 30% in those treated with 4 MU/m2/tiw). The distribution of HCV genotypes (according to the classification of Okamoto) was 9.8% type I, 45.5% type II, 37.1% type III and 7.6% type V. Both the biochemical and virological responses were significantly correlated to the HCV genotype, being significantly more frequent in patients infected with type III or V (71-60% biochemical and 48-50% virological response, respectively) than in patients with type I or II (15% biochemical and 18-21% virological response, respectively). CONCLUSIONS: 12 months of alpha IFN treatment seemed to be significantly more efficacious than 6 months of therapy, and a significant relationship between the HCV genotype and the biochemical and virological response to alpha IFN was found.

Adolescent↗