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PubMed1992

Sibling delinquency and the family environment: shared and unshared influences.

Few family studies of delinquency have focused on siblings. We use a sibling research design to evaluate shared (i.e., family) and unshared environmental influences on delinquency. The 15-22-year-old adolescent siblings were nationally representative, and uniquely, in families of 2 to 4 siblings. No unshared family environmental influences were found for sisters and for mixed-sex siblings, but they may exist for brothers. The data suggested substantial shared environmental and/or shared genetic influences for siblings: the median sibling correlations, averaged over family sizes, were: brothers, r = .30; sisters, r = .28, and mixed sex, r = .21.

Adolescent↗
PubMed2005

Fourth International Workshop on immunology of pre-eclampsia, December 2004, Reunion, France.

The Fourth International Workshop on 'Reproductive Immunology, Immunological Tolerance and Immunology of Pre-eclampsia' was held in the Island of La Reunion in December 2004. Besides intense sharing of immunological data, it included also epidemiological studies from South Africa, USA and Australia, as well as genetic studies from South Africa and Mauritius, discussions on the future of graft transplant tolerance, implications of inositol-phosphoglycans in the pathogenesis of pre-eclampsia (PE), pathways to the inflammatory syndrome and other topics. Participants shared the belief that we may be witnessing significant steps forward in our comprehension of PE as an immunological event, with a prominent role for deregulation of the innate immune system, probably controlled by T cells and cytokine networks at the feto-placental interface. There was a growing consensus for an NK cell (KIR)-dependent event, with regulation exerted by T cells, as well as an important role for HLA-C presentation/recognition and HLA-G in mediating inflammatory cytokine imbalance, with an emphasis on IL-12 and IL-16 It is hoped that the next Workshop in 2006 will prove the immune involvement by dissecting the NK/Treg/Ts cell and HLA-CI HLA-G circuits leading to cytokine and vascular dysfunction.

Female↗
PubMed2004

A shared random effect parameter approach for longitudinal dementia data with non-ignorable missing data.

A significant source of missing data in longitudinal epidemiologic studies on elderly individuals is death. It is generally believed that these missing data by death are non-ignorable to likelihood based inference. Inference based on data only from surviving participants in the study may lead to biased results. In this paper we model both the probability of disease and the probability of death using shared random effect parameters. We also propose to use the Laplace approximation for obtaining an approximate likelihood function so that high dimensional integration over the distributions of the random effect parameters is not necessary. Parameter estimates can be obtained by maximizing the approximate log-likelihood function. Data from a longitudinal dementia study will be used to illustrate the approach. A small simulation is conducted to compare parameter estimates from the proposed method to the 'naive' method where missing data is considered at random.

Aged↗
PubMed2025

Genomic structural equation modeling elucidates the shared genetic architecture of allergic disorders.

BACKGROUND: The intricate shared genetic architecture underlying allergic disorders-including allergic asthma, atopic dermatitis, contact dermatitis, allergic rhinitis, allergic conjunctivitis, allergic urticaria, anaphylaxis, and eosinophilic esophagitis-remains incompletely characterized. METHODS: Our study employed genomic structural equation modeling (Genomic SEM) to define the common factor representing the shared genetic architecture of allergic disorders. Coupled with diverse post-GWAS analytical methods, we aimed to discover susceptible loci and investigate genetic associations with external traits. Furthermore, we explored enriched genetic pathways, cellular layers, and genomic elements, and investigated putative plasma protein biomarkers. Polygenic risk score (PRS) analyses, leveraging our integrated GWAS data, were conducted to assess chromosomal-level risk associations for allergic disorders. RESULTS: A well-fitted genomic SEM integrated GWAS data, revealing the shared genetic architecture of allergic disorders. We identified a total of 2038 genome-wide significant SNP loci (p&#x2009;<&#x2009;5e-8), including 31 previously unreported loci. Fine-mapping of variants and gene sets pinpointed 2 causal variants and 31 candidate susceptible genes. Genetic correlation analyses further illuminated the shared genetic architecture underlying multiple traits, notably psychiatric disorders. Preliminary findings identified four putative causal plasma protein biomarkers. CONCLUSION: Notably, this study presents the first comprehensive genetic characterization of allergic disorders through a GWAS analysis of an unmeasured composite phenotype, providing novel insights into shared etiological pathways across these conditions.

Humans↗
PubMed2006

The development of a naturalistic data collection system to perform critical incident analysis: an investigation of safety and fatigue issues in long-haul trucking.

Traditionally, both epidemiological and empirical methods have been used to assess driving safety. This paper describes an alternative, hybrid, naturalistic approach to data collection that shares advantages with each traditional approach. Though this naturalistic approach draws on elements of several safety techniques that have been developed in the past, including the Hazard Analysis Technique, instrumented vehicle studies, and fleet studies of driving safety interventions, it has a number of unique elements. Sophisticated instrumented vehicles collected over 400,000 km of commercial vehicle data to address the long-haul trucking application described in this paper. The development of this data collection and analysis method and data collection instrumentation has resulted in a set of valuable tools to advance the current state-of-the-practice in driving safety assessment. An application of this unique approach to a study of long-haul truck driver performance, behavior, and fatigue is described herein.

Adult↗
PubMedDate not supplied

Clinician communication associated with diabetic patients' comprehension of their therapeutic regimen.

The purpose of this study was to identify the types of statements used by medical and nursing clinicians in encounters with diabetic outpatients that are associated with accurate comprehension of their therapeutic regimen. Encounters between 19 clinicians and 29 patients followed in an urban diabetes clinic were examined. Statements made by clinicians were classified by trained observers according to an 11-category observation scheme. Immediately after the encounters, each patient was interviewed and asked to recall his or her regimen as just discussed. Recall was verified by review of a videotape of the encounter. By use of multiple discriminant analysis, a combination of three types of statements by clinicians was found to predict high (better than 80%) comprehension by patients: demonstrating respect, sharing current clinical data, and acknowledging patient statements (inversely). Insofar as patient comprehension of the diabetic regimen is a prerequisite for compliance with that regimen, this study suggests that the chances for therapeutic success are increased when the interaction of clinician and patient takes a certain tone. Most importantly, the clinician should be informative. Current laboratory and physical findings should be shared with the patient in order to make more obvious the successes and failures of recent attempts at compliance. As suggested in previous research, this information should have its strongest effect when conveyed in a nonthreatening manner.

Communication↗
PubMed1992

Molecular genetics of pestiviruses.

Recent developments in understanding the molecular genetics of pestiviruses are reviewed. The genomic RNA of several pestiviruses has been molecularly cloned and sequenced. The genetic organization of the viral protein coding region has been refined, and the complete complement of virus-encoded proteins has been elucidated. Viral gene expression involves both co-translational and post-translational precursor polyprotein processing. Biogenesis of the virion structural proteins requires the proteolytic activity of the first protein of the open reading frame (p20), as well as host cell enzymes. A second virus-encoded proteinase (p80) is required for processing viral nonstructural proteins. Molecular and biochemical data indicate pestiviruses share many features with both the flaviviruses and human hepatitis C viruses, while at the same time, also reveal their distinct nature.

Base Sequence↗
PubMed1986

How cost sharing affects the use of ambulatory mental health services.

The less generous insurance coverage for mental health care has generated some controversy. The major unresolved question is how the demand for outpatient mental health care responds to cost sharing. We used data from a randomized trial of fee-for-service health insurance for the nonelderly to address this question. The study enrolled 5809 persons. The results are based on 19 819 person-years of data. One hundred thirty-three percent more is spent on outpatient psychotherapy when care is free to patients than when they pay 95% of the fee, subject to an annual catastrophic limit. But, the absolute level of expenditure is low on all plans; $32 per person per year with free care. The response to psychotherapy services to cost sharing is insignificantly larger than that for outpatient general medical services. We found no evidence that more generous coverage for outpatient psychotherapy decreases total health expenditures.

Ambulatory Care↗
PubMed1998

MHCWeb: converting a WWW database into a knowledge-based collaborative environment.

The World Wide Web (WWW) is useful for distributing scientific data. Most existing web data resources organize their information either in structured flat files or relational databases with basic retrieval capabilities. For databases with one or a few simple relations, these approaches are successful, but they can be cumbersome when there is a data model involving multiple relations between complex data. We believe that knowledge-based resources offer a solution in these cases. Knowledge bases have explicit declarations of the concepts in the domain, along with the relations between them. They are usually organized hierarchically, and provide a global data model with a controlled vocabulary. We have created the OWEB architecture for building online scientific data resources using knowledge bases. OWEB provides a shell for structuring data, providing secure and shared access, and creating computational modules for processing and displaying data. In this paper, we describe the translation of the online immunological database MHCPEP into an OWEB system called MHCWeb. This effort involved building a conceptual model for the data, creating a controlled terminology for the legal values for different types of data, and then translating the original data into the new structure. The OWEB environment allows for flexible access to the data by both users and computer programs.

Artificial Intelligence↗
PubMed1999

Abbreviated injury scale unification: the case for a unified injury system for global use.

BACKGROUND: The Abbreviated Injury Scale (AIS), developed by the Association for the Advancement of Automotive Medicine is the most widely used anatomic injury severity scale in the world (Association for the Advancement of Automotive Medicine. The Abbreviated Injury Scale; 1985 and 1990 revisions. Des Plaines, IL: Association for the Advancement of Automotive Medicine). However, different user groups have modified the AIS system to fit their needs, and these modifications prevent ready comparison and trending of data collected in these systems in the United States and throughout the world. The United States currently has five AIS-based severity systems and two AIS-based impairment systems in use, with additional revisions forthcoming. Other modified AIS systems are known to be in use in the United Kingdom and Japan. The data collected in these systems cannot be accurately combined or compared without re-coding or the use of complex "mapping" methodologies. Furthermore, the expanding use of data linked from multiple databases to answer complex medical, engineering, or policy issues emphasizes the need for coordination between severity and other injury systems. Linkage of state-wide motor vehicle crash data with data from hospital injury classification systems, mortality files, trauma registry, and national crash databases brings into immediate focus the lack of well defined relationships between the severity coding systems and these other widely used injury systems (Mango N, Garthe E. SAE Congress, February, 1998; Johnson, S, Walker, J. NHTSA Technical Report. DOT HS 808 338, Washington, DC: NHTSA; January, 1996). With the expanding use of linked data in state and national policy decisions, it is vital that consistent standards for injury descriptions, severities, and impairments be available for clinical, engineering, and policy users. METHODS: This paper compares five anatomic severity systems and two impairment systems in terms of purpose, code structure, and use and discusses the reasons for the differences between these systems. With global "harmonization" encouraging greater sharing of international data, the paper also presents the relationship of the severity and impairment systems to US morbidity and reimbursement and worldwide mortality classification systems. RESULTS: To resolve compatibility issues resulting from multiple injury systems, the authors propose that a "unified" system for global use be developed, configured by inputs from major "data owners," users, and analysts. The proposed unified system has six key attributes: backward compatibility with historical data through "maps" so no data are lost; "scalability" to allow a simple level of use for developing countries, a more complex level for crash research and a detailed level for clinical hospital use, all with data compatibility; the ability to satisfy the needs of the engineering community for injury location information and aspect, and also the clinical requirement for precise injury description; inherent integration with whole body severity scores to permit easy computation; compatibility with other injury data systems such as mortality, morbidity, and reimbursement systems; and a mechanism and process to maintain and upgrade the system into the 21st century. CONCLUSION: The authors believe that a "unified" injury system is a necessary and crucial advance from the currently fragmented injury system situation. Unified data can provide a pool of consistent international data to support a variety of important research and prevention and treatment efforts and is essential to satisfy the global needs of the medical and engineering communities.

Abbreviated Injury Scale↗
PubMed2003

Co-twin control study of relationships among combat exposure, combat-related PTSD, and other mental disorders.

The well-documented association between combat-related PTSD (C-PTSD) and other mental disorders may be an artifact of shared familial vulnerability. This study uses a co-twin control design to examine whether the association between C-PTSD and other mental disorders persists after adjusting for shared familial vulnerability. Data were from male monozygotic twin pairs in the Vietnam Era Twin Registry. Logistic regression analyses demonstrated that combat exposure, adjusted for C-PTSD, was significantly associated with increased risk for alcohol and cannabis dependence and that C-PTSD mediated the association between combat exposure and both major depression and tobacco dependence. We conclude C-PTSD comorbidity persists after controlling for shared vulnerability. Combat exposure is directly and indirectly, through C-PTSD, associated with increased risk for other mental disorders.

Adult↗
PubMed2005

[Professional health cards (CPS): informatic health care system in France].

The Professional Health Card Public interest group (Groupement d'Intérêt Public-Carte de professionnel de Santé (GIP-CPS)) was founded in 1993 as a joint initiative by the different parties involved in health care in France: the state, the representatives of the health care professions and the compulsory and complementary health insurance organizations. The CPS system enables safe exchange and electronic sharing of medical data. Via Intranet connections and Extranet hosting of medical files, databases, the CPS system enables health care professionals who access servers to be identified with certainty. For email exhanges, the CPS systems guarantees the sender's identity and capacity. The electronic signature gives legal value to the email. The system also enables confidential email. The health card system (CPS) contributes to making the health service efficient. Shared medical files, health care networks, health warning systems or electronic requests for reimbursement of health insurance expenses all use the CPS system. More than 300,000 health care professionals use it regularly. The freedom of movement of patients throughout Europe has led to the growth of exchanges and information sharing between health professionals in the States of the Union. More and more health professionals will be leaving their own countries to work in foreign countries in the future. It is essential that their freedom of movement is accompanied by the ability to prove their rights to practice.

Access to Information↗
PubMed1991

Environmental risk factors in siblings with Parkinson's disease.

To investigate possible risk factors in Parkinson's disease, we conducted a case-controlled study of 19 families having two or more siblings with Parkinson's disease. Demographic data were collected, including lifetime histories of places of residence; sources of drinking water; occupations, such as farming; and exposure to herbicides and pesticides. Rural living and drinking well water, but not farming and herbicide exposure, were significantly increased in 38 parkinsonians compared with 38 normal control subjects. A comparison of parkinsonian siblings with siblings with essential tremor revealed no differences in any risk factors for the years of shared environment. These data suggest that living in a rural environment and drinking well water are risk factors for Parkinson's disease and that the total life exposure to an environmental toxin may be more important than exposure in early life.

Aged↗
PubMed2006

Multiperson use of syringes among injection drug users in a needle exchange program: a gene-based molecular epidemiologic analysis.

Syringe-sharing behaviors among injection drug users (IDUs) are typically based on self-reports and subject to socially desirable responding. We used 3 short tandem repeat (STR) genetic biomarkers to detect sharing in 2,512 syringes exchanged by 315 IDUs in the Baltimore needle exchange program (NEP; 738 person-visits). Demographic characteristics as well as direct and indirect needle-sharing behaviors corresponding to the closest AIDS Link to Intravenous Experience (ALIVE) study visits were examined for association with multiperson use (MPU) of syringes. Overall, 56% of the syringes exchanged at the Baltimore NEP had evidence of MPU. Less MPU of syringes (48% vs. 71%; P < 0.0001) was seen with more rapid syringe turnaround (<3 days). IDUs always exchanging their own syringes ("primary" syringes) were less likely to return syringes with evidence of MPU (52%) than those who exchanged syringes for others ("secondary" syringes; 64%; P = 0.0001) and those exchanging primary and secondary syringes (58%; P = 0.004). In a multivariate analysis restricted to primary exchangers, MPU of syringes was associated with sharing cotton (adjusted odds ratio [AOR] = 2.06, 95% confidence interval [CI]: 1.30 to 3.28), lending syringes (AOR = 1.70, 95% CI: 1.24 to 2.34), and injecting less than daily (AOR = 0.64, 95% CI: 0.43 to 0.95). These findings support additional public health interventions such as expanded syringe access to prevent HIV and other blood-borne infections. Testing of STRs represents a promising approach to examining and accessing complex behavioral data, including syringe sharing.

Adult↗
PubMed2003

[Treatment of Helicobacter pylori infection--results and experiences with an Internet-based collaboration trial].

BACKGROUND: Indications for H. pylori treatment as well as treatment regimens vary. MATERIAL AND METHODS: This trial compares three regimens with ranitidine bismuth citrate (RBC) or omeprazole as first line therapy, evaluates the effect of one regimen for retreatment, compares practice at Norwegian centres, and evaluates the utility of internet-based collaboration. Consecutive H. pylori positive outpatients at 14 centres were randomised to open treatment with one of the regimens. Patients in whom the first treatment was unsuccessful were offered an "enhanced" regimen with RBC. All participating centres submitted their data to a shared database via the internet. RESULTS: The RBC 400 mg, clarithromycin 250 mg and metronidazole 500 mg regimen, all drugs given twice daily for 7 days, was significantly more effective than the other regimens; infections in 141 out of 146 patients (97%) were successfully eradicated. An enhanced regimen with RBC, clarithromycin and metronidazole was less suitable for retreatment after failure. There were significant differences in patient age and indication for treatment between the centres. The data were of high quality. INTERPRETATION: The regimen RBC, clarithromycin and metronidazole was the most effective and seems suitable as first-line treatment. The internet collaboration yielded data of high quality that disclosed that patients were not uniformly managed. Our collaborative approach seems to be a suitable method for quality assurance and the organisation of simple clinical multicentre trials.

Adult↗
PubMed1999

Identifying the race or ethnicity of SSI recipients.

The Social Security Administration (SSA) has, from its beginnings, recorded the race and ethnicity provided by those who apply for a Social Security card. Although some of these data are eventually used in published tabulations when persons file for benefits, problems with the data prevent a larger selection of published tables. These problems stem from: incomplete internal SSA computer processing; changes in the racial coding schemes over time; and missing codes for younger cohorts of applicants. In spite of these problems, more data can be shared with the public. This article shows how matching administrative files and using statistical techniques make it possible to associate a race/ethnicity code with the great majority of persons receiving a payment under the Supplemental Security Income (SSI) program, a means-tested program for persons who are aged or disabled. The article follows a 1-percent sample of SSI recipients through several steps in an attempt to develop a race code. This approach can provide data for the next several years on the race of all SSI recipients, as well as data on race and ethnicity for recipients under age 40. Beyond the next few years, these techniques will become less useful, and other methods will be needed. SSA is in the process of revising its standards for classification of federal data on race and ethnicity. The census for year 2000 will include coding changes. Other federal agencies will be given as long as January 2003 to comply with the new guidelines.

Adolescent↗
PubMed1994

Amino acids in the peptide-binding groove influence an antibody-defined, disease-associated HLA-DR epitope.

A shared amino-acid sequence on the alpha helix of certain DR beta 1 chains is predicted to generate a 'shared epitope' that is implicated in susceptibility to the development of rheumatoid arthritis (RA). Different relative risks (RR) for disease susceptibility and severity conferred by these DR beta 1 chains suggest that their 'shared epitopes' are not equivalent. A set of monoclonal antibodies (MoAb) that map to the critical region, and for which optimal binding depends on DR context and cell lineage, was used to test this idea. Mapping experiments using mutated DR beta 1* molecules showed that the antibody-binding epitopes are overlapping; residue 70Q is pivotal for each, but neighbouring residues on the alpha helix and on the floor of the groove are also involved. Importantly, these epitopes are profoundly modified by peptide loading of DR beta 1*0401 molecules. These data suggest that 'shared epitopes' on DR molecules that are associated with RA are influenced by their context; such structural modifications may be the basis for the varying susceptibilities conferred by these DR molecules for the development of RA.

Amino Acid Sequence↗
PubMed2006

The Nikon C1si combines high spectral resolution, high sensitivity, and high acquisition speed.

Spectral imaging is a natural extension of the capabilities of confocal microscopes. The first confocal spectral imaging (CSI) instruments were able to acquire spectral data that allowed the emissions of overlapping fluorescent probes to be assigned to data channels representing a spectrum rather than a range of emission wavelengths. This marked a significant improvement over what could be done by channel series with standard confocal microscopes. However the performance of these earlier designs can fall short in one or more of the following areas; sensitivity, spectral resolution and reproducibility, acquisition speed, and unmixing accuracy. Nikon has recently introduced a new CSI instrument, C1si, that overcomes some of the more serious performance deficiencies of earlier designs through unique optical, electronic, and data handling advances. C1si uses a multianode photomultiplier tube (PMT) as the detector and typically acquires spectral data in a single scan. Sensitivity is enhanced over designs diffracting randomly polarized fluorescence by rotating the polarization of all emission photons to the S-plane, the plane for which the diffraction grating is most efficient. Three diffraction gratings are provided supporting wavelength sampling increments of 2.5, 5, and 10 nm. Improvements have been made in the digitization process to increase detection efficiency as well. C1si is calibrated to a high enough standard that it is possible to share and reproduce data between instruments. The algorithm implemented in the EZ-C1 software is able to accurately and repeatedly unmix fluorescent probes with emission peaks separated by as little as 5 nm. It is possible to unmix probes with emission peaks separated by 20 nm with a 10-1 brightness difference. Three probes can be unmixed with emission peaks contained within a 20 nm range. Acquisition is fast enough and the sensitivity is sufficient for C1si to acquire more than 100 frames of spectral time series data without serious photobleaching.

Algorithms↗