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Protecting genomic sequence anonymity with generalization lattices.

OBJECTIVES: Current genomic privacy technologies assume the identity of genomic sequence data is protected if personal information, such as demographics, are obscured, removed, or encrypted. While demographic features can directly compromise an individual's identity, recent research demonstrates such protections are insufficient because sequence data itself is susceptible to re-identification. To counteract this problem, we introduce an algorithm for anonymizing a collection of person-specific DNA sequences. METHODS: The technique is termed DNA lattice anonymization (DNALA), and is based upon the formal privacy protection schema of k -anonymity. Under this model, it is impossible to observe or learn features that distinguish one genetic sequence from k-1 other entries in a collection. To maximize information retained in protected sequences, we incorporate a concept generalization lattice to learn the distance between two residues in a single nucleotide region. The lattice provides the most similar generalized concept for two residues (e.g. adenine and guanine are both purines). RESULTS: The method is tested and evaluated with several publicly available human population datasets ranging in size from 30 to 400 sequences. Our findings imply the anonymization schema is feasible for the protection of sequences privacy. CONCLUSIONS: The DNALA method is the first computational disclosure control technique for general DNA sequences. Given the computational nature of the method, guarantees of anonymity can be formally proven. There is room for improvement and validation, though this research provides the groundwork from which future researchers can construct genomics anonymization schemas tailored to specific datasharing scenarios.

Algorithms↗

Effects of socioeconomic status on the obesity knowledge of adolescents from six Latin American cities.

OBJECTIVE: To examine the effects of socioeconomic status (SES) on the obesity knowledge of adolescents in six Latin American cities. DESIGN: Data were collected using an anonymous, self-administered questionnaire consisting of demographic questions and a 25-item multiple-choice obesity knowledge test. Test items were clustered under five topics: the fat and calorie content of foods and beverages; weight loss methods; energy expenditure; food preparation methods; and the relationship between obesity and health. SUBJECTS: A total of 1272 ninth grade students from higher and lower SES families were recruited at schools in Buenos Aires, Argentina (n=195); Guatemala City, Guatemala (n=212); Havana, Cuba (n=213); Lima, Peru (n=218); Panama City, Panama (n=195); and Santiago, Chile (n=239). RESULTS: Mean test scores reflected a low level of obesity knowledge among adolescents from higher and lower SES groups in all six cities. Nevertheless, a trend for higher scores emerged in favor of adolescents from wealthier families. This income effect persisted after controlling for gender and weight status. The weakest knowledge areas among youth from the higher SES groups were food preparation methods and the relationship between obesity and health while those for adolescents from the lower SES groups were the fat and calorie content of foods and beverages and the relationship between obesity and health. Classroom instruction about obesity was generally more available to students from the higher SES groups. The majority of adolescents from both SES groups were interested in learning more about weight loss methods, energy expenditure, and the fat and calorie content of foods and beverages. The topic of least interest was the relationship between obesity and health. CONCLUSION: These preliminary findings suggest a need for more obesity education programs for adolescents, especially for those living in poverty.

Adolescent↗

Attitudes of applicants for surgical residency toward work hour limitations.

BACKGROUND: There is an ongoing debate regarding the merits of resident work-hour limitations. We postulated that this issue would be a factor in the decision-making process of applicants to surgical residency. METHODS: Candidates for surgical residency at a university-based program completed an anonymous survey during their visit. Data was analyzed by analysis of variance and the chi-square test. RESULTS: Most candidates viewed work-hour limitations as being favorable to their future training. Nevertheless, work-hour limitations ultimately were not a critical factor in the decision-making process compared with issues such as quality of training and program reputation. Candidates ranked "reading in surgery" the most likely way they would spend the leisure time afforded by work-hour limitations. CONCLUSIONS: Most applicants for surgical residency consider work hour-limitations as being favorable to their training and view the extra free time as an opportunity for furthering their education. However, other issues take precedence when choosing a residency.

Attitude of Health Personnel↗

High incidence of propionic acidemia in greenland is due to a prevalent mutation, 1540insCCC, in the gene for the beta-subunit of propionyl CoA carboxylase.

Propionyl CoA carboxylase (PCC) is a mitochondrial, biotin-dependent enzyme involved in the catabolism of amino acids, odd-chain fatty acids, and other metabolites. PCC consists of two subunits, alpha and beta, encoded by the PCCA and PCCB genes, respectively. Inherited PCC deficiency due to mutations in either gene results in propionic acidemia (PA), an autosomal recessive disease. Surprisingly, PA is highly prevalent among Inuits in Greenland. We have analyzed reverse transcriptase-PCR products of the beta-subunit mRNA, to characterize the responsible mutation(s). A 3-bp insertion, 1540insCCC, was found in homozygous form in three patients and in compound heterozygous form in one patient. The resulting PCC has no measurable activity, and the mutant beta-subunit appears to be very unstable. To test the hypothesis that a common mutation is responsible for PA in the Greenlandic Inuit population, 310 anonymous DNA samples of Inuit origin were screened for 1540insCCC. We found a carrier frequency of 5%, which is very high compared with those of most other autosomal recessive diseases. Analysis of alleles of a very closely linked marker, D3S2453, revealed a high degree of linkage disequilibrium between one specific allele and 1540insCCC, suggesting that this mutation may be a founder mutation.

Alleles↗

Prevalence of antibodies to hepatitis B, hepatitis C, and HIV and risk factors in Irish prisoners: results of a national cross sectional survey.

OBJECTIVES: To determine the prevalence of antibodies to hepatitis B core antigen, hepatitis C virus, and HIV in the prison population of the Republic of Ireland and to examine risk factors for infection. DESIGN: Cross sectional, anonymous, unlinked survey, with self completed risk factor questionnaire and provision of oral fluid specimen for antibody testing. SETTING: Nine of the 15 prisons in the Republic of Ireland. PARTICIPANTS: 1366 prisoners, of whom 1205 (57 women) participated. In the smaller prisons all prisoners were surveyed, while in the three largest prisons one half of the population was randomly sampled. Three small prisons believed not to have a problem with injecting drug use were excluded. MAIN OUTCOME MEASURES: Prevalence of antibodies to hepatitis B core antigen, antibodies to hepatitis C virus, and antibodies to HIV. Self reported risk factor status. RESULTS: Prevalence of antibodies to hepatitis B core antigen was 104/1193 (8.7%; 95% confidence interval 7.2% to 10.5%), to hepatitis C virus, 442/1193 (37%; 34.3% to 39.9%), and to HIV, 24/1193 (2%; 1.3% to 3%). The most important predictor of being positive for hepatitis B and hepatitis C was a history of injecting drug use. Thirty four women (60%) and 474 men (42%) reported ever injecting drugs. A fifth (104) of 501 injecting drug users reported first injecting in prison, and 347 (71%) users reported sharing needles in prison. CONCLUSIONS: Infection with hepatitis C secondary to use of injected drugs is endemic in Irish prisons. Better access to harm reduction strategies is needed in this environment.

AIDS-Related Opportunistic Infections↗

Evidence for linkage between a region on chromosome 1p and the acute insulin response in Pima Indians.

A low acute insulin response (AIR) is a predictor of non-insulin-dependent diabetes mellitus (NIDDM) in insulin-resistant Pima Indians. We have initiated a search for regions of the genome linked with the AIR using sib-pair linkage analysis as a first step in identifying genes that are determinants of this phenotype. Eighteen short tandem-repeat polymorphisms from chromosome 1 were genotyped in over 900 Pima Indians and tested for linkage with NIDDM and in a subset of Pima Indians for linkage with AIR. The anonymous DNA marker D1S198 on chromosome 1p was linked with AIR (P = 0.000056) in 175 sib pairs from 60 families, all with normal glucose tolerance, but no linkage was observed between D1S198 and NIDDM (P = 0.44, 996 sib pairs). Additional markers genotyped on chromosome 1 did not show linkage with AIR or NIDDM. This study indicates that a locus on chromosome 1p may be a determinant of the phenotypic variation seen in the AIR.

Chromosomes, Human, Pair 1↗

Plasmodium falciparum parasites in French Guiana: limited genetic diversity and high selfing rate.

The genetic characteristics of Plasmodium falciparum isolates collected in French Guiana, where malaria transmission is low and occurs in isolated foci, were studied. Blood samples were collected from 142 patients with symptomatic malaria and typed using a polymerase chain reaction-based strategy for merozoite surface protein-(MSP-1) block 2, the MSP-2 central domain, and glutamate-rich protein (GLURP) repeat domain polymorphism. This showed that the parasite population circulating in French Guiana presented a limited number of allelic forms (4, 2, and 3 for MSP-1 block 2, MSP-1, and GLURP, respectively) and a small number of mixed infections, contrasting with the large genetic diversity of parasite populations and infection complexity reported for Africa, Asia, and other parts of South America. Two groups of isolates displaying identical 3 loci allele combinations were further studied for the Pf332 antigen, histidine-rich protein-1, thrombospondin-related anonymous protein, and Pf60 multigene family polymorphism. Within each group, most isolates were identical for all markers tested. This suggests a high rate of self-fertilization of P. falciparum parasites in French Guiana, resulting in homogenization of the population. The implications of these findings for malaria control in areas of low endemicity are discussed.

Animals↗

Spiritual and religious beliefs and practices of family physicians: a national survey.

BACKGROUND: The current movement in American medicine toward patient-centered or relationship-centered care highlights the importance of assessing physician core beliefs and personal philosophies. Religious and spiritual beliefs are often entwined within this domain. The purpose of this study was to identify the personal religious and spiritual beliefs and practices of family physicians and to test a valid and reliable measure of religiosity that would be useful in physician populations. METHODS: An anonymous survey was mailed to a random sample of active members of the American Academy of Family Physicians who had the self-designated professional activity of direct patient care. Physicians reported their religious and spiritual beliefs and practices, including frequency of religious service attendance and private prayer or spiritual practice, and self-reported intrinsic or subjective religiosity. RESULTS: Seventy-four percent of the surveyed physicians reported at least weekly or monthly service attendance, and 79% reported a strong religious or spiritual orientation. A small percentage (4.5%) of physicians stated they do not believe in God. A 3-dimensional religiosity scale that assessed organized religious activity, nonorganized religious activity, and intrinsic religiosity was determined to be a valid and reliable measure (alpha = .87) of physician religious and spiritual beliefs and practices. CONCLUSIONS: Family physicians report religious and spiritual beliefs and practices at rates that are comparable with the general population.

Adult↗

[Current aspects of ambulatory anesthesia for otorhinolaryngologic and stomatologic surgery in France].

Ambulatory anaesthesia is becoming more popular in France for several reasons: -for humanitory reasons and greater comfort, -for reasons of economy in hospital, -professional responsibility and insurance. This change has been made possible by: -techniques of anaesthesia using drugs which are eliminated rapidly without any rebound phenomenon, -medical attitudes, such as prior examination of the patient by an anesthetist; this is much better than a rapid examination at night or in the morning on admission of the patient, thus precise control of awakening by tests of psychomotor activity. -changes in hospital structure, e.g. post-anaesthetic awakening wards with specialised personnel. Anonymous questionnaires were sent out to O.R.L. surgeons and French oral surgeons, we received 38.5% replies: -51.75% never used ambulatory anaesthesia, -48.25% used ambulatory anaesthesia almost always in hospital with a recovery room and anaesthetic consultation. Admission to hospital for one day seems rarer. It thus appears that ambulatory anaesthesia is becoming common in France and that more than 50% of surgeons remain opposed to this technique.

Anesthesia, Dental↗

Attitudes towards information system security among physicians in Croatia.

To examine attitudes about information system security among Croatian physicians a cross-sectional study was performed on a representative sample of 800 Croatian physicians. An anonymous questionnaire comprising 21 questions was distributed and statistical analysis was performed using a chi-square test. A 76.2% response rate was obtained. The majority of respondents (85.8%) believe that information system security is a new area in their work. In general, physicians are not informed about European directives, conventions, recommendations, etc. Only a small number of physicians use personal computers at work (29%). Those physicians who have a personal computer use it mainly for administrative reasons. Most healthcare institutions (89%) do not have a security manual and the area of information system security is left to individual interest and initiative. Only 25% of physicians who have a personal computer use any type of password. A high percentage of physicians (22%) has never thought about the problem of personal data being used by organizations (e.g. police, banks) without legal background; a small, but still significant percentage of physicians (5.6%) has even agreed with such use. Results indicate that for the vast majority of physicians, information system security is a new area in their daily work, one which is left to individual interest and initiative. They are not familiar with the ethical, technical and legal backgrounds which have been defined for that area within the Council of Europe and the European Union. New aspects: This is the first study performed in Central and Eastern Europe dealing with information system security, performed on a representative nationwide sample of all the physicians.

Adult↗

Awareness, prior use, and intent to use emergency contraception among Montana women at the time of pregnancy testing.

OBJECTIVES: To identify factors associated with awareness of emergency contraception (EC), prior use of EC, and intent to use EC in the future among women at the time of pregnancy testing. METHODS: A convenience sample of women presenting for pregnancy testing and being found to be pregnant in 38 primary health care facilities completed a self-administered, anonymous questionnaire. Information regarding demography, pregnancy intentions, use of any contraception, awareness of EC, prior use of EC, and intent to use EC in the future was collected. RESULTS: Of the 583 women that completed the questionnaire, 62% were aware of EC, 4% had previously used EC, and 13% considered using EC in the future. Women aware of EC were more likely to be white, have > or = 12 years of education, and report use of birth control prior to the current pregnancy. Younger women, those with < 12 years of education, and those not currently living with a partner were more likely to have previously used EC. Women who considered using EC in the future were more likely to be younger, non-white, have < 12 years of education, not currently living with a partner, and their usual source of care was a public clinic. Women who considered using EC in the future were also more likely to not want to be pregnant now or ever (21%) compared to women who wanted to be pregnant now or sooner (12%), or with those who were unsure of their current pregnancy (7%). CONCLUSION: Strategies need to be developed to increase the awareness of EC and determine the factors that would assist in enhancing its utilization.

Adolescent↗

Dried blood spots improve access to HIV diagnosis and care for infants in low-resource settings.

Effective health care delivery to the majority of perinatally exposed infants worldwide, including those enrolled in prevention of mother-to-child transmission programs, is hampered by lack of access to an HIV diagnosis in infancy. Dried blood spot collection from young infants for centralized HIV polymerase chain reaction (PCR) testing is attainable in low-resource settings, provided PCR methodology suitable for routine laboratory service is available. The accuracy of the Roche Amplicor HIV-1 DNA test version 1.5 (Branchburg, NJ) performed on dried blood spots collected prospectively on ordinary Whatman filter paper from a cohort of 300 6-week-old infants born to HIV-infected women in Johannesburg, South Africa, was assessed. Anonymous analysis of the blood spots using a unique DNA extraction procedure was performed in a routine diagnostic laboratory and the results compared with HIV DNA and RNA PCR liquid blood tests at age 6 weeks, and the HIV status of the infant. Dried blood spots were available for 288 infants (96%) of whom 25 (8.7%) were HIV infected. The Roche Amplicor assay yielded a sensitivity of 100% and a specificity of 99.6%. HIV DNA PCR tests on dried blood spots have the potential to improve health care delivery to HIV-affected children in low-resource settings right now.

Acquired Immunodeficiency Syndrome↗

Review of research on pathological gambling.

The literature including a number of review articles was examined for answers to the questions, have distinctive personality test profiles of pathological gamblers been identified, do pathological gamblers have control over their behavior, have studies of alcoholism and addiction increased understanding of compulsive gambling, and has psychotherapy or Gamblers Anonymous been successful for them? Much more information is needed to build on what research on these questions has yielded.

Gambling↗

[Effect of alcohol consumption on recurrence of venereal diseases].

INTRODUCTION: Sexually transmitted diseases (STDs) comprise a large group of infections caused by different microorganisms including spirochetes, bacteria, chlamydia, mycoplasma, protozoa, fungi, parasites, and viruses. A considerable number of patients with sexually transmitted diseases are STD recurrences. As reported by Marijanović and Lalosević, in Belgrade, among patients who visited the City Department of Skin and Venereal Diseases, during 1985 and 1986 because of syphilis or gonorrhea, 22.8% had these diseases two or more times during their lives (male/female ratio 10:1). The aim of this study was to test the hypothesis that there is a relationship between alcohol use and recurrence of STD. MATERIAL AND METHODS: A case-control study was performed in Belgrade population, from June, 1997 to April, 1998. Participants were recruited among patients attending the City Department of Skin and venereal Diseases of Belgrade because of sexually transmitted diseases (syphilis, gonorrhea, nongonoccocal urethritis and genital warts). The case group comprised 101 patients who already had STD two or more times in their personal histories. The control group consisted of 210 patients treated at the same institution for micotic diseases, patients who either never had STD or had it only once (13% of controls) in their personal histories. All participants were men aged 20 to 50 years and all were from Belgrade. Data on demographic characteristics, sexual history and sexual behavior, and data on antisocial behavior were collected from all participants using an anonymous questionnaire. In the present paper only data on alcohol use are presented. In the analysis of data chi 2-test was used. RESULTS: STD recurrence patients in comparison to their controls used alcohol more frequently (56.3%:16.1%), especially hard liquors, and 55.5% of them used alcohol at the time of STD infection. DISCUSSION: In the present study STD recurrence patients consumed alcohol more frequently than their controls, especially hard liquors. In the study of Myliueva et al, 50% of venereal disease patients consumed alcohol now and then and 10% consumed alcohol frequently. Scheidt and Windle found that 60% of alcoholics had at least one sexually transmitted disease as the result of a high number of sexual partners, low use of condoms and practicing sex for drugs or money. Alcohol has a depressive effect on central nervous system, reduces anxiety and increases libido. CONCLUSION: The obtained results support the hypothesis that alcohol use is related to recurrence of STDs.

Adult↗

Prevalence, donation practices, and risk assessment of blood donors with hemochromatosis.

CONTEXT: Despite changes in eligibility policies, practical barriers limit blood donations from individuals with hemochromatosis. Increased knowledge of hemochromatosis donor characteristics may help foster further changes that will promote more donations. OBJECTIVES: To estimate the prevalence of donors diagnosed as having hemochromatosis and to compare rates of unreported deferrable risks for transfusion-transmissible viral infections (TTVIs), positive screening test results for TTVIs, and donation patterns between hemochromatosis patient donors and donors reporting no medical conditions necessitating phlebotomy (non-health-related donors). DESIGN: An anonymous mail survey conducted in 1998 as part of the ongoing Retrovirus Epidemiology Donor Study. SETTING AND PARTICIPANTS: Among a stratified probability sample of 92 581 blood donors from 8 geographically diverse US blood centers, 52 650 (57%) responded. MAIN OUTCOME MEASURES: Prevalence of hemochromatosis among blood donors; prevalence of unreported deferrable risks and positive screening test results for TTVIs among hemochromatosis patient donors vs non-health-related donors. RESULTS: One hundred ninety-seven respondents (0.4%) identified themselves as hemochromatosis patients and 50 079 (95.1%) as non-health-related donors. An estimated 0.8% of all donations were from hemochromatosis patients, 45.8% of whom reported that they had donated blood to treat their illness. The proportion of repeat donors was higher in hemochromatosis patients than in non-health-related donors (83.5% vs 76.5%; P =.03). Among repeat donors, 68.7% of hemochromatosis patients reported donating at least 3 times in the past year compared with 49.1% of non-health-related donors (P<.001). The prevalence of unreported deferrable risks for TTVIs was similar in hemochromatosis patients (2.0%) and non-health-related donors(3.1%) as was the overall prevalence of positive screening test results (1.3% of hemochromatosis patients vs 1.6% of non-health-related donors). CONCLUSIONS: Although significant numbers of hemochromatosis patients reported donating blood for therapeutic reasons, our findings suggest that this population does not present a greater risk to blood safety than other donors.

Adult↗

Constructing and testing a model of trustworthiness, trust behavior and organizational identification.

This study, in which staff nurses in Taiwan participated, was aimed to construct a model for relationships among trustworthiness, trust behavior and organizational identification. One hundred and ninety five anonymously completed questionnaires were collected. Superiors' trustworthiness, staff nurses' trust behavior, and organizational identification were identified as latent variables to which the following indicators were to be applied: integrity, benevolence, ability, communication, consistency, compliance, sharing, teamwork, subordination, membership, loyalty and similarity. A logical trust and organizational identification model was constructed and tested with LISREL (Linear Structural Relations) analysis. Benevolence was eliminated due to excessive residual value. The adjusted model passed pertinent tests. It was also revealed that trust behavior acts as a mediator between trustworthiness and organizational identification. The results of this study may be taken as a reference for the training of supervisory level personnel, as well as for strengthening the organizational identification of staff nurses, and as a beginning phase in the construction and testing of a relationship model for the relationship between trust and organizational identification.

Adult↗

Failure to embrace the barrier/condom use message.

The objective of this study was to examine the consistency of barrier/condom use among men who have sex with men in the Kansas City metropolitan area. The authors sought to determine if barrier/condom usage patterns were associated with the type of sex act and whether it was insertive or receptive, HIV testing frequency, and number of sexual partners. Data were extracted from a 2003 community health assessment of the gay, lesbian, bisexual, and transgendered community in the metropolitan area. The health assessment instrument was anonymous, self-administered, and distributed at events in that community. Responses from 623 men indicated that consistent use of a barrier/condom was low regardless of the sex act. There was no relationship between barrier/condom usage patterns and HIV testing frequency for any sex act or the number of sex partners, with the exception of anal intercourse. The authors concluded that a different approach is needed to translate the barrier/condom use message into a behavioral response.

AIDS Serodiagnosis↗

Human immunodeficiency virus seroprevalence in community-based primary care practices, 1990-1992. A report from the Ambulatory Sentinel Practice Network.

OBJECTIVE: To estimate the seroprevalence of human immunodeficiency virus type 1 (HIV-1) infection in primary care practices. METHODS: Fifty-four practices in the United States participated in an anonymous, unlinked HIV seroprevalence study between January 1990 and December 1992. Residual blood samples drawn for routine clinical tests from patients 15 to 49 years of age were centrally tested for the HIV-1 antibody for 1 month of each quarter. Information about patient demographics, clinician-recognized risk factors, the known HIV status of the patient, and whether the blood was drawn for HIV testing was recorded with each specimen. RESULTS: Of 21,998 specimens collected, 99 (0.45%) were seropositive. Of these 99 seropositive persons, 31.3% (a seroprevalence of 0.15%) were not suspected by their clinicians of being infected with HIV. Seroprevalences in men (0.96%) exceeded those in women (0.22%), and rates in rural practices (0.18%) were lower than in urban practices (0.71%). Among patients with unsuspected HIV infection, however, the gender differences, especially in rural areas, were less pronounced. Risk factors for HIV infection were infrequently noted. There was an increase in the overall seroprevalence during the 1990 to 1992 study period (0.36% to 0.53%); however, this trend was not statistically significant. CONCLUSIONS: Within a 3-year period, clinicians in at least two of five primary care practices can expect to encounter patients infected with HIV, regardless of practice location. Also, nearly one third of the patients with HIV infection will not be suspected of having this condition by their clinician.

Adolescent↗