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PubMed2005

A content analysis of news coverage of skin cancer prevention and detection, 1979 to 2003.

OBJECTIVE: To analyze newspaper coverage between 1979 and 2003 to understand how print coverage may affect primary and secondary skin cancer prevention in the US population. DESIGN: Content analysis of 921 skin cancer articles released by the Associated Press during the study period. MAIN OUTCOME MEASURES: Amount of attention given to primary and secondary prevention practices and to risk communication. RESULTS: Media attention to skin cancer has not increased since 1986. Neither prevention (31.8% of all stories) nor detection (24.4% of all stories) received as much attention as treatment (47.0% of all stories). Specific sun protection practices were mentioned infrequently. Dermatologic detection (6.6%) or self-detection (5.5%) of skin cancer was rarely discussed. Risk communication about skin cancer was suboptimal: articles rarely presented absolute and relative risk. CONCLUSIONS: The media pay little attention to skin cancer, and, in general, stories do not contain important educational information. Strategies for generating increased media attention are discussed.

Female↗
PubMed1992

Ampicillin-sulbactam vs clindamycin in head and neck oncologic surgery. The need for gram-negative coverage.

This study was undertaken to assess whether gram-negative antimicrobial coverage is required in patients undergoing head and neck oncologic surgery. Ampicillin sodium-sulbactam sodium and clindamycin phosphate were compared in a prospective, randomized, parallel, double-blind trial of 212 patients undergoing head and neck procedures involving clean-contaminated wounds. Both antibiotics were given up to 1 hour before surgery and continued at 6-hour intervals after surgery for an additional eight doses. Fourteen infections occurred in the ampicillin-sulbactam-treated group (13.3%) and 29 infections in the clindamycin-treated group (27.1%). From patients receiving clindamycin, 29 gram-negative organisms were isolated, compared with six from those patients receiving ampicillin-sulbactam. This finding supports the need for gram-negative coverage in patients undergoing clean-contaminated head and neck oncologic surgery.

Adult↗
PubMed1989

Reduced incidence of the somnolence syndrome in leukemic children with steroid coverage during prophylactic cranial radiation therapy. Results of a pilot study.

Chemotherapeutic regimens for childhood acute lymphoblastic leukemia (ALL) include a remission induction period with high, daily doses of prednisone among other agents. A period of central nervous system (CNS) prophylaxis follows, during which steroids are often tapered entirely before cranial radiation (CRT) is completed or even initiated. The somnolence syndrome (SS) has been described 4 to 6 weeks after completion of CRT in up to 60% of the children with doses as low as 1800 cGy. A pilot study of continuous steroid coverage during CRT in childhood ALL was conducted. From July 1984 to July 1986, 38 children entered on Children's Cancer Study Group ALL protocols received CRT of 1800 cGy (180 cGy x 10). All patients received oral prednisone throughout the entire course of CRT at daily doses varying from 3.0 to 60.0 mg/m2. The overall incidence of the SS was 13% (five patients). The development of the syndrome was steroid dose-dependent: greater than or equal to 15 mg/m2/d (one of 32 patients), 3% incidence; less than 15 mg/m2 (four of six patients), 67% incidence. The presence of headache during CRT was also steroid dose-related: greater than or equal to 15 mg/m2, one of 32 patients; less than 15 mg/m2, six of six patients. Of the seven patients with headache during CRT, five developed the SS. The two patients (both of the less than 15 mg/m2 group) who did not develop the SS were the only cases treated with increased steroid doses at the onset of headache symptoms. Steroid coverage at a dose of greater than or equal to 15 mg/m2 during CRT appears to significantly reduce the incidence of acute radiation reactions and the SS. A prospective randomized study is planned to confirm these initial findings.

Adolescent↗
PubMed2001

Toward efficient analysis of >70 kDa proteins with 100% sequence coverage.

For complete characterization of larger proteins, primary structural analysis by mass spectrometry must be made more efficient. A straightforward approach is illustrated here using two proteins of 159 and 199 kDa with five and nine Lys residues, respectively. These proteins were degraded by Lys-C to mixtures of peptides ranging in size from 5 to 48 kDa, whose multiply charged ions (from electrospray ionization) are far more amenable than the intact proteins to direct interrogation in a Fourier-transform mass spectrometer. For the 199 kDa PchF of approximately 60% purity, an unfractionated Lys-C digest gave 106 isotopic distributions from 71 components (most of which were below 6 kDa); 15% sequence coverage was obtained. For the > 90% pure PchE (159 kDa), complete sequence coverage was obtained from six Lys-C peptides of 5, 8, 26, 32, 40 and 48 kDa, with all but the largest of these measured at isotopic resolution on a 4.7 Tesla instrument. Practical strategies for implementing this characterization strategy on a proteomic scale are considered.

Amino Acid Sequence↗
PubMed2006

Mandating coverage of biologic therapies for rheumatic disease: where evidence and politics meet.

In this issue of Arthritis Care & Research, we inaugurate an occasional series of commentaries entitled Policy Matters. In all of clinical research, our goal is to improve patient outcomes. Usually, that means focusing on the medical, demographic, and socioeconomic factors at the level of individuals with rheumatic diseases; sometimes, our scope of inquiry expands to encompass the impact of the communities in which they live. However, increasingly, the welfare of persons with rheumatic conditions is also affected by health policies through such diverse mechanisms as reimbursement decisions for specific treatments, insurance coverage, manpower, and NIH budgets (the foregoing list is hardly exhaustive).Recently, a piece of legislation was introduced in California (SB913) that has the potential to alter the availability of biologic response modifying agents (BRMs) by mandating that health plans that provide coverage for one such agent include all on their formularies (a revised version would preclude a trial of another disease-modifying antirheumatic drug before use of a BRM). In this state, the California Health Benefits Review Program (CHBRP) provides evidence reviews of the medical effectiveness, cost, and public health impact of proposed health insurance mandates for the legislature. The analysts from the University of California who conducted the medical effectiveness review of SB913 for CHBRP provide a legislative history of the proposed law in this article. We hope that the readership of Arthritis Care & Research find this article informative as an exemplar of the policies that could dramatically alter the welfare of our patients.

Biological Therapy↗
PubMedDate not supplied

Soft tissue coverage of mandibular reconstruction plates.

Free tissue transfer was compared to pectoralis major flap coverage of mandibular reconstruction plates in a retrospective review. The study group consisted of 14 patients whose composite defects were reconstructed with metal plates covered with either pectoralis flaps (9) or soft tissue free flaps (5). Four patients in the pectoralis group (44%) had plates that extruded compared to none in the free flap group. The mean operating room time for the free flap group (721 minutes) was longer than the pectoralis group (550 minutes), but the overall hospital stay for the free flap group (20 days) was half that of the pectoralis group (39 days). The pectoralis group required more secondary procedures (88%) than the free flap group (20%). Free flaps have a higher success rate, a shorter hospital stay, and require fewer additional procedures than do pectoralis flaps. This justifies the longer operating time and greater technical complexity of free tissue transfer for reliable coverage of mandibular reconstruction plates.

Aged↗
PubMed1995

Physician coverage of therapeutic apheresis.

A "snapshot" survey of physician coverage for evaluation and supervision of therapeutic apheresis procedures shows significant variation in current clinical practice between 39 blood center-and 41 non-blood center-based programs. Whereas 56% of blood center-based programs usually require physician's "in person" evaluation of the patient, 86% of non-blood center programs do (P < .005). Similarly, non-blood center-based programs were more likely to have physicians on the premises to supervise first and subsequent procedures and to bill separately for medical coverage. These differences were unrelated to location of the procedure (in hospital, blood bank, outpatient department, or other), the size of the program, or any information provided on adverse reactions.

Blood Component Removal↗
PubMed2006

QM/QM study of the coverage effects on the adsorption of amino-cyclopentene at the Si(100) surface.

In this work, we have tested 30 different adsorption situations in several coverage scenarios for the 1-amino-3-cyclopentene (ACP) molecule on the Si(100) surface. We have used a five-spot testing zone inserted in the high-level part of a quantum-mechanical/quantum-mechanical study performed in a big cluster. By defining several different scenarios, each one with a typical adsorption energy, we were able to understand in detail the process of surface functionalization. We are able to justify why the functionalization of this silicon surface achieves only a coverage of approximately 0.5 ML (half monolayer) and why the completely covered surface should be thermodynamically impossible to obtain.

Journal Article↗
PubMed2001

Magnetic resonance myocardial first-pass perfusion imaging: parameter optimization for signal response and cardiac coverage.

Fast imaging techniques allow monitoring of contrast medium (CM) first-pass kinetics in a multislice mode. Employing shorter recovery times improves cardiac coverage during first-pass conditions, but potentially flattens signal response in the myocardium. The aim of this study was therefore to compare in patients with suspected coronary artery disease (CAD) two echo-planar imaging strategies yielding either extended cardiac coverage or optimized myocardial signal response (protocol A/B, six/four slices; preparation pulse, 60 degrees /90 degrees; delay time, 10/120 msec; readout flip angle, 10 degrees /50 degrees; respectively). In phantoms and myocardium of normal volunteers (N= 10) the CM-induced signal increase was 2.5-3 times higher with protocol B (P < 0.005) than with protocol A. For the detection of individually diseased coronary arteries (> or =1 stenosis with > or =50% diameter reduction on quantitative coronary angiography (QCA)), receiver-operator characteristics of protocol B (signal upslope in 32 sectors/heart) yielded a sensitivity/specificity of 82%/73%, which was superior to protocol A (P < 0.05, N= 14). For the overall detection of CAD, the sensitivity/specificity of protocol B was 85%/81%. An adequate signal response in the myocardium is crucial for a reliable detection of perfusion deficits during first-pass conditions. The presented protocol B detects CAD with a sensitivity and specificity similar to scintigraphic techniques.

Coronary Disease↗
PubMed2005

An improved method for spinal functional MRI with large volume coverage of the spinal cord.

PURPOSE: To develop a spinal functional MRI (fMRI) method with three-dimensional coverage of a large extent of the spinal cord with minimal partial volume effects MATERIALS AND METHODS: fMRI data of the cervical spinal cord were obtained at 1.5 T with a single-shot fast spin-echo imaging method, from thin contiguous sagittal slices spanning the cord. Thermal stimulation was applied to the palm of the hand in a block pattern with 15 degrees C for stimulation and 32 degrees C during baseline periods. Prior to analysis, the image data at each time point were reformatted into three-dimensional volumes and resliced perfectly transverse to the spinal cord. Smoothing was applied only in the superior-inferior (S/I) direction across uniform tissue types. Active voxels were then identified by means of a correlation to a model paradigm. RESULTS: The resulting activity maps demonstrate activity primarily in ipsilateral sensory areas and in some motor areas, consistent with the spinal cord neuroanatomy. These data also demonstrate detail of the subsegmental organization of the spinal cord, as well as anatomical detail of the spinous processes and positions of nerve roots. CONCLUSION: The spinal fMRI method described enables large volume coverage of the spinal cord in three dimensions, with reliable and reproducible results.

Humans↗
PubMed2005

Surface characterization of salmeterol xinafoate powders by inverse gas chromatography at finite coverage.

In our previous studies, surface analysis by inverse gas chromatography (IGC) at infinite dilution (zero coverage) was performed on four salmeterol xinafoate (SX) powdered samples, viz, two supercritical CO2-processed Form I (SX-I) and Form II (SX-II) polymorphs, a commercial granulated SX (GSX) raw material and its micronized product (MSX). Both GSX and MSX are also of the same Form I polymorph. To further probe the differences in surface properties between the samples, the present study has extended the IGC analysis to the finite concentration range of selected energy probes. The adsorption isotherms of the SX samples were constructed using (nonpolar) octane, (polar acidic) chloroform, and (polar basic) tetrahydrofuran as liquid probes. Type II adsorption isotherms with weak knees were observed with each probe for all SX Form I samples. The extents of probe adsorption by the samples at various relative pressures follow the rank order: SX-II > GSX approximately MSX > SX-I, indicating that the SX-I has fewer high-energy adsorption sites than GSX and MSX. Type III isotherms were observed for SX-II with the two polar probes, indicative of weak adsorbate-adsorbent interactions. The additional information generated shows that IGC analysis at finite coverage is a valuable complementary tool to that at infinite dilution.

Adsorption↗
PubMed2006

Effect of coverage density and structure of chemically bonded silica stationary phases on the separation of compounds with various properties.

The chemical character, geometry, and architecture of chemically formed surface layers determine interactions between stationary phase, analyte, and mobile phase, and therefore the retention mechanisms (partitioning, adsorption, ion exchange, steric exclusion) of separated analytes. These interactions also depend on the structure and chemical character of the solutes and the composition of the mobile phase. High-molecular-weight fullerenes (C60 and C70) and water-soluble selenium-containing peptides (833 and 2607 Da) were used for the evaluation of laboratory-prepared octadecyl stationary phases with high and low coverage density before and after end-capping. The aim of this work was to study differences in surface coverage density and homogeneity and conformational changes of chemically bonded moieties and the influence of these parameters on the separation of mixtures of selenopeptides and fullerenes with significantly different molecular masses. A topographical model of the chemically modified stationary surface is presented.

Amino Acid Sequence↗
PubMed1994

Long-term follow-up of coverage of weight bearing surface of the foot with free muscular flap in a pediatric population.

Between 1985 and 1991, 13 muscular free flaps with split thickness skin grafts (10 latissimus dorsi, 2 rectus abdominis, and 1 gracilis) were done in 12 patients to cover the weight bearing surface of the foot. Four open wounds were closed primarily and nine unstable scars were replaced with a free flap. A retrospective analysis shows that over the short term the flaps provided a complete coverage of wounds, with a 100% survival of flaps, and permitted normal weight bearing ambulation starting at 1 month postoperatively. Long-term results show deep pressure sensation but no light touch sensation. All patients are able to wear normal shoes. Six patients (seven flaps) required further surgery to close subsequent wounds on the flaps: Three hypertrophic scars with recurrent ulcerations needed scar revisions, one child presented a fistula through the flap due to underlying osteomyelitis, and one patient presented a friction wound on the lateral malleolus requiring thinning of the flap. Two flaps presented an area of pressure necrosis through the full thickness of the flap and had to be replaced with another free flap (fasciocutaneous sensate flap) over the heel area. In conclusion, it seems that in the pediatric population, skin-grafted muscular coverage of the weight bearing surface of the foot is a good alternative, even if more problems with hypertrophic scarring around the grafts have been found than in the adult population. In two cases, the flaps had to be replaced because of pressure necrosis over the calcaneus.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2005

High sequence coverage by in-capillary proteolysis of native proteins and simultaneous analysis of the resulting peptides by nanoelectrospray ionization-mass spectrometry and tandem mass spectrometry.

Losses of proteolytic peptides during extraction and/or purification procedures succeeding in-gel or in-solution digests of proteins frequently occur in the course of protein identification investigations. In order to overcome this disadvantage, the method of in-capillary digest was developed: native proteins were incubated in the presence of endoproteases in the electrospray capillary and the resulting peptides were analyzed by nanoelectrospray-mass spectrometry during the ongoing proteolysis. In-capillary digest of apomyglobin by use of trypsin in a molar ratio of 25:1 yielded complete degradation already after 15 min. The sequence coverage based on formation of molecular ions was 100% and peptide ions could be fragmented by collision-induced dissociation and sequenced. When myoglobin was incubated in the electrospray capillary with trypsin in a molar ratio of 500:1, a clear shift from molecular ions and miscleaved peptide ions to the expected final tryptic peptide ions was observed over a 2 h period. The peptide spectra obtained from tryptic in-capillary proteolysis of bovine serum albumin and apotransferrin, respectively, gave rise to sequence coverages of more than 40% for both proteins. The data obtained from the peptide maps as well as from collision-induced dissociation (CID) of selected peptides were more than sufficient for protein identification by database searches. An elephant milk protein preparation was used to demonstrate the application of in-capillary proteolysis on protein mixtures. Tryptic digest, simultaneous analysis of the proteolytic peptides by use of CID, and subsequent sequencing allowed the identification of lactoferrin, alphas1-casein, beta-casein, delta-casein, and kappa-casein by homology search.

Amino Acid Sequence↗
PubMed2003

Use of different proteases working in acidic conditions to improve sequence coverage and resolution in hydrogen/deuterium exchange of large proteins.

The combination of hydrogen exchange and mass spectrometry has been widely used in structural biology, providing views on protein structure and protein dynamics. One of the constraints is to use proteases working at low pH and low temperature to limit back-exchange during proteolysis. Although pepsin works in these conditions and is currently used in such experiments, sequence coverage is not always complete especially for large proteins, and the spatial resolution of the exchange rate is limited by the size of the resulting peptides. In this study we tried two other proteases, protease type XIII from Aspergillus saitoi and protease type XVIII from Rhizhopus species. The penicillin-binding protein X (PBP-2X*), a 77-kDa protein, was selected as a model. Like pepsin, neither of these proteases is really specific, but we found very good reproducibility in the digestion pattern. Compared with using pepsin alone, combining the results of the three independent proteolyses increased the coverage for the peptide mapping, thus avoiding missing some potentially interesting regions of the protein. Furthermore, we obtained a better spatial resolution for deuterium incorporation data, specifying accurately the deuterated regions.

Amino Acid Sequence↗
PubMed2005

Dansylation of tryptic peptides for increased sequence coverage in protein identification by matrix-assisted laser desorption/ionization time-of-flight mass spectrometric peptide mass fingerprinting.

A database search using peptide mass fingerprints obtained by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry leads to protein identification with incomplete sequence coverage, because certain peptides are preferentially desorbed/ionized and some are not detected at all. We show that certain tryptic peptides mainly with C-terminal arginine not detected before derivatization become detectable upon dansylation. Others, mainly with C-terminal lysine, are suppressed. An increase in protein sequence coverage and protein identification score by combined data from underivatized and dansylated peptides in database search is demonstrated using human amnion proteins (human serum albumin precursor, calmodulin, collagen alpha 2(VI) chain precursor, galectin-3) separated by two-dimensional gel electrophoresis as well as femtomole amounts of BSA in solution.

Amino Acid Sequence↗
PubMed2006

Constructing binomial confidence intervals with near nominal coverage by adding a single imaginary failure or success.

In this paper we present a simple method for constructing (1- alpha)100 per cent confidence intervals for binomial proportions with near nominal coverage for all underlying proportion parameters on the unit interval. This new method uses, with a slight modification, the standard normal approximation technique taught in introductory statistics classes. Specifically, we first augment the observed binomial data with an imaginary failure to compute the lower bound and an imaginary success to compute the upper bound. By contrast, the Agresti-Coull method adds the same number of imaginary successes and failures to the observed data, yet it can still give somewhat subnominal coverage. As motivation, we discuss the relationship between this new method and the Clopper-Pearson exact method. We also present numerical calculations to illustrate the satisfactory performance of this new method compared with several common alternatives. Finally, we argue that for certain statistical applications, such as the design and analysis of clinical trials with adverse events, this new method represents a valuable complementary approach.

Biometry↗
PubMedDate not supplied

A GEE approach to estimating sensitivity and specificity and coverage properties of the confidence intervals.

A generalized estimating equation (GEE) approach is used to estimate the sensitivity and specificity of five non-culture screening tests for detecting Chlamydia trachomatis in endocervical specimens from women attending family planning clinics. Since the estimates of these parameters can be very close to the upper limit of one, confidence interval construction based on the traditional approaches, such as the delta method or a back-transformation approach, may not have the stated coverage. We compare different approaches to calculating confidence intervals for the sensitivity and specificity from the results of the GEE approach. These methods include the delta method, a back-transformation approach, and a bootstrap approach. In addition, we use simulations to investigate the estimated coverage rates of the delta method and the back-transformation approach. Published in 2001 by John Wiley & Sons, Ltd.

Chlamydia Infections↗