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PubMed1995

A community survey of traditional medical practitioners in high density suburbs of Harare.

Traditional medical practitioners (TMP) are an important part of the health system in Zimbabwe. The objective of this study was to determine, in the study area, their numbers, sociodemographic characteristics and clinical practice. A cross sectional community survey was conducted in two high density suburbs in Harare, Zimbabwe. A sampling frame of TMP was defined by means of a three stage community census (n = 189). A random stratified sample (n = 110) was interviewed with a semi-structured interview. Nearly half the TMP were not registered with formal organizations. Prophets were more likely to be Zimbabwean, Shona speaking, better educated, to have entered practice at a younger age, had fewer years of experience and charged less for consultations. Many TMP reported busy attendance at their clinics in the evenings or on weekends, but on average, most TMP see few patients. Few TMP specialised in physical disorders. Almost two thirds referred patients to formal medical services and most TMP wished to have greater collaboration with biomedical services.

Adult↗
PubMed2002

Cross-cultural communication with patients who use American Sign Language.

BACKGROUND: Although American Sign Language (ASL) is the third most commonly used primary language in the United States, physicians are often not adequately prepared for the challenges of conducting an interview with a deafpatient who signs. METHODS: A search of MEDLINE and PsychINFO databases for research on physician-patient communication and deaf people who use ASL was performed. Expert opinion helped guide discussion and recommendations. RESULTS: Few articles examined physician-patient communication involving ASL. Deaf people and their physicians report difficulties with physician-patient communication. Deaf people also report fear that their health care is substandard because of these difficulties. CONCLUSIONS: Preparing residents and medical students for working with patients and families who communicate in ASL presents many opportunities for teaching about physician-patient communication. ASL is quite different from English, and users of ASL often have sociocultural norms that differ from those of the majority culture. In addition to learning how to communicate with patients and families across languages and cultures, students and residents can learn how to collaborate with interpreters and how low literacy impacts physician-patient communication. Opportunities to teach about family dynamics, disability issues, and nonverbal communication also present themselves when working with families with Deaf members. Physician-patient communication involving ASL is an area that is ready for further research.

Communication↗
PubMed2006

Higher versus lower protein intake in formula-fed low birth weight infants.

BACKGROUND: The ideal quantity of dietary protein for formula-fed low birth weight infants < 2.5 kilograms is still a matter of controversy and debate. In premature infants, the protein intake must be sufficient to achieve normal growth without negative effects such as acidosis, uremia, and elevated levels of circulating amino acids (e.g. phenylalanine levels). This systematic review evaluates the benefits and risks of higher (>= 3.0 g/kg/day) versus lower (< 3.0 g/kg/day) protein intakes during the initial hospital stay of formula-fed preterm infants < 2.5 kilograms. OBJECTIVES: To determine whether higher (>= 3.0 g/kg/day) versus lower (< 3.0 g/kg/day) protein intakes during the initial hospital stay of formula-fed preterm infants < 2.5 kilograms result in improved growth and neurodevelopmental outcomes without evidence of short and long-term morbidity. SEARCH STRATEGY: Two review authors searched MEDLINE (1966 - May 2005), CINAHL (1982 - May 2005), PubMed (1966 - May 2005), EMBASE (1980 - May 2005), the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2005), abstracts, conferences and symposia proceedings from Society of Pediatric Research, and American Academy of Pediatrics. Cross references were reviewed independently for additional relevant titles and abstracts for articles up to fifty years old. SELECTION CRITERIA: Randomized controlled trials contrasting levels of formula protein intakes as low (< 3.0 g/kg/day), high (=> 3.0 g/kg/day but < 4.0 g/kg/day), or very high protein intake (=> 4.0 g/kg/day) during hospitalization of neonates less than 2.5 kilograms at birth who were formula-fed. Studies were not included if infants received partial parenteral nutrition during the study period or were fed formula as a supplement to human milk. Given the small number of studies that met all inclusion criteria, studies in which nutrients other than protein also varied (> 10% relative difference) were added in a post-facto analysis. DATA COLLECTION AND ANALYSIS: Two review authors used standard methods of the Cochrane Collaboration and of the Cochrane Neonatal Review Group to independently assess trial eligibility and quality, and extracted data. In a 3-arm trial where two groups fell within the same predesignated protein intake group, weighted means and pooled standard deviations were calculated. MAIN RESULTS: The literature search identified 37 studies, of which five met all the inclusion criteria. All five studies compared low (< 3.0 g/kg/day) to high protein intakes (=> 3.0 g/kg/day but < 4.0 g/kg/day). The overall analysis revealed an improved weight gain (WMD 2.36 g/kg/day, 95% CI 1.31, 3.40) and higher nitrogen accretion (WMD 143.7 mg/kg/day, 95% CI 128.7, 158.8) in infants receiving formula with higher protein content while other nutrients were kept constant. None of the studies reported IQ or Bayley scores at 18 months or later. No significant differences were seen in rates of necrotizing enterocolitis, sepsis or diarrhea. Of three studies included in the post-facto analysis, only one could be included in the meta-analysis. The post-facto analysis revealed further improvement in all growth parameters in infants receiving formula with higher protein content (weight gain: WMD 2.53 g/kg/day, 95% CI 1.62, 3.45, linear growth: WMD 0.16 cm/week, 95% CI 0.03, 0.30, and head growth: WMD 0.23, 95% CI 0.12, 0.35). There was no significant difference (WMD 0.25, 95% CI -0.20, 0.70) in the concentration of plasma phenylalanine between the high and low protein intake groups. One study (Goldman 1969) in the post-facto analysis documented a significantly increased incidence of low IQ scores, below 90, in infants of birth weight less than 1300 grams who received a very high protein intake (6 to 7.2 g/kg/day). AUTHORS' CONCLUSIONS: This systematic review suggests that higher protein intake (=> 3.0 g/kg/day but < 4.0 g/kg/day) from formula accelerates weight gain. Based on increased nitrogen accretion rates, this most likely indicates an increase in lean body mass. Although accelerated weight gain is considered to be a positive effect, increase in other outcome measures examined may represent a negative or ambivalent effect. These include elevated blood urea nitrogen levels and increased metabolic acidosis. Limited information was available regarding the impact of higher formula protein intakes on long term outcomes such as neurodevelopmental abnormalities. As determined in this review, existing research literature on this topic is not adequate to make specific recommendations regarding the provision of very high protein intake (> 4.0 g/kg/day) from formula.

Child Development↗
PubMed2004

[Olfactory dysfunction. Epidemiology, pathophsiological classification, diagnosis and therapy].

The present manuscript is the result of a collaborative effort within the framework of the Working Group of Olfactology and Gustology of the German Society for ENT, Head and Neck Surgery. It provides a comprehensive overview about the current views on the epidemiology, terminology, diagnostics, and therapy of olfactory dysfunction, and aims to offer a framework for the standardized procedures for the diagnosis and therapy of olfactory disorders.

Algorithms↗
PubMed1997

Contingent legitimacy: U.K. alternative practitioners and inter-sectoral acceptance.

Although alternative medicine has achieved an increasingly high profile in recent years, surprisingly little social research has been conducted in the area. This is noticeably the case when considering inter-sectoral contact and collaboration. This paper fills that gap by drawing on evidence from a large-scale study of non-orthodox practitioners in the U.K. By examining the lived experience of interaction the study aimed to discover the level of professional legitimacy which alternative practitioners routinely enjoy or are denied by mainstream practitioners. Results show that the last decade has been characterised by an increasing liberalisation of attitude toward inter-sectoral collaboration throughout the mainstream. However, the evidence also shows that this cannot be equated with the existence of a generalised acceptance of alternative practitioners, professional legitimacy. There is a schism within orthodoxy on this issue and that schism is occupationally based: at the extremes, consultants remain characteristically dismissive of alternative practitioners, nurses overwhelmingly enthusiastic. The nature of the non-orthodox practice being considered was of little significance. It is argued that the identification of differentiation within orthodoxy on this issue marks a significant point in developing an understanding of relations between the "sectors" and its component parts. There is a clear potential for conflicting developmental paths of action between orthodox groups, and for differing conceptions of who and what constitute a legitimate part of the medical totality. Cross-sectoral alignments, which challenge the state sanctioned dichotomy of mainstream/alternative, are viewed in quite different ways throughout orthodoxy. Knowledge of this intra-sectoral differentiation is essential to an understanding of emerging patterns of inter-sectoral relations.

Complementary Therapies↗
PubMed1997

Immature B cells from neonatal mice show a selective inability to up-regulate MHC class II expression in response to antigen receptor ligation.

Immature and mature B cells show phenotypic and functional differences. Thus immature B cells are functionally unresponsive to stimuli including ligation of slg and CD38 which induce proliferation in mature B cells. Furthermore, immature B cells have been widely shown to be hypersensitive to tolerance induction. To investigate the reasons for this differential responsiveness we have compared the ability of mature and immature B cells to show receptor-induced tyrosine phosphorylation of cellular substrates, a receptor-proximal response and MHC hyperexpression, which occurs later. Mature and neonatal B cells displayed a similar pattern of slg-induced tyrosine phosphorylation and their responses had similar kinetics. Importantly, cross-linking of slg on immature B cells induced tyrosine phosphorylation of substrates with mol. wt corresponding to the chains of the lg alpha beta dimer, which plays a critical role in B cell signalling. Immunofluorescence analysis showed that immature B cells constitutively express lower levels of MHC class II than their mature counterparts, consistent with previous studies. Here we report for the first time that immature B cells fail to hyperexpress class II after slg ligation, although this response is induced by other stimuli. These observations suggest that the ability to up-regulate class II is developmentally regulated in the B cell lineage. Moreover, the selective failure of slg-induced class II hyperexpression shown by immature B cells may not allow effective T-B cell collaboration and contribute to tolerance induction.

Animals↗
PubMed2004

Beyond a western bioethics?

Like theology and ethics generally, bioethics has increasingly developed a global consciousness. Controversies over AIDS research and access to affordable AIDS treatment have generated new awareness about the importance of international collaboration as well as the difficulty of achieving moral consensus across economic, political, and cultural divides. Advances in scientific and medical knowledge through initiatives such as the Human Genome Project invite new questions about the nature of health care as a common good. This budding global consciousness serves as a starting point for examining contemporary challenges to the secular, principle-based Western bioethics that has dominated national and international debate for three decades.

Acquired Immunodeficiency Syndrome↗
PubMed1985

A multivariate analysis of familial associations of lipoprotein levels in the Lipid Research Clinics Collaborative Family Study: I. Familial correlation and regression analyses.

In view of the complex, intraindividual relationships among different lipoprotein levels (LDL-C, HDL-C, and VLDL-C), multivariate methods aimed at assessing joint familial associations and their possible determinants were performed in the white, random sample component of the Collaborative Lipid Research Clinics Family Study data (1,336 families with 5,097 subjects). After appropriate transformations and covariate adjustments of the data, several kinds of correlation and regression analyses were performed, taking into consideration variable family size and possible age and clinic differences. The association patterns across clinics and age strata were found to be homogeneous for the vast majority of comparisons. The results of multivariate analyses (especially the significant association of each lipoprotein among biological relatives), the persistence of parental levels as the best predictors for the same lipoprotein levels among the offspring, and the essentially unchanged partial correlation estimates as compared to ordinary correlations suggest strong influence of factors specific to each lipoprotein in the familial associations. But the highly significant intraindividual correlations and the nonnegligible cross-correlations among relatives also suggest the additional presence of common underlying factors for the familial associations, especially between HDL-C and VLDL-C and to a lesser extent between LDL-C and VLDL-C. The issues stemming from these analyses and the directions for further analyses are discussed.

Cholesterol↗
PubMed2004

A comparison of classification methods for differentiating fronto-temporal dementia from Alzheimer's disease using FDG-PET imaging.

Flurodeoxyglucose positron emission tomography (FDG-PET) is being explored to determine its ability to differentiate between a diagnosis of Alzheimer's disease (AD) and fronto-temporal dementia (FTD). We have examined statistical discrimination procedures to help achieve this purpose and compared the results to visual ratings of FDG-PET images. The methods are applied to a data set of 48 subjects with autopsy confirmed diagnoses of AD or FTD (these subjects come from a multi-centre collaborative study funded by the National Alzheimer's Coordinating Center). FDG-PET images are composed of thousands of voxels (volume elements) so one is left with a situation where there are vastly more variables than subjects. Therefore, it is necessary to perform a data reduction before a statistical procedure can be applied. Approaches using both the entire image and summary statistics calculated on a number of volumes of interest (VOI) are examined. We performed the data reduction techniques of principal components analysis (PCA) and partial least-squares (PLS) on the entire image and then used linear discriminant analysis (LDA), quadratic (QDA) or logistic regression (LR) to classify subjects as having AD or FTD. Some of these methods achieve diagnostic accuracy (as assessed by leave-one-out cross-validation) that is similar to visual ratings by expert raters. Methods using PLS appear to be more successful. Averaging or using VOI data may also be helpful.

Alzheimer Disease↗
PubMed1999

Implementation of an interactive computer-assisted infection monitoring program at the bedside.

A new computer-assisted infection monitoring (CAI) software program has been developed for use in an intensive-care unit (ICU). By means of an interactive dialogue with physicians at the bedside, infection diagnoses and therapeutic decisions were recorded prospectively during a 3-month test period. By linking epidemiological data with information about therapeutic decisions, CAI could assess the quality of the therapeutic decisions. Antibiotics chosen empirically before the availability of any culture results, matched the antibiotic susceptibility patterns of the subsequently identified pathogens in 74% of the cases. Therapy chosen in collaboration with the computer after the pathogen was known, but before sensitivity results were available, corresponded with the eventual antibiograms of the microorganisms in 90% of the cases. Data analysis by CAI allowed us to assess critically the diagnostic and therapeutic habits in our ICU. Using the query-by-example method, CAI automatically calculated device-associated infection rates.

Adolescent↗
PubMed1993

Campus student suicide rates: fact or artifact?

A review of all English-language studies (14 foreign and 17 American) on campus student suicides was undertaken. Only studies reporting original data and containing sufficient demographic information to compute standard mortality rates (SMR) or crude suicide rates were analyzed and organized into single-site studies. Only 4 single-site studies had a higher suicide rate than the comparable populations. Multiple-site collaborative studies done in the United States since 1960 strongly suggest a campus student suicide rate significantly less than in the matched control population. However, deficiencies in case finding, case definition, sampling bias, and statistical techniques may place these conclusions in doubt. The author outlines research methods that might be applied to future multiple-site studies to resolve questions related to late adolescent and young adult suicidal behavior on campus and in other similar educational settings.

Adolescent↗
PubMed2000

Factor analytic study of two questionnaires measuring oral health-related quality of life among children and adults in New Zealand, Germany and Poland.

A questionnaire designed to measure oral health-related quality of life (OHRQOL) in adults and children was assessed for its factorial structure and reliability using data from the Second International Collaborative Study on Oral Health Outcomes in New Zealand, Poland and Germany. Principal component analysis with orthogonal and oblique rotation was applied. The three-factor structure hypothesized for the children's questionnaire (self-reported oral disease symptoms, perceived oral well-being, social and physical functioning) was confirmed in New Zealand and Poland, and two self-reported oral disease symptom dimensions emerged in Germany. Five factors instead of the three hypothesized were identified for adults: two dimensions of symptoms were identified, and social and physical functioning appeared to be independent dimensions of OHRQOL. Similarity between the factors was demonstrated in all three countries. The reliability of the questionnaire ranged from moderate to excellent depending on the dimension and the country. These findings provide preliminary evidence of the cross-cultural stability of the OHRQOL questionnaire in New Zealand, Poland and Germany, for both children and adults. Further investigations by the present authors of the properties of the instrument in other samples will focus on demonstrating the stability and replicability of the factor structure identified here.

Adolescent↗
PubMed1986

Immediate public health concerns and actions in volcanic eruptions: lessons from the Mount St. Helens eruptions, May 18-October 18, 1980.

A comprehensive epidemiological evaluation of mortality and short-term morbidity associated with explosive volcanic activity was carried out by the Centers for Disease Control in collaboration with affected state and local health departments, clinicians, and private institutions. Following the May 18, 1980 eruption of Mount St. Helens, a series of public health actions were rapidly instituted to develop accurate information about volcanic hazards and to recommend methods for prevention or control of adverse effects on safety and health. These public health actions included: establishing a system of active surveillance of cause-specific emergency room (ER) visits and hospital admissions in affected and unaffected communities for comparison; assessing the causes of death and factors associated with survival or death among persons located near the crater; analyzing the mineralogy and toxicology of sedimented ash and the airborne concentration of resuspended dusts; investigating reported excesses of ash-related adverse respiratory effects by epidemiological methods such as cross-sectional and case-control studies; and controlling rumors and disseminating accurate, timely information about volcanic hazards and recommended preventive or control measures by means of press briefings and health bulletins. Surveillance and observational studies indicated that: excess in morbidity were limited to transient increases in ER visits and hospital admissions for traumatic injuries and respiratory problems (but not for communicable disease or mental health problems) which were associated in time, place, and person with exposures to volcanic ash; excessive mortality due to suffocation (76 per cent), thermal injuries (12 per cent), or trauma (12 per cent) by ash and other volcanic hazards was directly proportional to the degree of environmental damage--that is, it was more pronounced among those persons (48/65, or about 74 per cent) who, at the time of the eruption, were residing, camping, or sightseeing (despite restrictions) or working (with permission) closer to the crater in areas affected by the explosive blast, pyroclastic and mud flows, and heavy ashfall; and de novo appearance of ash-related asthma was not observed, but transient excesses in adverse respiratory effects occurred in two high-risk groups--hypersusceptibles (with preexisting asthma or chronic bronchitis) and heavily exposed workers. Laboratory and field studies indicated that: volcanic ash had mild to moderate fibrogenic potential, consisting of greater than 90 per cent (by count) respirable size particles which contained 4-7 per cent (by weight) crystalline free silica (SiO2).(ABSTRACT TRUNCATED AT 400 WORDS)

Air↗
PubMed2003

Collaborative iIslet Transplant Registry.

The Collaborative Islet Transplant Registry (CITR) was established in 2001 with support from the National Institute of Diabetes and Digestive Diseases to collect and analyze information on islet transplants in North America. Thirteen of 27 invited islet transplant centers from the United States and Canada were already participants as of January 2004 with 5 additional centers awaiting IRB approval. In October 2003, CITR had preliminary data on 58 recipients of 107 islet transplants performed at the 13 member centers. These islet recipients averaged 41 years of age (SD 8.9), had diabetes for almost 28 years (SD 10.2) and were predominantly (67%) female. Islets were procured from 118 deceased donors whose average age was 42 (SD 12.2), weight was 90 kg (SD 23.5), and BMI was 30.5 (SD 7.9). The time from cross-clamp to pancreas recovery averaged 56 minutes (SD 134.6). An average of 7,127 islets (SD 2,973) were infused per kg of the recipient's weight. Outcome data are still pending as the Registry prepares its first annual report. Here we describe the organization, goals and design of the data collection instruments for CITR.

Data Collection↗
PubMed1988

Characterization of the effector mechanism of help for antigen-presenting and bystander resting B cell growth mediated by Ia-restricted Th2 helper T cell lines.

The mechanism of help for resting B cell growth in MHC-restricted T-B collaboration was investigated using an in vitro polyclonal model for these T cell-B cell interactions. In the presence of rabbit anti-mouse Ig, small, size-selected B cells elicit help from syngeneic Ia-restricted Th2 cell lines specific for F(ab')2 rabbit globulin. Both Ag-presenting and bystander B cells receive signals from stimulated Th cells that lead to B cell proliferation. The results suggest that the direct activation of resting Ag-presenting and bystander B cells by Th2 cells is mediated by a similar effector mechanism. Although proliferative responses by Ag-presenting B cells are of greater magnitude, help for both Ag-presenting and bystander B cell populations is characterized by the lack of a requirement for membrane Ig cross-linking, by identical kinetics, and by the necessity for direct cell contact or close proximity with Th cells. B cell proliferation is not induced by exposure to the sequence of diffusable mediators released from a synchronized Ag-specific T-B interaction. The T cell-dependent proliferation by both B cell populations can be inhibited by excess mitomycin C-treated syngeneic "cold target" B cells, demonstrating a requirement for a short-range T cell-B cell interaction. mAb inhibition experiments fail to identify a role for class II, LFA-1, or CD4 membrane molecules in the delivery of help to bystander B cells. Antibody against H2d bystander class II molecules has no effect on bystander B cell proliferation at concentrations that completely block Ag presentation by H2d B cells to an H2d-restricted Th cell line. Antibodies against the cell adhesion molecule LFA-1 or the Th cell molecule CD4 do inhibit bystander B cell proliferation, but only to the extent that they block T cell activation and the induction of help. The inductive stimulus leading to resting B cell growth results from an early, short-range interaction with Th cells. B cell proliferation is supported by T cell soluble mediators as a consequence of this interaction, which is required for at least 8 hr after T cell recognition of Ag/Ia on the surface of Ag-presenting B cells.

Animals↗
PubMed1995

Nuclear translocation of prolactin: collaboration of tyrosine kinase and protein kinase C activation in rat Nb2 node lymphoma cells.

Recent evidence has suggested that prolactin (PRL), internalized by lactogen-dependent Nb2 lymphoma cells, is actively translocated to the nucleus where it binds to PRL receptors. Moreover, the mitogenic action of PRL in these cells has been separately linked to protein tyrosyl phosphorylation and activation of protein kinase C (PKC). Therefore, the coupling of PRL internalization and nuclear translocation to the activation of these signal transduction pathways was investigated. Results from control experiments indicated that 30% of internalized and 5% total cell-associated 125I-rat PRL could be recovered within nuclei obtained from Nb2 cells previously incubated with the radiolabel for 3 h at 37 degrees C. Furthermore, internalized PRL was found to be intact and not associated with any carrier proteins. Addition of tyrosine kinase (TK) antagonists, genistein or tyrphostin, significantly reduced cell surface binding, internalization, and nuclear translocation of 125I-rat PRL. In contrast, neither the level of cell-associated nor internalized hormone differed between cells treated with the PKC antagonists, staurosporine or calphostin C, and control cultures. Instead, PKC inhibition significantly reduced nuclear PRL translocation. The inhibitory effects of the TK and PKC antagonists on PRL internalization and nuclear translocation in intact Nb2 cells were verified by immunofluorescence microscopy in parallel experiments. In other experiments, each of the kinase inhibitors blocked PRL-stimulated Nb2 cell proliferation in a concentration-dependent manner. It is concluded that activated TK and PKC collaborate in the process of PRL internalization and translocation to the nucleus. TK activation may participate in PRL receptor binding or hormone internalization while activation of PKC appears to be required for its nuclear targeting. Since TK and PKC activation are required for lactogen-stimulated Nb2 cell proliferation, we suggest that a component of the mitogenic pathway in these cells is a direct nuclear interaction of PRL.

Animals↗
PubMed1984

Antigen-specific suppression of human antibody responses by allogeneic T cells. I. Frequency and antigen specificity of allogeneic suppressor T cells and their role in major histocompatibility complex-controlled genetic restriction.

Specific antibody responses to influenza virus were obtained in vitro from human blood mononuclear cells (PBM). The addition of allogeneic T cells to responding PBM profoundly suppressed antigen-induced antibody responses, but had no effect on pokeweed mitogen (PWM)-induced polyclonal Ig formation. This raised the possibility that suppression by allogeneic T cells may result from the activation of antigen-specific T suppressor (Ts) cells rather than nonspecific allogeneic effects. The frequency of allogeneic Ts in PBM from a number of different donors, estimated in a series of limiting dilution analyses, was found to range from 0.8 X 10(-5) to 4.5 X 10(-5), which is more typical of antigen-specific than alloreactive T cells. By adding limiting numbers of allogeneic T cells to antibody-forming cultures stimulated simultaneously with two non-cross-reacting antigens (influenza A and B strain viruses A/X31 and B/HK), it was possible to demonstrate suppression of the response to one antigen, but not the other, in the same culture well. Moreover, the frequency of wells in which the response to both antigens was suppressed was not significantly different from that predicted from the calculated frequency of specific allogeneic Ts. These results show that allogeneic suppression was antigen specific, and was not due to non-specific allogeneic effects. By separating T cell preparations into Leu-3a+ (helper) and Leu-2a+ (suppressor/cytotoxic) T cell subsets, suppression was shown to be mediated by a radiosensitive Leu-2a+ T cell. The removal of Leu-2a+ cells from T cell preparations abrogated the suppressor effect and permitted T cell collaboration with B cells, across an HLA-A, -B, and -DR barrier. This result shows that in at least some combinations, suppression rather than major histocompatibility complex restriction is the reason for the failure of allogeneic T and B cells to collaborate in T cell-dependent antibody responses.

Antibody-Producing Cells↗
PubMed1994

The World Health Organization Global Programme on AIDS proposal for standardization of HIV sequence nomenclature. WHO Network for HIV Isolation and Characterization.

The World Health Organization Global Programme on AIDS (WHO/GPA) is conducting a large-scale collaborative study of human immunodeficiency virus type 1 (HIV-1) variation, based in four potential vaccine-trial site countries: Brazil, Rwanda, Thailand, and Uganda. Through the course of this study, it was crucial to keep track of certain attributes of the samples from which the viral nucleotide sequences were derived (e.g., country of origin and viral culture characterization), so that meaningful sequence comparisons could be made. Here we describe a system developed in the context of the WHO/GPA study that summarizes such critical attributes by representing them as standardized characters directly incorporated into sequence names. This nomenclature allows linkage of clinical, phenotypic, and geographic information with molecular data. We propose that other investigators involved in human immunodeficiency virus (HIV) nucleotide sequencing efforts adopt a similar standardized sequence nomenclature to facilitate cross-study sequence comparison. HIV sequence data are being generated at an ever-increasing rate; directly coupled to this increase is our deepening understanding of biological parameters that influence or result from sequence variability. A standardized sequence nomenclature that includes relevant biological information would enable researchers to better utilize the growing body of sequence data, and enhance their ability to interpret the biological implications of their own data through facilitating comparisons with previously published work.

AIDS Vaccines↗