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Publishing nutrition research: a review of study design, statistical analyses, and other key elements of manuscript preparation, Part 1.

To enhance the Journal's position as the premier source for peer-reviewed research in the science of food, nutrition, and dietetics, members of the Board of Editors recognize the importance of providing a resource for researchers to ensure quality and accuracy of reporting in the Journal. This first monograph of a periodic four-part series focuses on the study hypothesis, study design, and collaboration with a statistician. The basics of study design start with a clear hypothesis or research question and a definitive outcome measure. Throughout the development of a research project, the questions of what is to be discovered and why the research is being conducted need to be addressed. Decisions about parameters to measure and study design most appropriate to test a hypothesis create the foundation for future conclusions. Collaboration with a statistician can aid in the research development process. Documentation that coherently communicates the research process will advance the science of evidence-based practice in nutrition and dietetics. Real examples from published literature are provided, as well as references to books and online resources.

Dietetics↗

Axonal sprouting regulates myelin basic protein gene expression in denervated mouse hippocampus.

The regulation of oligodendrocyte gene expression and myelination in vivo in the normal and injured adult CNS is still poorly understood. We have analyzed the effects of axotomy-induced axonal sprouting and microglial activation, on oligodendrocyte myelin basic protein (MBP) gene expression from 2 to 35 days after transection of the entorhino-hippocampal perforant path axonal projection. In situ hybridization analysis showed that anterograde axonal and terminal degeneration lead to upregulated oligodendrocyte MBP mRNA expression starting between day 2 and day 4, in (1) the deep part of stratum radiatum of CA3 and the dentate hilus, which display axonal sprouting but no degenerative changes or microglial activation, and (2) the outer part of the molecular layer of the fascia dentata, and in stratum moleculare of CA3 and stratum lacunosum-moleculare of CA1, areas that display dense anterograde axonal and terminal degeneration, myelin degenerative changes, microglial activation and axotomi-induced axonal sprouting. Oligodendrocyte MBP mRNA expression reached maximum in both these areas at day 7. MBP gene transcription remained constant in stratum radiatum, stratum pyramidale and stratum oriens of CA1, areas that were unaffected by perforant path transection. These results provide strong evidence that oligodendrocyte MBP gene expression can be regulated by axonal sprouting independently of microglial activation in the injured adult CNS.

Acetylcholinesterase↗

The Brisighella Heart Study: an interim report.

In 1972, the Brisighella Study was initiated to monitor the spontaneous trend of risk factors for atherosclerosis and the incidence of coronary heart disease (CHD) in a rural population. This study, which is one of the largest Italian studies on the epidemiology of atherosclerosis and cardiovascular disease, established a strong correlation between increased cholesterol levels and the incidence of CHD. The apparent unwillingness of the population to alter dietary and exercise habits independently led the researchers to establish the Brisighella Heart Study in 1984. This study attempted to reduce the risk of CHD by modifying the population's dietary habits through a nutritional education program. While the nutritional education program succeeded in lowering total cholesterol, a segment of the population still remained at risk. At this point, the high-risk strategy arm of the study was initiated. In 1988, those participants whose total cholesterol level was greater than 239 mg dl-1 were started on a twice-daily regimen of 600 mg of gemfibrozil. The Brisighella Heart Study High-Risk Project will continue for at least 5 years, during which all participants will be followed-up every 6 months and all fatal and non-fatal events will be recorded.

Age Factors↗

Promoter prediction on a genomic scale--the Adh experience.

We describe our statistical system for promoter recognition in genomic DNA with which we took part in the Genome Annotation Assessment Project (GASP1). We applied two versions of the system: the first uses a region-based approach toward transcription start site identification, namely, interpolated Markov chains; the second was a hybrid approach combining regions and signals within a stochastic segment model. We compare the results of both versions with each other and examine how well the application on a genomic scale compares with the results we previously obtained on smaller data sets.

Alcohol Dehydrogenase↗

Malaria in the post-genomics era: light at the end of the tunnel or just another train?

Malaria remains the third leading cause of death attributable to an infectious disease worldwide, with an estimated death toll of over 2 million per year, predominately in sub-Saharan Africa. The first serious attempt to eradicate this disease was unsuccessful, and 50 years later in 1998 a second programme coined "roll back malaria" was started. While this programme is at present unlikely to reach its stated aims, the completion of the genome sequencing projects on the human host, the mosquito vector, and the malaria parasite offers new hope. It is probable that the burden of disease caused by the most malignant form of the parasite Plasmodium falciparum can be, if not eliminated, then effectively suppressed within a generation through new and novel treatments aimed at all three arms of malaria control.

Animals↗

Progress in the theory of mixed quantum-classical dynamics.

Quantum-classical Liouville dynamics can be used to study the properties of open quantum systems that are coupled to bath or environmental degrees of freedom whose dynamics can be approximated by classical equations of motion. In contrast to many open quantum system approaches, quantum-classical dynamics provides a detailed description of the bath molecules. Such a description is especially appropriate for the study of quantum rate processes, such as proton and electron transport, where the detailed dynamics of the bath has a strong influence on the quantum rate. The quantum-classical Liouville equation can also serve as a starting point for the derivation of reduced descriptions where all or some of the bath degrees of freedom are projected out. Quantum-classical Liouville dynamics can be simulated in terms of an ensemble of surface-hopping trajectories whose character differs from that in other surface-hopping schemes. The results of studies of proton transfer in condensed phase and reactive dynamics in a dissipative environment are presented to illustrate applications of the formalism.

Journal Article↗

Sino-MONICA project: a collaborative study on trends and determinants in cardiovascular diseases in China, Part i: morbidity and mortality monitoring.

BACKGROUND: The Sino-MONICA project is a 7-year study monitoring trends and determinants of cardiovascular disease (CVD) in geographically defined populations in different parts of China. METHODS AND RESULTS: The study is a community-based prospective disease surveillance that uses the methodology and criteria of the World Health Organization's Monitoring Trends and Determinants in Cardiovascular Disease (WHO MONICA) project, with slight modifications for local use. After a pilot study of 2 years (1985 through 1986), data collection started formally on January 1, 1987, and ended on December 31, 1993. The main results were as follows. By international standards, both the incidence and mortality rate of coronary heart disease in Chinese populations were low. The highest incidence was 108.7 of 100,000 (1987 to 1989), and the lowest was 3.3 of 100,000 for men 35 to 64 years of age, a 33-fold difference. Both the incidence and mortality rate of cerebrovascular disease were high. The highest incidence was 553.3 of 100,000 (1987 to 1989), and the lowest was 33.0 of 100,000 for men 35 to 64 years of age, a 17-fold difference. There were significant geographic variations in both CVD incidence and mortality rate, with higher rates in the north and lower rates in the south. During 1987 to 1993, increasing trends were found in CVD rates in some populations, whereas decreasing trends were found in others. The trends were not significant statistically in most cases. CONCLUSIONS: Monitoring CVD with international standardized methods in China is feasible and urgently needed in view of the rapid socioeconomic development and transition of disease patterns taking place in China. The results are of significance in combating CVD both at home and abroad.

Adult↗

Chance and choice, change and continuity--that's life.

Responding to this invitation to write an autobiography, I have tried to put in some order, the jumble of memories that come to mind. There are markers of the journey--the major decisions and changes in direction, many influenced by external events. Despite turns and detours, there is also continuity of interests and behavioral style. My beginnings on a Nebraska farm were a considerable distance in place and character from my current retirement in Oregon. The trail of events was especially marked by the death of my father, early choice of psychology, military service in Germany, marriage in Paris, establishing the university clinic and clinical program at the University of Oregon, starting a school of Community Service and Public Affairs, working with Leona Tyler on books and an extensive research project, and a year going around the world with my family including a long period in India. My principal contributions to personality assessment include cross-cultural studies, development of a boredom scale, community psychology connections, many reviews, books in clinical psychology and assessment, and work with students and others who continue this important branch of psychology.

Career Choice↗

Aiming for consistency in the way teachers sign.

A four year study examined the effects of a sign communication intervention program designed to enhance teachers' ability to consistently code English into sign. The secondary goal of the project was to help teachers use American Sign Language as an intervention tool for enhancing students' comprehension of instructions. Starting with an initial sign to speech ratio of 59.8% and 66.2%, two teachers were able to improve their ratio to 98.9% and 89.7% respectively. The basic components of the intervention program are presented along with their rationale. A breakdown of the sign to speech ratio is provided in an examination of how effectively the teachers coded articles, pronouns, sign markers, and the verb "to be."

Deafness↗

Evaluation of the creatinine assay on the Reflotron analyser under centralized and non-centralized conditions.

The creatinine assay, performed on Reflotron "dry chemistry" analysers in six offices of general practitioners, was evaluated as part of a project on the quality of laboratory determinations in decentralized situations. The method itself was evaluated before this investigation was started. Differences were noticed between Reflotron machines, batches of strips, and various types of sample, viz. heparin-treated blood or plasma gave higher results than serum of EDTA-treated samples. All Reflotron results were lower in comparison with wet chemistry methods. The "dry chemistry" technique was not influenced by the presence of glucose or bilirubin (below 170 mumol/l); haemoglobin interfered. By simultaneous sampling, all creatinine determinations performed on whole EDTA blood in the general practitioners offices were repeated on serum in centralized laboratories using "wet chemistry" techniques. In this comparison 3% of all creatinine determinations in general practitioners offices were outside the 95% confidence interval. We conclude that the creatinine determination on the Reflotron may be used in general practitioners office testing as long as the general practitioner is aware of its limitations and can rely on a "reference" laboratory for training, quality control and repetition of unexpected results.

Bilirubin↗

[Trypanosoma cruzi genome: transcriptional mapping and karyotype correlation; molecular characterization of a surface antigen from the Tc13 family].

We describe herein the genome mapping of Trypanosoma cruzi, the etiological agent of Chagas' disease, by hybridization of a cosmid library gridded in high density filters with cDNA from an epimastigote expression library as probes. We also show the correlation of some cosmid contigs with parasite chromosomal bands. With libraries from the T. cruzi Genome Project we have characterized a new member of the Tc13 family belonging to the superfamily of trypomastigote surface antigens. Starting with a Tulahuén strain (Tul 2 stock) clone, homologous to these antigens, we have sequenced and characterized the complete gene in the CL Strain (CL Brener clone). We have also found homologies with different ESTs which characterization would lead to further knowledge of this antigen family.

Animals↗

[A study of perspective vision].

The present study describes the structure of monocular depth perception using an experimental basis. It regards the traditional theory of perspective, which is a subset of descriptive geometry, only as a construction guide for flat, albeit depth eliciting, visual stimuli. The investigation starts with a definition of structure as a set with an automorphism on it. In the present context the projection of the physical stimuli onto the retina provide a suitable ground set. After suitable confinement of the stimuli to a horizontal plane, the effects of eye and head movements of the subject can be represented as projective mappings of the retinal image onto itself. The present approach represents these as visual automorphisms. They are each characterized by a special visual invariance. The automorphisms form a group which comprises the affine, the affine unimodular and the orthogonal groups (in this order) as subgroups. Experimental studies of the different invariants of these subgroups as well as the consideration of other empirical observations lead to the conclusion that the structure of monocular space perception is characterized by the affine unimodular subgroup of the projective group. There are indications that the phenomena of size constancy can be represented by affine unimodular maps instead of orthogonal (metric) maps as sometimes has been conjectured.

Attention↗

Michigan hospitals and kids SCORE big.

The Michigan Health Council, in cooperation with four Michigan hospital systems, initiated Strive for Challenging Outcomes and Reach Excellence (SCORE) to develop a more diverse health care work force for Michigan. This project is aimed at helping minorities and underrepresented youth learn about careers in health care and helping hospitals get started toward building diversity programs in their communities.

Adolescent↗

Managing resources in a GP national network: problems and achievements.

This paper presents the results and identifies problems in our experience concerning the development of Medinet sentinel dispensaries network in Romania. Medinet stations network consists in 100 computerized family doctors practices all around the country, where doctors collect primary care data and send it to the project central server through Internet. At present the network is fully functional and the collection of data have already started. Many problems have been identified while building and developing the network, both technical organizational and human resources problems.

Computer Communication Networks↗

Family medicine in Croatia: past, present, and forthcoming challenges.

The aim of this paper is to present the effects of the reform of primary care by privatization and direct contracting between general practitioners/family physicians and the Croatian Institute for Health Insurance, as well as to propose possible improvements. Using the data of the Croatian Institute of Public Health, we analyzed the coverage of population and accessibility of service, management of chronic illnesses, home visits, and preventive check-ups in the family medicine service. In 2001, 2,408 (30.8% vocationally trained) doctors worked in the family medicine service, taking care of 3.759,248 (84.7%) registered inhabitants of Croatia. There was an average of 6 office encounters, 0.1 home visits, 0.05 preventive check-ups and 1.4 referrals per patient per year. Within the Project of Health System Reform a working group of primary care experts proposed the following improvements: 1) the family medicine service should be organized in accordance with the fundamental principles of accessibility, continuity, and integrated care; and 2) a multilayered financing model should be used, containing a capitation fee payment, fee for service payment, and specific program payment. Taking into account the European Union recommendation, a project aimed at ensuring the specialization of family medicine for all doctors working in the family medicine service was started in 2003. This study indicates that there is a gap between proclaimed health system improvements and effects of the reform of primary care. In order to achieve evidence-based health policy, concerted action of all participants in the decision-making process is needed.

Croatia↗

Long-term monitoring of immunological profile in children with immunodeficiency disorders.

1. The fulfillment of research project allowed us to make deeper scope of literature sources with the children IDS topic. The proper experience with children IDS management has been acquired in the specialized service for immunodeficient children at Pediatric Clinic of Teaching Hospital in Hradec Králové. 2. IDS screening and diagnostic in children were studied with participation of immunologic laboratories, and the development of available immunologic indices in IDS children has been monitored at long-term. Problems mentioned were the content of partial research project VII-6-6/19 for 1976-1980, VII-6-6/9 for 1980-1985, VIII-6-5/11 starting from 1986 and resolved till now by Pediatric Clinic of Teaching Hospital in Hradec Králové. The immunodeficient conditions were studied minutely at long-term and with complex relations. 3. Authors were involved in management of life threatening infectious complications and performed both control and moderation of diseases manifested as such. Applied management approaches were then evaluated from the scope of actual therapy. Our pathophysiologic IDS concept is more extended. The individual IDS represents a complex real situation developing in time. Therefore, the long-term monitoring is of benefit in detecting certain developmental IDS tendencies such as, e. g., occurrence of autoimmune diseases and malignancies in children with IDS. 4. We stated that thymectomy in infants: --was of no expressed disturbing influence on health of two children at least for 12 years of long-term monitoring; --manifested the transient decrease of circulating T-lymphocyte percentage which was detected in one child 2 years after TE, in other up 10 years after TE, respectively. However, both of them showed a constant decreasing tendency; --is responsible of changes in subpopulations of T-lymphocytes; --changes of laboratory tests provided after TE 12 years till now show no clinical significance. 5. Selective IgA deficiency has been diagnosed in a total of 14 children, and the development of their immunologic indices was monitored at long-term. Several literature data were proved as well as enlarged and extended: --IgA deficiency is a constant defect; --this is a simultaneous deficiency of both serum and secretory IgA in a majority of cases; --selective IgA deficiency is most pronounced and complex immunity disorder involving not only humoral, but also cellular immunity; --in IgA deficiencies, mainly respiratory infections are predominant though having neither serious course nor complications; --immunoglobulins are not necessary in managing infections in IgA deficient cases for as much as an appropriate antiinfection therapy is of choice. Dispensary care is needed similarly to other IDS conditions due to recurrent infections and risk of autoimmune diseases and tumors.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

[Activities of Balint groups--a way to survive].

For the past twenty years there has been growing interest in 'Balint groups' in Sweden, and today about 40 such groups are active in the country. Originally Balint groups took the form of seminars with special emphasis on the doctor-patient relationship, run for GPs as part of a research project by the late Michael Balint, a psychoanalyst at the Tavistock Clinic in London. Similar groups have since been started in a number of countries, and obviously fulfil an important need. The system is applicable both as a component in medical education and as an adjunct to the practising clinician's schedule; and, suitably adapted, it has recently been taken up by other patient or client oriented professionals. In the presentation are reviewed practical aspects of this kind of continuous group activity among clinical staff, the time frame envisaged being two hours twice a month for one to two years. The review is followed by a report with comments by a group leader and group members on their experience in a currently active Balint group.

Education, Medical, Continuing↗

Treatment of adults with lingual orthodontic appliances.

With the advent of lingual orthodontic treatment, an alternative became available to the adult patient who preferred to avoid the unesthetic appearance of conventional orthodontic appliances. The newer brackets and archwires described in this article, in combination with the proven technique developed by the author and others, has made lingual orthodontic treatment a practical reality. The appliance has been shown to be as effective as labial counterparts in correcting all types of malocclusions. New laboratory and indirect bonding techniques have eliminated the need for intricate wire bending and have reduced patient chair time and overall treatment time. Because of the premature introduction of early lingual appliances, many dental practitioners mistakenly believe that lingual treatment is less effective than labial treatment. As more examples of successful treatment are seen, dental practitioners will be more apt to refer patients to orthodontists proficient in this technique. Many graduate orthodontic programs now are teaching this technique to their residents. About 3000 patients currently are starting treatment with lingual appliances each year. This represents only about 1 per cent of adult patients. It is projected that this slowly will climb to about 10 per cent of adult orthodontic treatment over the next 5 years. The increased cost of this treatment, coupled with the resistance on the part of many orthodontists to learn the new technique, seem to be the limiting factors.

Adolescent↗