The effect of multiple reminders on response patterns in a Danish health survey.

BACKGROUND: Reminders are routinely applied in surveys to increase response rates and reduce the possibility of bias. This study examines the effect of multiple reminders on the response rate, non-response bias, prevalence estimates and exposure-outcome relations in a national self-administered health survey. METHODS: Data derive from the Danish National Health Survey 2010, in which 298,550 individuals (16 years of age or older) were invited to participate in a cross-sectional survey using a mixed-mode approach (paper and web questionnaires). At least two reminders were sent to non-respondents, and 177,639 individuals completed the questionnaire (59.5%). Response patterns were compared between four groups of individuals (first mailing respondents, second mailing respondents, third mailing respondents and non-respondents). RESULTS: Multiple reminders led to an increase in response rate from 36.7 to 59.5%; however, the inclusion of second and third mailing respondents did not change the overall characteristics of respondents compared with non-respondents. Furthermore, only small changes in prevalence estimates and exposure-outcome relationships were observed when including second and third mailing respondents compared with only first mailing respondents. CONCLUSIONS: Multiple reminders were an effective way to increase the response rate in a national Danish health survey. However, when differences do exist between respondents and non-respondents, the results suggest that second and third mailings are unlikely to eliminate these differences. Overall, multiple reminders seemed to have only minor effect on response patterns and study conclusions in the present study.

Spatially differentiated regulation: Can it save the Baltic Sea from excessive N-loads?

The Baltic Sea Action Plan and the EU Water Framework Directive both require substantial additional reductions of nutrient loads (N and P) to the marine environment. Focusing on nitrogen, we present a widely applicable concept for spatially differentiated regulation, exploiting the large spatial variations in the natural removal of nitrate in groundwater and surface water. By targeting mitigation measures towards areas where nature's own capacity for removal is low, spatially differentiated regulation can be more cost-effective than the traditional uniform regulation. We present a methodology for upscaling local modelling results on targeted measures at field scale to Baltic Sea drainage basin scale. The paper assesses the potential gain and discusses key challenges related to implementation of spatially differentiated regulation, including the need for more scientific knowledge, handling of uncertainties, practical constraints related to agricultural practice and introduction of co-governance regimes.

Delay in catchment nitrogen load to streams following restrictions on fertilizer application.

A MIKE SHE hydrological-solute transport model including nitrate reduction is employed to evaluate the delayed response in nitrogen loads in catchment streams following the implementation of nitrogen mitigation measures since the 1980s. The nitrate transport lag times between the root zone and the streams for the period 1950-2011 were simulated for two catchments in Denmark and compared with observational data. Results include nitrogen concentration and mass discharge to streams. By automated baseflow separation, stream discharge was separated into baseflow and drain flow components, and the nitrogen concentration and mass discharge in baseflow and drain flow were determined. This provided insight on the development of stream nitrogen loads, with a short average lag time in drain flow and a long average lag time in baseflow. The long term effect of nitrogen mitigation measures was determined, with results showing that there is a 15 years long delay in the appearance of peak nitrogen loads in streams. This means that real time stream monitoring data cannot be used alone to assess the effect of nitrogen mitigation measures.

Reversible left hemispheric ischemia secondary to carotid compression in Eagle syndrome: surgical and CT angiographic correlation.

Symptoms of ipsilateral carotid artery compression secondary to an elongated styloid process or calcified stylohyoid ligament may be seen in Eagle syndrome. The patient will typically experience cervicofacial pain due to stimulation of the arterial nervous plexus. In addition, symptoms directly attributable to compression of the carotid artery may be seen, including visual symptoms and syncope. We report here the case of a patient who developed symptoms consistent with left hemispheric ischemia within 15 seconds of turning his head to the left. These symptoms were completely reversible on returning the head to the neutral position. No long-term sequelae were detected clinically or radiographically.

Enhancement of radiosensitivity in human malignant glioma cells by hypericin in vitro.

Hypericin, an antidepressant and antiviral agent being evaluated in phase I and II trials for patients with HIV infection, is known to be a potent protein kinase C inhibitor. We have investigated its effects on cellular response to radiation via a tetrazolium-formazan cell growth rate assay using 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide and clonogenic assay in three human glioblastoma cell lines, U87-MG, A-172, and T98G, and a low-passage malignant glioma culture, 93-492. At a concentration of 5 microM, hypericin inhibited these cells slightly but caused significant radiosensitization (e.g., the cell survival rate after the radiation treatment was 50.2 and 26.0% in cells treated with 6 Gy and 6 Gy plus 5 microM hypericin in U87-MG cells, respectively; P = 0.0285). Hypericin also enhanced the radiosensitivity significantly in the low-passage glioma 93-492 cells. These findings suggest that hypericin represents a potential new agent in combination with radiation therapy of malignant gliomas.

Impact of 5-HTTLPR on hippocampal subregional activation in older adults.

Studies have shown that a functional polymorphism of the serotonin transporter gene (5-HTTLPR) impacts performance on memory-related tasks and the hippocampal structures that subserve these tasks. The short (s) allele of 5-HTTLPR has been linked to greater susceptibility for impaired memory and smaller hippocampal volume compared to the long allele (l). However, previous studies have not examined the associations between 5-HTTLPR allele and activation in subregions of the hippocampus. In this study, we used functional magnetic resonance imaging (fMRI) to measure activation in hippocampal and temporal lobe subregions in 36 elderly non-clinical participants performing a face-name encoding and recognition task. Although there were no significant differences in task performance between s allele carriers and l homozygotes, right CA1 and right parahippocampal activation during recognition errors was significantly greater in individuals bearing the s allele. In an exploratory analysis, we determined that these effects were more pronounced in s allele carriers with the apolipoprotein ɛ4 allele. Our results suggest that older individuals with the s allele inefficiently allocate neural resources while making errors in recognizing face-name associations, which could negatively impact memory performance during more challenging tasks.

Systematic determination of telomerase activity and telomerase length during the progression of human breast cancer in cell culture models.

The purpose of the study was to determine systematically the expression of telomerase activity and the length of telomere repeat arrays by utilizing two different cell culture models that derive from normal individual donors, and probably represent various stages of human breast oncogenesis in cell culture. The models consist of mortal, non-tumorigenic immortal and tumorigenic immortal human mammary epithelial cell (MEC) lines. Using a recently developed polymerase chain reaction (PCR)-based telomeric repeat amplification protocol (TRAP) assay, telomerase activity was undetectable in mortal MEC cells. In contrast, the immortal MEC that were nontumorigenic or tumorigenic in immunosuppressed athymic mice, showed telomerase activity. The absence of telomerase activity in mortal and its presence in both non-tumorigenic and tumorigenic immortal cell lines did not reflect their proliferative rate, as demonstrated by the similar pattern and intensity of reactivity of these cell lines with anti-Ki 67 antibody which recognizes a human nuclear cell proliferation--associated antigen. Southern blot analyses of Hinf I-digested genomic DNA hybridized with a (TTAGGG)4 probe revealed arrays of telomeric repeat lengths ranging from 3 to 5, 3.5 to 9, 3.2 to 9 or 3 to 15 kilobase pair (kbp) for mortal, nontumorigenic immortal, and tumorigenic immortal or established MEC lines respectively. These results suggest that telomerase activity and stable telomeric repeat lengths may be a molecular phenotype of the early stages in the progression of breast cancer.

A theoretical conformational study of substituted O-anisamides as models of a class of dopamine antagonists.

The quantum mechanical PCILO method has been used to investigate the conformational behaviour of N-(2-aminoethyl)- and N-(2-dimethylaminoethyl)-o-anisamide, two model molecules of substituted benzamides. The molecules are shown to have only limited conformational freedom due to the presence of two intramolecular hydrogen bonds acting as conformational locks. The molecules in their preferred conformation are characterized by a distance between the centre of the aromatic ring and the nitrogen atom of almost 6 A, i.e. almost 1 A longer than in the fully extended dopamine conformers. Some implications at the receptor level of this topographical dissimilarity are discussed.

[General methods and specifications]. / Méthodes et spécifications générales

The reasons are explained why general methods are described in pharmacopeias. With the help of examples taken from European Pharmacopeias, the United States Pharmacopeia, and the International Pharmacopeia, the author reports the general chemical and physical methods that were used in compiling these pharmacopeias. The description of these general methods, and particularly of the instruments, goes often beyond the actual bounds of a pharmacopeia and may fulfill a didactic function. The methods used in the various pharmacopeias, especially the chemical ones, are here compared and subjected to the author's critical analysis. The author explains also that technical progress in the analytical field should not be hampered by the rigidity of the pharmacopeia's rules; this can be easily avoided by resorting to alternate methods.

Filling the gaps. Systems offer two models of care management: community outreach and inpatient care.

The growing number of vulnerable people, such as the elderly and people with long-term disabilities, calls for healthcare providers to offer more programs to ensure a continuum of care. Client-focused care management programs offer access to such a continuum. Care managers understand services and reimbursement and can pull it all together for the client. The Sisters of Charity Health Care Systems, Cincinnati, have two models of care management. St. Joseph Coordinated Care provides extensive outreach to a large, culturally diverse New Mexico community, serving urban and rural clients. Penrose-St. Francis Healthcare System offers inpatient medical care management in Colorado. Coordinated Care at St. Joseph Healthcare System in Albuquerque is comprehensive, covering a wide spectrum of client needs--medical, social, and psychological. The program's central goal is to help individuals remain safely at home. Persistence and devotion to the client are the hallmarks of effective care management and the foundation of the new geriatric care management program at Penrose-St. Francis Healthcare System in Colorado Springs, CO. The program's goals are to improve inpatient geriatric care, smooth the patient's transition to alternative care settings, and ensure efficient and effective resource use during the patient's hospital stay.

Social marginalization reduces use of ENT physicians in primary care.

OBJECTIVE: The aim of this study was to explore the association between social marginalization of the mothers and their children's use of the healthcare system and ear-nose-throat (ENT) physicians in the year 2009 in a region of Denmark. METHODS: A regional register-based cross-sectional study of use of healthcare services among children (n=10,232) of marginalized mothers and children (n=101,582) of non-marginalized mothers in the North Denmark Region. Social marginalization was defined as having received public social benefits for more than 80% of the year. RESULTS: Children with a marginalized mother had more chronic medical diagnoses (OR=1.22, 95% confidence interval 1.17-1.28), they had more frequently been in contact with their general practitioner during the year, and they used the healthcare system more often than children of non-marginalized mothers, except in the case of ENT specialists (OR=0.90, 0.85-0.95), and they had more seldom tympanostomy tubes inserted (OR=0.75, 0.66-0.87). The distance between ENT-clinic and place of residence of the patients had only a small effect on the use of ENT-physician, and only significant in the non-marginalized. CONCLUSIONS: Children of marginalized mothers used the healthcare system more than other children, except in case of ENT-physicians. They had fewer ENT-consultations and had less frequently inserted tympanostomy tubes when they attended the surgery.

Quantitative structure-retention relationship studies of odor-active aliphatic compounds with oxygen-containing functional groups.

High-quality regression equations (R greater than 0.996) modeling the gas chromatographic retention indices of 115 odor-active compounds on stationary phases of different polarity are generated by using the ADAPT software system. Multiple linear regression techniques are used to describe the statistical relationship between the Kováts retention indices and structure-based molecular descriptors. These descriptors encode topological, geometrical, and electronic features of the molecules. The utility of several new descriptors encoding functions of partial atomic charge and solvent accessible surface area is demonstrated. Quantitative predictions of odor threshold values for a subset of these compounds containing the alcohol functional group are also calculated by using a similar methodology.

p53 protein accumulation and gene mutations in human glioma cell lines.

Mutations in, and aberrant expression of, the p53 tumor suppressor gene were assessed in 17 cell lines derived from human malignant brain tumors (glioblastoma multiforme). Exons 5 through 8 were screened by single strand conformational polymorphism analysis (SSCP), followed by direct DNA sequencing. Mutations were found in 6 of 17 glioma cell lines, i.e., at a frequency similar to that found in primary malignant gliomas. Loss of the wild type allele was observed in 4 of the mutated cell lines. Two cell lines had the same mutation (CGG-->TGG; Arg-->Trp) in codon 248. Five of 6 mutations were transitions, 4 of which occurred at CpG dinucleotides. In one cell line a 10-bp deletion at the intron 4/exon 5 junction was found. Five of 6 glioma cell lines contained a mutation identical to that in the respective primary tumor despite prolonged in vitro culture (140-221 passages). Thus, the acquisition of p53 mutations during culture appears to be infrequent. Two cell lines derived from heterozygous tumors maintained the wild type p53 allele during long term culture. p53 protein levels were assessed by immunofluorescence cytochemistry and immunoprecipitation followed by Western blot analysis and revealed elevated levels of the p53 protein, although to a variable extent, in all cell lines with p53 mutations. A marked p53 protein accumulation was also observed in two cell lines lacking p53 mutations in exons 5 through 8, indicating that a prolonged half life of the gene product is not solely dependent on an aberrant coding sequence. The remaining cell lines had either low levels or no detectable p53 protein; one of the latter contained a gross rearrangement of the p53 gene. Our results suggest that with respect to p53 gene status, glioma cell lines usually resemble the original tumors and may, therefore, be suitable for studying the biological changes associated with p53 mutations in glial tumors.

Lovastatin induces growth inhibition and apoptosis in human malignant glioma cells.

The competitive HMG-CoA reductase inhibitor lovastatin has been shown to suppress growth and induce morphological changes in a variety of non-glioma tumor cell lines. This study assesses the effects of this agent on the growth and survival of the human malignant glioma cell lines A172 and U87-MG. The response to the drug was investigated using a cell proliferation assay which revealed significant dose-dependent growth inhibition. Treatment with as little as 100 nM lovastatin over a period of 72 hours led to DNA degradation into nucleosome-sized fragments characteristic of apoptosis. Our data suggest that HMG-CoA reductase inhibitors such as lovastatin merit further investigation as potential therapeutic agents for the treatment of malignant gliomas.