Detection-loophole-free test of quantum nonlocality, and applications.

We present a source of entangled photons that violates a Bell inequality free of the "fair-sampling" assumption, by over 7 standard deviations. This violation is the first reported experiment with photons to close the detection loophole, and we demonstrate enough "efficiency" overhead to eventually perform a fully loophole-free test of local realism. The entanglement quality is verified by maximally violating additional Bell tests, testing the upper limit of quantum correlations. Finally, we use the source to generate "device-independent" private quantum random numbers at rates over 4 orders of magnitude beyond previous experiments.

Concordance of familial characteristics in Crohn's disease and ulcerative colitis.

The diagnosis of inflammatory bowel disease (IBD) in a proband increases the probability of a parallel IBD diagnosis in a family member. In this study, we were able to confirm the IBD diagnosis in 35 (9.9 percent) of the relatives of 352 registry probands. To confirm a proband's report of a positive family history of IBD, efforts were made to directly contact all first-degree relatives regardless of their IBD status (parents, siblings, and children). Consent to contact family members was obtained from the proband, who furnished the registry personnel with names, addresses, and phone numbers. We then attempted to contact each identified relative by phone. After verbal consent was obtained, family members were asked if they had been diagnosed with IBD. This diagnosis was confirmed by contacting the relative's physician. A McNemar (chi 2 Mc) matched-pair analysis was used to analyze concordance between the proband and the affected family member. Within the CD/CD (Crohn's disease) concordant pairs, sex was a significant risk factor. Sex was not a significant risk factor within the UC/UC (ulcerative colitis) concordant pairs. In the concordant surgery pairs, no surgical procedure was a significant risk factor for the prediction of a similar surgical procedure for the affected relative. In concordant extraintestinal complications, only the appearance of a skin rash was significantly related to the appearance of a skin rash in the affected relative.

Analysis of SBIR phase I and phase II review results at the National Institutes of Health.

A cohort of phase I and phase II summary statements for the SBIR grant applications was evaluated to determine the strengths and weaknesses in approved and disapproved applications. An analysis of outcome variables (disapproval or unfunded status) was examined with respect to exposure variables (strengths or shortcomings). Logistic regression models were developed for comparisons to measure the predictive value of shortcomings and strengths to the outcomes. Disapproved phase I results were compared with an earlier 1985 study. Although the magnitude of the frequencies of shortcomings was greater in the present study, the relative rankings within shortcoming class were more alike than different. Also, the frequencies of shortcomings were, with one exception, not significantly different in the two studies. Differences in the summary statement review may have accounted for some differences observed between the 1985 data and results of the present study. Comparisons of Approved/Disapproved and Approved-Unfunded/Funded yielded the following observations. For phase I applicants, a lack of a clearly stated, testable hypothesis, a poorly qualified or described investigative team, and inadequate methodological approaches contributed significantly (in that order) to a rating of disapproval. A critical flaw for phase II proposals was failure to accomplish objectives of the phase I study. Methodological issues also dominate the distinctions in both comparison groups. A clear result of the data presented here and that published previously is that SBIR applicants need continuing assistance to improve the chances of their success. These results should serve as a guide to assist NIH staff as they provide information to prospective applicants focusing on key elements of the application. A continuing review of the SBIR program would be helpful to evaluate the quality of the submitted science.

Lag time between stress events and risk of recurrent episodes of inflammatory bowel disease.

We followed a cohort of 124 subjects with a history of inflammatory bowel disease to ascertain risk estimates for clinically active disease associated with exposure to recent stress events. We calculated risk estimates for three lag models (-1, 0, + 1 month). The data indicated a strong association between stress exposures and new clinical episodes of disease (RR = 2.9, 95% Cl: 2.0-4.1), most apparent in the immediate period (lag = 0). Risk estimates were also elevated for extended episodes of disease in subjects under stress compared with unexposed subjects. These results underscore the importance of monitoring stress exposures in prevention and treatment of recurrent disease.

Relevance of major stress events as an indicator of disease activity prevalence in inflammatory bowel disease.

The impact of psychological stress in recurrence of inflammatory bowel disease (IBD) is unclear. Why some patients with ulcerative colitis (UC) or Crohn's disease (CD) have unrelenting relapses whereas other IBD patients experience long periods of quiescent disease remains an enigma. The authors examined the risk of exposure to major stress events in clinical episodes of IBD. They followed up on 124 persons in a prospective study that monitored behavioral and biological characteristics for a period of 6 months. Stress-exposed subjects demonstrated increased risk of clinical episodes of disease when compared with unexposed subjects (RR = 2.6, 95% CI: 1.3-4.9). Elevated effect measures were highest for the domain of health-related stress (RR = 3.8, 95% CI: 1.5-9.9). In the multiple regression analysis, major stress events remained the most significant indicator of disease activity in the presence of the covariables considered. Only 7% of the variation in disease activity was uniquely attributed to stress. Baseline activity was the other notable indicator of subsequent disease activity in the study sample. All variables considered together explained 52% of the variance observed and implicated factors of potential clinical importance in monitoring recurrence of the disease.

Improved pregnancy outcome following successful treatment of chlamydial infection.

Pregnancy outcomes of 244 women, successfully treated with erythromycin ethylsuccinate for cervical chlamydial infection, were compared with those of 79 chlamydia-positive pregnant women, who failed to respond to treatment, and 244 chlamydia-free control women, who were not treated. The three groups were at high risk for infection with Chlamydia trachomatis. The frequencies of premature rupture of the membranes, premature contractions, and small-for-gestational-age infants were significantly lower in the successfully treated patients when compared with those of the chlamydia-positive patients, but were not significantly different when compared with those of the control patients. These data indicate that in a pregnant population at high risk for infection with C trachomatis, repeated prenatal chlamydial testing, plus successful erythromycin treatment, can significantly reduce certain adverse effects on pregnancy outcome.

Enzyme-altered foci in colons of carcinogen-treated rats.

The distal colon and rectum from male F344 rats treated with 15 mg/kg 1,2-dimethylhydrazine.2HCl (DMH) for 20 weeks were analyzed for focal areas of enzyme alteration. Tissues were embedded in methacrylate at 4 degrees C and cut in 2- to 4-micron serial sections. In DMH-treated rats, 8.8 +/- 2.4 foci/cm2 of examined mucosa were observed at 20 weeks and 7.7 +/- 1.1 foci/cm2 at 31 to 52 weeks, compared with 1.2 +/- 0.6 foci/cm2 in control rats (P = 0.01). The number of foci at 31 to 52 weeks compared with 20 weeks did not change significantly, but the area of altered rectal mucosa increased from 0.22 +/- 0.2% at 20 weeks to 1.47 +/- 0.6% at 31 to 52 weeks (P = 0.051). Most foci had decreased N-acetyl-beta-D-glucosaminidase, alpha-naphthyl butyrate esterase, and mucin in epithelial cells and increased gamma-glutamyl transpeptidase in the stroma. Morphologically, the foci varied from normal to overtly dysplastic. Grossly, tumors were identified in 5 of 20 DMH-treated rats killed at 31 to 52 weeks but not in 12 DMH-treated rats killed at 20 weeks or 30 control rats killed at 20 to 52 weeks. These data suggest but do not establish that enzyme-altered foci are putative preneoplastic lesions in the colon.

Florence Nightingale: on feeding an army.

Florence Nightingale's work for the British Army during the Crimean War earned her the well-deserved honor of being considered the mother of modern nursing. Less well recognized is her involvement with the development of nutritional services for the military. A nutrient-intake analysis is developed here based on her recommendations and recipes for army troops. The intake profile is compared with modern recommendations for dietary intake for adequacy of the diet.

A meta-analysis of the role of smoking in inflammatory bowel disease.

A relationship between not smoking and ulcerative colitis has been examined in all English reports. This paper evaluates the ulcerative colitis/nonsmoking and the Crohn's disease/smoking association by meta-analysis and against causality criterion for chronic diseases. A review of the literature, meta-analysis of selected studies, and assessment of causality criterion all suggest that not smoking and ulcerative colitis and smoking and Crohn's disease are consistent with a causal relationship. It is not inconceivable that tobacco may contain some substance beneficial to ulcerative colitis patients. Identification of the specific product in tobacco producing a beneficial effect would be a prudent next step in the study of this association. In spite of the findings of this review and analysis, the author finds no justification for health care providers to change the Surgeon General's recommendations on smoking or tobacco use for ulcerative colitis patients specifically.

Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Composition, intake, and excretion of fiber constituents.

The role of fiber in human diet in preventing a number of chronic diseases has been a widely debated topic in recent years. The claim that populations at low risk for colon cancer generally consume a more fiber-rich diet than those at high risk, has been used to postulate a protective role for this group of substances. In this study we asked the question whether populations leading different dietary lifestyles and who are at varying risks for colon cancer show marked differences in their dietary and fecal profiles of various fiber components. Four study groups consisting of Seventh-day Adventist (SDA) pure vegetarians, SDA lacto-ovo vegetarians, SDA nonvegetarians, and a group of general population nonvegetarians were selected from the greater Los Angeles Basin area. Three-day composite diets, and stools were analyzed for neutral detergent fiber (NDF), hemi-cellulose, lignin, cellulose, cutin + silica, and pectin. The percentage composition and the daily intake and output of each of these components were computed for each population group. The dietary profile revealed a trend (not statistically significant) toward generally higher daily intake values among the vegetarian subgroups, neutral detergent fiber values in g/day: SDA pure vegetarians, 63.0 +/- 7.9; SDA-lacto-ovo vegetarians, 55.8 +/- 3.5; SDA nonvegetarians, 57.2 +/- 3.5; general population nonvegetarians, 52.5 +/- 4.9), lignin, cellulose, and pectin being the major contributors to this difference.(ABSTRACT TRUNCATED AT 250 WORDS)

Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Concordance of nutrient information obtained by different methods.

Data obtained from two vegetarian and two nonvegetarian populations by 24-h diet recall, 3-day weighed diet diary, analysis of 3-day composite food samples, and measurement of certain biochemical parameters were compared. Correlations for group means (both sexes combined) for values obtained by 24-h recall versus 3-day diet diary were protein, r = 0.96 and total calories r = 0.86. For 3-day diet diary with food analysis, protein r = 0.89, fat r = 0.90 and for reported protein intake with serum prealbumin r = 0.74, with urinary urea nitrogen r = 0.87. Correlations were low for comparisons of means of male groups for most parameters. Individual correlations for reported protein intake and biochemical parameters were lower for males than for females. This suggests that male subjects may require special attention to insure accuracy of reporting and specimen collection. These findings indicate comparability of data from 24-h recall and 3-day diary, and agreement of dietary records with certain biochemical parameters. Protein and fat intake as determined from chemical analysis of a composite food sample correlated well (r = 0.89; r = 0.90) with that calculated from food tables.

Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Metabolism of neutral sterols.

Cholesterol and its metabolites, together with bile acids, are implicated as risk factors in the genesis and progression of colon cancer. This study was designed to determine differences in the neutral sterol composition of stools from four different population groups differing in their dietary habits as well as in their expected rates for colon cancer. Four study groups consisting of 18 Seventh-day Adventist (SDA) pure vegetarians, 50 SDA lacto-ovo vegetarians, 50 SDA nonvegetarians, and 50 general population nonvegetarians were selected from the greater Los Angeles Basin area. Three-day composite stool samples were lyophilized and then analyzed for their neutral sterol composition. Cholesterol excretion values consistently showed an age-dependent peak in 46- to 50-yr age group for the total population, SDA lacto-ovo vegetarian and SDA-nonvegetarian subgroups being the principal contributors to this age-dependent phenomenon. The SDA pure vegetarians exhibited the lowest fecal concentrations and daily excretion of cholesterol as expected since their intake of dietary cholesterol is insignificant. Among the other SDA, regardless of whether they are lacto-ovo vegetarians or nonvegetarians, their cholesterol excretion patterns were similar but higher than in the nonvegetarians from the general population. Since dietary intakes of cholesterol are not significantly different among the two nonvegetarian groups, the differences in excretion values are attributable to differences in colonic metabolism. The ratio of cholesterol/cholesterol metabolites showed generally lower values among nonvegetarians compared to the matched group of lacto-ovo vegetarians. The observation was made that fecal cholesterol and its metabolites tend to be higher among nonvegetarians compared to those in the corresponding vegetarian groups.

Trends in incidence rates of ulcerative colitis and Crohn's disease.

Between 1960 and 1979, three studies were conducted in the Baltimore Standard Metropolitan Statistical Area to ascertain the incidence rates of first hospitalizations for ulcerative colitis and Crohn's disease. The age-adjusted rates per 100,000 population for the 1977-1979 survey for ulcerative colitis in white and nonwhite males and females were 2.92, 1.79, 1.29, and 2.90, respectively; the Crohn's disease rates were 3.39, 3.54, 1.29, and 4.08, respectively. In Baltimore the age-adjusted rate for Crohn's disease has increased to exceed the ulcerative colitis rate for whites of both sexes and nonwhite females. The ulcerative colitis and Crohn's disease rates for nonwhite males are similar. The rate for white males exceeds that for nonwhite males for both ulcerative colitis and Crohn's disease, but the converse is true for females. Females have higher rates than males for Crohn's disease in both color groups and for ulcerative colitis among nonwhites. White ulcerative colitis rates are higher for males than for females. From the first to the second surveys, the white male and female rates for ulcerative colitis converge with increasing male and decreasing female rates, but then both decline from the second to the third surveys. For Crohn's disease, the age-adjusted rates increased for whites of both sexes and nonwhite females from the first to second surveys. The Crohn's disease rates appeared to stabilize for whites of both sexes between the second and present surveys, but they increased for nonwhites of both sexes. Trends in age-adjusted rates for other areas are also discussed.

Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Selected biochemical parameters in blood and urine.

Selected biochemical parameters (serum protein, albumin, prealbumin, total retinol-binding protein, vitamins A and E, total carotenoids, and urinary urea and creatinine) were determined in healthy, free-living vegetarian and nonvegetarian subjects. The groups studied were composed of Seventh-day Adventist pure vegetarians, Seventh-day Adventist lacto-ovo vegetarians, Seventh-day Adventist nonvegetarians, and general population nonvegetarians. No values indicative of nutritional deficiencies were observed in any of the subjects. Serum carotenoid levels were significantly higher in Seventh-day Adventist pure vegetarians than in members of the other groups. Mean values for serum vitamin A showed no differences between the dietary groups, although 41% of general population nonvegetarian subjects (the group considered at highest risk for colon cancer) had serum vitamin A levels in the upper quartile of the distribution. From these data no conclusions can be drawn relating to the role of dietary habits as determinants of colon cancer risk.

Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Population: demographic and anthropometric characteristics.

A study was designed to compare nutritional and metabolic parameters on subjects with a spectrum of vegetarian and nonvegetarian dietary patterns. The method of selection of the study population, the description of its characteristics, and the data collection protocol are described. Anthropometric measurements of vegetarians and nonvegetarians are reported and compared with previously reported measurements on similar populations.

Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Nutrient intake.

A 3-day diary with portion sizes weighed by the subject and a 24-h recall were obtained on 50 sets of subjects: Seventh-day Adventist lacto-ovo-vegetarians and nonvegetarians, and general population nonvegetarians, matched on age (+/- 5 yr), sex, marital status, education, type of milk preferred, and an index of the frequency of dairy and egg product use. An additional 18 unmatched persons who follow a pure vegetarian dietary pattern (use no meat, fish, fowl, dairy, or egg products) were recruited into the study. The rational for the dietary methods used is presented and details of each of the methods used are given. The results of the nutrient analysis of the 24-h recall and 3-day diary are presented. The 3-day nutrient intake means for the four groups are compared to the sex-specific recommended daily allowance both with and without supplements. The contribution of nutritional supplements to the nutrient intake is discussed. All groups show adequate or excess intake levels of calories, protein, and fat when either the 24-h recall or the 3-day diary values are considered. The higher intake of calories noted among nonvegetarians can be explained by a higher intake of both fat and protein in these groups. A, B, and C vitamin levels (3-day dairy estimates) are adequate both with and without supplements. Calcium intake is much below recommended levels for pure vegetarian females. Iron intake is low for all females. A heme iron source does not improve the intake levels for nonvegetarian females. A comparison of these results with prior reports of nutrient intake among Seventh-day Adventists is presented.

Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Laboratory analysis of 3-day composite of food samples.

In a study designed to characterize dietary patterns of vegetarian and nonvegetarian populations, chemical analysis of 3-day composite food samples showed lower fat content of food of vegetarians than that of nonvegetarians; pure vegetarians had the lowest. Unsaturated fatty acids were highest in the food of the pure vegetarian group. No significant difference was seen in percentage protein of the food consumed by male vegetarians and nonvegetarians while the food of female vegetarians was of lower protein content than that of the nonvegetarians. The relationship of these findings to the lower incidence of colon cancer in vegetarian populations remains to be determined.

Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Dietary cholesterol, beta-sitosterol, and stigmasterol.

Cholesterol and fat are implicated as dietary factors enhancing the risk for colon carcinogenesis. Plant sterols such as beta-sitosterol when added to diets of experimental animals treated with colon carcinogens reduce tumor yields and counteract the proliferative changes associated with carcinogenesis. The question of whether the diet of human populations at low risk for colon cancer is mirrored in their sterol composition is addressed in this study. Four study groups consisting of 18 Seventh-day Adventist (SDA) pure vegetarians, 50 SDA lacto-ovo vegetarians, 50 SDA nonvegetarians, and 50 general population nonvegetarians were selected from the greater Los Angeles basin, and 3-day composite diets were analyzed for their sterol composition. The most significant index of dietary sterol status is the ratio, beta-sitosterol + stigmasterol/cholesterol (plant sterol/cholesterol ratio). The values for the four groups ranged from 0.49 to 16.0 (general population nonvegetarians = 0.49; SDA-nonvegetarians = 0.98; SDA lacto-ovo vegetarians = 3.26; SDA pure vegetarians = 16.0). The data also show that the absolute amounts of cholesterol consumed as a factor by itself might not be as significant as its relationship to total plant sterols in the diet.