Family Physicians
21 years of experience

Accepting new patients
Brentwood-oak Hills
6451 Brentwood Stair Rd Ste 200
Fort Worth, TX 76112
817-496-9700
Locations and availability (4)

Education ?

Medical School Score
A.T. Still University - Kirksville (1989)
  • Currently 1 of 4 apples

Affiliations ?

Dr. Hall is affiliated with 9 hospitals.

Hospital Affilations

Score

Rankings

  • Texas Health Harris Methodist Hospital Southwest Fort Worth
    6100 Harris Pkwy, Fort Worth, TX 76132
    • Currently 4 of 4 crosses
    Top 25%
  • Harris Methodist H E B
    1600 Hospital Pkwy, Bedford, TX 76022
    • Currently 4 of 4 crosses
    Top 25%
  • Texas Health Harris Methodist Hospital Azle
    108 Denver Trl, Azle, TX 76020
    • Currently 3 of 4 crosses
    Top 50%
  • Texas Health Presbyterian Hospital Of Dallas
    8200 Walnut Hill Ln, Dallas, TX 75231
    • Currently 3 of 4 crosses
    Top 50%
  • Denton Hospital
    3000 N Interstate 35, Denton, TX 76201
    • Currently 2 of 4 crosses
  • Texas Health Denton
  • Harris Continued Care Hospital
    1301 Pennsylvania Ave, Fort Worth, TX 76104
  • Presbyterian Hosp Of Denton
  • Harris Methodist - Springwood
    1608 Hospital Pkwy, Bedford, TX 76022
  • Publications & Research

    Dr. Hall has contributed to 71 publications.
    Title Improving the Prediction of Virological Response to Tipranavir: the Development and Validation of a Tipranavir-weighted Mutation Score.
    Date February 2011
    Journal Antiviral Therapy
    Excerpt

    The purpose of this study was to develop a tipranavir-weighted mutation score that provides guidance to treating physicians on the relative effect of specific protease mutations on tipranavir activity.

    Title 25-hydroxyvitamin D, Insulin-like Growth Factor-i, and Bone Mineral Accrual During Growth.
    Date February 2011
    Journal The Journal of Clinical Endocrinology and Metabolism
    Excerpt

    The extent to which 25-hydroxyvitamin D [25(OH)D] and IGF-I influence bone mineral content (BMC) accrual from early to mid-puberty is unclear. OBJECTIVE, SETTING, AND PARTICIPANTS: This study sought to determine relationships among 25(OH)D, IGF-I, and BMC in community-dwelling prepubertal females (n = 76; aged 4-8 yr at baseline) over a period of up to 9 yr.

    Title An Estimate of Phthalate Exposure Among Pregnant Women Living in Trujillo, Peru.
    Date October 2010
    Journal Chemosphere
    Excerpt

    Phthalates are a group of phthalic acid esters which are used as plasticizers and additives. In laboratory animals, several phthalates are known endocrine disruptors. Several studies have described phthalate exposure in the United States and developed countries but little is known about phthalate exposure in the developing world, particularly during pregnancy. To assess exposure to six different phthalates, we measured the concentrations of nine phthalate metabolites in spot urine samples collected during the first, second, and third trimester of pregnancy from a group of 72 women living in Trujillo, Peru. Additionally, women completed questionnaires to provide demographic characteristics. Statistical analysis via linear models was used to evaluate potential differences in the concentrations of phthalate metabolites by trimester, cooking fuel type, socioeconomic status, and education. All metabolites were detected in>40% of samples analyzed, and mono-n-butyl phthalate, mono (2-ethyl-5-carboxypentyl) phthalate, and monoethyl phthalate were found in>90% of samples. Five of nine unadjusted urinary metabolites and four of nine creatinine-adjusted urinary metabolites were significantly lower in this group of pregnant women living in Peru compared to pregnant women in the US general population.

    Title Personal Glimpses.
    Date July 2010
    Journal Science (new York, N.y.)
    Title Recommendations for Safety Planning, Data Collection, Evaluation and Reporting During Drug, Biologic and Vaccine Development: a Report of the Safety Planning, Evaluation, and Reporting Team.
    Date January 2010
    Journal Clinical Trials (london, England)
    Excerpt

    The Safety Planning, Evaluation and Reporting Team (SPERT) was formed in 2006 by the Pharmaceutical Research and Manufacturers of America.

    Title Efficacy of Short-course Azt Plus 3tc to Reduce Nevirapine Resistance in the Prevention of Mother-to-child Hiv Transmission: a Randomized Clinical Trial.
    Date January 2010
    Journal Plos Medicine
    Excerpt

    Single-dose nevirapine (sdNVP)-which prevents mother-to-child transmission of HIV-selects non-nucleoside reverse-transcriptase inhibitor (NNRTI) resistance mutations in the majority of women and HIV-infected infants receiving it. This open-label, randomised trial examined the efficacy of short-course zidovudine (AZT) and lamivudine (3TC) with sdNVP in reducing NNRTI resistance in mothers, and as a secondary objective, in infants, in a setting where sdNVP was standard-of-care.

    Title Assessment of Exposure to Secondhand Smoke at Outdoor Bars and Family Restaurants in Athens, Georgia, Using Salivary Cotinine.
    Date October 2009
    Journal Journal of Occupational and Environmental Hygiene
    Excerpt

    Exposure to secondhand smoke (SHS) in outdoor settings is a growing public health concern due to recent indoor smoking bans. The objective of this study was to measure salivary cotinine, a metabolite of nicotine, in subjects aged 21-30 exposed to SHS outside bars and restaurants in Athens, Georgia. Nonsmokers participated during 6-hr periods in outdoor standing or seating areas of bars and restaurants where indoor smoking was banned, as well as a control outdoor location with no smokers over six weekends during the summer and early fall of 2007. Pre- and post-exposure saliva samples (N = 25 person-days at the bar site, N = 28 person-days at the restaurant site, and N = 11 person-days at the control) were collected and analyzed for cotinine. The mean change in the response, (ln(post) - ln(pre)) salivary cotinine levels, was significantly impacted by the type of site (bar, restaurant, control) (F = 5.09; d.f. = 2, 6.7; p = 0.0455). The median percent increase in salivary cotinine from pre-test to post-test was estimated to be 162%, 102%, and 16% at the bar, restaurant, and control sites, respectively, values that were significant increases at bars (t = 4.63; d.f. = 9.24; p = 0.0011) and restaurants (t = 4.33; d.f. = 4.47; p = 0.0097) but not at the control sites. On average, these pre-test to post-test increases in salivary cotinine were significantly higher at bar sites than control sites (t = 3.05; d.f. = 9.85; p = 0.0176) and at restaurant sites compared with control sites (t = 2.35; d.f. = 5.09; p = 0.0461). Nonsmokers outside restaurants and bars in Athens, Georgia, have significantly elevated salivary cotinine levels indicative of secondhand smoke exposure.

    Title How Common is Repeat Sudden Infant Death Syndrome?
    Date April 2008
    Journal Archives of Disease in Childhood
    Excerpt

    Recurrence of sudden infant death syndrome (SIDS) is rare but may give rise to confusion and controversy because of the differential diagnoses of familial disease or covert homicide. We examine eight studies of recurrent SIDS published in English since 1970. These studies reported relative risks of recurrence, as compared with the population or with controls, ranging from 1.7 to 10.1. We assess the validity of the studies by three main criteria: accuracy of ascertainment, adequacy of investigation and matching of controls. We found that all the studies failed to meet these criteria, and we think that their flaws would have resulted mainly in overestimation of recurrence risk. We conclude that, although an increase in risk is probable on theoretical grounds, this risk cannot be quantified from the available evidence. We suggest that professionals should be cautious in their pronouncements on the chances of recurrence, and that parents who have lost a baby to SIDS can, with the exception of particularly vulnerable families, be reassured that the risk of recurrence is small.

    Title Characterization of Htrb and Msbb Mutants of the Light Organ Symbiont Vibrio Fischeri.
    Date March 2008
    Journal Applied and Environmental Microbiology
    Excerpt

    Bacterial lipid A is an important mediator of bacterium-host interactions, and secondary acylations added by HtrB and MsbB can be critical for colonization and virulence in pathogenic infections. In contrast, Vibrio fischeri lipid A stimulates normal developmental processes in this bacterium's mutualistic host, Euprymna scolopes, although the importance of lipid A structure in this symbiosis is unknown. To further examine V. fischeri lipid A and its symbiotic function, we identified two paralogs of htrB (designated htrB1 and htrB2) and an msbB gene in V. fischeri ES114 and demonstrated that these genes encode lipid A secondary acyltransferases. htrB2 and msbB are found on the Vibrio "housekeeping" chromosome 1 and are conserved in other Vibrio species. Mutations in htrB2 and msbB did not impair symbiotic colonization but resulted in phenotypic alterations in culture, including reduced motility and increased luminescence. These mutations also affected sensitivity to sodium dodecyl sulfate, kanamycin, and polymyxin, consistent with changes in membrane permeability. Conversely, htrB1 is located on the smaller, more variable vibrio chromosome 2, and an htrB1 mutant was wild-type-like in culture but appeared attenuated in initiating the symbiosis and was outcompeted 2.7-fold during colonization when mixed with the parent. These data suggest that htrB2 and msbB play conserved general roles in vibrio biology, whereas htrB1 plays a more symbiosis-specific role in V. fischeri.

    Title Case-control Exploration of Relationships Between Early Rash or Liver Toxicity and Plasma Concentrations of Nevirapine and Primary Metabolites.
    Date January 2008
    Journal Hiv Clinical Trials
    Excerpt

    This investigation measured trough nevirapine and five oxidative metabolite concentrations in plasma specimens collected from patients who exhibited a rash or liver function abnormality during the first 6 weeks of treatment.

    Title Is Adiposity Advantageous for Bone Strength? A Peripheral Quantitative Computed Tomography Study in Late Adolescent Females.
    Date December 2007
    Journal The American Journal of Clinical Nutrition
    Excerpt

    BACKGROUND: Whereas excess adiposity is presumed to be advantageous for the skeleton, studies investigating relations between bone strength and fat during youth have been equivocal. OBJECTIVES: Relations of percentage body fat (BF) and bone strength indexes were assessed in late adolescent females, taking into consideration surrogates of muscle force [ie, muscle cross-sectional area (MCSA) and bone length]. Bone measurements in the normal- and high-fat groups were also compared. DESIGN: Late adolescent females (n = 115; aged 18.2 +/- 0.4 y) participated in this cross-sectional study. Fat-free soft tissue mass, fat mass, and percentage BF were measured with the use of dual-energy X-ray absorptiometry. Tibial and radial peripheral quantitative computed tomography measurements were taken at the 4% (trabecular bone), 20% (cortical bone), and 66% (for measurement of MCSA) sites from the distal metaphyses. RESULTS: Percentage BF was inversely related to radial cortical bone area, total bone cross-sectional area (CSA), cortical bone mineral content (BMC), periosteal circumference, and strength-strain index (SSI) (20% site; all P < 0.05). After control for MCSA and limb length, negative relations remained between percentage BF and radial measurements and were also observed at the tibia (20% site). Unadjusted bone measures were not different between groups. After control for MCSA, the high- compared with the normal-fat group had lower bone measures at the 20% site (cortical bone area and cortical BMC at the tibia, total bone CSA at the radius, and SSI at both the tibia and radius; P < 0.05 for all). CONCLUSION: Excess weight in the form of fat mass does not provide additional benefits, and may potentially be negative, for adolescent bone.

    Title Particulate Matter and Carbon Monoxide Multiple Regression Models Using Environmental Characteristics in a High Diesel-use Area of Baguio City, Philippines.
    Date September 2007
    Journal The Science of the Total Environment
    Excerpt

    In Baguio City, Philippines, a mountainous city of 252,386 people where 61% of motor vehicles use diesel fuel, ambient particulate matter <2.5 microm (PM(2.5)) and <10 microm (PM(10)) in aerodynamic diameter and carbon monoxide (CO) were measured at 30 street-level locations for 15 min apiece during the early morning (4:50-6:30 am), morning rush hour (6:30-9:10 am) and afternoon rush hour (3:40-5:40 pm) in December 2004. Environmental observations (e.g. traffic-related variables, building/roadway designs, wind speed and direction, etc.) at each location were noted during each monitoring event. Multiple regression models were formulated to determine which pollution sources and environmental factors significantly affect ground-level PM(2.5), PM(10) and CO concentrations. The models showed statistically significant relationships between traffic and early morning particulate air pollution [(PM(2.5)p=0.021) and PM(10) (p=0.048)], traffic and morning rush hour CO (p=0.048), traffic and afternoon rush hour CO (p=0.034) and wind and early morning CO (p=0.044). The mean early morning, street-level PM(2.5) (110+/-8 microg/m3; mean+/-1 standard error) was not significantly different (p-value>0.05) from either rush hour PM(2.5) concentration (morning=98+/-7 microg/m3; afternoon=107+/-5 microg/m3) due to nocturnal inversions in spite of a 100% increase in automotive density during rush hours. Early morning street-level CO (3.0+/-1.7 ppm) differed from morning rush hour (4.1+/-2.3 ppm) (p=0.039) and afternoon rush hour (4.5+/-2.2 ppm) (p=0.007). Additionally, PM(2.5), PM(10), CO, nitrogen dioxide (NO2) and select volatile organic compounds were continuously measured at a downtown, third-story monitoring station along a busy roadway for 11 days. Twenty-four-hour average ambient concentrations were: PM(2.5)=72.9+/-21 microg/m3; CO=2.61+/-0.6 ppm; NO2=27.7+/-1.6 ppb; benzene=8.4+/-1.4 microg/m3; ethylbenzene=4.6+/-2.0 microg/m3; p-xylene=4.4+/-1.9 microg/m3; m-xylene=10.2+/-4.4 microg/m3; o-xylene=7.5+/-3.2 microg/m3. The multiple regression models suggest that traffic and wind in Baguio City, Philippines significantly affect street-level pollution concentrations. Ambient PM(2.5) levels measured are above USEPA daily (65 microg/m3) and Filipino/USEPA annual standards (15 microg/m3) with concentrations of a magnitude rarely seen in most countries except in areas where local topography plays a significant role in air pollution entrapment. The elevated pollution concentrations present and the diesel-rich nature of motor vehicle emissions are important pertaining to human exposure and health information and as such warrant public health concern.

    Title Nonadditive Effects of Leaf Litter Species Diversity on Breakdown Dynamics in a Detritus-based Stream.
    Date July 2007
    Journal Ecology
    Excerpt

    Since species loss is predicted to be nonrandom, it is important to understand the manner in which those species that we anticipate losing interact with other species to affect ecosystem function. We tested whether litter species diversity, measured as richness and composition, affects breakdown dynamics in a detritus-based stream. Using full-factorial analyses of single- and mixed-species leaf packs (15 possible combinations of four dominant litter species; red maple [Acer rubrum], tulip poplar [Liriodendron tulipifera], chestnut oak [Quercus prinus], and rhododendron [Rhododendron maximum]), we tested for single-species presence/absence (additive) or species interaction (nonadditive) effects on leaf pack breakdown rates, changes in litter chemistry, and microbial and macroinvertebrate biomass. Overall, we found significant nonadditive effects of litter species diversity on leaf pack breakdown rates, which were explained both by richness and composition. Leaf packs containing higher litter species richness had faster breakdown rates, and antagonistic effects of litter species composition were observed when any two or three of the four litter species were mixed. Less-consistent results were obtained with respect to changes in litter chemistry and microbial and macroinvertebrate biomass. Our results suggest that loss of litter species diversity will decrease species interactions involved in regulating ecosystem function. To that end, loss of species such as eastern hemlock (Tsuga canadensis) accompanied by predicted changes in riparian tree species composition in the southeastern United States could have nonadditive effects on litter breakdown at the landscape scale.

    Title Plasma Lipid Concentrations After 1.5 Years of Exposure to Nevirapine or Efavirenz Together with Stavudine and Lamivudine.
    Date April 2007
    Journal Hiv Medicine
    Excerpt

    To assess long-term changes in lipids and lipoproteins concentrations associated with exposure to non-nucleoside reverse transcriptase inhibitors.

    Title A Prospective Analysis of Plasma 25-hydroxyvitamin D Concentrations in White and Black Prepubertal Females in the Southeastern United States.
    Date February 2007
    Journal The American Journal of Clinical Nutrition
    Excerpt

    BACKGROUND: Little is known regarding changes in vitamin D status among children living in the southern United States and whether these changes are race-dependent. OBJECTIVES: The aims were to prospectively assess plasma 25-hydroxyvitamin D [25(OH)D] concentrations in prepubertal black and white girls (n = 83) living in northeast Georgia and to determine whether 25(OH)D concentrations change with increasing age. DESIGN: Plasma samples were obtained annually over a time frame of 1-7 y, and 25(OH)D concentrations were assessed by using radioimmunoassay. Percentage body fat (%BF) and fat-free soft tissue (FFST) mass were measured by using dual-energy X-ray absorptiometry. Linear mixed-effects models were used with height, weight, body mass index percentile, %BF, FFST, pubertal stage, dietary intake, physical activity, and socioeconomic status as covariates. RESULTS: Plasma 25(OH)D values < 80 nmol/L were observed in 75% of the participants. Plasma 25(OH)D values (analyzed on the natural logarithm scale) decreased with increasing age (P = 0.02), independent of race. Plasma 25(OH)D values were higher in whites than in blacks (P < 0.0001), and the amount of this difference depended on season (P < 0.001 for all seasons). A significant negative association between FFST and 25(OH)D, beyond the effects of age, race, and season (P = 0.007), was observed. The effects of age, race, and season on 25(OH)D remained significant when dietary calcium, vitamin D, and physical activity were used as covariates; however, after adjustment for FFST, only the effects of race and season remained. CONCLUSIONS: White girls living in the southeastern United States have higher 25(OH)D concentrations than do black girls, and the magnitude of this difference depends on the season. Decreases in 25(OH)D with age are associated with increases in FFST. Whether FFST requires additional vitamin D during growth remains to be determined.

    Title Seeking Ethical Designs for Hiv Clinical Trials in Treatment-experienced Patients: an Industry Perspective.
    Date January 2007
    Journal Aids Research and Human Retroviruses
    Title Genotypic Changes in Human Immunodeficiency Virus Type 1 Protease Associated with Reduced Susceptibility and Virologic Response to the Protease Inhibitor Tipranavir.
    Date December 2006
    Journal Journal of Virology
    Excerpt

    Tipranavir is a novel, nonpeptidic protease inhibitor of human immunodeficiency virus type 1 (HIV-1) with activity against clinical HIV-1 isolates from treatment-experienced patients. HIV-1 genotypic and phenotypic data from phase II and III clinical trials of tipranavir with protease inhibitor-experienced patients were analyzed to determine the association of protease mutations with reduced susceptibility and virologic response to tipranavir. Specific protease mutations were identified based on stepwise multiple-regression analyses of phase II study data sets. Validation included analyses of phase III study data sets to determine if the same mutations would be selected and to assess how these mutations contribute to multiple-regression models of tipranavir-related phenotype and of virologic response. A tipranavir mutation score was developed from these analyses, which consisted of a unique string of 16 protease positions and 21 mutations (10V, 13V, 20M/R/V, 33F, 35G, 36I, 43T, 46L, 47V, 54A/M/V, 58E, 69K, 74P, 82L/T, 83D, and 84V). HIV-1 isolates displaying an increasing number of these tipranavir resistance-associated mutations had a reduced phenotypic susceptibility and virologic response to tipranavir. Regression models for predicting virologic response in phase III trials revealed that each point in the tipranavir score was associated with a 0.16-log10 copies/ml-lower virologic response to tipranavir at week 24 of treatment. A lower number of points in the tipranavir score and a greater number of active drugs in the background regimen were predictive of virologic success. These analyses demonstrate that the tipranavir mutation score is a potentially valuable tool for predicting the virologic response to tipranavir in protease inhibitor-experienced patients.

    Title An Hmg Protein, Hmo1, Associates with Promoters of Many Ribosomal Protein Genes and Throughout the Rrna Gene Locus in Saccharomyces Cerevisiae.
    Date May 2006
    Journal Molecular and Cellular Biology
    Excerpt

    HMG proteins are architectural proteins that bind to DNA with low sequence specificity, but little is known about their genomic location and biological functions. Saccharomyces cerevisiae encodes 10 HMG proteins, including Hmo1, which is important for maximal transcription of rRNA. Here we use chromatin immunoprecipitation coupled with microarray analysis to determine the genome-wide association of Hmo1. Unexpectedly, Hmo1 binds strongly to the promoters of most ribosomal protein (RP) genes and to a number of other specific genomic locations. Hmo1 binding to RP promoters requires Rap1 and (to a lesser extent) Fhl1, proteins that also associate with RP promoters. Hmo1, like Fhl1 and Ifh1, typically associates with an IFHL motif in RP promoters, but deletion of the IFHL motif has a very modest effect on Hmo1 binding. Surprisingly, loss of Hmo1 abolishes binding of Fhl1 and Ifh1 to RP promoters but does not significantly affect the level of transcriptional activity. These results suggest that Hmo1 is required for the assembly of transcription factor complexes containing Fhl1 and Ifh1 at RP promoters and that proteins other than Fhl1 and Ifh1 also play an important role in RP transcription. Lastly, like mammalian UBF, Hmo1 associates at many locations throughout the rRNA gene locus, and it is important for processing of rRNA in addition to its role in rRNA transcription. We speculate that Hmo1 has a role in coordinating the transcription of rRNA and RP genes.

    Title Pharmacokinetic Parameters of Nevirapine and Efavirenz in Relation to Antiretroviral Efficacy.
    Date May 2006
    Journal Aids Research and Human Retroviruses
    Excerpt

    Optimal adherence is essential for successful antiretroviral therapy. We analyzed the relation between minimum plasma drug concentration (Cmin) and total drug exposure over 24 hr (AUC24) with virologic failure for therapy-adherent patients in the nevirapine (NVP) and efavirenz (EFV) groups of the double nonnucleoside study (2NN), which compared the efficacy of NVP and/or EFV together with stavudine and lamivudine. The objective was to find cutoff values of the Cmin and AUC24 below which the risk of virologic failure increased. The relation between Cmin and AUC24 with virologic failure (never a plasma viral load [pVL] < 50 copies/ml or a rebound to two consecutive pVL > 50 copies/ml) was analyzed with proportional hazard analyses. Data were censored at end of study or change of allocated treatment. The risk of virologic failure with NVP (n = 511) started to increase at a Cmin < 3.1 mg/L (hazard ratio [HR], 1.33; 95% confidence interval [CI], 0.89-1.97), but there was no cutoff value below which a statistically significant increased risk occurred. Neither was such a cutoff point identified for the AUC24. The risk of virologic failure with EFV (n = 312) was significantly increased at a Cmin < 1.1 mg/L (HR, 1.95; 95% CI, 1.08-3.54) and an AUC24 < 40 mg x hr x L1 (HR, 1.95; 95% CI, 1.07-3.54). Both cutoff values represent the median values for adherent patients. These associations were driven by patients from Thailand. Adjusting for geographical region made the association between Cmin and AUC24 with virologic failure statistically nonsignificant. The sensitivity of the Cmin values was too low (29% for NVP, 64% for EFV) to be an adequate predictor for virologic failure. We conclude that identifying the Cmin value for the sole purpose of predicting virologic failure in patients who report to be adherent to NVP or EFV is questionable because of the absence of a concentration-response relation (NVP) or the low sensitivity for such a cutoff value (NVP and EFV).

    Title Nevirapine and Efavirenz Elicit Different Changes in Lipid Profiles in Antiretroviral-therapy-naive Patients Infected with Hiv-1.
    Date April 2006
    Journal Plos Medicine
    Excerpt

    BACKGROUND: Patients infected with HIV-1 initiating antiretroviral therapy (ART) containing a non-nucleoside reverse transcriptase inhibitor (NNRTI) show presumably fewer atherogenic lipid changes than those initiating most ARTs containing a protease inhibitor. We analysed whether lipid changes differed between the two most commonly used NNRTIs, nevirapine (NVP) and efavirenz (EFV). METHODS AND FINDINGS: Prospective analysis of lipids and lipoproteins was performed in patients enrolled in the NVP and EFV treatment groups of the 2NN study who remained on allocated treatment during 48 wk of follow-up. Patients were allocated to NVP (n = 417), or EFV (n = 289) in combination with stavudine and lamivudine. The primary endpoint was percentage change over 48 wk in high-density lipoprotein cholesterol (HDL-c), total cholesterol (TC), TC:HDL-c ratio, non-HDL-c, low-density lipoprotein cholesterol, and triglycerides. The increase of HDL-c was significantly larger for patients receiving NVP (42.5%) than for patients receiving EFV (33.7%; p = 0.036), while the increase in TC was lower (26.9% and 31.1%, respectively; p = 0.073), resulting in a decrease of the TC:HDL-c ratio for patients receiving NVP (-4.1%) and an increase for patients receiving EFV (+5.9%; p < 0.001). The increase of non-HDL-c was smaller for patients receiving NVP (24.7%) than for patients receiving EFV (33.6%; p = 0.007), as were the increases of triglycerides (20.1% and 49.0%, respectively; p < 0.001) and low-density lipoprotein cholesterol (35.0% and 40.0%, respectively; p = 0.378). These differences remained, or even increased, after adjusting for changes in HIV-1 RNA and CD4+ cell levels, indicating an effect of the drugs on lipids over and above that which may be explained by suppression of HIV-1 infection. The increases in HDL-c were of the same order of magnitude as those seen with the use of the investigational HDL-c-increasing drugs. CONCLUSION: NVP-containing ART shows larger increases in HDL-c and decreases in TC:HDL-c ratio than an EFV-containing regimen. Based on these findings, protease-inhibitor-sparing regimens based on non-nucleoside reverse transcriptase inhibitor, particularly those containing NVP, may be expected to result in a reduced risk of coronary heart disease.

    Title Concerns with Nerve Blocks at Home.
    Date March 2006
    Journal Anesthesia and Analgesia
    Title Serum 25-hydroxyvitamin D Concentrations in Girls Aged 4-8 Y Living in the Southeastern United States.
    Date February 2006
    Journal The American Journal of Clinical Nutrition
    Excerpt

    BACKGROUND: Evidence suggests that adults and adolescents throughout the United States are at risk of poor vitamin D status. However, vitamin D concentrations in young American children have not been assessed. OBJECTIVE: The relations between serum 25-hydroxyvitamin D [25(OH)D] and bone were examined in prepubertal girls. DESIGN: In the present cross-sectional study, serum 25(OH)D concentration was assessed in 168 prepubertal girls aged 4-8 y living in the southeastern United States with the use of radioimmunoassay. Bone area, bone mineral content, and areal bone mineral density were measured from total body, lumbar spine, proximal femur, and forearm with dual-energy X-ray absorptiometry. Data were analyzed with analysis of variance, analysis of covariance, stepwise multiple regression, and partial correlations. RESULTS: The mean (+/-SD) serum 25(OH)D was 93.8 +/- 28.1 nmol/L (range: 31.1-181.4 nmol/L). In a multiple regression analysis, race and season were the strongest predictors of vitamin D status. The black girls had lower mean 25(OH)D values than did the white girls (P < 0.01), and 25(OH)D values were significantly different in the total sample between the seasons (P < 0.001), ranging from 74.4 nmol/L during the winter months to 107 nmol/L during the summer. After adjustment for season, age, race, and body mass index, 25(OH)D values were negatively correlated with forearm bone mineral content (r = -0.18; P = 0.02). CONCLUSIONS: Unlike prior reports of adults and adolescents living in the southeastern United States, vitamin D status was adequate in the children of the present study. 25(OH)D concentrations were not positively associated with higher bone mineral.

    Title A Group Sequential Adaptive Treatment Assignment Design for Proof of Concept and Dose Selection in Headache Trials.
    Date October 2005
    Journal Contemporary Clinical Trials
    Excerpt

    The trial objective was to test whether a new mechanism of action would effectively treat migraine headaches and to select a dose range for further investigation. The motivation for a group sequential, adaptive, placebo-controlled trial design was (1) limited information about where across the range of seven doses to focus attention, (2) a need to limit sample size for a complicated inpatient treatment and (3) a desire to reduce exposure of patients to ineffective treatment. A design based on group sequential and up and down designs was developed and operational characteristics were explored by trial simulation. The primary outcome was headache response at 2 h after treatment. Groups of four treated and two placebo patients were assigned to one dose. Adaptive dose selection was based on response rates of 60% seen with other migraine treatments. If more than 60% of treated patients responded, then the next dose was the next lower dose; otherwise, the dose was increased. A stopping rule of at least five groups at the target dose and at least four groups at that dose with more than 60% response was developed to ensure that a selected dose would be statistically significantly (p=0.05) superior to placebo. Simulations indicated good characteristics in terms of control of type 1 error, sufficient power, modest expected sample size and modest bias in estimation. The trial design is attractive for phase 2 clinical trials when response is acute and simple, ideally binary, placebo comparator is required, and patient accrual is relatively slow allowing for the collection and processing of results as a basis for the adaptive assignment of patients to dose groups. The acute migraine trial based on this design was successful in both proof of concept and dose range selection.

    Title Pharmacokinetic Evaluation and Short-term Activity of Stavudine, Nevirapine, and Nelfinavir Therapy in Hiv-1-infected Adults.
    Date September 2005
    Journal Journal of Acquired Immune Deficiency Syndromes (1999)
    Excerpt

    OBJECTIVE: Evaluate pharmacokinetic interaction, short-term safety, and antiretroviral activity of stavudine (d4T), nevirapine (NVP), and nelfinavir (NFV) as combination HIV-1 therapy. DESIGN: Prospective, open-label study investigating the pharmacokinetic interactions between d4T, NVP, and NFV and documenting short-term tolerability and virologic and immunologic activity. METHODS: Twenty-five HIV-1-infected adults, naive to nonnucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs), < or = 6 months of d4T treatment, CD4 > or = 100 cells/mm, and viral load > = 5,000 copies/mL enrolled. All received NFV 750 mg 3 times daily and d4T 30-40 mg twice daily for 1 week, then added NVP at 200 mg once daily for 2 weeks and 200 mg twice daily thereafter. Steady-state pharmacokinetic parameters of NFV, AG1402 (metabolite of NFV), and d4T were compared before and after the addition of NVP. RESULTS: No statistically significant changes in NFV or d4T pharmacokinetics were observed following the addition of NVP. Levels of AG1402 were suppressed 60-70%. Drug-related adverse events were seen at expected rates. At day 36, median viral load suppression was 2.0 log10 and absolute CD4 count increased by 111 cells/mm. CONCLUSIONS: NVP administration did not significantly affect the steady-state pharmacokinetic parameters of NFV or d4T. The combination of d4T, NVP, and NFV induced rapid suppression of HIV-1 viral load and rises in CD4 cell count.

    Title Initial Years of Recreational Artistic Gymnastics Training Improves Lumbar Spine Bone Mineral Accrual in 4- to 8-year-old Females.
    Date June 2005
    Journal Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research
    Excerpt

    Gymnasts' bone mineral characteristics are generally not known before starting their sport. Prepubertal females who enrolled in beginning artistic gymnastics (n = 65) had lower bone mineral than controls (n = 78). However, 2 years of gymnastics participation versus no participation led to a significantly greater accrual of forearm bone area and lumbar spine areal BMD. INTRODUCTION: The skeletal response to exercise in children compared with adults is heightened because of the high bone turnover rate and the ability of bone to change its size and shape. Whereas child gymnasts generally have greater rates of bone mineral accrual compared with nongymnasts, it is unknown if some of these skeletal advantages are present before the onset of training or are caused entirely by training. MATERIALS AND METHODS: Changes in bone area (BA; cm2), BMC (g), and areal BMD (aBMD; g/cm2) over 24 months were examined in prepubertal females, 4-8 years of age, who selected to perform recreational gymnastics (GYM; n = 65), nongymnastic activities, or no organized activity (CON; n = 78). Participants had essentially no lifetime history of organized athletic participation (< 12 weeks). Pubertal maturation was assessed annually by a physician. Total body, lumbar spine, total proximal femur, and forearm BA, BMC, and aBMD were measured every 6 months using DXA (Hologic QDR-1000W). Independent samples t-tests determined baseline group differences. Nonlinear mixed effects models were used to model 24-month changes in bone data. In subset analyses, high-level gymnasts advancing to competition (HLG; n = 9) were compared with low-level nonadvancing gymnasts (LLG; n = 56). RESULTS: At baseline, GYM were shorter, lighter, and had lower BA, BMC, and aBMD compared with CON (p < 0.05), whereas HLG did not differ significantly in these measurements compared with LLG (p > 0.05). Controlling for differences in race, baseline measures of body mass, height, and calcium intake, and change in breast development beyond stage II at 24 months, GYM had greater long-term (asymptotic) mean responses for total body aBMD and forearm BMC (p < 0.04) and greater rates of increase in the mean responses of lumbar spine aBMD and forearm BA compared with CON over 24 months. Over time, forearm BA increased to a greater extent in HLG compared with LLG (p < 0.01). CONCLUSIONS: Females participating in recreational gymnastics initiated during childhood have enhanced bone mineral gains at the total body, lumbar spine, and forearm over 24 months. Higher-level training promotes additional gains in forearm BA.

    Title Plasma Hiv-1 Rna Decline Within the First Two Weeks of Treatment is Comparable for Nevirapine, Efavirenz, or Both Drugs Combined and is Not Predictive of Long-term Virologic Efficacy: A 2nn Substudy.
    Date April 2005
    Journal Journal of Acquired Immune Deficiency Syndromes (1999)
    Excerpt

    The initial rate of plasma HIV-1 RNA (pVL) decline has been proposed as a marker of early efficacy of antiretroviral therapy (ART) and a possible predictor of late efficacy. We compared the rate of pVL decline in patients starting ART with nevirapine (NVP), efavirenz (EFV), or both drugs combined in addition to lamivudine (3TC) and stavudine (d4T).

    Title The Transcription Factor Ifh1 is a Key Regulator of Yeast Ribosomal Protein Genes.
    Date February 2005
    Journal Nature
    Excerpt

    Ribosomal protein (RP) genes in eukaryotes are coordinately regulated in response to growth stimuli and environmental stress, thereby permitting cells to adjust ribosome number and overall protein synthetic capacity to physiological conditions. Approximately 50% of RNA polymerase II transcription is devoted to RP genes. The transcriptional regulator Rap1 binds most yeast RP promoters, and Rap1 sites are important for coordinate regulation of RP genes. However, Rap1 is not the specific regulator that controls RP transcription because it also functions as a repressor, and many Rap1-activated promoters are not coordinately regulated with RP promoters. Here we show that the transcription factors Fhl1 and Ifh1 associate almost exclusively with RP promoters; association depends on Rap1 and (to a lesser extent) a DNA element at many RP promoters. Ifh1 is recruited to promoters via the forkhead-associated (FHA) domain of Fhl1; the level of Ifh1 associated with RP promoters determines the level of transcription; and environmental stress causes a marked reduction in the association of Ifh1, but not Fhl1 or Rap1. Thus, Ifh1 association with promoters is the key regulatory step for coordinate expression of RP genes.

    Title Multivariate Multilevel Nonlinear Mixed Effects Models for Timber Yield Predictions.
    Date November 2004
    Journal Biometrics
    Excerpt

    Nonlinear mixed effects models have become important tools for growth and yield modeling in forestry. To date, applications have concentrated on modeling single growth variables such as tree height or bole volume. Here, we propose multivariate multilevel nonlinear mixed effects models for describing several plot-level timber quantity characteristics simultaneously. We describe how such models can be used to produce future predictions of timber volume (yield). The class of models and methods of estimation and prediction are developed and then illustrated on data from a University of Georgia study of the effects of various site preparation methods on the growth of slash pine (Pinus elliottii Engelm.).

    Title Confinement and Processing Effects on Glass Transition Temperature and Physical Aging in Ultrathin Polymer Films: Novel Fluorescence Measurements.
    Date April 2004
    Journal The European Physical Journal. E, Soft Matter
    Excerpt

    Fluorescence intensity measurements of chromophore-doped or -labeled polymers have been used for the first time to determine the effects of decreasing film thickness on glass transition temperature, T(g), the relative strength of the glass transition, and the relative rate of physical aging below T(g) in supported, ultrathin polymer films. The temperature dependence of fluorescence intensity measured in the glassy state of thin and ultrathin films of pyrene-doped polystyrene (PS), poly(isobutyl methacrylate) (PiBMA), and poly(2-vinylpyridine) (P2VP) differs from that in the rubbery state with a transition at T(g). Positive deviations from bulk T(g) are observed in ultrathin PiBMA and P2VP films on silica substrates while substantial negative deviations from bulk T(g) are observed in ultrathin PS films on silica substrates. The relative difference in the temperature dependences of fluorescence intensity in the rubbery and glassy states is usually reduced with decreasing film thickness, indicating that the strength of the glass transition is reduced in thinner films. The temperature dependence of fluorescence intensity also provides useful information on effects of processing history as well as on the degree of polymer-substrate interaction. In addition, when used as a polymer label, a mobility-sensitive rotor chromophore is demonstrated to be useful in measuring relative rates of physical aging in films as thin as 10 nm.

    Title Use of the Professional Nurse Case Study As a Method to Earn Credit in an Rn to Bsn Program.
    Date October 2003
    Journal The Abnf Journal : Official Journal of the Association of Black Nursing Faculty in Higher Education, Inc
    Excerpt

    This article describes the author's experience in developing a professional nurse case study as a means of allowing registered nurse students enrolled in a baccalaureate degree nursing program to satisfy the clinical requirement at a public institution in New Jersey. The author used a survey to assess the lower level competencies of their RN students. In addition, a survey was mailed to the BSN graduates who completed the program within the past five years to determine if they would have selected an alternative to the clinical examination. Results showed that the PNCS could validate prior learning of basic nursing competencies for RNs returning to obtain a BSN degree.

    Title Randomized, Controlled Study of the Effects of a Short Course of Prednisone on the Incidence of Rash Associated with Nevirapine in Patients Infected with Hiv-1.
    Date June 2003
    Journal Journal of Acquired Immune Deficiency Syndromes (1999)
    Excerpt

    To examine the effect of 2 weeks of treatment with prednisone on the incidence of nevirapine-associated rash in HIV-1-infected patients receiving combination antiretroviral therapy.

    Title The Vp16 Activation Domain Interacts with Multiple Transcriptional Components As Determined by Protein-protein Cross-linking in Vivo.
    Date January 2003
    Journal The Journal of Biological Chemistry
    Excerpt

    Transcriptional activator proteins recruit the RNA polymerase II machinery and chromatin-modifying activities to promoters. Biochemical experiments indicate that activator proteins can associate with a large number of proteins, and many such proteins have been proposed to be direct targets of activators. However, there is great uncertainty about which biochemical interactions are physiologically relevant. Here, we develop a formaldehyde-based cross-linking procedure to identify protein-protein interactions that occur under physiological conditions. We show that the VP16 activation domain directly interacts with TATA-binding protein (TBP), TFIIB, and the SAGA histone acetylase complex in vivo.

    Title Dose Response and Safety Study of Meloxicam Up to 22.5 Mg Daily in Rheumatoid Arthritis: a 12 Week Multicenter, Double Blind, Dose Response Study Versus Placebo and Diclofenac.
    Date September 2002
    Journal The Journal of Rheumatology
    Excerpt

    OBJECTIVE: This Phase III, placebo and active controlled, multicenter trial evaluated the efficacy and safety of meloxicam 7.5, 15, and 22.5 mg daily for the treatment of rheumatoid arthritis (RA). METHODS: A 12 week, randomized, double blind, double dummy, parallel group trial compared daily oral meloxicam 7.5, 15, and 22.5 mg to placebo (negative control) and diclofenac 75 mg BID (positive control). A total of 894 patients (18 years of age with confirmed RA who flared following an NSAID-free period) were randomized to be treated. Baseline scores for all endpoints were similar among the treatment groups. Patient assessments were at 0, 2, 4, 8, and 12 weeks or early termination. RESULTS: All treatment groups demonstrated significant improvement from baseline (p < 0.001). Meloxicam 7.5 and 22.5 mg was significantly superior to placebo in all 5 primary efficacy endpoints (swollen joint count, tender joint count, patient pain, patient and physician global; all p < 0.05). Diclofenac 150 mg was superior to placebo for 4 of 5 primary efficacy measures (all but swollen joint count; p < 0.05) and meloxicam 15 mg was superior for 3 of 5 primary endpoints (patient pain and patient and physician global). AUC of patient global, patient pain, and modified Health Assessment Questionnaire demonstrated dose-response (p < 0.04), while AUC ACR20 showed a qualitative trend in the same direction. The rate of gastrointestinal (GI) events during the 12 week trial for all doses of meloxicam and diclofenac did not differ significantly from placebo (23.2-32.0%). GI withdrawals were comparable and not significantly different across all treatment groups (4.3-5.7%). CONCLUSION: This trial demonstrated a dose response relationship for meloxicam 7.5, 15, and 22.5 mg using AUC measurement of response for the treatment of RA. All 3 doses of meloxicam. and positive control, were effective in the treatment of RA. The overall incidence rate of GI events did not differ significantly from placebo in either the meloxicam treatment groups or the positive control.

    Title Methodologic Issues in a Population-based Health Survey of Gulf War Veterans.
    Date June 2002
    Journal Journal of Clinical Epidemiology
    Excerpt

    This report describes the principal methods used in the development, conduct, and analysis of the research study "Health Assessment of Persian Gulf War Veterans from Iowa" (Iowa Gulf War Study). The methods presented include an outline of the organizational structure, study timeline, hypotheses, outcome definitions, and study design. Adhering to a strict timeline, the study protocol and instruments were developed, and a stratified sample of 3,695 military personnel (76% participation) was located and surveyed by structured telephone interview. The study tracked personnel from all service branches residing nationally and internationally, including those discharged from service. This study required development and implementation of methods appropriate to analysis of data collected in a complex sampling framework and methodological procedures to ensure scientific rigor in a highly public and politicized environment. Statistical analyses were conducted on a priori health outcomes and required development of methods to compute Cochran-Mantel-Haenszel adjusted rate differences. This environment facilitated rapid implementation, critique by scientific and public advisors, a high participation rate, and rapid publication.

    Title Application Technique and Irrigation Method Affect Imidacloprid Control of Silverleaf Whiteflies (homoptera: Aleyrodidae) on Poinsettias.
    Date December 2001
    Journal Journal of Economic Entomology
    Excerpt

    Subirrigation systems are increasingly used to water and fertilize greenhouse crops. They also appear to be well suited for the application of systemic pesticides. We conducted two studies to look at interactive effects ofimidacloprid application technique and irrigation method on plant uptake of imidacloprid and whitefly control. Drench applications of imidacloprid resulted in much higher concentrations in the leaves than applications to the bottom of pots after 14 d. However, imidacloprid efficacy in subirrigated plants was better if the imidacloprid was applied to the bottom of the pot than when an equal amount was applied as a drench. In drip-irrigated plants, imidacloprid efficacy was greater after a drench than after an application to the bottom of the pots. A second study showed that drench applications to drip-irrigated plants result in high imidacloprid concentrations in the bottom of the canopy, whereas bottom applications to subirrigated plants result in a more even distribution of imidacloprid throughout the plant. Surprisingly, the high leaf imidacloprid concentrations in the bottom layer of drip-irrigated plants did not result in improved whitefly control. Imidacloprid efficacy was better in subirrigated, bottom-treated plants than in drip-irrigated, drenched plants. Overall, results from these studies indicate that imidacloprid is very effective when applied to the bottom of subirrigated pots.

    Title Zero-inflated Poisson and Binomial Regression with Random Effects: a Case Study.
    Date February 2001
    Journal Biometrics
    Excerpt

    In a 1992 Technometrics paper, Lambert (1992, 34, 1-14) described zero-inflated Poisson (ZIP) regression, a class of models for count data with excess zeros. In a ZIP model, a count response variable is assumed to be distributed as a mixture of a Poisson(lambda) distribution and a distribution with point mass of one at zero, with mixing probability p. Both p and lambda are allowed to depend on covariates through canonical link generalized linear models. In this paper, we adapt Lambert's methodology to an upper bounded count situation, thereby obtaining a zero-inflated binomial (ZIB) model. In addition, we add to the flexibility of these fixed effects models by incorporating random effects so that, e.g., the within-subject correlation and between-subject heterogeneity typical of repeated measures data can be accommodated. We motivate, develop, and illustrate the methods described here with an example from horticulture, where both upper bounded count (binomial-type) and unbounded count (Poisson-type) data with excess zeros were collected in a repeated measures designed experiment.

    Title Imidacloprid Applications by Subirrigation for Control of Silverleaf Whitefly (homoptera: Aleyrodidae) on Poinsettia.
    Date August 2000
    Journal Journal of Economic Entomology
    Excerpt

    The objective of this study was to determine whether silverleaf whiteflies, Bemisia argentifolii Bellows & Perring, on poinsettia, Euphorbia pulcherrima Willdenow ex Klotsch, can be controlled with imidacloprid applied by subirrigation. Different amounts of imidacloprid uptake by the growing medium were obtained by not watering the subirrigated plants for 0, 1, 2, or 4 d before the imidacloprid application. These treatments resulted in absorption of 12-175 ml of imidacloprid solution by the growing medium. These treatments were compared with untreated control plants and plants that were treated with a standard drench application (100 ml) to the top of the growing medium. All imidacloprid treatments resulted in a significant decrease in both the survival of adult whiteflies and number of immature whiteflies on the plants. Subirrigation treatments resulted in better control of adult and immature whiteflies than drench application. Withholding water for 2 or 4 d before the imidacloprid application by subirrigation improved control of immature whiteflies. This indicates that the application of imidacloprid to poinsettia by subirrigation is a practical and efficient method to control silverleaf whiteflies.

    Title A Thyroid Shield Can Correct a Laryngeal Mask Airway Air Leak.
    Date November 1999
    Journal Anesthesiology
    Title A Laryngeal Mask Airway "tip".
    Date September 1999
    Journal Anesthesia and Analgesia
    Title Takes a Lickin' and Keeps on Tickin'.
    Date June 1999
    Journal Anesthesia and Analgesia
    Title Antiviral Effect and Pharmacokinetic Interaction Between Nevirapine and Indinavir in Persons Infected with Human Immunodeficiency Virus Type 1.
    Date June 1999
    Journal The Journal of Infectious Diseases
    Excerpt

    Nevirapine and indinavir have the potential of affecting the pharmacokinetics of each other. In a prospective trial, 24 human immunodeficiency virus (HIV)-infected subjects on stable nucleoside or no therapy were treated with 800 mg of indinavir every 8 h. After 7 days, 200 mg of nevirapine a day was added for 14 days and then increased to 200 mg twice a day. At day 7 (before nevirapine), there was a sevenfold difference among the subjects in indinavir area under the curve (AUC), and there was a significant correlation between indinavir AUC (r2=0.378, P=.019), minimum plasma concentration (Cmin; r2=0.359, P=.023), maximum plasma concentration (Cmax; r2=0.340, P=.028), and plasma HIV RNA decline. Nevirapine significantly reduced median indinavir Cmin (47.5%) and AUC (27.4%) and, to a lesser extent, Cmax (11%). Plasma HIV RNA values were </=20 copies/mL in 10 of 17 (58.8%) subjects at 58 weeks or last visit. These data suggest that indinavir dosing should be dependent on drug exposure and not on cotherapy with nevirapine.

    Title Long-range Oxidative Damage to Dna: Effects of Distance and Sequence.
    Date March 1999
    Journal Chemistry & Biology
    Excerpt

    Oxidative damage to DNA in vivo can lead to mutations and cancer. DNA damage and repair studies have not yet revealed whether permanent oxidative lesions are generated by charges migrating over long distances. Both photoexcited *Rh(III) and ground-state Ru(III) intercalators were previously shown to oxidize guanine bases from a remote site in oligonucleotide duplexes by DNA-mediated electron transfer. Here we examine much longer charge-transport distances and explore the sensitivity of the reaction to intervening sequences.

    Title Long-range and Short-range Oxidative Damage to Dna: Photoinduced Damage to Guanines in Ethidium-dna Assemblies.
    Date December 1998
    Journal Biochemistry
    Excerpt

    Short-range and long-range photoreactions between ethidium and DNA have been characterized. While no DNA reaction is observed upon excitation into the visible absorption band of ethidium, higher-energy irradiation (313-340 nm) leads both to direct strand cleavage at the 5'-G of 5'-GG-3' doublets and to piperidine-sensitive lesions at guanine. This reactivity is not consistent with oxidation of guanine by either electron transfer or singlet oxygen as shown by comparison with reactions of a rhodium intercalator and methylene blue, respectively. By covalently tethering ethidium to one end of a DNA duplex, we demonstrate the presence of two distinct reactions, one short-range and the other long-range. The short-range reaction involves a covalent modification of guanine by ethidium, based upon HPLC analysis of the nucleoside products and studies with ethidium derivatives. The long-range reaction is entirely consistent with oxidation of guanine by DNA-mediated electron transfer. The yield of this electron-transfer reaction is not attenuated with distance; equal yields of guanine damage are observed at a proximal (17 A Et-GG separation) and distal (44 A Et-GG separation) site. These results are quite similar to those previously observed with a covalently tethered rhodium photooxidant and underscore the unique ability of the DNA base stack to facilitate long-range electron transfer so as to effect oxidative damage from a distance.

    Title Induction-maintenance Antiretroviral Therapy: Proof of Concept.
    Date August 1998
    Journal Aids (london, England)
    Excerpt

    To investigate the concept of aggressive initial combination therapy followed by reduction to a less demanding maintenance regimen with respect to its potential for sustaining viral suppression.

    Title A Computer Program for Regression Analysis of Ordered Categorical Repeated Measurements.
    Date February 1997
    Journal Computer Methods and Programs in Biomedicine
    Excerpt

    RMORD is an easy-to-use FORTRAN program for the analysis of clustered ordinal data using the method of Stram, Wei, and Ware. This method constitutes an extension of the proportional-odds model to the situation in which groups of responses are correlated. At each measurement occasion, a proportional-odds regression model is fit to the data by maximizing the occasion-specific likelihood function. The joint asymptotic distribution of the occasion-specific regression parameter estimators is obtained along with a consistent estimator of their asymptotic covariance matrix. RMORD may be used when ordinal measurements are obtained at a common set of observation times for multiple subjects or clusters. Both missing data and covariates which vary within clusters can be accommodated. The program can be run on microcomputers, workstations, and mainframe computers. Two examples illustrating the usage and features of RMORD are provided.

    Title Sodium and Potassium Currents of Type I Spiral Ganglion Cells from Rat.
    Date December 1996
    Journal Acta Oto-laryngologica
    Excerpt

    Ion channel activity of acutely dissociated type I spiral ganglion cells isolated from rats was investigated using the whole-cell variation of the patch clamp technique. Tetrodotoxin-sensitive sodium current and tetraethylammonium-sensitive potassium current were recorded. With a holding potential of -80 mV, peak sodium currents were generated by depolarizations to membrane potentials more positive than -50 mV. Potassium currents were elicited at membrane potentials more positive than -40 mV. Some cells which did not exhibit sodium current exhibited delayed rectifier potassium currents. Steady-state sodium channel inactivation curve yielded a slope of 12 mV and a half-inactivated potential of -83 mV. Recovery from inactivation of the sodium channel proceeded with a fast and slow time course; recovery began as early as 0.8 ms and proceeded with a time constant of 7.5 ms. It is concluded that type I spiral ganglion cells are endowed with sodium and potassium channels which are responsible for generation and propagation of auditory nerve action potentials.

    Title Auditory Cortex Neurons: Primary Culture and Ion Channel Activity in Rat.
    Date December 1996
    Journal Acta Oto-laryngologica
    Excerpt

    We have developed a primary dissociated cell culture of the fetal (E17) and post-natal (P0-P10) rat auditory cortex. Pyramidal and non-pyramidal cells had a mean cross-sectional diameter of 12.73 +/- 1.80 microns (mean +/- S.D., n = 25) and 17.58 +/- 1.67 microns (mean +/- S.D., n = 10), respectively, measured at 6 days in culture. These cells were viable for as long as 18-21 days. They expressed voltage-gated sodium and potassium channel currents as early as one day in culture, and at various phases in cell culture. Sodium current, activated at membrane potentials more positive than -60 mV, displayed fast activation and inactivation kinetics. Fifty percent inactivation of sodium channels occurred at a pre-pulse potential of -63 mV. Delayed rectifier potassium channels were activated at potentials positive to -40 mV. Large hyperpolarizing constant current pulses elicited anode break action potentials, and large depolarizing constant current pulses exhibited rectification indicative of the delayed rectifying potassium channel activity.

    Title Oxidative Dna Damage Through Long-range Electron Transfer.
    Date September 1996
    Journal Nature
    Excerpt

    The possibility has been considered for almost forty years that the DNA double helix, which contains a pi-stacked array of heterocyclic base pairs, could be a suitable medium for the migration of charge over long molecular distances. This notion of high charge mobility is a critical consideration with respect to DNA damage. We have previously found that the DNA double helix can serve as a molecular bridge for photo-induced electron transfer between metallointercalators, with fast rates (> or = 10(10)s-1) and with quenching over a long distance (>40 A). Here we use a metallointercalator to introduce a photoexcited hole into the DNA pi-stack at a specific site in order to evaluate oxidative damage to DNA from a distance. Oligomeric DNA duplexes were prepared with a rhodium intercalator covalently attached to one end and separated spatially from 5'-GG-3' doublet sites of oxidation. Rhodium-induced photo-oxidation occurs specifically at the 5'-G in the 5'-GG-3' doublets and is observed up to 37 A away from the site of rhodium intercalation. We find that the yield of oxidative damage depends sensitively upon oxidation potential and pi-stacking, but not on distance. These results demonstrate directly that oxidative damage to DNA may be promoted from a remote site as a result of hole migration through the DNA pi-stack.

    Title What to Do when Your Patients Outweigh Your Scales--another Alternative.
    Date February 1996
    Journal Anesthesia and Analgesia
    Title Rift Valley Fever in Rural Northern Senegal: Human Risk Factors and Potential Vectors.
    Date August 1994
    Journal The American Journal of Tropical Medicine and Hygiene
    Excerpt

    To investigate past infection in and transmission of Rift Valley fever (RVF) virus to humans within an endemic focus, we undertook a retrospective cohort study of the seminomadic Peul people living in sub-Saharan northcentral Senegal. Residents of the rural settlement of Yonofere five years of age or older were studied during February-May 1989. Anti-RVF virus IgG was found in blood samples of 22.3% of 273 persons who responded to a standard questionnaire; none had IgM antibodies. Seropositivity was similar for males (25.4%) and females (21.1%), increased markedly with age for both sexes, and varied considerably among compounds (groups of huts) (0-37.5%). Risk factors for past RVF virus infection were nursing sick people, assisting animals during abortions/births, and treating sick animals. In all age groups, odds ratios (ORs) for RVF viral antibody among females who reported treating sick animals were three to six times greater than for those who did not. The ORs for males who reported assisting with animal births/abortions and nursing sick people were approximately five times those for males who did not. Serologic prevalence of RVF viral antibody among sheep averaged 30.1% overall (0.8% IgM), but varied among compounds (0-66.7%) in a manner different from that of humans. The seasonal abundance and relative density of potential mosquito vectors were estimated by monthly samples captured in Centers for Disease Control and Prevention-type traps. Mosquito abundance varied seasonally with rainfall (> 90% captures during four months). Species diversity was large (28 spp.), dominated by Aedes and Culex. Rift Valley fever virus was not isolated from 142 pools of 2,956 unengorged mosquitoes tested, although three other arboviruses were found. Results indicate that RVF is endemic in this region, people are at considerable risk of infection, and that a heretofore unrecognized mode of human infection under nonepizootic conditions may be transmission via contact with infected animals or humans.

    Title Urban Epizootic of Rabies in Mexico: Epidemiology and Impact of Animal Bite Injuries.
    Date January 1994
    Journal Bulletin of the World Health Organization
    Excerpt

    From 1 July 1987 to 31 December 1988, a total of 317 animals (91% of which were dogs) were confirmed to have rabies in Hermosillo, Mexico. The median age of rabid dogs was 1 year, 69% were male, and 98% were owned. The epizootic started in the southern areas of the city, rapidly involved the entire city, and persisted mainly in lower socioeconomic status areas. The area of the city and mean household size were significant predictor variables for the population density of rabid dogs around household clusters (Poisson linear regression, P < 0.001 and P = 0.03, resp). Approximately 2.5% of city residents were bitten by dogs in 1987, with the rate of reported dog bite injuries being positively correlated with mean household size and the proportion of households that owned dogs. Visits to the city health centre for evaluation of possible exposures to rabies increased by 135% after the start of the epizootic; approximately 273 per 100,000 city residents were administered a full or partial course of rabies post-exposure prophylaxis in 1987. Children were at greatest risk for exposures to rabies, accounting for 60% of all reported animal bite injuries evaluated at the health centre. Also they were more likely than older persons to have received bite injuries to the head, face, and neck (odds ratio = 21.6, 95% confidence interval = 5.4, 186.5).

    Title Confidence Intervals and Controlled Clinical Trials: Incompatible Tools for Medical Research.
    Date December 1993
    Journal Journal of Biopharmaceutical Statistics
    Excerpt

    The probabilistic rationale for statistical design and analysis of clinical trials is random assignment. While arithmetic and mathematical formulations may be identical to those used with random samples, we should not indiscriminately borrow tools from survey sample methods. Specifically, the confidence interval should be used sparingly, if at all. Observations have an internal validity, within the clinical trial, with no basis for claims of quantitative external generalizability. Confidence intervals encourage an unnecessary dependence on statistical analysis when the careful design should allow the data to speak for itself. Confidence intervals encourage a statistical focus and statistical conclusions that ignore scientific context and misrepresent relationships among results from related research. The clinician is presented with information about population parameters when facing confidence intervals. These do not address questions about treatment and prognosis of an individual patient. Confidence intervals are particularly distracting when a clinical trial has failed to produce anticipated results. The clinical trial is the model research tool for clinical medical research, founded on randomization. The confidence interval is a statistical tool for parameter estimation based on population sampling concepts. These tools are incompatible.

    Title Risk Factors for Crimean-congo Hemorrhagic Fever in Rural Northern Senegal.
    Date October 1991
    Journal The Journal of Infectious Diseases
    Excerpt

    The extent of infection among 722 residents of an enzootic focus of Crimean-Congo hemorrhagic fever (CCHF) virus in rural northern Senegal and putative modes of transmission were studied by a cross-sectional seroprevalence survey done from February through May 1989. Anti-CCHF virus IgG was found in 13.1% of 283 persons who completed a standard questionnaire and provided blood samples. Seropositivity rates were similar between sexes and increased significantly with age among nomadic persons. Behavior patterns providing exposure to multifactorial risk factors were gender-based. Male risk factors, primarily associated with herding activities, included sleeping outside during seasonal migrations (also a risk factor for nomadic women), bite by a tick (adult male Hyalomma truncatum), tick bite during the cool dry season, and contact with sick animals. Human infection of CCHF occurred more frequently or with less mortality in the region studied than has been found elsewhere in Africa; however, the rate of seroconversion-associated illness is undetermined. Hyalomma ticks appear to be the primary transmission mode.

    Title Outbreak of Paralytic Poliomyelitis in Oman: Evidence for Widespread Transmission Among Fully Vaccinated Children.
    Date October 1991
    Journal Lancet
    Excerpt

    From January, 1988, to March, 1989, a widespread outbreak (118 cases) of poliomyelitis type 1 occurred in Oman. Incidence of paralytic disease was highest in children younger than 2 years (87/100,000) despite an immunisation programme that recently had raised coverage with 3 doses of oral poliovirus vaccine (OPV) among 12-month-old children from 67% to 87%. We did a case-control study (70 case-patients, 692 age-matched controls) to estimate the clinical efficacy of OPV, assessed the immunogenicity of OPV and extent of poliovirus spread by serology, retrospectively evaluated the cold chain and vaccine potency, and sought the origin of the outbreak strain by genomic sequencing. 3 doses of OPV reduced the risk of paralysis by 91%; vaccine failures could not be explained by failures in the cold chain nor on suboptimum vaccine potency. Cases and controls had virtually identical type 1 neutralising antibody profiles, suggesting that poliovirus type 1 circulation was widespread. Genomic sequencing indicated that the outbreak strain had been recently imported from South Asia and was distinguishable from isolates indigenous to the Middle East. Accumulation of enough children to sustain the outbreak seems to have been due to previous success of the immunisation programme in reducing spread of endemic strains, suboptimum efficacy of OPV, and delay in completing the primary immunisation series until 7 months of age. Additionally, the estimated attack rate of infection among children aged 9-23 months exceeded 25% in some regions, suggesting that a substantial proportion of fully vaccinated children had been involved in the chain of transmission.

    Title Occupational Risk of Human Parvovirus B19 Infection for School and Day-care Personnel During an Outbreak of Erythema Infectiosum.
    Date April 1990
    Journal Jama : the Journal of the American Medical Association
    Excerpt

    Human parvovirus B19, the cause of erythema infectiosum, has recently been associated with adverse fetal outcomes. During a large outbreak of erythema infectiosum in Connecticut, a survey was conducted on 571 (90%) of 634 school and day-care personnel to determine the risk of acquiring B19 infection. Serologic evidence of B19 infection was determined by using an enzyme-linked immunosorbent assay. Of the school and day-care personnel, 58% had evidence of previous B19 infection. The minimal rate of B19 infection in susceptible personnel during the outbreak was 19%. The risk was increased for teachers and day-care providers who had contact with younger children and with greater numbers of ill children. These results suggest that B19 infection is an occupational risk for school and day-care personnel.

    Title An Epidemic of Acute Hemorrhagic Conjunctivitis in American Samoa Caused by Coxsackievirus A24 Variant.
    Date January 1990
    Journal American Journal of Epidemiology
    Excerpt

    Between May 25 and July 5, 1986, an epidemic of acute hemorrhagic conjunctivitis affected an estimated 47% of the population on American Samoa. Coxsackievirus A24 variant was isolated from 18 of 22 patients. This is the first documented outbreak of acute hemorrhagic conjunctivitis due to coxsackievirus A24 variant outside of Southeast Asia and the Indian subcontinent. When this outbreak was compared with an outbreak on the island in 1981-1982 caused by enterovirus 70, conjunctival hemorrhage or injection and the severity of hemorrhage were less prevalent among cases in 1986, while upper respiratory and systemic symptoms were more common. Residents of traditional housing had significantly higher attack rates (48%) than residents of government housing (23%). Serum specimens collected from the residents of Samoa in 1985, before the outbreak, unexpectedly revealed the presence of neutralizing antibodies against coxsackievirus A24 variant. The presence of these antibodies correlated with protection against coxsackievirus A24 variant infection in this outbreak.

    Title Analysis of Surveillance Data: a Rationale for Statistical Tests with Comments on Confidence Intervals and Statistical Models.
    Date May 1989
    Journal Statistics in Medicine
    Excerpt

    In the examination of differences between subgroups in surveillance data, whether through simple counting or through sophisticated statistical modelling, the comparison is not between simple random samples from two or more populations. The rationale for statistical tests rests on an appeal to a model of random permutation of demographic and disease factors for the observed population during the surveillance period. The testing evaluates chance as a possible explanation for the observed results. In the analysis of internal structure in a surveillance data set, statistical tests produce a conceptually simple result that lends itself to concise presentation and flexible interpretation. Tests limit emphasis on probabilistic manipulation and on parameter estimates. They cannot stand alone, and thus encourage descriptive presentation of observations. In contrast, statistical models and confidence intervals emphasize parameters rather than distributions and compete with the data for limited space.

    Title Duration of Immunogenicity and Efficacy of Hepatitis B Vaccine in a Yupik Eskimo Population.
    Date May 1989
    Journal Jama : the Journal of the American Medical Association
    Excerpt

    In 1981, a hepatitis B virus vaccine demonstration project was conducted in 1630 Yupik Eskimos in southwest Alaska. Levels of antibody to hepatitis B surface antigen and markers for hepatitis B virus infection in vaccinees were monitored yearly for 5 years. After 5 years of follow-up, 19% of those who initially had an immune response to vaccine of 10 sample ratio units or greater subsequently had levels of antibody to hepatitis B surface antigen lower than 10 sample ratio units. During the 5 years after the first dose of vaccine, in three responders and one person with an antibody to hepatitis B surface antigen response lower than 10 sample ratio units, antibody to hepatitis B core antigen developed, and the level of antibody to hepatitis B surface antigen was boosted. Hepatitis B surface antigen did not develop in any subjects, and none had clinical hepatitis. In the 5 years following the demonstration project, the annual incidence of hepatitis B virus infection decreased from 50 cases per 1000 population before the vaccine trial to 0.45 per 1000.

    Title Factitious Malignant Hyperthermia.
    Date October 1988
    Journal Anesthesia and Analgesia
    Title Pharyngeal Carriage and Acquisition of Anticapsular Antibody to Haemophilus Influenzae Type B in a High-risk Population in Southwestern Alaska.
    Date January 1988
    Journal American Journal of Epidemiology
    Excerpt

    Haemophilus influenzae type b disease in Alaskan Eskimos is characterized by greatly increased disease incidence at younger ages. This suggests that Eskimo infants have increased exposure to the disease. Exposure was studied in 1982-1983 in children less than age three years who lived in four Eskimo villages, as well as in a random sample of their family members (354 people from 132 households). During a 12-month period, up to four pharyngeal cultures and two serum specimens were obtained from each participant. Colonization with H. influenzae type b was relatively uncommon (overall 2.5% of cultures, 6.8% of individuals) and was not associated with age, sex, season, or prior incidence of disease in the village. Biotyping and outer-membrane-protein typing of H. influenzae type b isolates revealed homogeneity within villages, with differences between villages. Matched sera revealed a significant decline in H. influenzae type b capsular antibody in the course of the study year. However, pharyngeal carriage of H. influenzae type b was associated with increases in antibody for carriers and members of their households. Antibody levels were positively associated with age. Only one case of H. influenzae type b disease developed during the study. Low carriage of H. influenzae type b was coincident with low incidence of disease and declining levels of capsular antibody in these villages. Mechanisms for increased exposure which would not be reflected in high carriage rates may exist for these young children.

    Title Decline in Infant Mortality of Alaskan Yupik Eskimos from 1960 to 1980.
    Date July 1986
    Journal Public Health Reports (washington, D.c. : 1974)
    Excerpt

    A 1960-62 study of southwestern Alaskan Eskimos documented an infant mortality rate--102.6 deaths per 1,000 live births--that was four times greater than that of U.S. whites. In 1980-81, 20 years after the original study, a similar cohort was identified in this population so that changes in infant mortality and other birth characteristics could be examined. Average birth weight and the amount of prenatal care received by the mothers increased from 1960 to 1980. Birth weight and prenatal visits were positively correlated. Results of the followup also revealed a 1980-81 infant mortality rate--17.1 deaths per 1,000 live births--that was less than a fifth of the 1960-62 rate and no longer significantly different from the national rate. Major changes associated with the decrease in mortality during the first 28 days of life (neonatal mortality) were a significant increase in the proportion of infants born in hospitals and an associated decrease in the number of deaths of infants weighing less than 2,500 grams at birth. The reduction in mortality during the rest of the first year of life was related to a decrease in deaths due to infectious diseases, particularly measles and pertussis. Changes in infant mortality reflect the increased availability of health care in this region, improved immunization programs, and the establishment of the Bethel Prematernal Home in Bethel, AK.

    Title High Prevalence of Myopia Among Young Adult Yupik Eskimos.
    Date April 1986
    Journal Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
    Excerpt

    Myopia is common in Western populations but is considered rare in nonindustrialized population groups. However, studies in undeveloped areas of the Arctic and sub-Arctic have demonstrated increased rates of myopia among young Inuit adults indigenous to the region. We examined the refractive status of Yupik Eskimos, a group that had not previously been evaluated. Our subjects were young adults born between November 1960 and December 1962 to persons living in 10 villages in southwestern Alaska. The refractive status was obtained for 92% of these persons. The prevalence of myopia (refractive error -0.50 D or greater) was 68%, a rate among the highest reported for a general population anywhere in the world. The young women were significantly more myopic than the young men (mean refractive errors -1.91 and -1.36 D respectively). Astigmatism and myopia were positively correlated (r = 0.20, p less than 0.01). The etiology of myopia in this population is under study.

    Title Invasive Haemophilus Influenzae Type B Disease in Alaska: Background Epidemiology for a Vaccine Efficacy Trial.
    Date January 1986
    Journal The Journal of Infectious Diseases
    Excerpt

    In a previous study we demonstrated that Alaskan Eskimos had the highest endemic incidence of invasive Haemophilus influenzae type b (Hib) disease. In 1980 we established a prospective surveillance program for all invasive Hib disease throughout Alaska to characterize additional epidemiological features of disease in Native Alaskans to plan for a vaccine efficacy trial and define the epidemiology of Hib disease in all population groups in the state. For the three-year period, 1980-1982, 287 confirmed episodes of invasive Hib disease occurred. For children less than five years of age, the incidences for Eskimos, Indians, and non-Natives were 705, 401, and 129 cases per 100,000 population, respectively. The Native population represents only 16% of the population of Alaska but has 51% of all invasive Hib disease. Disease differed significantly among Eskimos, Indians, and non-Natives with regard to risk, age of onset, disease type, antibiotic susceptibility of strains, and regional incidence, but mortality and seasonal occurrence were similar. For Native Alaskans the cumulative Hib disease risk for the first two years of life was 4% (range, 1%-7% by region). This high endemic disease risk, concentrated in the first two years of life, provides a unique opportunity to prospectively evaluate the protective efficacy of a vaccine in a randomized, blinded, and placebo-controlled trial. Such a trial was initiated in December 1984.

    Title Uridine Monophosphate Kinase 3: a Genetic Marker for Susceptibility to Haemophilus Influenzae Type B Disease.
    Date October 1985
    Journal Lancet
    Excerpt

    Alaskan Eskimos have the highest known prevalence of invasive Haemophilus influenzae type b (Hib) disease, primarily meningitis, affecting 1-5% of all children in the first two years of life. In this population a polymorphic genetic variant of the pyrimidine pathway enzyme, uridine monophosphate kinase-3 (UMPK-3), was found to be positively associated with invasive Hib disease (relative risk 3.3) and a tendency towards a younger age at onset of illness. There was no difference in levels of naturally acquired Hib anticapsular antibody between persons with Hib disease and healthy controls in this population. This suggests that UMPK-3 may have a role in mediating non-humoral immunity to Hib. However, unlike other enzyme variants in the nucleoside synthesis pathways which result in syndromes of severe immunodeficiency, this gene appears to confer a more subtle disease susceptibility.

    Title The Control of Hepatitis B Virus Infection with Vaccine in Yupik Eskimos. Demonstration of Safety, Immunogenicity, and Efficacy Under Field Conditions.
    Date August 1985
    Journal American Journal of Epidemiology
    Excerpt

    In 1981, a hepatitis B vaccine demonstration project was initiated among Yupik Eskimos of southwest Alaska to demonstrate that, under field conditions, the vaccine was safe, immunogenic, and efficacious. Laboratory tests for serologic markers of hepatitis B virus infection (HBsAg, anti-HBs, and anti-HBc) performed on sera collected in May 1981 from 3,988 residents of 17 remote Eskimo villages revealed that 2,645 (66.3%) had no evidence of hepatitis B virus infection. Because of a limited supply of vaccine, specific criteria for selection were used so that those at highest risk of infection would be immunized first. In November 1981, the first dose of vaccine was administered to 1,693 carefully selected individuals. The second dose was administered to 1,678 (99.1%) of those who received the first dose, and the final dose was administered to 1,630 persons (96.3%). Serologic follow-up showed the vaccine to be safe (0.4% experienced minor adverse reactions) and immunogenic (97.4% developed antibody). Vaccine-induced antibody levels were significantly higher for persons less than 30 years of age (p less than 0.001) and for females (p less than 0.001). Vaccine recipients were also protected from hepatitis B virus infection (p = 0.002). This public health measure proved to be feasible and effective in this remote arctic population despite difficult conditions for delivery and administration of this temperature-sensitive vaccine. This strategy for immunization is now being applied on a larger scale in Alaska as part of a program for the primary prevention of this infection and its sequelae.

    Title The Long-term Serological Course of Asymptomatic Hepatitis B Virus Carriers and the Development of Primary Hepatocellular Carcinoma.
    Date April 1985
    Journal The Journal of Infectious Diseases
    Excerpt

    One hundred fifty asymptomatic patients who were carriers of hepatitis B surface antigen (HBsAg) were studied serologically for up to 11.3 years (mean, 6.1 years). Only 9 (6.0%) lost HBsAg during the study period, for a mean annual clearance rate of 1.0%. We found no difference in the clearance of HBsAg by age, but a higher percentage of females lost HBsAg than did males (P less than .02). Hepatitis B e antigen (HBeAg) was found in 102 (68.5%) of the 149 carriers of HBsAg who were tested. Carriers of HBsAg who were seropositive for HBeAg were younger than those who were seronegative for HBeAg (P less than .01). The prevalence of HBeAg was not affected by the patients' sex. The clearance of HBeAg was gradual; 9.6% of the HBsAg carriers lost HBeAg each year. Females were more likely to clear HBeAg than were males (P less than .01), and those who cleared HBeAg were older than those who did not (P less than .01). Three (2.0%) of the HBsAg carriers developed primary hepatocellular carcinoma during the study period.

    Title Acute Hepatitis B Virus Infection: Relation of Age to the Clinical Expression of Disease and Subsequent Development of the Carrier State.
    Date April 1985
    Journal The Journal of Infectious Diseases
    Excerpt

    Yupik Eskimos of southwestern Alaska have the highest known prevalence of hepatitis B virus infection of any general population in the United States. Prospective serological surveys of 1,280 seronegative Yupik Eskimos, performed between 1971 and 1976, identified 189 (14.8%) who developed serological evidence of hepatitis B virus infection. Twenty-six (13.8%) developed clinical hepatitis during the interval when seroconversion occurred. The proportion of patients with clinically apparent hepatitis increased with age (P less than .01), ranging from 9.5% of infections in patients who were four years of age or less to 33.3% of infections in patients who were 30 years of age or older. Twenty-five (13.3%) of the 188 individuals who were studied became chronic carriers of hepatitis B surface antigen. The risk of becoming a carrier was inversely related to the age of the patient at the time of infection (P = .02). Among patients who were four years of age or less when infected, 28.8% became chronic carriers of hepatitis B, as compared with 7.7% of those who were 30 years of age or older.

    Title Prevalence of Hepatitis B in Selected Alaskan Eskimo Villages.
    Date December 1983
    Journal American Journal of Epidemiology
    Excerpt

    Sera collected in 1973-1975 from 3053 residents of 12 selected Alaskan Eskimo villages were tested for evidence of hepatitis B virus infection. Overall, hepatitis B surface antigen (HBsAg) was found in 6.4% of those tested. Evidence of hepatitis B infection (positive for HBsAg or antibody to hepatitis B surface antigen (anti-HBs] varied considerably by village, from 4.6% to 69.9%, and increased with advancing age. The proportion with HBsAg was significantly higher in those under the age of 13 years, and the male/female ratio varied from 0.9 to 1.5 to 1.5 in the prepubertal, postpubertal-premenopausal, and postmenopausal age groups, respectively. The prevalence of hepatitis B e antigen (HBeAg) in HBsAg-positive persons decreased with advancing age, and conversely, the prevalence of antibody to hepatitis B e antigen (anti-HBe) increased with age. Hepatitis B infection was found to be sporadically distributed, with great village-to-village variation and further variation by household within most villages. The high HBsAg and HBeAg seropositivity observed in children suggests that children are both more recently infected with hepatitis B and are more involved in hepatitis B transmission in these villages.

    Title Bone and Fat Relationships in Postadolescent Black Females: a Pqct Study.
    Date
    Journal Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the Usa
    Excerpt

    Despite adolescent black females experiencing the highest rates of obesity, the effect of excess fat mass on bone structure and strength in this population is unknown. Our findings in postadolescent black females suggest that excess weight in the form of fat mass may adversely influence cortical bone structure and strength.

    Title Comparisons of Trabecular and Cortical Bone in Late Adolescent Black and White Females.
    Date
    Journal Journal of Bone and Mineral Metabolism
    Excerpt

    Few childhood studies have investigated racial differences in volumetric bone mineral density (vBMD), bone geometry, and bone strength indices measured by three-dimensional bone imaging. The purpose of this study was to compare trabecular and cortical bone parameters at the radius and tibia between late adolescent white and black females using peripheral quantitative computed tomography (QCT). White (n = 25) and black females (n = 25), 18-19 years of age, were pair-matched for age, height, and fat-free soft tissue mass. Peripheral QCT scans were obtained at the 4% (trabecular bone), 20% (cortical bone), and 66% [muscle cross-sectional area (CSA)] sites from the distal metaphyses. Bone strength was determined from vBMD and bone geometry to calculate bone strength index (BSI; trabecular site) and polar strength-strain index (SSI; cortical site). Radial SSI was not different between groups; however, blacks had greater radial BSI (P = 0.02) than whites. After adjustment for the longer forearm in blacks, the greater radial BSI in blacks no longer remained. At the tibia, blacks versus whites had greater bone strength at the trabecular and cortical bone sites (BSI, P = 0.03; SSI, P = 0.04, respectively). When controlling for differences in tibial length and muscle CSA, the higher estimates of bone strength persisted in blacks versus whites (BSI, P = 0.01; SSI, P = 0.02). Our data suggest that when differences in body size are considered, late adolescent black versus white females have a stronger bone profile, due to greater bone geometry and vBMD, at the trabecular and cortical regions of the tibia but not at the radius.

    Title Dimensional Stability Tests over Time and Temperature for Several Low-expansion Glass Ceramics.
    Date
    Journal Applied Optics
    Excerpt

    The dimensional stabilities of five commercially available low-expansion glass ceramics have been measured between -40 °C and +90 °C. Materials tested include Zerodur, Zerodur M, Astrositall, Clearceram 55, and Clearceram 63. With the use of a standardized thermal testing procedure, the thermal expansion, isothermal shrinkage, and hysteresis behavior of the various materials are compared with one another. A detailed comparison of three separate melts of Astrositall, two separate melts of Zerodur, and one melt of Zerodur M indicates that between -40 °C and +90 °C the dimensional stability and uniformity characteristics of two of the melts of Astrositall are somewhat better than those of the other two materials. To my knowledge, this is the first published comparison of data from these glass ceramics taken with identical test procedures.


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