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Background: Information on the characteristics and behaviors of persons at high risk for gonorrhea and chlamydial infection has typically been derived from studies of sexually transmitted disease (STD) clinic populations. The Baltimore STD and Behavior Survey (BSBS) used urine-based nucleic acid amplification testing (NAAT) to assess the prevalence and behavioral correlates of gonorrhea and chlamydial infection in a population-based cross-sectional survey of adults in Baltimore, Maryland.Goal: The goal of this study was to examine the demographic characteristics and behavioral markers of gonorrhea and chlamydial infection as reported by adults with a self-reported history of gonorrhea and chlamydial infection and to compare these to the characteristics and behaviors of individuals with current NAAT-identified gonorrhea and/or chlamydial infection.Study Design: A probability sample of adults aged 18 to 35 years residing in Baltimore was evaluated with collection of urine specimens and administration of a health and behavior survey. Data and specimens were collected between January 1997 and September 1998.Results: Respondents with NAAT-detected gonorrhea and/or chlamydial infection (7.9%) did not report a history of high-risk behaviors or more recent occurrences of those behaviors, and the majority were asymptomatic. However, adults in our study who self-reported a history of infection (26.0%) were more likely than those with no history of infection to report multiple partners, paid sex, partners with prior STDs, and STD symptoms-a pattern consistent with findings described in previous clinic-based reports.Conclusion: The risk profile generated from studies of clinic populations, with a focus on symptomatic disease, may not characterize the broader population with current, untreated, largely asymptomatic infection. [ABSTRACT FROM AUTHOR]

Cancer is the second leading cause of death attributed to disease worldwide. Current standard detection methods often rely on a single cancer marker, which can lead to inaccurate results, including false negatives, and an inability to detect multiple cancers simultaneously. Here, we developed a multiplex method that can effectively detect and classify surface proteins associated with three distinct types of breast cancer by utilizing gap-enhanced Raman scattering nanotags and machine learning algorithm. We synthesized anisotropic magnetic core-gold shell gap-enhanced Raman nanotags incorporating three different Raman reporters. These multicolor Raman nanotags were employed to distinguish specific surface protein markers in breast cancer cells. The acquired signals were deconvoluted and analyzed using classical least-squares regression to generate a surface protein profile and characterize the breast cancer cells. Furthermore, computational data obtained via finite-difference time-domain and discrete dipole approximation showed the amplification of the electric fields within the gap region due to plasmonic coupling between the two gold layers. Finally, a random forest classifier achieved an impressive classification and profiling accuracy of 93.9%, enabling effective distinguishing between the three different types of breast cancer cell lines in a mixed solution. With the combination of immunomagnetic multiplex target specificity and separation, gap-enhancement Raman nanotags, and machine learning, our method provides an accurate and integrated platform to profile and classify different cancer cells, giving implications for identification of the origin of circulating tumor cells in the blood system.

The seventh session of the Oncological Pathology Conference (JoPaO) entitled 'Pathological Anatomy in the context of the National Cancer Law: An overview of the Latin American experience', was held virtually on July 15, 22 and 23. Peru was the headquarters for this event, where 17 national and international professors of high academic standing participated. They interacted in a multidisciplinary context through talks with national panellists and the general public. The recent promulgation of the 'National Cancer Law' fosters the development of discussion forums to analyse the national realities and uphold continuous learning about experiences in other Latin American countries with successful cancer programmes, in which pathology holds a principal role. The topics addressed during this JoPaO included the exchange of Latin American cancer management experiences, an emphasis on investments in and the development of strategic plans to improve care, the use of new technologies, laboratory quality control, and the need to advance scientific research., Competing Interests: The authors declare that there are no conflicts of interest., (© the authors; licensee ecancermedicalscience.)

An immunotherapeutic strategy is discussed supporting anti-tumor activity toward malignancies overexpressing ganglioside D3. GD3 can be targeted by NKT cells when derived moieties are presented in the context of CD1d. NKT cells can support anti-tumor responses by secreting inflammatory cytokines and through cytotoxicity toward CD1d + GD3 + tumors. To overexpress GD3, we generated expression vector DNA and an adenoviral vector encoding the enzyme responsible for generating GD3 from its ubiquitous precursor GM3. We show that DNA encoding α-N-acetyl-neuraminide α-2,8-sialyltransferase 1 (SIAT8) introduced by gene gun vaccination in vivo leads to overexpression of GD3 and delays tumor growth. Delayed tumor growth is dependent on CD1d expression by host immune cells, as shown in experiments engaging CD1d knockout mice. A trend toward greater NKT cell populations among tumor-infiltrating lymphocytes is associated with SIAT8 vaccination. A single adenoviral vaccination introduces anti-tumor activity similarly to repeated vaccination with naked DNA. Here, greater NKT tumor infiltrates were accompanied by marked overexpression of IL-17 in the tumor, later switching to IL-4. Our results suggest that a single intramuscular adenoviral vaccination introduces overexpression of GD3 by antigen-presenting cells at the injection site, recruiting NKT cells that provide an inflammatory anti-tumor environment. We propose adenoviral SIAT8 (AdV-SIAT8) can slow the growth of GD3 expressing tumors in patients.

The nonextensive entropic measure proposed by Tsallis [C. Tsallis, J. Stat. Phys. 52, 479 (1988)] introduces a parameter, q, which is not defined but rather must be determined. The value of q is typically determined from a piece of data and then fixed over the range of interest. On the other hand, from a phenomenological viewpoint, there are instances in which q cannot be treated as a constant. We present two distinct approaches for determining q depending on the form of the equations of constraint for the particular system. In the first case the equations of constraint for the operator Ô can be written as Tr(F(q)Ô)=C, where C may be an explicit function of the distribution function F. We show that in this case one can solve an equivalent maxent problem which yields q as a function of the corresponding Lagrange multiplier. As an illustration the exact solution of the static generalized Fokker-Planck equation (GFPE) is obtained from maxent with the Tsallis enropy. As in the case where C is a constant, if q is treated as a variable within the maxent framework the entropic measure is maximized trivially for all values of q. Therefore q must be determined from existing data. In the second case an additional equation of constraint exists which cannot be brought into the above form. In this case the additional equation of constraint may be used to determine the fixed value of q.

A program of in situ experiments, supported by laboratory studies, was initiated to study diffusion in sparsely fractured rock (SFR), with a goal of developing an understanding of diffusion processes within intact crystalline rock. Phase I of the in situ diffusion experiment was started in 1996, with the purpose of developing a methodology for estimating diffusion parameter values. Four in situ diffusion experiments, using a conservative iodide tracer, were performed in highly stressed SFR at a depth of 450 m in the Underground Research Laboratory (URL). The experiments, performed over a 2 year period, yielded rock permeability estimates of 2 x 10(-21) m(2) and effective diffusion coefficients varying from 2.1 x 10(-14) to 1.9 x 10(-13) m(2)/s, which were estimated using the MOTIF code. The in situ diffusion profiles reveal a characteristic "dog leg" pattern, with iodide concentrations decreasing rapidly within a centimeter of the open borehole wall. It is hypothesized that this is an artifact of local stress redistribution and creation of a zone of increased constrictivity close to the borehole wall. A comparison of estimated in situ and laboratory diffusivities and permeabilities provides evidence that the physical properties of rock samples removed from high-stress regimes change. As a result of the lessons learnt during Phase I, a Phase II in situ program has been initiated to improve our general understanding of diffusion in SFR., (Crown Copyright 2002 Published by Elsevier Science B.V.)

Context: The prevalence and distribution of gonococcal and chlamydial infections in the general population are poorly understood. Development of nucleic acid amplification tests, such as the ligase chain reaction assay, provides new opportunities to estimate the prevalence of untreated infections in the population., Objective: To estimate the overall prevalence of untreated gonococcal and chlamydial infections and to describe patterns of infection within specific demographic subgroups of the young adult population in Baltimore, Md., Design and Setting: Cross-sectional behavioral survey based on a probability sample of Baltimore households with collection of urine specimens between January 1997 and September 1998., Participants: A total of 728 adults aged 18 to 35 years completed the interview portion of the study, and 579 of these respondents also provided a urine specimen adequate for testing., Main Outcome Measure: Prevalence of untreated infection, as measured by the percentage of specimens testing positive for gonococcal and chlamydial infection by ligase chain reaction, weighted to reflect variations in probabilities of sample selection from the population. Alternate estimates of the prevalence of recent treated infection were derived from clinically diagnosed cases reported to the Baltimore City Health Department and by diagnoses reported by participants in the survey., Results: An estimated 5.3% (SE, 1.4%) of the population aged 18 to 35 years has an untreated gonococcal infection, and 3.0% (SE, 0.8%) is estimated to have an untreated chlamydial infection. While 7.9% (SE, 1.6%) of the population is estimated to have either an untreated gonococcal or chlamydial infection, estimated prevalence is substantially higher among black women (15.0%; SE, 3.7%). Few participants with untreated infections reported dysuria or discharge during the 6 months preceding testing. The estimated number of untreated gonococcal infections in the population (9241; SE, 2441) substantially exceeds both the number of such infections diagnosed among Baltimore adults aged 18 to 35 years and reported to the Baltimore City Health Department during 1998 (4566), and the estimated number of diagnoses derived using participants' reports for the 12 months prior to the survey (4708 [SE, 1918] to 5231 [SE, 2092]). The estimated number of untreated chlamydial infections (5231; SE, 1395) is also greater than the number of cases reported to the health department in 1998 (3664) but is slightly less than the estimated number of diagnoses derived using participants' reports of chlamydial infections diagnosed during the 12 months prior to the survey (5580 [SE, 1918] to 6975 [SE, 2441])., Conclusion: In 1997-1998, the estimated number of undiagnosed gonococcal and chlamydial infections prevalent in the population of Baltimore adults aged 18 to 35 years approached or exceeded the number of infections that were diagnosed and treated annually.

Measurements of drug use and other illicit or stigmatized behaviors are subject to nontrivial underreporting biases. During in-person surveys, respondents are more likely to report such behaviors when interviewed using techniques that maximize interviewee privacy, e.g., use of paper SAQs and audio-CASI rather than questioning by human interviewers. Until recently, respondents in telephone surveys could not be offered similar privacy. A new technology, telephone audio computer-assisted self-interviewing (T-ACASI) overcomes this limitation of telephone surveys by allowing respondents to respond to a computer. A randomized experimental test of T-ACASI was embedded in the Urban Men's Health Study (UMHS). UMHS surveyed a probability sample of 2,881 men from four United States cities and who reported having sex with men. Respondents interviewed using T-ACASI reported a higher prevalence of drug use and drug-related behaviors than respondents interviewed by human interviewers. However, survey respondents were more likely to break off an interview when the interview was conducted by a T-ACASI computer rather than by a human interviewer.

Studies of sexual and other sensitive behaviors are often fraught with a variety of reporting biases. When IAQs are used to collect data, respondents may underreport certain sensitive behaviors and overreport normative behaviors. SAQs can also pose problems: requiring that respondents be literate and able to follow skip patterns. In recent years, the development of computerized technologies--audio-CASI and T-ACASI--have begun to overcome some of the limitations of IAQs and SAQs. By providing a more private mode for data collection and standardized delivery of all questions, as well as automated skip patterns and range checks, audio-CASI and T-ACASI have been tested in a number of studies and found to be an effective way of reducing response bias, and thus, contributing to a better understanding of the prevalence and patterns of sexual and other sensitive behaviors.

Context: Sexually transmitted diseases (STDs) of bacterial origin such as gonorrhea and chlamydial infection can lead to pelvic inflammatory disease (PID) and infertility. Identifying behaviors and characteristics associated with infection may assist in preventing these often asymptomatic diseases and their sequelae., Methods: Data from 9,882 sexually active women who participated in the 1995 National Survey of Family Growth describe the characteristics of women who report a history of infection with a bacterial STD or of treatment for PID. Multivariate analysis is used to determine which demographic characteristics and sexual and health-related behaviors affect the likelihood of infection or the occurrence of complications., Results: Overall, 6% of sexually active women reported a history of a bacterial STD, and 8% reported a history of PID. Women who first had sexual intercourse before age 15 were nearly four times as likely to report a bacterial STD, and more than twice as likely to report PID, as were women who first had sex after age 18. Having more than five lifetime sexual partners also was associated with both having an STD and having PID. PID was more common among women reporting a history of a bacterial STD (23%) than among women who reported no such history (7%). In multivariate analyses, age, race, age at first intercourse and lifetime number of sexual partners had a significant effect on the risk of a bacterial STD. Education, age, a history of IUD use, douching and a history of a bacterial STD had a significant impact on the risk of PID, but early onset of intercourse did not, and lifetime number of partners had only a marginal effect., Conclusions: The pattern of characteristics and behaviors that place women at risk of infection with bacterial STDs is not uniform among groups of women. Further, the level of self-reported PID would suggest higher rates of gonorrhea and chlamydial infection than reported.

Because of a dearth of research on reporting biases in the measurement of HIV-related sexual and drug use behaviors in older populations, it is frequently assumed that methodological findings of research conducted with younger populations will generalize to older respondents. In this study, estimates of the effect of the experimental manipulation of interview mode (interviewer administered vs. self-administered) were derived separately for three age strata: 12 to 49, 50 to 64, and 65+. Results of these analyses indicate that there were a number of noteworthy reversals in which interviewer-administered questioning in the older age strata produced higher esti-mates of the prevalence of substance use or alcohol-related problem behaviors. These results suggest that caution should be exercised in making generalizations from studies of reporting bias for HIV-related behaviors to older populations.

CD40 is a TNF receptor superfamily member that provides activation signals in antigen-presenting cells such as B cells, macrophages, and dendritic cells. Multimerization of CD40 by its ligand initiates signaling by recruiting TNF receptor-associated factors (TRAFs) to the CD40 cytoplasmic domain. Recombinant human TRAF proteins overexpressed in insect cells were biochemically characterized and used to finely map TRAF binding regions in the human CD40 cytoplasmic domain. TRAF1, TRAF2, TRAF3, and TRAF6, but not TRAF4 or TRAF5, bound directly to the CD40 cytoplasmic domain. CD40 interactions with TRAF2 and TRAF3 were stronger than the interactions with TRAF1 and TRAF6. Full-length TRAF3 and TRAF5 formed hetero-oligomers, presumably through their predicted isoleucine zippers. TRAF3-TRAF5 hetero-oligomers interacted with CD40, indicating that TRAF5 can be indirectly recruited to the CD40 cytoplasmic domain. Overlapping peptides synthesized on cellulose membranes were used to map each TRAF interaction region. TRAF1, TRAF2, and TRAF3 interacted with the same region. The recognition site for TRAF6 was a nonoverlapping membrane proximal region. Using peptides with progressive deletions, a minimal TRAF1, TRAF2, and TRAF3 binding region was mapped to the PVQET sequence in the CD40 cytoplasmic domain. The minimal region for TRAF6 binding was the sequence QEPQEINF. These studies demonstrate that the CD40 cytoplasmic domain contains two nonoverlapping TRAF binding regions and suggest that TRAF1, TRAF2, and TRAF3 could bind competitively to one site. Relative affinities and competition of individual and hetero-oligomeric TRAF proteins for CD40 binding sites may contribute to receptor specificity and cell-type selectivity in CD40-dependent signaling.

Three recent empirical studies have provided strong evidence that self-administered questionnaires (SAQs), compared with interviewer questioning, substantially improve the reporting of drug use in population surveys. Specifically, SAQs appear to diminish underreporting bias. Two of these studies previously reported that this effect of interview mode varied significantly across gender, race/ethnicity, and age. Data from a randomized experiment embedded in the 1990 National Household Survey of Drug Abuse (NHSDA) field test were reanalyzed to test for those interaction effects. To better replicate prior studies, the NHSDA field test sample was restricted to people ages 18 to 45 (N = 1,877). The results of our statistical analyses generally replicated the finding of a main effect of SAQs on the reporting of drug use. However, only weak evidence was found to support the hypothesis that the advantage of SAQs varies substantially by the gender, race/ethnicity, or age of the respondent.

This paper describes a new interview data collection system that uses a personal computer equipped with a telephone interface card. This system, telephone audio computer-assisted self-interviewing or T-ACASI, offers the economy of telephone interviews while providing the privacy of self-administered questionnaires. We describe T-ACASI design considerations and operational characteristics. In addition, we present data from recent studies indicating that the T-ACASI system is stable, robust, and suitable for administering relatively long and complex questionnaires on sensitive topics, including drug use and sexual behaviors associated with HIV and other STDs.

Since the 1970s the United States and other nations have conducted regular statistical monitoring of the prevalence and patterns of drug use in their populations. Given the importance of such surveys for policymaking, their quality is a critical issue, and the biases that may affect their measurements become a major concern. An increasing volume of empirical evidence shows that the mode of administration of a survey can strongly influence the validity of respondents' reports. Compared with interviewer-administered questionnaires, self-administered forms appear to elicit more complete reporting of drug use, but the challenges they pose to the literacy skills of respondents may result in measurement biases. In addition, processes of social change may confound true shifts in drug use with changes in the willingness of respondents to report such use. The authors propose several strategies to improve monitoring of trends in drug use. Those approaches include 1) more frequent use of a survey technology--audio computer-assisted self-interviewing--that ensures full privacy for all survey respondents but does not require literacy; 2) increased use of time-series of indicators of drug use consequences built from blinded surveys of medical records; and 3) population-based surveys that collect biological specimens (e.g., hair samples). Data from the latter two sources are not subject to the same constellation of biases that afflict self-reports of drug use. Time-series of those data can be integrated with self-reports to provide a better understanding of changes over time in the prevalence and patterns of drug use.

Background and Objectives: In the January-February, 1995 issue of Sexually Transmitted Diseases, Zenilman and colleagues reported a null association between incident sexually transmitted diseases (STDs) and self-reported condom use. That anomalous finding generated a flurry of letters to the editor, some of which were quite heated. This article reconsiders the Zenilman team's results., Study Design: New statistical analyses were conducted to test two hypotheses that sought to account for the null association: (1) deviation from study protocol, and (2) differential risks of acquiring an incident STD among segments of the study population that varied by reported level of condom use., Results: No support was found for hypotheses concerning deviation from study protocol and differential risk of acquiring an incident STD by level of condom use. Indeed, for respondents who reported multiple sexual partners, the analyses found increased rates of infection among those who reported more consistent condom use., Conclusions: Two of the most promising hypotheses for explaining Zenilman's anomalous findings are unsupported by reanalysis of the available empirical evidence. It is still possible that respondents who reported that they used condoms consistently differed from self-reported nonusers or inconsistent users in some way that altered their risk of acquiring an STD and thus obscured the protective effects of properly used condoms. Nonetheless, as Zenilman and others suggest, fallibility in self-reports of condom use remains the primary suspect as the cause of these anomalous results. Such fallibility may be particularly pronounced when self-reported behavioral data are collected in contexts that include strong educational campaigns or other norm-setting interventions.

This study examines the reliability over a 2-month period of self-reports of drug use, sexual behaviors, and use of treatment services provided by 2,968 clients participating in a large, multisite, prospective study of drug treatment in the United States-the Drug Abuse Treatment Outcome Study (DATOS). Analyses focus on responses to 62 pairs of logically related questions that were asked at two points in time: (1) 1 month after entry into treatment, and (2) 3 months after entry into treatment. Subjects' responses to questions asked at these two time points are assessed for logical consistency. Prior analyses of self-reports provided by DATOS clients at one point in time (entry into treatment) found surprisingly high levels of within-interview consistency in their reporting of alcohol use (Turner & Hubbard, 1995) and cocaine use (Adair, Craddock, Miller, & Turner, 1995). The crosstemporal tests of consistency reported in this article eliminate several potential sources of artifactual consistency that may have affected prior analyses, (e.g., consistency imposed by an interviewer or constructed by a respondent during the course of a single interview). Contrary to expectations, crosstemporal comparisons reveal high levels of logical consistency in clients' responses. The mean percent of substantively inconsistent responses ranges from 0.7% for questions asking about frequency of drug use to 4.4% for questions asking about sexual behaviors.

This study examines consistency of self-reported responses to items within the questionnaire of a multi-site, prospective study of drug abuse treatment in the United States (DATOS). The analyses use data from 2842 interviewer-administered intake interviews. Questions that were logically related are paired and responses compared. The questions cover three topics: (1) age at which different types of cocaine was used, (2) reports on most recent use and (3) frequency of cocaine use during period of "heaviest" use. Responses are coded as consistent, inconsistent, or as survey administration error. The latter is related to interviewer errors such as erroneous skip pattern, out-of-range responses, "don't know" responses, missing data, or illegible responses. Contrary to expectations inconsistent responses were relatively rare in this study, with fewer than 5% (0.5-4.6%) of respondents reporting inconsistent answers for pairs of logically related questions. A careful review of responses also found few survey administration errors (0.2-1.3%).

Pulmonary Edema associated with negative airway pressure caused by upper airway obstruction is a most serious complications in anaesthetic practice (Tami et al, 1986). Laryngospasm associated with intubation and general anaesthesia is the most common cause of upper airway obstruction leading to negative pressure pulmonary edema (NPPE) in the anaesthetic adult (Tami et al, 1986). Other risk factors for the development of upper airway obstruction are identified, and individuals at risk should be observed closely while they remain at risk during the post anaesthetic period. NPPE appears to be related to markedly negative intrathoracic pressure due to forced inspiration against a closed upper airway resulting in transudation of fluid from pulmonary capillaries to the interstitium. The following is a presentation of a case of a healthy young male who developed NPPE secondary to airway obstruction caused by biting down on the endotracheal tube while awakening from general anaesthesia.