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Background Many older Americans are overweight or obese, but it is unclear whether obesity is associated with other nutritional risk indicators. Objective This study investigated sex-associated differences in nutritional risk among community-dwelling, rural older adults and determined whether weight status [body mass index (BMI; in kg/m(2)) and waist circumference] was related to other measures of nutritional risk. Design This cross-sectional study explored relations between weight status and nutritional risk, which was determined on the basis of the Level II Screen, overall diet quality, nutrient intakes, and plasma biomarkers. Results Of the 179 subjects, 44% were overweight (BMI 25-29.9) and 35% were obese (BMI > 30). There were few differences in nutrient intakes between older men and women after we controlled for energy intake. In women, BMI was directly associated with multiple additional nutritional risk indicators, including the number of Level II items (r = 0.30), intakes of fat (r = 0.26) and saturated fat (r = 0.21), and homocysteine concentration (r = 0.25). Weight status in women was inversely associated with intakes of carbohydrates (r = -0.25), fiber (r = -0.35), folate (r = -0.24), magnesium (r = -0.29), iron (r = -0.22), and zinc (r = -0.23); Healthy Eating Index scores (r = -0.22); and plasma pyridoxal 5' phosphate (r = -0.30). Associations with waist circumference were similar. In men, weight status was associated only with plasma cobalamin (r = -0.33 for BMI) and pyridoxal 5' phosphate (r = -0.24 for waist circumference). Conclusions Overweight and obese older women, particularly those living alone, may be at greater nutritional risk than are men with a high BMI. Targeted nutritional intervention emphasizing nutrient-dense food choices to improve dietary patterns may be warranted.

Body weight provides vital information for patient care; therefore, measurement at hospital admission should be standard practice. Our objective was to test compliance with this standard.This was a study of 300 patients, agedor = 18 years, admitted to general medicine and surgery services of 3 tertiary care teaching hospitals in Nashville, Chicago, and San Francisco. At 24 to 36 hours after admission, participants were queried as to whether they had been weighed, and if not, they were asked whether they had been questioned by nursing personnel about their weight. Subjects were then weighed by research personnel using identical protocol at all 3 institutions. Any admission body weight documented by nursing was noted.Compliance was similar at all 3 institutions, with only 197 (65.7%) of patients reporting being weighed. There were 213 (71.0%) patients who had a weight documented in the nursing record. Of those who had not been weighed, 69 (67.0%) indicated that they had been queried about their weight. Comparison of documented weights in the nursing records with those measured by research personnel revealed that 55 (25.9%) differed byor = 5 pounds (2.27 kg). Those who had a documented weight in the nursing record but were not weighed by nursing personnel were also more likely to deviate from the weight measured by research personnel byor = 5 pounds (2.27 kg) in comparison with those who had been weighed by nursing personnel (42.8% versus 21.8%, respectively, p.0147).Overall compliance with weight measurement is poor. Recorded weights are often inaccurate.

Bovine mastitis caused by Streptococcus agalactiae is mainly subclinical and therefore can be diagnosed only in the laboratory. We developed a polymerase chain reaction (PCR)-based method for specific and sensitive detection of S. agalactiae in raw milk. The specificity of the PCR reaction is based on unique S. agalactiae DNA sequences within the 16S subunit of the rRNA genes. Two pairs of sequences were used as positive controls; general streptococci primers, which anneal to conserved areas within the 16S rRNA subunit gene, and primers, which anneal to sequences within bovine mitochondrial DNA. The method of detection includes selective enrichment of S. agalactiae in the milk sample, followed by DNA extraction using a rapid and simple procedure developed for this purpose, and specific PCR reaction with appropriate controls. The method enables the detection of one bacterium in 1 ml of raw milk. The method developed can be easily incorporated as part of routine screening of bulk milk collection tanks for early detection of infected cows in a herd.

OBJECTIVES: This investigation sought to examine potential gender differences in the relationship between body mass index (BMI) and functional decline. DESIGN: Cohort study. SETTING: Rural Pennsylvania. PARTICIPANTS: Medicare managed-risk program participants (aged ≥65) in the Geisinger Health Plan. Mean age at study baseline was 71. Final analyzable sample was 2,634 participants. MEASUREMENTS: Self-reported weight, weight change, living and eating habits, alcohol and medication use, depression, dentition, and functional status were obtained upon enrollment and again between 3 and 4 years later. Measured height and weight were also recorded at enrollment. Functional decline was defined as any increase in reported limitations in activities of daily living or instrumental activities of daily living over the study period. Logistic regression was used to evaluate the relationship between BMI, as defined by current National Institutes of Health categories, and risk of functional decline while controlling for age, depression, and polypharmacy. The referent category was BMI 18.5 to 24.9. RESULTS: Women had a higher prevalence of reported functional decline than men at the upper range of BMI categories (31.4% vs 14.3% for BMI ≥40). Women (odds ratio (OR) = 2.61, 95% confidence interval (CI) = 1.39–4.95) and men (OR = 3.32, 95% CI = 1.29–8.46) exhibited increased risk for any functional decline at BMI of 35 or greater. Weight loss of 10 pounds and weight gain of 20 pounds were also risk factors for any functional decline. CONCLUSIONS: Obesity was a risk factor for functional decline in older persons of either gender. Change in body weight did not benefit function for many older persons.

Dieser Beitrag beschaftigt sich mit Sichcrhcitsfragestellungen einer auf CORBA basierenden Dienstmanagement-Architektur. Diese erlaubt Dienstnehmern die Verwaltung der von ihnen in Anspruch genommenen IT-Dienste. Aus diesem Szenario ergeben sich erhohte, spezifische Sicherheitsanforderungen. Zur Erfullung dieser Anforderungen wurde ein Konzept entwickelt, das neue und standardisierte Ansatze der Public-Key Technologie (Public-Key Infrastruktur und Privilege Management Infrastruktur) in die vorgestellte Managementarchitektur integriert. Die praktische Umsetzung dieses Konzepts wird durch eine prototypische Implementierung demonstriert.

Cadmium-mediated toxicity of cultured proximal tubule (PT) cells is associated with increased production of reactive oxygen species (ROS) and apoptosis. We found that cadmium-dependent apoptosis (Hoechst 33342 and annexin V assays) decreased with prolonged CdCl(2) (10 microM) application (controls: 2.4 +/- 1.6%; 5 h: +5.1 +/- 2.3%, 20 h: +5.7 +/- 2.5%, 48 h: +3.3 +/- 1.0% and 72 h: +2.1 +/- 0.4% above controls), while cell proliferation was not affected. Reduction of apoptosis correlated with a time-dependent up-regulation of the drug efflux pump multidrug resistance P-glycoprotein (mdr1) in cadmium-treated cells ( approximately 4-fold after 72 h), as determined by immunoblotting with the monoclonal antibody C219 and measurement of intracellular accumulation of the fluorescent probe calcein +/- the mdr1 inhibitor PSC833 (0.5 microM). When mdr1 inhibitors (PSC833, cyclosporine A, verapamil) were transiently added to cells with mdr1 up-regulation by pretreatment for 72 h with cadmium, cadmium-induced apoptosis increased significantly and to a percentage similar to that obtained in cells with no mdr1 up-regulation (72-h cadmium: 5.2 +/- 0.9% versus 72-h cadmium + 1-h PSC833: 7.2 +/- 1.4%; p < or = 0.001). Cadmium-induced apoptosis and mdr1 up-regulation depended on ROS, since co-incubation with the ROS scavengers N-acetylcysteine (15 mM) or pyrrolidine dithiocarbamate (0.1 mM) abolished both responses. Moreover, cadmium- and ROS-associated mdr1 up-regulation was linked to activation of the transcription factor NF-kappaB; N-acetylcysteine, pyrrolidine dithiocarbamate, and the IkappaB-alpha kinase inhibitor Bay 11-7082 (20 microM) prevented both, mdr1 overexpression and degradation of the inhibitory NF-kappaB subunit, IkappaB-alpha, induced by cadmium. The data show that 1) cadmium-mediated apoptosis in PT cells is associated with ROS production, 2) ROS increase mdr1 expression by a process involving NF-kappaB activation, and 3) mdr1 overexpression protects PT cells against cadmium-mediated apoptosis. These data suggest that mdr1 up-regulation, at least in part, provides anti-apoptotic protection for PT cells against cadmium-mediated stress.

Purpose Autoimmune hemolytic anemia (AIHA) due to warm-reactive immunoglobulin M (IgM) antibodies is rare in adults and has never been described in children. This report describes a pediatric patient with warm AIHA due to high-titer complete IgM antibody. Patients and methods A 9-year-old girl with a history of Evan's syndrome had severe anemia, fatigue, and skin mottling. Results Serologic evaluation revealed a high-titer, high thermal amplitude (37 degrees C) complete IgM autoantibody. Despite aggressive management (including high dose corticosteroids, intravenous immune globulin, cyclophosphamide, mycophenolate mofetil, whole blood exchange transfusions, and cyclosporine A), the patient remained markedly anemic and developed multiorgan system failure related to diffuse in vivo hemagglutination. Her clinical course included cardiovascular collapse caused by agglutinated red blood cells in the right ventricle with outflow obstruction, cerebrovascular infarcts, hepatic failure, and infarction of her extremities. She ultimately died from disseminated Aspergillosis infection. Conclusion This rare form of AIHA is associated with a dismal prognosis. Early, aggressive treatment is advocated, although it remains to be seen whether the clinical course can be reversed and the outcome improved.

Die Errichtung von wasserundurchlassigen Bauwerken aus Beton wird auch in Berlin seit mehr als zwei Jahrzehnten praktiziert und ist heute Stand der Technik. Entsprechend dem Hauptanwendungsgebiet konzentriert sich der vorliegende Beitrag auf das Einsatzgebiet im Grundwasser („weise Wannen“). Dabei ubernimmt der Stahlbeton neben seiner tragenden auch die abdichtende Funktion. Der Bau von weisen Wannen ist nicht in einer speziellen DIN-Norm geregelt. Planung, Berechnung, Konstruktion und Ausfuhrung richten sich nach den anerkannten Regeln der Technik, wie z.B. der DIN 1045. Sinngemas gelten diese auch fur verwandte wasserundurchlassige Betonbauwerke wie Klaranlagen, Behalter, Flachdacher, Auffangwannen usw. [1]

The EFS/OS for SR (age 1-9.99 yrs and initial white blood cell count AALL0331 enrolled 5311 SR B-ALL pts from 4/2005-5/2010. All patients received a 3 drug induction (dexamethasone, vincristine (VCR), PEG-asparaginase (PEG), intrathecal (IT) MTX). SR-Av pts were randomized at end-induction between SC (mercaptopurine (MP) 75 mg/m2 d 1-28, VCR 1.5 mg/m2 d 1, IT MTX d 1, 8, 15) vs. IC (cyclophosphamide 1000 mg/m2 d 1,29, cytarabine 75 mg/m2 d 1-4, 8-11, 29-32, 36-39, MP 60 mg/m2 d 1-14, 29-42, VCR 1.5 mg/m2 d 15, 22, 43, 50, PEG 2500 units/m2 d 15, 43, IT MTX d 1, 8, 15, 22). Therapy following consolidation was the same for all SR-Av pts after 2008. The 5-yr EFS/OS for all evaluable SR B-ALL pts was 89% and 96% (see Table 1). IC did not significantly improve outcome for SR Av pts, with 5-yr continuous complete remission (CCR) rates for SC vs. IC of 88% (1.6%) vs. 89.3% (1.5%) (p=0.13) and 5-yr OS rates for SC vs. IC of 95.8% (1.0%) vs. IC 95.7% (1.0%) (p=0.93). Because COG has now shown that end-induction MRD of 0.01% is a better discriminator of poor outcome than the 0.1% level used in AALL0331, we examined overall outcome and the results of the randomized intervention in two different MRD defined subsets of SR-Av pts (Table 1). The 5-yr CCR rates for pts with MRD 0.01%-0.01- The outcome for the 1857 SR-Low pts (TT or ETV6-RUNX1 plus d 8 (or 15) M1 BM and d 29 MRD 0.01% that is now part of all COG protocols. COG AALL0331 is the largest trial of SR B-ALL pts ever conducted and establishes the value of risk directed treatment intensification. Disclosures: Matloub: Novartis: Consultancy.

year EFS for localized and metastatic patients are 81% and 29% (p 8 cm), 95% vs 77%. General toxicities are shown in the table. In 31 patients with head and neck disease sites the CI of cataract is 35% at 5 years and is highly correlated with orbital disease site (100% vs 21%, p < 0.01) and dose to the lens (p < 0.01). Tumor size at diagnosis correlates with reduced mandibular ROM (p Z 0.04), while site does not (fav/unfav, p Z 0.15). In 14 patients with extremity disease sites, the CI of fracture is 17%, with an average max dose to bone of 46.8 Gy for all 14 patients. In a proportional hazard model, increasing age correlates with physis closure (p Z 0.01), while mean physis dose approaches, but is not significant (p Z 0.13). Growth rate of the bone is reduced by increasing age at RT (p < 0.01), while the impact of mean physis dose approaches significance (p Z 0.10). In 14 patients with pelvic disease 5/14 experienced at least one episode of 3+ hematuria within the first year of RT. Nine of 14 had a measurable degree of hematuria during that year. Ten of 14 had some degree of bladder wall thickening post RT on imaging. No patient required permanent urinary diversion. Conclusions: Modern 3DCRT/IMRT with specific targeting guidelines yields excellent local control for most children with RMS. Despite the use of modern RT and limited target volumes, measurable toxicities are evident and can be correlated with age and RT dose. Techniques and targeting paradigms that further reduce normal tissue exposures are needed. Author Disclosure: M. Krasin: E. Research Grant; Lance Armstrong Foundation Survivorship Grant 2005-2007. C. Hua: None. L.E. Kun: None. A. Pappo: None. A. Pai Panandiker: None. M. Brown: None. A. Davidoff: None. B. Shulkin: None. B. McCarville: None. T.E. Merchant: None.

10001 Background: Response to initial therapy is a powerful prognostic factor in pediatric ALL. Traditionally, slow early response (SER) has been defined by marrow morphology 8 or 15 days after start of induction therapy. More recently, MRD has been identified as the most important predictor of adverse outcome. The value of morphologic assessment of response in the setting of MRD has not been established. Methods: In COG studies AALL0331 (for NCI Standard Risk (SR) B ALL patients (pts)) and AALL0232 (High Risk (HR) B ALL pts), SER was defined by morphology as either ≥5% blasts in a day 15 marrow, or by flow cytometry as ≥0.1% MRD in a d29 marrow (SER MRD). Assignment to treatment arms also depended upon cytogenetic findings and extramedullary disease; each protocol had randomized treatment questions. SER pts were non-randomly assigned to receive augmented BFM therapy (ABFM) with 2 interim maintenance and delayed intensification phases (and CNS radiation for HR SER pts only). All pt treatment groups were combined for these analyses. Rapid early responders (RER) had a better outcome than SER pts (Table). However, pts who were SER only by morphology had a 5y DFS that was not significantly different from that of RER pts, and superior to that of pts who were SER MRD, or SER by both morphology and MRD. In multivariate analysis, SER by morphology was not an adverse prognostic factor after adjusting for risk group and MRD, or separately in SR or HR pts after adjusting for MRD. However, pts with .01-.1% MRD who were SER by morphology had a better 5y DFS than the.01-.1% MRD pts who were RER (90±6%, n=91 vs 77±3%, n=592). Only the former group received ABFM, suggesting intensification based on response rescues some poor risk pts. We conclude that a day 15 marrow is not needed to assess response if MRD is measured at end induction, provided that SER MRD is defined using a .01% cutoff, the threshold for intensifying therapy in current COG ALL trials. Clinical trial information: NCT00103285, NCT00075725. [Table: see text]

10002 Background: ON is a known toxicity of childhood ALL therapy, particularly in patients (pts) >9 years (y). Intensified use of DEX, methotrexate (MTX), and asparaginase (ASNase) may increase the risk of developing ON among B-precursor NCI SR-ALL pts despite their younger age. Methods: Newly diagnosed SR-ALL pts 1-9y enrolled on AALL0331 between 4/05 and 5/10 were prospectively monitored for symptomatic ON within three treatment cohorts risk-stratified by clinical, cytogenetic, and early response criteria. ON sites were confirmed by imaging. SR-Low (SRL) pts were randomized to standard therapy +/- 4 additional doses of PEG-ASNase. SR-Average (SRA) pts were randomized (2x2) to standard therapy +/- an intensive consolidation (IC) +/- an augmented interim maintenance/delayed intensification (AIM/ADI). SR-High (SRH) pts all received IC and two AIM/ADI phases. After 6/08, alternate week DEX (AWD, days 1-7/15-21) replaced continuous DEX (days 1-21) during DI, and escalating-dose MTX replaced oral MTX during IM. All pts received DEX days 1-28 during induction and 5-day pulses every 4 weeks during maintenance. Results: Overall ON cumulative incidence (CI) at 5y was 2.7% (133/5261), correlating with sex (F 3.7%, M 1.9%, p

9502 Background: To evaluate the efficacy of 12 weeks of Stanford V chemotherapy (prednisone, vinblastine, doxorubicine, nitrogen mustard, etoposide, vincristine, and bleomycin) without routine growth factor support plus response-adapted low-dose, involved-field radiotherapy (IFRT) in children and adolescents with unfavorable risk Hodgkin lymphoma (HL). Methods: Multi-institutional (St. Jude Children’s Research Hospital, Stanford University, Children’s Hospital Boston, Massachusetts General Hospital and Maine Children’s Hospital) clinical trial. One hundred forty-one patients with clinical stages IIB (n=43), IIIB (n=19), IVA (n=27), and IVB (n=52) HL were treated with 12 weeks of Stanford V chemotherapy and low dose IFRT between June 2002 and May 2011. Involved nodal sites in complete remission (CR, defined as > 75% shrinkage of the original tumor and PET negative) after 8 weeks of Stanford V received 15 Gy IFRT; those sites that achieved only partial response received 25.5 Gy IFRT after completion of all 12 weeks of chemotherapy. Results: With a median follow-up of 4.6 years, the 3-year overall and event-free survival (EFS) are 97% (SE=2%) and 79% (SE=4%) respectively. There was no significant difference in EFS by stage (IIB vs. IIIB vs. IV; P=0.84). Ten patients developed progessive disease and 18 relapsed, while 5 have died (1 after relapse in an accident and 4 of refractory disease). Most common toxicities were grade 3 hematologic with 234 episodes of neutropenia in 101 patients (72%) and 85 episodes of anemia in 52 patients (37%); Fever and neutropenia occurred 13 times in 12 patients (9%). Conclusions: Risk-adapted, combined-modality therapy using 12 weeks of Stanford V chemotherapy plus IFRT is well tolerated in this population with manageable acute toxicities. Overall survival is comparable to other more intense chemotherapy regimens. Future high-risk front line therapies may consider a Stanford V backbone with targeted intensification and further tailoring of radiation therapy.

9585 Background: Pediatric rhabdomyosarcoma (RMS) is commonly cured with chemotherapy and radiation. However, late effects of radiotherapy (RT) can be disabling. Proton RT irradiates less normal tissue, which should result in fewer late side effects of treatment. The purpose of this study was to describe the disease control and side effect profile of proton RT in RMS patients (pts). Methods: Eligible pts included those with localized disease and metastatic embryonal RMS if age 2-10. All pts were treated with VAC (vincristine, actinomycin, cyclophosphamide) based chemotherapy and proton RT, median dose 50.4 Gy (36-50.4 GyRBE). Concurrent enrollment in COG protocols was allowed. All pathology/imaging was reviewed at the treating institution. Results: 47 pts with RMS were prospectively enrolled from January 2005 to June 2011 and evaluable for analysis. Median age was 3.1 yrs, (range 0.6-15.6 years; M/F ratio 23:24). There were 1, 7, 37, and 2 Group I, II, III and IV and 14, 12, 19 and 2, Stage I-IV pts respectively, and 33 with embryonal 14 with alveolar/other. Most common sites included PM (48.9%), orbital (23.4%) bladder/prostate (6.4%), H&N non-PM (6.4%), extremities (4.3%), trunk/abdomen 2.1%), perineal/anal region (2.1%) and other (6.4%). Median follow-up is 15.2 months. One/two-year overall survival (OS) and progression-free survival (PFS) for the entire group is 94/81% (OS) and 79/73% (PFS). 2-year OS for stage I,II/III,IV pts is 91/66% (OS, p=0.114) and two-year PFS for these pts is 86/57%, respectively, (p=0.083. 16 (34%) had grade 3/4 acute toxicities attributable to the radiation during treatment, the most common of which was mucositis/oral pain (12.8%), anorexia (4.3%), and erythema (4.3%). Among the 24 pts analyzable for late toxicities with at least 2 yrs of follow up, there were no grade 3 or 4 late toxicities attributable to radiation. Conclusions: Early results of this prospective trial demonstrate comparable disease outcomes and thus far limited late effects in a young pediatric RMS population. However, additional follow up is needed to determine if protons truly reduce rates and severity of late effects compared with photon cohorts published in the literature.

9503 Background: To evaluate the efficacy of 4 cycles of vinblastine, doxorubicin, methotrexate, and prednisone (VAMP) alone in patients with early-stage, favorable Hodgkin lymphoma (HL) who achieve a complete response after 2 cycles of VAMP. Methods: Multi-institutional phase II trial. Eighty-eight patients with clinical stages I and II, favorable risk (< 3 nodal sites, no B symptoms, no mediastinal bulk and no extranodal extension) HL were treated with four cycles of VAMP chemotherapy with or without involved field radiotherapy (IFRT). Patients who achieved a complete response (CR) (n=46) after 2 cycles of VAMP received no IFRT and those who achieved less than CR (n=42) were given 25.5 Gy IFRT, one patient progressed prior to starting IFRT and another withdrew consent to be treated elsewhere. Results: With a median follow-up of 5.4 years, the 5-year overall survival and event-free survival (EFS) for the whole cohort are 100% and 88% (SE=4.6%) respectively; the EFS for patients who did not get IFRT is 89...

e18544 Background: Maintenance rituximab (R) therapy every two months for 2 years after chemoimmunotherapy (R-Chemo) has demonstrated improved progression-free survival (PFS) in previously untreate...

Abstract 414 The COG uses clinical characteristics, blast cytogenetic features and early response to therapy, as measured by bone marrow (BM) morphology on days 8, 15 and 29 and BM minimal residual disease (MRD) measured by flow cytometry in one of two central COG reference laboratories on day 29 of induction in order to modulate the intensity of post-induction therapy for children with ALL. A slow early response (SER) to therapy was defined by M2/M3 BM on day 15 or MRD ≥ 0.1% on day 29. The COG AALL0331 trial accrued 5377 children with NCI SR- ALL (age 1–10 years with an initial white blood cell count of 25% blasts) on day 29, or an M2 marrow or MRD ≥1% on day 43 after 2 weeks of extended induction therapy were classified as induction failures. Following the first month of therapy, patients were assigned to different risk groups for post-induction therapy. We examined the correlations between clinical features, leukemic blast cytogenetic features (favorable: ETV6-RUNX1 and trisomies 4, 10, and 17 or unfavorable: MLL rearrangements, BCR-ABL1 and hypodiploidy), and response to induction therapy. MRD at end induction was ≥ 0.1% more frequently in patients with the absence of either ETV6-RUNX1 (10.4% vs. 3.5%, P 0.1% at end induction was seen in 23.3% of hypodiploid patients and 32.4% of Philadelphia chromosome + or BCR-ABL1 + patients. In addition, those who had an M2/M3 marrow at day 15 (36.7% vs. 5.9%, p Conclusions: Inferior MRD responses were associated with the absence of favorable blast cytogenetics and slow initial responses (M2/3 marrow) on day 15 of induction consistent with the known prognostic significance of these variables. Overall, NCI SR patients on AALL0331 had a very low incidence of induction failures, as measured either by bone marrow morphology or by MRD≥1% at day 43. However, the use of MRD identified additional patients who had a suboptimal response to induction, allowing for early augmentation of therapy. Disclosures: Borowitz: genzyme: Research Funding; becton-dickinson: Research Funding; Alexion: Consultancy; beckman-coulter: Research Funding. Mattano:pfizer: Employment.

e16500 Background: R-FC significantly increases progression-free survival (PFS) compared to FC in previously untreated CLL (phase III trial ML 17102-CLL-8). A cost-effectiveness analysis was conduc...

In the Federal Institution for Testing and Research/Arsenal the suitability of the Austromir-apparatus for space was tested.

The protein predicted by the sequence of the human pim-1 proto-oncogene shares extensive homology with known serine/threonine protein kinases, and yet the human Pim-1 enzyme has previously been reported to exhibit protein tyrosine kinase activity both in vitro and in vivo. Recently a new class of protein kinases has been identified which exhibits both protein-serine/threonine and protein-tyrosine kinase activities. We therefore investigated the possibility that the human Pim-1 kinase likewise possesses such bifunctional enzymatic phosphorylating activities. A full-length human pim-1 cDNA was subcloned into the bacterial vector pGEX-2T and the Pim-1 protein expressed as a fusion product with bacterial glutathione S-transferase (GST). The hybrid GST-Pim-1 fusion protein was affinity purified on a glutathione-Sepharose column prior to treatment with thrombin for cleavage of the Pim-1 protein from the transferase. Pim-1 was purified and the identity of recombinant protein confirmed by amino-terminal sequence analysis. Pim-1 was tested for kinase activity with a variety of proteins and peptides known to be substrates for either mammalian protein-serine/threonine or protein-tyrosine kinases and was found to phosphorylate serine/threonine residues exclusively in vitro. Both the Pim-1-GST fusion protein and the isolated Pim-1 protein exhibited only serine/threonine phosphorylating activity under all in vitro conditions tested. Pim-1 phosphorylated purified mammalian histone H1 with a Km of approximately 51 microM. Additionally, Pim-1 exhibited low levels of serine/threonine autophosphorylating activity. These observations place the human Pim-1 in a small select group of cytoplasmic transforming oncogenic kinases, including the protein kinase C, the Raf/Mil, and the Mos subfamilies, exhibiting serine/threonine phosphorylating activity.

Background: The potential for the use of nutritional screening to identify older persons at risk of hospitalization has not been contrasted with the use of tools developed for predicting hospital admissions. Objective: Our goal was to compare the associations of items from the Level II Nutrition Screen (LII) and the Probability of Repeated Admissions (Pra) questionnaire with the outcome of hospitalization. Design: This was a cohort study of participants in a Medicare managed-risk health plan who completed both the LII and Pra (n = 386). All hospitalizations within 1 y of screening were recorded. Hierarchical multivariate logistic regression was used to model associations with hospitalization. Results: Pra items that retained significant associations with hospitalization were self-reported health, hospitalization in the past year, and >6 doctor visits in the past year (positive predictive value: 20%; sensitivity: 53.1; specificity: 69.7). LII items that retained significant associations with hospitalizatio...

LEARNING OUTCOME: To describe two methods used to estimate Food Guide Pyramid servings Nutrition researchers are increasingly using the Food Guide Pyramid (FGP) as a standard to evaluate dietary intake data. Various methods have been described for evaluating FGP servings but little information is available on the comparability of methods within the same group of individuals. Therefore, we estimated the FGP servings in a single group of women (n = 156) using both a food frequency questionnaire (FFQ) and three 24-hour dietary recalls. Women (age >60 years) were recruited from a medical center clinic in rural Pennsylvania. FFQ data were collected by telephone using Health History and Habits Questionnaire Diet Analysis System software (National Cancer Institute). Following the FFQ interviews, three 24-hour diet recalls were collected by telephone on randomly assigned days using the Nutrition Data System (Nutrition Coordinating Center, University of Minnesota). FFQ data were categorized into food groups by converting frequency of consumption to daily intakes using a medium serving as the standard for FGP servings. Recall data were categorized into FGP servings by editing nutrient and food summary data generated within NDS; foods listed as ingredients were aggregated into whole foods and assigned to FGP servings with the appropriate serving sizes. The mean number of FGP servings from each of six groups: breads, vegetables, fruits, dairy, meats, and fats, oils and sweets were calculated from both methods. Paired t-tests were used to assess differences between methods. The difference between methods were statistically significant for all food groups (p

LEARNING OUTCOME: To identify three key elements of the Level II Nutrition Screen (LII) that predict post hospitalization (p-hosp) weight loss or hypoalbuminemia. This study examined the predictive validity of LII items for p-hosp weight loss and hypoalbuminemia in 96 male and female Medicare patients. Subjects were already at "nutritional risk" at hospital discharge (D/C) based on serum albumin ≤ 3.5 g/dL (80%) or weight

With the implementation of Diagnostic Related Groups (DRGs) as the basis of hospital reimbursement, the average length of hospital stay has declined. As a result, elderly patients are being discharged from short-stay hospitals more rapidly than those with similar illnesses in the past. This may result in more frequent need for early non-elective readmission. Predicting which elderly persons may be readmitted will enable preventative interventions to reduce overall health care costs. The purpose of this study was to determine predictors and assess predictive models of early non-elective hospital readmission. The sample consists of 134 male and female Medicare patients who were found to be nutritionally compromised at the time of discharge. The study is a secondary data analysis utilizing a repeated measures design of multiple variables representing demographics, anthropometries, laboratory values, and impairment in Activities of Daily Living (ADLs). Data have been collected at four time points: at hospital discharge, and during dietitian or nurse home visits at one week, one month, and three months post discharge. Bivariate logistic regression analysis reveal that serum albumin and change in weight measured at one month post discharge are highly significant predictors of readmission. There is a 31% decrease in the log odds of readmission associated with every 0.1 unit increase in serum albumin at one month post discharge (Wald χ 2 = 8.2748, p=0.0040), such that an albumin value of 3.3mg/dL relates to a 51% probability of early non-elective readmission compared to an albumin value of 3.7mg/dL with a 20% probability of readmission. Serum albumin at one month post discharge accounts for approximately 28% of the variance in non-elective readmission (McFadden's R 2 = .2753). For every kilogram of weight loss, there is a 75% increase in the odds of readmission (Wald χ 2 = 5.1757, p=0.0229). Change in weight accounts for 8% of the variability in non-elective readmission (McFadden's R 2 = .0843). It is of interest that serum albumin measured at the time of hospital discharge was not significantly associated with non-elective readmission in this population. This suggests that an evaluation of serum albumin and change in body weight should be routine during early post-hospitalization office visits to identify those at increased risk of early non-elective readmission.

The double-stranded RNAs (I)n X (C)n and (A)n X (dUfl)n (dUfl is 2'-fluoro-2'-deoxyuridylic acid) have been compared as inhibitors of translation in cell-free systems from interferon-treated mouse L cells and from rabbit reticulocytes. In the interferon-treated mouse L-cell system, both double-stranded RNAs stimulated kinase activity, leading to phosphorylation of protein P1 and eukaryotic initiation factor 2 alpha (eIF-2 alpha), but only (1)n X (C)n activated the (2'-5')-oligoadenylate synthetase. Moreover, in this system, (I)n X (C)n, but not (A)n X (dUfl)n, inhibited translation. Both (A)n X (dUfl)n and (I)n X (C)n also activated the rabbit reticulocyte kinase to phosphorylate protein P1 and eIF-2 alpha, but, in contrast to mouse L-cell systems, both (A)n X (dUfl)n and (I)n X (C)n were potent inhibitors of translation in reticulocyte lysates. These results indicate that protein P1 and eIF-2 alpha phosphorylation are not sufficient to cause inhibition of protein synthesis in interferon-treated mouse L-cell extracts. They further suggest that protein synthesis inhibition by (I)n X (C)n in extracts of interferon-treated L cells correlates better with activation of (2'-5')-oligoadenylate synthetase than with activation of the protein P1 and eIF-2 alpha kinase.

A scattering theory method is used to treat the one-dimensional problem of a particle simultaneously acted upon by an attractive potential and by a constant electric field. Effective phaseshifts are obtained; Stark shifts and broadening of energy levels are easily calculated.

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