Miracle-dz/UniFAR-FTUs huggingface dataset:
Health Informatics – A Scientific Challenge?

Abstract: The paper attempts to derive directions for research and teaching in health informatics. To this end, the achievements and continuing challenges of health informatics are exemplified, categorized, and related to common underlying phenomena. Suggestions by Blum and Blois are adopted which point to the complexity of health information as the critical ingredient. Examples are given of current efforts directed at dealing with this complexity. According to Popper and Brookes one may have to search for yet other ways of dealing specifically with information; we have barely started to explore these. It is suggested that this requirement for a fundamentally different orientation has profound consequences not only for our research but also for our teaching.
Fertilisation competence of bovine normally matured or aged oocytes derived from different antral follicles: morphology, protein synthesis, H1 and MBP kinase activity

Summary We have investigated the fertilisation competence, protein synthesis, histone H1 kinase and myelin basic protein (MBP) kinase activities in three categories of bovine oocytes (derived from three size categories of follicles: M–medium, 2.5–5.0 mm; S–small, 1.5–2.5 mm; T – tiny, 1.0–1.5mm). In contrast to more or less normal meiotic maturation (85.6%) and fertilisation (70.8%) of M oocytes cultured for 24h, the fertilisation of M oocytes cultured for 40h was associated with increased rates of retarded male pronuclear development and retention of the second polar body. The S and T oocytes cultured for 24h or 40h were mostly arrested at defective late diakinesis - metaphase I (77.5–100%) stage. After fertilisation of S and T oocytes cultured for 24h no polar body was extruded and formation of one, three or four female pronuclei, together with mostly normal male pronuclei, was observed. The fertilisation of S and T oocytes after 40h culture resulted in a higher number of female and a decreased number of male pronuclei. A major change in the pattern of protein synthesis was associated with the resumption of meiosis. There were no significant differences in the profile of protein synthesis between oocyte categories in all groups either matured or fertilised. The H1 kinase activity reached comparable increased levels in oocytes of all categories matured for 24h and decreased during the 40h culture, most significantly in M oocytes. The MBP kinase activity was at approximately the same high level in all categories of oocytes after 24h of culture and remained stable until 40h. The fertilisation after 24h of culture resulted, in M oocytes, in low levels of both H1 and MBP kinase activities; in S oocytes, only H1 kinase was completely inactivated while MBP kinase activity decreased to some extent; in T oocytes, both H1 and MBP kinase activity decreased. Fertilisation of all oocyte categories after 40h culture resulted in complete inactivation of both these kinases to their basal levels.
Bone Mineral Density is a Prognostic Factor for Postmenopausal Caucasian Women with Breast Cancer

Numerous studies have convincingly shown that women with low bone mineral density have lower risk of breast cancer. As many risk factors for breast cancer are also prognostic factors, we hypothesized that women with breast cancer and low bone mineral density will have lower breast cancer recurrence rates than women with normal bone densities. A prospectively collected data base of breast cancer patients was used to identify postmenopausal Caucasian women. Their records were reviewed and 309 patients with complete follow‐up and bone density tests within 1 year of their surgery were identified. The outcome of patients with low bone density (t > −1.0) was compared to the outcome for patients with normal bone density (t < −1.1). Among the 193 patients with invasive breast cancers and low bone density, distant disease‐free survival at 5 years was 96% compared to 84% for 114 patients with invasive breast cancers and normal bone density (p = 0.0239). Local disease‐free survival was 94% for low bone density patients compared to 86% for patients with normal bone densities (p = 0.0794). Bone mineral density is a significant prognostic factor for postmenopausal Caucasian women with breast cancer. Low bone mineral density is associated with a lower local and distant rate of recurrence.
Bortezomib induces apoptosis in T-cell prolymphocytic leukemia (T-PLL)

T-cell prolymphocytic leukemia (T-PLL) is an aggressive lymphoproliferative disorder with postthymic T cell phenotype and prolymphocytoid morphology. T-PLL is characterized by an increased WBC count in peripheral blood, often exceeding 1006 10/L. Although new therapies have been developed for T-PLL, the disease progresses rapidly and patients die shortly after diagnosis (median survival of 7 months). Purine analogs, alkylating agents and combination therapy (CHOP), along with monoclonal antibody therapy (CAMPATH-1H) are the major treatments currently used. Despite these therapies, it is necessary to explore novel therapies to improve disease outcome. We report here the efficacy of Bortezomib on three T-PLL patient samples. Bortezomib is a dipeptidyl boronic acid inhibitor that specifically inhibits the 20 S proteosome. It inhibits hydrolysis of polypeptide substrates by the 20 S proteosome and hydrolysis of ubiquitinated proteins by the 26 S proteosome [1]. The ubiquitine-proteosome pathway plays an important role in cell cycle regulation and cell survival. One of the proteins degraded through ubiquitine-proteosome is the transcription regulator protein IkB. Degradation of IkB results in activation of NF-kB, which plays an important role in regulating protein survival. Bortezomib has been used in various clinical trials including hematologic malignancies, breast and brain tumors. It has been recognized with potent anti-myeloma effect and recently found a wider utilization for the treatment of this disease [2]. We wanted to investigate the in vitro effects of Bortezomib on T-PLL patient samples for potential anti-leukemic effect. Proteosome inhibitor, Bortezomib was obtained from the Millennium Pharmaceuticals, Cambridge, MA and resuspended in a stock solution of 2.6 mmol/L. Various concentrations of Bortezomib were used to develop a dose response curve. Fresh peripheral blood samples isolated from T-PLL patients were washed with cell culture media and then treated with lymphocyte separation medium for in vitro isolation of lymphocytes according to the Ficoll separation procedure. The viability of cells was determined by Trypan blue (0.5%) dye exclusion at 4006 magnification. Cells were counted in a randomized manner using a hemocytometer. Cells (36 10) were suspended in RPMI-1640 (Life Technologies, Grand Island, NY) supplemented with 10% heat inactivated fetal bovine serum (568C for 30 min), penicillin (10,000 units/mL, Sigma, St. Louis, MO), streptomycin (10 mg/mL; Sigma), gentamicin (50 mg/mL; Life Technologies), amphotericin B (25 mg/mL; Sigma), and L-glutamine (200 mmol/L, 29.2 mg/mL; Life Technologies). Peripheral blood from two T-PLL patients were cryopreserved in RPMI-1640, 30% FBS and 10% DMSO (Sigma), in liquid nitrogen. After washing in RPMI-1640, cells were grown in media as described above. Flow cytometric analysis and morphologic analysis using Wright – Giemsa staining were used for detection of apoptosis. The reagents utilized for flow cytometric analysis were Annexin V-phycoerythrin
Presynaptic calcium transients evoked by paired‐pulse stimulation in the hippocampal slice

The fluorescent dye Calcium Green and optical recording techniques were used to record intracellular Ca2+ transients resulting from paired-pulse stimulation in stratum moleculare of area CA1 in guinea-pig hippocampal slices. Presumed presynaptic calcium transients were recorded while glutamatergic synaptic transmission was blocked by kynurenic acid. Peak responses to paired-pulses (10-160 ms interval) were higher than responses to single pulses of same stimulation strength (42-23% increase). The isolated response to the second pulse, however, was of smaller magnitude in comparison to the first one; the difference in magnitude depended on the interstimulus interval. Thus, the residual presynaptic free calcium concentration may be responsible for paired-pulse facilitation of synaptic transmission in hippocampus. At the same time, a use-dependent inactivation of presynaptic calcium channels may occur.
Sensitivity and specificity of anti-Sa autoantibodies for rheumatoid arthritis.

OBJECTIVE To assess the sensitivity and specificity of the recently described anti-Sa autoantibodies in order to determine their potential usefulness for the diagnosis of rheumatoid arthritis (RA). METHODS Sera from 67 patients with RA (including 31 patients with early RA of <3 months duration), from 180 patients with other rheumatic diseases and from 30 healthy control subjects were investigated by immunoblotting employing partially purified Sa antigen. Additionally, all sera were tested for rheumatoid factor (RF), anti-A2/RA33, antinuclear antibodies (ANA) and ANA subsets. RESULTS Twenty-one (31%) of the 67 patients with RA, but only four of the 180 control patients, were anti-Sa positive; therefore, anti-Sa was approximately 98% specific for RA. Anti-Sa was not associated with either RF or with anti-A2/RA33. The latter antibody was present in 21 RA sera, only eight of which also contained anti-Sa. Thus, 34 RA sera (51%) showed at least one of these two autoantibodies and, importantly, 18 of these sera were RF negative. Furthermore, of the 31 patients with early RA, 12 (40%) were anti-Sa and/or anti-A2/RA33 positive. CONCLUSION Although the numbers studied remain small, taken together, these data suggest that anti-Sa may represent a promising novel serological marker with high specificity for RA.
Hepatic blood volume responses and compliance in cats with long‐term bile duct ligation

Hepatic capacitance responses were compared in sham‐operated and 14‐day bile duct–ligated cats under pentobarbital anesthesia. Both groups were subjected to splenectomy and had the anterior hepatic nerve plexus sectioned to allow stimulation; the posterior plexus was intact. Blood volume compensation for hemorrhage was reduced in the bile duct ligation group compared with the control group: The liver compensated for 20.1% and 10.6% of blood loss, respectively. Portal hypertension did not exist and hepatic compliance was unaltered despite the presence of severe biliary hyperplasia, portal tract distortion and fibrosis. The capacitance responses to hemorrhage in the bile duct ligation group were accounted for entirely by a passive compliant response to reduced portal pressure, whereas the sham surgery group showed an additional active component. Responses of liver volume and venous resistance to norepinephrine were normal, but responses to nerve stimulation were reduced. The nerve dysfunction was not universal; reflex arterial blood pressure response to carotid occlusion was normal. The data suggest that hepatic blood volume response to hemorrhage is mediated by passive compliant responses to reduced portal pressure (stressed volume) and active responses (unstressed volume) to nerve stimulation but that long‐term bile duct ligation produces selective hepatic neuropathy resulting in loss of the active component. (HEPATOLOGY 1993;18:969‐977).
Delayed referral for dialysis.

Immunosuppressive therapy may enhance viral replication and exacerbate or accelerate the progression of chronic hepatitis B and C. A late reduction in the dosage of azathioprine seems not to cause any changes in the natural course of chronic hepatitis B, and therefore an early reduction in the dosage of the drug might be a possible approach for such patients. Corticosteroids seem to be particularly harmful, in that they favour viral replication. To avoid or minimize this risk the maintenance doses of prednisone should be kept as low as possible from the time of transplantation. As there is growing evidence that cyclosporin alone may lead to excellent graft survival, steroid-free immunosuppression might be tried for HBsAg-positive and/or HCV-positive patients. This is even more justified since HBsAg-positive and/or HCV-positive patients have a lower immunological reactivity. Unfortunately, however, no specific trial with such an immunosuppressive patients with viral infection has been done. Although immunosuppressive therapy should be kept as low as possible after transplantation, it cannot be ignored that rapid reduction of immunosuppressive therapy in patients with deteriorating liver function might accelerate liver damage in some cases. This paradoxical response is probably due to the fact that while immunosuppressive agents may protect from the autoimmune response to virus, in some cases an abrupt reduction or discontinuation of immunosuppressive therapy might lead to cytolysis and further destruction of the livers.
Health Care Expenditures in Ulcerative Colitis: The Perspective of a Self-Insured Employer

Objective:This study was designed to investigate the incidence, prevalence, treatment patterns, disease severity, and direct costs associated with ulcerative colitis (UC) for claimants in health plans offered by a large self-insured employer in the United States. Methods:Retrospective analysis of medical claims with and without UC identified from a population of approximately 500,000 employees, retirees, and dependents. Results:Costs for UC claimants were more than twice those for the comparator group ($14,486 vs $6158; P < 0.005). Total health care costs for the severe disease cohort were double those of the mild or moderate cohorts ($26,875 vs $12,154 and $12,731), as were inpatient costs ($13,516 vs $3235 and $2244). The annual incremental cost of treating severe disease was $6812 (P < 0.005) compared with mild UC. Conclusion:UC is a significant predictor of increased medical costs with severe disease, driven mainly by inpatient costs.
Chemical Composition, Antibacterial and Antioxidant Properties of Essential Oil from the Rhizomes of Hedychium forrestii var. palaniense Sanoj and M. Sabu

The essential oil constituents of rhizomes of Hedychium forrestii var. palaniense were analyzed by gas chromatography and gas chromatography-mass spectrometry. A total of 26 constituents comprising 68.20% of the oils were identified. The volatile fraction was characterized by monoterpene hydrocarbons (42.31%), oxygenated monoterpenes (38.46%), sesquiterpene hydrocarbons (15.38%) and oxygenated sesquiterpenes (3.85%). The predominant constituents identified were β-pinene (18.30%), β-linalool (17.80%), 1,8-cineole (12.00%), and 4-terpineol (5.50%). Sesquiterpenoids were present only in negligible quantities. The antibacterial activities of the essential oil was evaluated against ten bacteria and Pseudomonas aeruginosa was the most susceptible organism with a zone of inhibition of 42.16±0.76 mm. Additionally, the essential oil showed promising radical scavenging and electron donating activity.
Pharmacokinetics of medetomidine and atipamezole in dairy calves: an agonist-antagonist interaction.

Medetomidine and atipamezole are licensed for use in dogs and cats in several countries and are highly selective and specific alpha2-adrenoceptor agents. The pharmacokinetics of the agonist medetomidine and the antagonist atipamezole were studied in a cross-over trial in eight dairy calves. The animals were injected intravenously (i.v.) with medetomidine (40 microg/kg i.v.), followed by atipamezole (200 microg/kg i.v.) or saline after 60 min. The wash-out period between experiments was 1 week. Drug concentrations in plasma were determined using HPLC. Atipamezole significantly (P < 0.05) increased the AUMC and MRT of medetomidine due to an increase in the medetomidine concentration when atipamezole was injected i.v. The mean increment in medetomidine concentration was 6.4 ng/mL, increased levels having a mean duration of 39.4 min. Other pharmacokinetic parameters of medetomidine were not significantly altered by atipamezole. Sedative effects of the agonist, and the effectiveness of the antagonist were recorded. All the animals relapsed into sedation on average 80 min after reversal with atipamezole. It is likely that the increase in medetomidine concentration after the injection of atipamezole i.v. results from displacement of medetomidine from alpha2-adrenoceptors in highly perfused tissues.
Diagnosis of peritoneal dissemination: comparison of 18F-FDG PET/CT, diffusion-weighted MRI, and contrast-enhanced MDCT.

OBJECTIVE The purpose of this study was to compare the diagnostic performance of (18)F-FDG PET/CT, MRI with and without diffusion-weighted imaging (DWI), and contrast-enhanced MDCT in the detection of peritoneal dissemination of malignant tumors. MATERIALS AND METHODS We retrospectively evaluated the cases of 107 patients who underwent PET/CT and 130 patients who underwent MRI and contrast-enhanced MDCT. Twenty-six patients who underwent PET/CT and 23 who underwent MRI and contrast-enhanced MDCT were found to have peritoneal dissemination. All images were independently evaluated by two radiologists using a 5-point grading system. The results of PET/CT, T1- and T2-weighted MRI without DWI, MRI with DWI (b = 1,000 s/mm(2)), and contrast-enhanced MDCT were compared patient by patient and lesion by lesion by use of receiver operating characteristics analysis. Sensitivity, specificity, and positive predictive value were calculated and compared by use of the chi-square test. RESULTS Patient by patient, the area under the receiver operating characteristics curve of MRI without DWI (0.88) was significantly less than that of the other modalities (contrast-enhanced MDCT, 0.91; MRI with DWI, 0.93; PET/CT, 0.97). The sensitivity of PET/CT (94%) was significantly higher than that of MRI without DWI (70%). The specificities of the modalities were not significantly different. In lesion-by-lesion analysis, MRI without DWI had significantly lower sensitivity (56%) than the other modalities (contrast-enhanced MDCT, 76%; MRI with DWI, 84%; PET/CT, 89%). The positive predictive value of PET/CT (93%) was significantly higher than that of the other three modalities (contrast-enhanced MDCT, 73%; MRI without DWI, 70%; MRI with DWI, 72%). CONCLUSION PET/CT is the most useful technique for pathologic staging in the care of patients with malignant disease. If PET/CT is not available, DWI can be used as a screening tool.
A Taxonomy of Stakeholders: Human Roles in System Development

Systems engineers have often paid too little attention to the nature of the so-called â€œusersâ€ of products under development. These are better called stakeholders, as many roles are involved, and few of those are in direct contact with the developed products. A simple and robust conceptual framework for classifying development stakeholders â€” a taxonomy â€” is proposed. The taxonomy is product centric, with concentric â€œcirclesâ€ denoting broad categories of stakeholders. Within these, generic â€œslotsâ€ describe typical classes of stakeholders; these are subdivided into â€œroles,â€ which are expected to vary at least in name with the domain. Examples are given, and a popular template is reanalysed using the framework. The taxonomy has immediate value in identifying and validating stakeholder roles in requirements elicitation, helping to ensure that key viewpoints are not missed, and hence reducing the risk of instability and failure during development.
Meaningful Information or a Bureaucratic Exercise? Exploring the Value of Routine Outcome Measurement in Mental Health

Routine outcome measures have been introduced into mental health services throughout Australia, with the ultimate aim of developing standards for service delivery, and a means to determine the extent to which these standards are being realised in practice. Criticism that the existing measures are not reflecting the aspects of mental health care and treatment considered important by the consumers of those services is common and widespread. The aim of the current study was to explore the utility, effectiveness, and assumptions underlying routine outcome measures used by Victorian mental health services from the perspective of service users. Two focus group interviews were conducted with consumer members of a group known as Psych. Action and Training (a group of consumers and senior nurses with a commitment to consumer participation). The findings demonstrated criticism of the outcome measures routinely used in Victoria. The three main themes to emerge were: assumptions behind routine outcome measures; consumer concerns with routine outcome measures; and consumer perspective: purpose, process and principles.
Spiral computed tomography for the initial evaluation of spine trauma: A new standard of care?

BACKGROUND Although spiral computed tomographic scanning (SCT) is frequently used for spinal imaging in injured patients, many trauma centers continue to rely on plain film radiography (PFR). The purpose of this study was to determine the effects of a trauma center's transition from PFR to SCT for initial spine evaluation in trauma patients by comparing diagnostic sensitivity, time required for radiographic imaging, costs, charges, and radiation exposure. METHODS Registry-based review of all trauma patients evaluated for spinal trauma during two three-month intervals, one before (1999, "X-ray Group"), and one after (2002, "CT Group") adopting SCT as the initial spinal imaging method. Demographic data, mechanism of injury, Injury Severity Score (ISS), the presence and location of spine fractures, and the results of all spine imaging were recorded. The dates and diagnostic sensitivity for spine fractures, time for initial imaging, costs, and charges were compared between groups. Radiation exposure associated with both SCT and PFR of the spine was measured. RESULTS There were 254 patients in the X-ray Group and 319 in the CT Group, with similar demographic data, ISS, mechanism of injury, and incidence of spine fractures. Sensitivity in the detection of spine fractures was 70% (14 out of 20) in the X-ray Group compared with 100% (34 out of 34) for the CT Group (p < 0.001). Mean time in the radiology department during initial evaluation decreased significantly in the CT Group compared with the X-ray Group (1.0 hours vs. 1.9 hours; p < 0.001). SCT of the spine was associated with higher mean overall spinal imaging charges than PFR (4,386 dollars vs. 513 dollars, p < 0.001), but a similar mean overall spinal imaging cost per patient (172 dollars vs. 164 dollars). Radiation exposure was higher with SCT versus PFR for cervical spine imaging (26 mSv vs. 4 mSv) but SCT involved lower levels of exposure than PFR for thoracolumbar imaging (13 mSv vs. 26 mSv). CONCLUSIONS SCT is a more rapid and sensitive modality for evaluating the spine compared with PFR and is obtained at a similar cost. The advantages of SCT suggest that this readily available diagnostic modality may replace PFR as the standard of care for the initial evaluation of the spine in trauma patients.
Strategic Contractual Inefficiency and the Optimal Choice of Legal Rules

Two separate groups of academics have brought about a renaissance of sorts in the analysis of incomplete contracts. Law and economics scholars-writing in law reviews-have shown renewed interest in how efficiencyminded lawmakers should fill gaps in incomplete contracts. ' Yet even before this, a group of economists-writing in economics journals-began developing new theories of "incomplete contracting" that are still largely unincorporated in the legal literature. ' These two strands of analysis have remained largely