Confidential genetic testing and electronic health records: A survey of current practices among Huntington disease testing centers

BACKGROUND: Clinical care teams providing presymptomatic genetic testing often employ advanced confidentiality practices for documentation and result storage. However, patient requests for increased confidentiality may be in conflict with the legal obligations of medical providers to document patient care activities in the electronic health record (EHR). Huntington disease presents a representative case study for investigating the ways centers currently balance the requirements of EHRs with the privacy demands of patients seeking presymptomatic genetic testing. METHODS: We surveyed 23 HD centers (53% response rate) regarding their use of the EHR for presymptomatic HD testing. RESULTS: Our survey revealed that clinical care teams and laboratories have each developed their own practices, which are cumbersome and often include EHR avoidance. We found that a majority of HD care teams record appointments in the EHR (91%), often using vague notes. Approximately half of the care teams (52%) keep presymptomatic results of out of the EHR. CONCLUSION: As genetic knowledge grows, linking more genes to late-onset conditions, institutions will benefit from having professional recommendations to guide development of policies for EHR documentation of presymptomatic genetic results. Policies must be sensitive to the ethical differences and patient demands for presymptomatic genetic testing compared to those undergoing confirmatory genetic testing

Knowledge-Based Client-Server Approach to Structural Information Retrieval: The Digital Anatomist Browser

Structural information can be defined as data and knowledge about biological objects ranging in size from molecules to the whole body. A framework is described for organizing structural information around a well-defined set of terminology and semantic relationships, and for disseminated multimedia structural information by means of a wide-area information server that is accessible over the internet. A Macintosh-based client of this server, called the Digital Anatomist Browser, has been used to teach neuroanatomy for the last 2 years. The client-server approach provides each student unlimited access to a rapidly growing knowledge base of structral biology that, while immediately useful for anatomy teaching, has the potential to be an organizing framework for other kinds of medial knowledge as well

Human rights, human development, and peace: inseparable ingredients in Africa's quest for prosperity

Despite decades of foreign aid, abundance of natural and human resources, and numerous development initiatives, the African continent remains largely underdeveloped, marginalised and excluded from major decision-making processes that shape today’s world. The purpose of this research is to examine the reasons for the continuous underdevelopment and marginalisation of the African continent and to advance pragmatic measures to be put in place to reverse the situation. The thesis demonstrates that Africa’s underdevelopment and marginalisation cannot be divorced from the effects of centuries of exploitation, domination, and exclusion through the slave trade, colonialism, and neo-colonialism on the one hand, and decades of poor socio-economic and political governance that have characterised the continent since independence, on the other. One of the main findings of the research is that, over the years, African leaders have consciously or unconsciously failed to recognise the fundamental link between human rights, human development, and peace as a foundation for development, and this failure has resulted in their inability to craft sustainable development initiatives for the continent. Given the prominent place human rights, good governance, democracy, peace and stability occupy in both the Constitutive Act of the African Union (CA-AU)1 and the New Partnership for Africa’s Development2 (referred throughout this thesis as the NEPAD Document), the thesis further demonstrates that there is an intrinsic relationship between human rights, human development, and peace which is necessary for development. It analyses the extent to which this relationship has been taken into account in 1 The Constitutive Act of the African Union, OAU Doc. CAB/LEG/23.15, was adopted 11 July 2000 in Lomé, Togo and entered into force May 26, 2001. 2 The New Partnership for Africa's Development (NEPAD or the NEPAD Document) 2001. The NEPAD is an economic development program of the African Union. The NEPAD was adopted at the 37th Session of the Assembly of Heads of State and Government in July 2001 in Lusaka, Zambia. PhD Thesis Human Rights, Human Development and Peace – inseparable ingredients in Africa’s quest for prosperity xvi the conception, formulation, and implementation of the objectives of both the AU and the NEPAD; and concludes that the NEPAD and the AU initiatives provide a strong foundation and offer an excellent opportunity for Africans to begin to reverse centuries of exploitation, domination, and decades of socioeconomic and political exclusion, as well as re-orientate the governance and development strategy of the continent. The thesis is premised on the realisation that respect for human rights, the promotion of human development, and the consolidation of peace, coupled with good political and economic governance are conditions sine qua non for any meaningful development. It further reveals that respect for human rights provides a foundation upon which rests the political structures of human freedoms. The achievement of human freedom generates the will as well as the capacity for economic and social progress. The attainment of economic and social progress provides the basis for durable peace. The thesis concludes that human rights, human development, and peace are interdependent, interrelated, indivisible and mutually reinforcing, and thus inseparable ingredients in Africa’s quest for prosperity

Limits on WWgamma and WWZ Couplings from W Boson Pair Production

The results of a search for W boson pair production in pbar-p collisions at sqrt{s}=1.8 TeV with subsequent decay to emu, ee, and mumu channels are presented. Five candidate events are observed with an expected background of 3.1+-0.4 events for an integrated luminosity of approximately 97 pb^{-1}. Limits on the anomalous couplings are obtained from a maximum likelihood fit of the E_T spectra of the leptons in the candidate events. Assuming identical WWgamma and WWZ couplings, the 95 % C.L. limits are -0.62<Delta_kappa<0.77 (lambda = 0) and -0.53<lambda<0.56 (Delta_kappa = 0) for a form factor scale Lambda = 1.5 TeV.Comment: 10 pages, 1 figure, submitted to Physical Review

The Search for Supersymmetry at the Tevatron Collider

We review the status of searches for Supersymmetry at the Tevatron Collider. After discussing the theoretical aspects relevant to the production and decay of supersymmetric particles at the Tevatron, we present the current results for Runs Ia and Ib as of the summer of 1997. To appear in the book "Perspectives in Supersymmetry", edited by G.L. Kane, World Scientific.Comment: 84 pages with 31 figures imbedded using psfig.tex. Uses sprocl.st

Search for a Fourth-Generation Quark More Massive than the Z0 Boson in ppbar Collisions at sqrt(s) = 1.8 TeV

We present the results of a search for pair production of a fourth-generation charge -1/3 quark (b') in sqrt(s)=1.8 TeV ppbar collisions using 88 pb^(-1) of data obtained with the Collider Detector at Fermilab. We assume that both quarks decay via the flavor-changing neutral current process b' -> bZ and that the b' mass is greater than m_Z + m_b. We studied the decay mode b'b'bar -> ZZ b bbar where one Z0 decays into e^+e^- or mu^+ mu^- and the other decays hadronically, giving a signature of two leptons plus jets. An upper limit on the cross section of ppbar -> b'b'bar times [BR (b' -> bZ)]^2 is established as a function of the b' mass. We exclude at 95% confidence level a b' quark with mass between 100 and 199 GeV/c^2 for BR(b' -> bZ) = 100%.Comment: 12 pages, 2 figures, submitted to Phys. Rev. Letters on 9/12/9

Search for a Fourth Generation Charge -1/3 Quark via Flavor Changing Neutral Current Decay

We report on a search for pair production of a fourth generation charge -1/3 quark (b') in pbar p collisions at sqrt(s) = 1.8 TeV at the Fermilab Tevatron using an integrated luminosity of 93 pb^-1. Both quarks are assumed to decay via flavor changing neutral currents (FCNC). The search uses the signatures gamma + 3 jets + mu-tag and 2 gamma + 2 jets. We see no significant excess of events over the expected background. We place an upper limit on the production cross section times branching fraction that is well below theoretical expectations for a b' quark decaying exclusively via FCNC for b' quark masses up to m(Z) + m(b).Comment: Eleven pages, two postscript figures, submitted to Physical Review Letter

A search for W bb and W Higgs production in ppbar collisions at sqrt(s)=1.96 TeV

We present a search for W b \bar{b} production in p \bar{p} collisions at sqrt{s}=1.96 TeV in events containing one electron, an imbalance in transverse momentum, and two b-tagged jets. Using 174 pb-1 of integrated luminosity accumulated by the D0 experiment at the Fermilab Tevatron collider, and the standard-model description of such events, we set a 95% C.L. upper limit on W b \bar{b}$production of 6.6 pb for b quarks with transverse momenta p_T^b > 20 GeV and b \bar{b} separation in pseudorapidity-azimuth space Delta R_bb > 0.75. Restricting the search to optimized b \bar{b} mass intervals provides upper limits on$WH$production of 9.0$-$12.2 pb, for Higgs-boson masses of 105$-$135 GeV.Comment: 7 pages, 4 figures, 1 table, submitted to Physical Review Letter

The Azimuthal Decorrelation of Jets Widely Separated in Rapidity

This study reports the first measurement of the azimuthal decorrelation between jets with pseudorapidity separation up to five units. The data were accumulated using the D{\O}detector during the 1992--1993 collider run of the Fermilab Tevatron at $\sqrt{s}=$ 1.8 TeV. These results are compared to next--to--leading order (NLO) QCD predictions and to two leading--log approximations (LLA) where the leading--log terms are resummed to all orders in $\alpha_{\scriptscriptstyle S}$. The final state jets as predicted by NLO QCD show less azimuthal decorrelation than the data. The parton showering LLA Monte Carlo {\small HERWIG} describes the data well; an analytical LLA prediction based on BFKL resummation shows more decorrelation than the data.Comment: 6 pages with 4 figures, all uuencoded and gzippe