Facilitating pre-operative assessment guidelines representation using SNOMED CT

Objective: To investigate whether SNOMED CT covers the terms used in pre-operative assessment guidelines, and if necessary, how the measured content coverage can be improved. Pre-operative assessment guidelines were retrieved from the websites of (inter)national anesthesiarelated societies. The recommendations in the guidelines were rewritten to ‘‘IF condition THEN action” statements to facilitate data extraction. Terms were extracted from the IF–THEN statements and mapped to SNOMED CT. Content coverage was measured by using three scores: no match, partial match and complete match. Non-covered concepts were evaluated against the SNOMED CT editorial documentation. Results: From 6 guidelines, 133 terms were extracted, of which 71% (n = 94) completely matched with SNOMED CT concepts. Disregarding the vague concepts in the included guidelines SNOMED CT’s content coverage was 89%. Of the 39 non-completely covered concepts, 69% violated at least one of SNOMED CT’s editorial principles or rules. These concepts were categorized based on four categories: non-reproducibility, classification-derived phrases, numeric ranges, and procedures categorized by complexity. Conclusion: Guidelines include vague terms that cannot be well supported by terminological systems thereby hampering guideline-based decision support systems. This vagueness reduces the content coverage of SNOMED CT in representing concepts used in the pre-operative assessment guidelines. Formalization of the guidelines using SNOMED CT is feasible but to optimize this, first the vagueness of some guideline concepts should be resolved and a few currently missing but relevant concepts should be added to SNOMED CT

The Use of SNOMED CT for Representing Concepts Used in Preoperative Guidelines

The use of guidelines to improve quality of care depends on presenting them in a standard machine-interpretable form and using common terms in guidelines as well as in patient records. In this study, the use of SNOMED CT for representing concepts used in preoperative assessment guidelines was evaluated. Terms used in six of these guidelines were mapped to this terminology. Mappings were presented based on three scores: no match, partial match, and complete match. As eleven of the terms were repeatedly used in different guidelines, we analyzed the results based on “token” and “type” coverage. Of 133 extracted terms from guidelines, 107 terms should be covered by SNOMED CT of which 87% was completely represented by this terminology. Our study showed that SNOMED CT content should be extended before preoperative assessment guidelines can be completely automated

Negative Echo in the Density Evolution of Ultracold Fermionic Gases

We predict a nonequilibrium critical phenomenon in the space-time density evolution of a fermionic gas above the temperature of transition into the superfluid phase. On the BCS side of the BEC-BCS crossover, the evolution of a localized density disturbance exhibits a negative echo at the point of the initial inhomogeneity. Approaching the BEC side, this effect competes with the slow spreading of the density of bosonic molecules. However, even here the echo dominates for large enough times. This effect may be used as an experimental tool to locate the position of the transition.Comment: 4 pages, 2 figure

Development of a National Core Dataset for Preoperative Assessment

Objective:To define a core dataset for preoperative assessment to leverage uniform data collection in this domain. This uniformity is a prerequisite for data exchange between care providers and semantic interoperability between health record systems. Methods: To design this core dataset a combination of literature review and expert consensus meetings were used. In the first meeting a working definition for “core dataset” was specified. Subgroups were formed to address major headings of the core dataset. In the following eight meetings data items for each subheading were discussed. The items in the resulting draft of the dataset were compared to those retrieved from an earlier literature review study. In the last two expert meetings modifications of the dataset were performed based on the result of this literature study. Results: Based on expert consensus a draft dataset including 82 data items was designed. Seventy-six percent of data items in the draft dataset were covered by the literature study. Nine data items were modified in the draft and 14 data items were added to the dataset based on input from the literature review. The final dataset of 93 data items covers patient history, physical examination, supplementary examination and consultation, and final judgment. Conclusions: This preoperative-assessment dataset was defined based on expert con - sensus and literature review. Both methods proved to be valuable and complementary. This dataset opens the door for creating standardized approaches in data collection in the preoperative assessment field which will facilitate interoperability between different electronic health records and different users

Engineering E. coli cell surface in order to develop a one-step purification method for recombinant proteins

Sortases are enzymes mostly found in Gram-positive bacteria which cleave proteins site-specifically. This feature makes them a promising tool in molecular biology and biotechnology. In this study, using bacterial surface display of recombinant proteins and ability of sortase A in site-specifically cleavage of the amino acid sequences, a novel method for one-step purification of recombinant proteins was developed. Using computational program tools, a chimeric protein containing a metallothionein (mt) and chitin binding domain (ChBD) was attached to the C-terminal domain of the truncated outer membrane protein A (Lpp�-ompA) using sortase recognition site (amino acid residues: LPQTG) as a separator. The structure of the chimeric protein was simulated using molecular dynamics to determine if the LPQTG motif is accessible to the sortase active site. The designed chimeric protein was expressed and purified. The purified chimeric protein was also displayed on the surface of E. coli cells. Both purified chimeric protein and the E. coli cells displaying Lpp�-ompA-mt-ChBD carrier protein were then treated with sortase to evaluate the efficiency of sortase-mediated cleavage of purified chimeric protein as well as surface displayed-chimeric protein. It is shown that mt-ChBD protein was successfully cleaved and dissociated from Lpp�-ompA carrier and released into the medium after treatment with sortase in both recombinant protein and surface displayed-chimeric protein. The experimental results confirmed the molecular dynamics analysis results. The presented method could be regarded as a novel strategy for one step expression and purification of recombinant proteins. © 2018, The Author(s)

Resource Discovery in Non-Structured Peer to Peer Grid Systems Using the Shuffled Frog Leaping Algorithm

In Peer to Peer (P2P) grid systems, users can utilize the resources of other machines for their tasks without involving themselves in the detailed aspects of addressing. One of the greatest challenges for these systems is finding the resource that matches the user’s request to minimize query traffic in the network. Thus, inspired by the Shuffled Frog Leaping Algorithm (SFLA), this article presents a new method for resource discovery in grid systems. This algorithm finds the resource that matches the user’s request via sending requests to the most suitable neighbors, thus preventing the flooding of requests and reducing traffic. The evaluation and comparison of the proposed method with the Genetic Algorithm (GA) and Differential Evolution Algorithm (DEA) indicate that it yields higher performance considering the speed and number of sent queries in the network

Uncertain viscoelastic models with fractional order: a new spectral tau method to study the numerical simulations of the solution

The analysis of the behaviors of physical phenomena is important to discover significant features of the character and the structure of mathematical models. Frequently the unknown parameters involve in the models are assumed to be unvarying over time. In reality, some of them are uncertain and implicitly depend on several factors. In this study, to consider such uncertainty in variables of the models, they are characterized based on the fuzzy notion. We propose here a new model based on fractional calculus to deal with the Kelvin–Voigt (KV) equation and non-Newtonian fluid behavior model with fuzzy parameters. A new and accurate numerical algorithm using a spectral tau technique based on the generalized fractional Legendre polynomials (GFLPs) is developed to solve those problems under uncertainty. Numerical simulations are carried out and the analysis of the results highlights the significant features of the new technique in comparison with the previous findings. A detailed error analysis is also carried out and discussed

Introducing standard protocol for enrichment of Artemia urmiana nauplii with Canola oil

This research was performed to introduce a standard protocol for enrichment of Artemia urmian with Canola oil. Artemia urmiana nauplii were enriched at three densities (50000, 100000 and 200000 nauplii L^-1) and three concentrations of Canola oil (0.1, 0.2 and 0.3 g L^-1). Their effects were evaluated on survival, total length and profile of fatty acids at 6, 9, 12, 15 and 18 hours after the onset of enrichment. Cysts of A.urmiana were hatched according to the standard method. A.urmiana nauplii were stocked at above densities in 7 L cylindrical containers. Canola oil emulsion was added at concentrations of 0.1, 0.2 and 0.3 g L^-1 at the beginning and 12 hours after the onset of enrichment. The results of analysis showed that enrichment of A.urmiana with 0.3 g L^ -1 Canola oil at 100000 nauplii L^-1 for 18 hours was considered as the best treatment. Artemia nauplii enriched in this treatment had significantly higher levels of (n-3) PUFA and survival and minimum total length comparing to other treatments. The treatment had significantly higher levels of (n-6) PUFA than all treatments except treatment with a density of 50,000 nauplii L^-1 with 0.1 g L^-1 Canola oil for 18 hours

A subcutaneous adipose tissue-liver signalling axis controls hepatic gluconeogenesis.

The search for effective treatments for obesity and its comorbidities is of prime importance. We previously identified IKK-ε and TBK1 as promising therapeutic targets for the treatment of obesity and associated insulin resistance. Here we show that acute inhibition of IKK-ε and TBK1 with amlexanox treatment increases cAMP levels in subcutaneous adipose depots of obese mice, promoting the synthesis and secretion of the cytokine IL-6 from adipocytes and preadipocytes, but not from macrophages. IL-6, in turn, stimulates the phosphorylation of hepatic Stat3 to suppress expression of genes involved in gluconeogenesis, in the process improving glucose handling in obese mice. Preliminary data in a small cohort of obese patients show a similar association. These data support an important role for a subcutaneous adipose tissue-liver axis in mediating the acute metabolic benefits of amlexanox on glucose metabolism, and point to a new therapeutic pathway for type 2 diabetes