Using a Service Oriented Architecture Approach to Clinical Decision Support: Performance Results from Two CDS Consortium Demonstrations

The Clinical Decision Support Consortium has completed two demonstration trials involving a web service for the execution of clinical decision support (CDS) rules in one or more electronic health record (EHR) systems. The initial trial ran in a local EHR at Partners HealthCare. A second EHR site, associated with Wishard Memorial Hospital, Indianapolis, IN, was added in the second trial. Data were gathered during each 6 month period and analyzed to assess performance, reliability, and response time in the form of means and standard deviations for all technical components of the service, including assembling and preparation of input data. The mean service call time for each period was just over 2 seconds. In this paper we report on the findings and analysis to date while describing the areas for further analysis and optimization as we continue to expand our use of a Services Oriented Architecture approach for CDS across multiple institutions

Motifs, themes and thematic maps of an integrated Saccharomyces cerevisiae interaction network

BACKGROUND: Large-scale studies have revealed networks of various biological interaction types, such as protein-protein interaction, genetic interaction, transcriptional regulation, sequence homology, and expression correlation. Recurring patterns of interconnection, or 'network motifs', have revealed biological insights for networks containing either one or two types of interaction. RESULTS: To study more complex relationships involving multiple biological interaction types, we assembled an integrated Saccharomyces cerevisiae network in which nodes represent genes (or their protein products) and differently colored links represent the aforementioned five biological interaction types. We examined three- and four-node interconnection patterns containing multiple interaction types and found many enriched multi-color network motifs. Furthermore, we showed that most of the motifs form 'network themes' – classes of higher-order recurring interconnection patterns that encompass multiple occurrences of network motifs. Network themes can be tied to specific biological phenomena and may represent more fundamental network design principles. Examples of network themes include a pair of protein complexes with many inter-complex genetic interactions – the 'compensatory complexes' theme. Thematic maps – networks rendered in terms of such themes – can simplify an otherwise confusing tangle of biological relationships. We show this by mapping the S. cerevisiae network in terms of two specific network themes. CONCLUSION: Significantly enriched motifs in an integrated S. cerevisiae interaction network are often signatures of network themes, higher-order network structures that correspond to biological phenomena. Representing networks in terms of network themes provides a useful simplification of complex biological relationships

Geocoding rural addresses in a community contaminated by PFOA: a comparison of methods

BACKGROUND: Location is often an important component of exposure assessment, and positional errors in geocoding may result in exposure misclassification. In rural areas, successful geocoding to a street address is limited by rural route boxes. Communities have assigned physical street addresses to rural route boxes as part of E911 readdressing projects for improved emergency response. Our study compared automated and E911 methods for recovering and geocoding valid street addresses and assessed the impact of positional errors on exposure classification. METHODS: The current study is a secondary analysis of existing data that included 135 addresses self-reported by participants of a rural community study who were exposed via public drinking water to perfluorooctanoate (PFOA) released from a DuPont facility in Parkersburg, West Virginia. We converted pre-E911 to post-E911 addresses using two methods: automated ZP4 address-correction software with the U.S. Postal Service LACS database and E911 data provided by Wood County, West Virginia. Addresses were geocoded using TeleAtlas, an online commercial service, and ArcView with StreetMap Premium North America NAVTEQ 2008 enhanced street dataset. We calculated positional errors using GPS measurements collected at each address and assessed exposure based on geocoded location in relation to public water pipes. RESULTS: The county E911 data converted 89% of the eligible addresses compared to 35% by ZP4 LACS. ArcView/NAVTEQ geocoded more addresses (n = 130) and with smaller median distance between geocodes and GPS coordinates (39 meters) than TeleAtlas (n = 85, 188 meters). Without E911 address conversion, 25% of the geocodes would have been more than 1000 meters from the true location. Positional errors in TeleAtlas geocoding resulted in exposure misclassification of seven addresses whereas ArcView/NAVTEQ methods did not misclassify any addresses. CONCLUSIONS: Although the study was limited by small numbers, our results suggest that the use of county E911 data in rural areas increases the rate of successful geocoding. Furthermore, positional accuracy of rural addresses in the study area appears to vary by geocoding method. In a large epidemiological study investigating the health effects of PFOA-contaminated public drinking water, this could potentially result in exposure misclassification if addresses are incorrectly geocoded to a street segment not serviced by public water

Supercollider Signatures of Supergravity Models with Yukawa Unification

We study the predictions of the simplest SU(5) grand unified model within the framework of minimal supergravity, including constraints from the radiative breaking of electroweak symmetry. As a consequence of the unification of the $b$-quark and $\tau$-lepton Yukawa couplings, the top quark mass is predicted to be close to its fixed point value. We delineate the regions of the supergravity parameter space allowed by constraints from the non-observation of proton decay and from the requirement that the LSP does not overclose the universe. These constraints lead to a definite pattern of sparticle masses: the feature unique to Yukawa unified models is that some of the third generation squarks are much lighter than those of the first two generations. Despite the fact that all sparticle masses and mixings are determined by just four SUSY parameters at the GUT scale (in addition to $m_t$), we find that the signals for sparticle production can vary substantially over the allowed parameter space. We identify six representative scenarios and study the signals from sparticle production at the LHC. We find that by studying the signal in various channels, these scenarios may be distinguished from one another, and also from usually studied ``minimal models'' where squarks and sleptons are taken to be degenerate. In particular, our studies allow us to infer that some third generation squarks are lighter than other squarks---a feature that could provide the first direct evidence of supergravity grand unification.Comment: 28 pages Revtex files with 5 PS figures available from [email protected], Preprint nos. FSU-HEP-940311, KEK-TH-392, MAD/PH/825, UH-511-785-9

Shared Skeletal Support in a Coral-Hydroid Symbiosis

Hydroids form symbiotic relationships with a range of invertebrate hosts. Where they live with colonial invertebrates such as corals or bryozoans the hydroids may benefit from the physical support and protection of their host's hard exoskeleton, but how they interact with them is unknown. Electron microscopy was used to investigate the physical interactions between the colonial hydroid Zanclea margaritae and its reef-building coral host Acropora muricata. The hydroid tissues extend below the coral tissue surface sitting in direct contact with the host's skeleton. Although this arrangement provides the hydroid with protective support, it also presents problems of potential interference with the coral's growth processes and exposes the hydroid to overgrowth and smothering. Desmocytes located within the epidermal layer of the hydroid's perisarc-free hydrorhizae fasten it to the coral skeleton. The large apical surface area of the desmocyte and high bifurcation of the distal end within the mesoglea, as well as the clustering of desmocytes suggests that a very strong attachment between the hydroid and the coral skeleton. This is the first study to provide a detailed description of how symbiotic hydroids attach to their host's skeleton, utilising it for physical support. Results suggest that the loss of perisarc, a characteristic commonly associated with symbiosis, allows the hydroid to utilise desmocytes for attachment. The use of these anchoring structures provides a dynamic method of attachment, facilitating detachment from the coral skeleton during extension, thereby avoiding overgrowth and smothering enabling the hydroid to remain within the host colony for prolonged periods of time

Neutralino Dark Matter in Minimal Supergravity: Direct Detection vs. Collider Searches

We calculate expected event rates for direct detection of relic neutralinos as a function of parameter space of the minimal supergravity model. Numerical results are presented for the specific case of a $^{73}$Ge detector. We find significant detection rates ($R> 0.01$ events/kg/day) in regions of parameter space most favored by constraints from $B\to X_s\gamma$ and the cosmological relic density of neutralinos. The detection rates are especially large in regions of large $\tan\beta$, where many conventional signals for supersymmetry at collider experiments are difficult to detect. If the parameter $\tan\beta$ is large, then there is a significant probability that the first direct evidence for supersymmetry could come from direct detection experiments, rather than from collider searches for sparticles.Comment: 25 page REVTEX file including 9 PS figure

Anomaly-Free Gauged R-Symmetry

We review the gauging of an R-symmetry in local and global susy. We then construct the first anomaly-free models. We break the R-symmetry and susy at the Planck scale and discuss the low-energy effects. We include a solution to the mu-problem, and the prediction of observable effects at HERA. The models also nicely allow for GUT-scale baryogenesis and R-parity violation without the sphaleron interactions erasing the baryon-asymmetry.Comment: 6 pages, latex, no figures. Talk presented at SUSY-95. Work done in collaboration with A. Chamseddin

Mixed Wino Dark Matter: Consequences for Direct, Indirect and Collider Detection

In supersymmetric models with gravity-mediated SUSY breaking and gaugino mass unification, the predicted relic abundance of neutralinos usually exceeds the strict limits imposed by the WMAP collaboration. One way to obtain the correct relic abundance is to abandon gaugino mass universality and allow a mixed wino-bino lightest SUSY particle (LSP). The enhanced annihilation and scattering cross sections of mixed wino dark matter (MWDM) compared to bino dark matter lead to enhanced rates for direct dark matter detection, as well as for indirect detection at neutrino telescopes and for detection of dark matter annihilation products in the galactic halo. For collider experiments, MWDM leads to a reduced but significant mass gap between the lightest neutralinos so that chi_2^0 two-body decay modes are usually closed. This means that dilepton mass edges-- the starting point for cascade decay reconstruction at the CERN LHC-- should be accessible over almost all of parameter space. Measurement of the m_{\tz_2}-m_{\tz_1} mass gap at LHC plus various sparticle masses and cross sections as a function of beam polarization at the International Linear Collider (ILC) would pinpoint MWDM as the dominant component of dark matter in the universe.Comment: 29 pages including 19 eps figure

Neutralino versus axion/axino cold dark matter in the 19 parameter SUGRA model

We calculate the relic abundance of thermally produced neutralino cold dark matter in the general 19 parameter supergravity (SUGRA-19) model. A scan over GUT scale parameters reveals that models with a bino-like neutralino typically give rise to a dark matter density \Omega_{\tz_1}h^2\sim 1-1000, i.e. between 1 and 4 orders of magnitude higher than the measured value. Models with higgsino or wino cold dark matter can yield the correct relic density, but mainly for neutralino masses around 700-1300 GeV. Models with mixed bino-wino or bino-higgsino CDM, or models with dominant co-annihilation or A-resonance annihilation can yield the correct abundance, but such cases are extremely hard to generate using a general scan over GUT scale parameters; this is indicative of high fine-tuning of the relic abundance in these cases. Requiring that m_{\tz_1}\alt 500 GeV (as a rough naturalness requirement) gives rise to a minimal probably dip in parameter space at the measured CDM abundance. For comparison, we also scan over mSUGRA space with four free parameters. Finally, we investigate the Peccei-Quinn augmented MSSM with mixed axion/axino cold dark matter. In this case, the relic abundance agrees more naturally with the measured value. In light of our cumulative results, we conclude that future axion searches should probe much more broadly in axion mass, and deeper into the axion coupling.Comment: 23 pages including 17 .eps figure