Analysis and classification of oncology activities on the way to workflow based single source documentation in clinical information systems

BACKGROUND: Today, cancer documentation is still a tedious task involving many different information systems even within a single institution and it is rarely supported by appropriate documentation workflows. METHODS: In a comprehensive 14 step analysis we compiled diagnostic and therapeutic pathways for 13 cancer entities using a mixed approach of document analysis, workflow analysis, expert interviews, workflow modelling and feedback loops. These pathways were stepwise classified and categorized to create a final set of grouped pathways and workflows including electronic documentation forms. RESULTS: A total of 73 workflows for the 13 entities based on 82 paper documentation forms additionally to computer based documentation systems were compiled in a 724 page document comprising 130 figures, 94 tables and 23 tumour classifications as well as 12 follow-up tables. Stepwise classification made it possible to derive grouped diagnostic and therapeutic pathways for the three major classes - solid entities with surgical therapy - solid entities with surgical and additional therapeutic activities and - non-solid entities. For these classes it was possible to deduct common documentation workflows to support workflow-guided single-source documentation. CONCLUSIONS: Clinical documentation activities within a Comprehensive Cancer Center can likely be realized in a set of three documentation workflows with conditional branching in a modern workflow supporting clinical information system

Untersuchungen zur Herstellung und zum Abbrandverhalten von Wirbelschichtpyrolysekoksen

Der partielle und selektive Abbrand von Pyrolysekoksen in einem Wirbelbett mit Steinkohlekoks als Bettmaterial könnte die benötigte Wärme erzeugen, um in demselben Reaktor endotherme Pyrolyse- und Vergasungsreaktionen zur Behandlung organischer Reststoffe durchzuführen. Zur Messung der Reaktivitätsunterschiede der Kokse bezüglich Sauerstoff wurde an zwei Laborapparaturen (Thermowaage, Sandwirbelschicht) das Abbrandverhalten von Wirbelschicht-Pyrolysekoksen und Kohlekoksen im chemisch kontrollierten Temperaturbereich untersucht. Zur Bestimmung der formalkinetischen Parameter Aktivierungsenergie EA und Stoßfaktor k0 wurde im Falle der Thermowaage die Massenverlustkurve bei isothermer Reaktionführung ausgewertet. Im Falle der Wirbelschicht wurde der zeitliche CO/ CO2\- Verlauf im Abgas in eine Massenverlustkurve an Kohlenstoff umgerechnet und anschließend analog zur Thermowaage ausgewertet. Zur Beschreibung der Kinetik wurde ein massenbezogener Ansatz erster Ordnung bezüglich der Kohlenstoffmasse und -ter Ordnung bezüglich der Sauerstoffkonzentration verwendet. Die an der Thermowaage bestimmten Reaktivitäten der Kokse werden vergleichend in einem Arrhenius-Diagramm (T=250-600°C) dargestellt. Nach steigender Reaktivität geordnet lautet die Reihenfolge der untersuchten Kokse: Steinkohlenkoks < Braunkohlenkoks < DSD-Koks < Holzkoks < Strohkoks. Durch die an der Thermowaage bestimmten Reaktivitätsunterschiede zwischen Pyrolysekoksen und Bettmaterial ist ein selektiver Abbrand der Pyrolysekokse beim Betrieb einer kontinuierlichen Kokswirbelschicht zu erwarten

Cluster-based density-functional approach to quantum transport through molecular and atomic contacts

We present a cluster-based density-functional approach to model charge transport through molecular and atomic contacts. The electronic structure of the contacts is determined in the framework of density functional theory, and the parameters needed to describe transport are extracted from finite clusters. A similar procedure, restricted to nearest-neighbor interactions in the electrodes, has been presented by Damle et al. [Chem. Phys. 281, 171 (2002)]. Here, we show how to systematically improve the description of the electrodes by extracting bulk parameters from sufficiently large metal clusters. In this way we avoid problems arising from the use of nonorthogonal basis functions. For demonstration we apply our method to electron transport through Au contacts with various atomic-chain configurations and to a single-atom contact of Al.Comment: 18 pages, 13 figure

Nucleon-nucleon elastic scattering analysis to 2.5 GeV

A partial-wave analysis of NN elastic scattering data has been completed. This analysis covers an expanded energy range, from threshold to a laboratory kinetic energy of 2.5 GeV, in order to include recent elastic pp scattering data from the EDDA collaboration. The results of both single-energy and energy-dependent analyses are described.Comment: 23 pages of text. Postscript files for the figures are available from ftp://clsaid.phys.vt.edu/pub/said/n

CRFs form protein–protein interactions with each other and with members of the cytokinin signalling pathway in Arabidopsis via the CRF domain

Cytokinin is a plant hormone essential for growth and development. The elucidation of its signalling pathway as a variant of the bacterial two-component signalling system (TCS) has led to a better understanding of how this hormone is involved in general plant processes. A set of cytokinin-regulated transcription factors known as cytokinin response factors (CRFs) have been described as a potential branch emanating from the TCS, yet little is known about how CRFs actually interact with each other and with members of the TCS pathway. Here the interactions of CRF proteins (CRF1–CRF8) using the yeast two-hybrid system and bimolecular fluorescence complementation in planta assays are described. It was found that CRFs are readily able to form both homo- and heterodimers with each other. The first analysis of CRF versus TCS pathway protein interactions is also provided, which indicates that CRFs (CRF1–CRF8) are able specifically to interact directly with most of the Arabidopsis histidine-phosphotransfer proteins (AHP1–AHP5) further solidifying their link to the cytokinin signalling pathway. In addition, the region of CRF proteins involved in these interactions was mapped and it was determined that the clade-specific CRF domain alone is sufficient for these interactions. This is the first described function for the CRF domain in plants

Nutritional Factors Modulating Alu Methylation inan Italian Sample from The Mark-Age StudyIncluding Offspring of Healthy Nonagenarians

Alu hypomethylation promotes genomic instability and is associated with aging and age-related diseases. Dietary factors affect global DNA methylation, leading to changes in genomic stability and gene expression with an impact on longevity and the risk of disease. This preliminary study aims to investigate the relationship between nutritional factors, such as circulating trace elements, lipids and antioxidants, and Alu methylation in elderly subjects and offspring of healthy nonagenarians. Alu DNA methylation was analyzed in sixty RASIG (randomly recruited age-stratified individuals from the general population) and thirty-two GO (GeHA offspring) enrolled in Italy in the framework of the MARK-AGE project. Factor analysis revealed a different clustering between Alu CpG1 and the other CpG sites. RASIG over 65 years showed lower Alu CpG1 methylation than those of GO subjects in the same age class. Moreover, Alu CpG1 methylation was associated with fruit and whole-grain bread consumption, LDL2-Cholesterol and plasma copper. The preserved Alu methylation status in GO, suggests Alu epigenetic changes as a potential marker of aging. Our preliminary investigation shows that Alu methylation may be affected by food rich in fibers and antioxidants, or circulating LDL subfractions and plasma copper

Quality of human-computer interaction - results of a national usability survey of hospital-IT in Germany

<p>Abstract</p> <p>Background</p> <p>Due to the increasing functionality of medical information systems, it is hard to imagine day to day work in hospitals without IT support. Therefore, the design of dialogues between humans and information systems is one of the most important issues to be addressed in health care. This survey presents an analysis of the current quality level of human-computer interaction of healthcare-IT in German hospitals, focused on the users' point of view.</p> <p>Methods</p> <p>To evaluate the usability of clinical-IT according to the design principles of EN ISO 9241-10 the IsoMetrics Inventory, an assessment tool, was used. The focus of this paper has been put on suitability for task, training effort and conformity with user expectations, differentiated by information systems. Effectiveness has been evaluated with the focus on interoperability and functionality of different IT systems.</p> <p>Results</p> <p>4521 persons from 371 hospitals visited the start page of the study, while 1003 persons from 158 hospitals completed the questionnaire. The results show relevant variations between different information systems.</p> <p>Conclusions</p> <p>Specialised information systems with defined functionality received better assessments than clinical information systems in general. This could be attributed to the improved customisation of these specialised systems for specific working environments. The results can be used as reference data for evaluation and benchmarking of human computer engineering in clinical health IT context for future studies.</p

Human Monocytes Undergo Excessive Apoptosis following Temozolomide Activating the ATM/ATR Pathway While Dendritic Cells and Macrophages Are Resistant

Immunodeficiency is a severe therapy-limiting side effect of anticancer chemotherapy resulting from sensitivity of immunocompetent cells to DNA damaging agents. A central role in the immune system is played by monocytes that differentiate into macrophages and dendritic cells (DCs). In this study we compared human monocytes isolated from peripheral blood and cytokine matured macrophages and DCs derived from them and assessed the mechanism of toxicity of the DNA methylating anticancer drug temozolomide (TMZ) in these cell populations. We observed that monocytes, but not DCs and macrophages, were highly sensitive to the killing effect of TMZ. Studies on DNA damage and repair revealed that the initial DNA incision was efficient in monocytes while the re-ligation step of base excision repair (BER) can not be accomplished, resulting in an accumulation of DNA single-strand breaks (SSBs). Furthermore, monocytes accumulated DNA double-strand breaks (DSBs) following TMZ treatment, while DCs and macrophages were able to repair DSBs. Monocytes lack the DNA repair proteins XRCC1, ligase IIIα and PARP-1 whose expression is restored during differentiation into macrophages and DCs following treatment with GM-CSF and GM-CSF plus IL-4, respectively. These proteins play a key role both in BER and DSB repair by B-NHEJ, which explains the accumulation of DNA breaks in monocytes following TMZ treatment. Although TMZ provoked an upregulation of XRCC1 and ligase IIIα, BER was not enhanced likely because PARP-1 was not upregulated. Accordingly, inhibition of PARP-1 did not sensitize monocytes, but monocyte-derived DCs in which strong PARP activation was observed. TMZ induced in monocytes the DNA damage response pathways ATM-Chk2 and ATR-Chk1 resulting in p53 activation. Finally, upon activation of the Fas-receptor and the mitochondrial pathway apoptosis was executed in a caspase-dependent manner. The downregulation of DNA repair in monocytes, resulting in their selective killing by TMZ, might impact on the immune response during cancer chemotherapy

Nanooptics of molecular-shunted plasmonic nanojunctions.

Gold nanoparticles are separated above a planar gold film by 1.1 nm thick self-assembled molecular monolayers of different conductivities. Incremental replacement of the nonconductive molecules with a chemically equivalent conductive version differing by only one atom produces a strong 50 nm blue-shift of the coupled plasmon. With modeling this gives a conductance of 0.17G(0) per biphenyl-4,4'-dithiol molecule and a total conductance across the plasmonic junction of 30G(0). Our approach provides a reliable tool quantifying the number of molecules in each plasmonic hotspot, here <200.We acknowledge financial support from EPSRC grant EP/ G060649/1, EP/I012060/1, EP/L027151/1, EP/K028510/1, ERC grant LINASS 320503. F.B. acknowledges support from the Winton Programme for the Physics of Sustainability. C.T. and J.A. acknowledge financial support from Project FIS2013- 41184-P from MINECO, ETORTEK 2014-15 of the Basque Department of Industry and IT756-13 from the Basque consolidated groups.This paper was originally published in Nano Letters under a CC-BY licence (F Benz, C Tserkezis, LO Herrmann, B de Nijs, A Sanders, DO Sigle, L Pukenas, SD Evans, J Aizpurua, JJ Baumberg, Nano Letters 2015, 15, 669−674