Identifying translational science within the triangle of biomedicine

Background: The National Institutes of Health (NIH) Roadmap places special emphasis on “bench-to-bedside” research, or the “translation” of basic science research into practical clinical applications. The Clinical and Translational Science Awards (CTSA) Consortium is one example of the large investments being made to develop a national infrastructure to support translational science, which involves reducing regulatory burdens, launching new educational initiatives, and forming partnerships between academia and industry. However, while numerous definitions have been suggested for translational science, including the qualitative T1-T4 classification, a consensus has not yet been reached. This makes it challenging to tract the impact of these major policy changes. Methods: In this study, we use a bibliometric approach to map PubMed articles onto a graph, called the Triangle of Biomedicine. The corners of the triangle represent research related to animals, cells and molecules, and humans; and, the position of a publication on the graph is based on its topics, as determined by its Medical Subject Headings (MeSH). We define translation as movement of a collection of articles, or the articles that cite those articles, towards the human corner. Results: The Triangle of Biomedicine provides a quantitative way of determining if an individual scientist, research organization, funding agency, or scientific field is producing results that are relevant to clinical medicine. We validate our technique using examples that have been previously described in the literature and by comparing it to prior methods of measuring translational science. Conclusions: The Triangle of Biomedicine is a novel way to identify translational science and track changes over time. This is important to policy makers in evaluating the impact of the large investments being made to accelerate translation. The Triangle of Biomedicine also provides a simple visual way of depicting this impact, which can be far more powerful than numbers alone

Extracting Physician Group Intelligence from Electronic Health Records to Support Evidence Based Medicine

Evidence-based medicine employs expert opinion and clinical data to inform clinical decision making. The objective of this study is to determine whether it is possible to complement these sources of evidence with information about physician “group intelligence” that exists in electronic health records. Specifically, we measured laboratory test “repeat intervals”, defined as the amount of time it takes for a physician to repeat a test that was previously ordered for the same patient. Our assumption is that while the result of a test is a direct measure of one marker of a patient's health, the physician's decision to order the test is based on multiple factors including past experience, available treatment options, and information about the patient that might not be coded in the electronic health record. By examining repeat intervals in aggregate over large numbers of patients, we show that it is possible to 1) determine what laboratory test results physicians consider “normal”, 2) identify subpopulations of patients that deviate from the norm, and 3) identify situations where laboratory tests are over-ordered. We used laboratory tests as just one example of how physician group intelligence can be used to support evidence based medicine in a way that is automated and continually updated

The spectroscopic orbit of Capella revisited

Context. Capella is among the few binary stars with two evolved giant components. The hotter component is a chromospherically active star within the Hertzsprung gap, while the cooler star is possibly helium-core burning. Aims. The known inclination of the orbital plane from astrometry in combination with precise radial velocities will allow very accurate masses to be determined for the individual Capella stars. This will constrain their evolutionary stage and possibly the role of the active star's magnetic field on the dynamical evolution of the binary system. Methods. We obtained a total of 438 high-resolution \'echelle spectra during the years 2007-2010 and used the measured velocities to recompute the orbital elements. Our double-lined orbital solution yields average residuals of 64 m/s for the cool component and 297 m/s for the more rapidly rotating hotter component. Results. The semi-amplitude of the cool component is smaller by 0.045 km/s than the orbit determination of Torres et al. from data taken during 1996-1999 but more precise by a factor of 5.5, while for the hotter component it is larger by 0.580 km/s and more precise by a factor of 3.6. This corresponds to masses of 2.573\pm0.009 M_sun and 2.488\pm0.008 M_sun for the cool and hot component, respectively. Their relative errors of 0.34% and 0.30% are about half of the values given in Torres et al. for a combined literature- data solution but with absolute values different by 4% and 2% for the two components, respectively. The mass ratio of the system is therefore q = M_A/M_B = 0.9673 \pm 0.0020. Conclusions. Our orbit is the most precise and also likely to be the most accurate ever obtained for Capella

Topological Semimetal features in the Multiferroic Hexagonal Manganites

Using first-principles calculations we examine the band structures of ferromagnetic hexagonal manganites $\mathrm{YXO_3}$ (X=V, Cr, Mn, Fe and Co) in the nonpolar nonsymmorphic $P6_3/mmc$ space group. For $\mathrm{YVO_3}$ and $\mathrm{YCrO_3}$ we find a band inversion near the Fermi energy that generates a nodal ring in the $k_z=0$ mirror plane. We perform a more detailed analysis for these compounds and predict the existence of the topological "drumhead" surface states. Finally, we briefly discuss the low-symmetry polar phases (space group $P6_3cm$) of these systems, and show they can undergo a $P6_3/mmc \rightarrow P6_3cm$ transition by condensation of soft $K_3$ and $\Gamma_2^-$ phonons. Based on our findings, stabilizing these compounds in the hexagonal phase could offer a promising platform for studying the interplay of topology and multiferroicity, and the coexistence of real-space and reciprocal-space topological protection in the same phase

Query Health: standards-based, cross-platform population health surveillance

Objective: Understanding population-level health trends is essential to effectively monitor and improve public health. The Office of the National Coordinator for Health Information Technology (ONC) Query Health initiative is a collaboration to develop a national architecture for distributed, population-level health queries across diverse clinical systems with disparate data models. Here we review Query Health activities, including a standards-based methodology, an open-source reference implementation, and three pilot projects. Materials and methods Query Health defined a standards-based approach for distributed population health queries, using an ontology based on the Quality Data Model and Consolidated Clinical Document Architecture, Health Quality Measures Format (HQMF) as the query language, the Query Envelope as the secure transport layer, and the Quality Reporting Document Architecture as the result language. Results: We implemented this approach using Informatics for Integrating Biology and the Bedside (i2b2) and hQuery for data analytics and PopMedNet for access control, secure query distribution, and response. We deployed the reference implementation at three pilot sites: two public health departments (New York City and Massachusetts) and one pilot designed to support Food and Drug Administration post-market safety surveillance activities. The pilots were successful, although improved cross-platform data normalization is needed. Discussions This initiative resulted in a standards-based methodology for population health queries, a reference implementation, and revision of the HQMF standard. It also informed future directions regarding interoperability and data access for ONC's Data Access Framework initiative. Conclusions: Query Health was a test of the learning health system that supplied a functional methodology and reference implementation for distributed population health queries that has been validated at three sites

Model of Enterpreneurship and Social-cultural and Market Orientation of Small Business Owners in Poland

In the development of SMEs in Poland crucial meaning is legislation, steadily adapted to EU regulations, especially to the European Charter for Small Enterprises. Research conducted in Poland by many authors provide data for doing so, to confirm the hypothesis that among small businesses a vital role in shaping their work situation did not continue to play the market mechanisms and orientations, but mainly socio-cultural factors.W rozwoju MŚP w Polsce podstawowe znaczenie mają również uregulowania prawne, systematycznie dostosowywane do regulacji unijnych, zwłaszcza zaś do Europejskiej Karty Małych Przedsiębiorstw. Badania prowadzone w Polsce przez wielu autorów dostarczają danych ku temu, by potwierdzić tezę, że wśród drobnych przedsiębiorców decydującą rolę w kształtowaniu ich sytuacji pracy odgrywają nadal nie mechanizmy i orientacje rynkowe, ale przede wszystkim czynniki społeczno-kulturowe

Binary-induced magnetic activity? Time-series echelle spectroscopy and photometry of HD123351 = CZ CVn

We present a first and detailed study of the bright and active K0IV-III star HD 123351. The star is found to be a single-lined spectroscopic binary with a period of 147.8919+-0.0003 days and a large eccentricity of e=0.8086+-0.0001. The rms of the orbital solution is just 47 m/s, making it the most precise orbit ever obtained for an active binary system. The rotation period is constrained from long-term photometry to be 58.32+-0.01 days. It shows that HD 123351 is a very asynchronous rotator, rotating five times slower than the expected pseudo-synchronous value. Two spotted regions persisted throughout the 12 years of our observations. Four years of Halpha, CaII H&K and HeI D3 monitoring identifies the same main periodicity as the photometry but dynamic spectra also indicate that there is an intermittent dependence on the orbital period, in particular for Ca ii H&K in 2008. Line-profile inversions of a pair of Zeeman sensitive/insensitive iron lines yield an average surface magnetic-flux density of 542+-72 G. The time series for 2008 is modulated by the stellar rotation as well as the orbital motion, such that the magnetic flux is generally weaker during times of periastron and that the chromospheric emissions vary in anti-phase with the magnetic flux. We also identify a broad and asymmetric lithium line profile and measure an abundance of log n(Li) = 1.70+-0.05. The star's position in the H-R diagram indicates a mass of 1.2+-0.1 Msun and an age of 6-7 Gyr. We interpret the anti-phase relation of the magnetic flux with the chromospheric emissions as evidence that there are two magnetic fields present at the same time, a localized surface magnetic field associated with spots and a global field that is oriented towards the (low-mass) secondary component

SHRINE: Enabling Nationally Scalable Multi-Site Disease Studies

Results of medical research studies are often contradictory or cannot be reproduced. One reason is that there may not be enough patient subjects available for observation for a long enough time period. Another reason is that patient populations may vary considerably with respect to geographic and demographic boundaries thus limiting how broadly the results apply. Even when similar patient populations are pooled together from multiple locations, differences in medical treatment and record systems can limit which outcome measures can be commonly analyzed. In total, these differences in medical research settings can lead to differing conclusions or can even prevent some studies from starting. We thus sought to create a patient research system that could aggregate as many patient observations as possible from a large number of hospitals in a uniform way. We call this system the ‘Shared Health Research Information Network’, with the following properties: (1) reuse electronic health data from everyday clinical care for research purposes, (2) respect patient privacy and hospital autonomy, (3) aggregate patient populations across many hospitals to achieve statistically significant sample sizes that can be validated independently of a single research setting, (4) harmonize the observation facts recorded at each institution such that queries can be made across many hospitals in parallel, (5) scale to regional and national collaborations. The purpose of this report is to provide open source software for multi-site clinical studies and to report on early uses of this application. At this time SHRINE implementations have been used for multi-site studies of autism co-morbidity, juvenile idiopathic arthritis, peripartum cardiomyopathy, colorectal cancer, diabetes, and others. The wide range of study objectives and growing adoption suggest that SHRINE may be applicable beyond the research uses and participating hospitals named in this report