Challenges of ultra large scale integration of biomedical computing systems

The NCRI Informatics Initiative is overseeing the implementation of an informatics framework for the UK cancer research community. The framework advocates an integrated multidisciplinary method of working between scientific and medical communities. Key to this process is community adoption of high quality acquisition, storage, sharing and integration of diverse data elements to improve knowledge of the causes, prevention and treatment of cancer. The integration of the complex data and meta-data used by these multiple communities is a significant challenge and there are technical, resource-based and sociological issues to be addressed. In this paper we review progress aimed at establishing the framework and outline key challenges in ultra large scale integration of biomedical computing systems

The use of bisphosphonates to meet orthopaedic challenges

The anti-resorptive properties of bisphosphonates have been explored to manage several conditions that traditionally have required a surgical solution. In osteonecrosis, their use is predicated on the principle that bone collapse occurs during the revascularisation phase of the disease. If the associated resorptive activity were modulated, the resultant preserved joint architecture may improve clinical outcome and reduce the need for joint replacement. Pre-clinical and small-scale clinical studies have given non-conclusive support for this principle. Adequately powered clinical trials with relevant long-term endpoints are still required to firmly clarify the clinical efficacy of this treatment. Several clinical studies have shown that bisphosphonates can reduce periprosthetic bone loss and, in some situations, enhance implant fixation in the early period after joint replacement. This may be advantageous in settings where osseointegration is problematic. However, the ultimate goals of their use in joint replacement has been to reduce the incidence of late periprosthetic inflammatory osteolysis, the main cause of prosthesis failure. Population-based observational studies have associated bisphosphonate use with a lower incidence of revision surgery, supported by pre-clinical data. However, clinical trials have, to date, failed to demonstrate any efficacy for the human disease. The timing of bisphosphonate administration for secondary prevention after acute osteoporotic fracture has been subject to extensive investigation, with pre-clinical studies showing increased callus formation but decreased remodelling and no effect on the restoration of mechanical integrity of bone. Meta-analysis of clinical trial data indicates that early administration of bisphosphonate after acute fracture does not adversely affect fracture union, pain or functional outcomes. Finally, bisphosphonates have also been explored as a treatment for complex regional pain syndrome type-I. A recent meta-analysis has shown a beneficial effect on visual analogue scale pain scores, but an increase in mild adverse events

Selective Expression of Immune-Associated Surface Antigens by Keratinocytes in Irritant Contact Dermatitis

The expression of three immunoregulatory surface antigens by epidermal keratinocytes was studied in irritant contact dermatitis (lCD), in order to assess whether keratinocytes have a modulatory role in the pathogenesis of this disorder. Biopsies were taken from 48-h patch test reactions to six structurally unrelated irritants, and frozen sections immunolabeled with monoclonal antibodies to the major histocompatibility complex class II antigen, HLA-DR, intercellular adhesion molecule-i (ICAM-1), and the 88-Kd glycoprotein CD36 (OKM5), as well as to the CD3 (T cells) and CD11a (lymphocyte function associated antigen-1, LFA-1) antigens. We found that there was very limited expression of HLA- DR by keratinocytes, with no correlation between the extent of HLA-DR positivity and the degree of T cell infiltration into the epidermis and dermis, suggesting that interferon gamma may not be a significant mediator of lCD at 48h. In contrast, keratinocytes showed extensive upregulation of ICAM-1, with an excellent spatial association between ICAM-1 expression and LFA-1 positive leucocytes in the epidermis. This indicates that keratinocyte JCAM-1 induction is not restricted to diseases in which antigen presentation is pivotal, but that it has a generalized role in cutaneous inflammatory reactions, promoting the infiltration of leucocytes into the epidermis. Immunolabeling with OKM5 revealed that CD36 is present to a variable degree on keratinocytes in normal skin. Differential changes in the pattern of keratinocyte expression occurred between irritants, in a manner that suggested that the CD36 antigen does not act as an adhesion molecule in lCD, but rather that its expression is related to the proliferative state of the epidermis. The results of this study demonstrate that immune-associated antigens are selectively expressed on the surface of keratinocytes in 48-h ICD biopsies, implying that these cells play an important regulatory role in the development of the inflammatory response to irritant chemicals

Heterogeneous strain distribution in the subchondral bone of human osteoarthritic femoral heads, measured with digital volume correlation

Osteoarthritis (OA) is a chronic disease, affecting approximately one third of people over the age of 45. Whilst the etiology and pathogenesis of the disease are still not well understood, mechanics play an important role in both the initiation and progression of osteoarthritis. In this study, we demonstrate the application of stepwise compression, combined with microCT imaging and digital volume correlation (DVC) to measure and evaluate full-field strain distributions within osteoarthritic femoral heads under uniaxial compression. A comprehensive analysis showed that the microstructural features inherent in OA bone did not affect the level of uncertainties associated with the applied methods. The results illustrate the localization of strains at the loading surface as well as in areas of low bone volume fraction and subchondral cysts. Trabecular thickness and connectivity density were identified as the only microstructural parameters with any association to the magnitude of local strain measured at apparent yield strain or the volume of bone exceeding yield strain. This work demonstrates a novel approach to evaluating the mechanical properties of the whole human femoral head in case of severe OA

Muon sites in PbF2 and YF3: Decohering environments and the role of anion Frenkel defects

Muons implanted into ionic fluorides often lead to a so-called F– μ –F state, in which the time evolution of the muon spin contains information about the geometry and nature of the muon site. Nuclei more distant from the muon than the two nearest-neighbor fluorine ions result in decoherence of the F– μ –F system, and this can yield additional quantitative information about the state of the muon. We demonstrate how this idea can be applied to the determination of muon sites within the ionic fluorides α − PbF 2 and YF 3 , which contain fluoride ions in different crystallographic environments. Our results can be used to distinguish between different crystal phases and provide strong evidence for the existence of anion Frenkel defects in α − PbF 2

The kink Casimir energy in a lattice sine-Gordon model

The Casimir energy of quantum fluctuations about the classical kink configuration is computed numerically for a recently proposed lattice sine-Gordon model. This energy depends periodically on the kink position and is found to be approximately sinusoidal.Comment: 10 pages, 4 postscript figure

Human breast cancer bone metastasis in vitro and in vivo: a novel 3D model system for studies of tumour cell-bone cell interactions.

Bone is established as the preferred site of breast cancer metastasis. However, the precise mechanisms responsible for this preference remain unidentified. In order to improve outcome for patients with advanced breast cancer and skeletal involvement, we need to better understand how this process is initiated and regulated. As bone metastasis cannot be easily studied in patients, researchers have to date mainly relied on in vivo xenograft models. A major limitation of these is that they do not contain a human bone microenvironment, increasingly considered to be an important component of metastases. In order to address this shortcoming, we have developed a novel humanised bone model, where 1 × 10(5) luciferase-expressing MDA-MB-231 or T47D human breast tumour cells are seeded on viable human subchaodral bone discs in vitro. These discs contain functional osteoclasts 2-weeks after in vitro culture and positive staining for calcine 1-week after culture demonstrating active bone resorption/formation. In vitro inoculation of MDA-MB-231 or T47D cells colonised human bone cores and remained viable for <4 weeks, however, use of matrigel to enhance adhesion or a moving platform to increase diffusion of nutrients provided no additional advantage. Following colonisation by the tumour cells, bone discs pre-seeded with MDA-MB-231 cells were implanted subcutaneously into NOD SCID mice, and tumour growth monitored using in vivo imaging for up to 6 weeks. Tumour growth progressed in human bone discs in 80 % of the animals mimicking the later stages of human bone metastasis. Immunohistochemical and PCR analysis revealed that growing MDA-MB-231 cells in human bone resulted in these cells acquiring a molecular phenotype previously associated with breast cancer bone metastases. MDA-MB-231 cells grown in human bone discs showed increased expression of IL-1B, HRAS and MMP9 and decreased expression of S100A4, whereas, DKK2 and FN1 were unaltered compared with the same cells grown in mammary fat pads of mice not implanted with human bone discs

Influence of femoral component design on proximal femoral bone mass after total hip replacement : a randomized controlled trial

Background: In this randomized controlled trial (RCT), we compared bone remodeling and bone turnover between 2 total hip arthroplasty implants—the short, proximally porous-coated Tri-Lock Bone-Preservation Stem and a conventional, fully-coated Corail prosthesis—over a 2-year postoperative period. Methods: Forty-six participants received the Tri-Lock prosthesis and 40 received the Corail prosthesis. At baseline, the 2 groups had similar demographics, proximal femoral bone mineral density (BMD), bone turnover markers, radiographic canal flare index, and patient-reported outcome measure (PROM) scores. Outcomes were measured at weeks 26, 52, and 104. Results: Loss of periprosthetic bone, measured by high-sensitivity dual x-ray absorptiometry region-free analysis (DXA-RFA), was identified at the calcar and proximal-lateral aspect of the femur in both prosthesis groups (p 0.05). The adverse-event rate was also similar between the groups (p > 0.05). Conclusions: This RCT shows that prostheses intended to preserve proximal femoral bone do not necessarily perform better in this regard than conventional cementless designs. DXA-RFA is a sensitive tool for detecting spatially complex patterns of periprosthetic bone remodeling. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence

Optimal modelling and experimentation for the improved sustainability of microfluidic chemical technology design

Optimization of the dynamics and control of chemical processes holds the promise of improved sustainability for chemical technology by minimizing resource wastage. Anecdotally, chemical plant may be substantially over designed, say by 35-50%, due to designers taking account of uncertainties by providing greater flexibility. Once the plant is commissioned, techniques of nonlinear dynamics analysis can be used by process systems engineers to recoup some of this overdesign by optimization of the plant operation through tighter control. At the design stage, coupling the experimentation with data assimilation into the model, whilst using the partially informed, semi-empirical model to predict from parametric sensitivity studies which experiments to run should optimally improve the model. This approach has been demonstrated for optimal experimentation, but limited to a differential algebraic model of the process. Typically, such models for online monitoring have been limited to low dimensions. Recently it has been demonstrated that inverse methods such as data assimilation can be applied to PDE systems with algebraic constraints, a substantially more complicated parameter estimation using finite element multiphysics modelling. Parametric sensitivity can be used from such semi-empirical models to predict the optimum placement of sensors to be used to collect data that optimally informs the model for a microfluidic sensor system. This coupled optimum modelling and experiment procedure is ambitious in the scale of the modelling problem, as well as in the scale of the application - a microfluidic device. In general, microfluidic devices are sufficiently easy to fabricate, control, and monitor that they form an ideal platform for developing high dimensional spatio-temporal models for simultaneously coupling with experimentation. As chemical microreactors already promise low raw materials wastage through tight control of reagent contacting, improved design techniques should be able to augment optimal control systems to achieve very low resource wastage. In this paper, we discuss how the paradigm for optimal modelling and experimentation should be developed and foreshadow the exploitation of this methodology for the development of chemical microreactors and microfluidic sensors for online monitoring of chemical processes. Improvement in both of these areas bodes to improve the sustainability of chemical processes through innovative technology. (C) 2008 The Institution of Chemical Engineers. Published by Elsevier B.V. All rights reserved