Towards a Holistic Biomedical Information Platform for Primary and Secondary Use Settings

BACKGROUND

Clinical information is often used for biomedical research. Data warehouses can help providing researchers with data and the opportunity to find eligible participants for clinical trials.

OBJECTIVES

To define an information platform for healthcare and biomedical research based on requirements by clinicians and researchers.

METHODS

Interviews with clinicians, researchers, data privacy officers, IT and hospital administration combined with a questionnaire sent to 60 medical departments at our hospital were conducted.

RESULTS

Resulting requirements were grouped and a platform architecture was designed based on the requirements.

CONCLUSION

Requirements lead to a single platform supporting both, patient care and biomedical research.

Membranolytic anticancer peptides

Understanding the structure–activity relationships and mechanisms of action of membranolytic anticancer peptides could help them advance to therapeutic success.

Implementing the Patient Portal of the PEHR in the Metropolitan Region Rhine-Neckar - Experiences with Liferay

A patient portal with access to a personal cross-enterprise electronic health record (PEHR) had to be developed for the project "INFormation technology for PATient-oriented healthcare in the Rhine-Neckar metropolitan region" (INFOPAT). Liferay was chosen as the platform technology in previous researches. Multiple portlets for patients, study members, security officers and administrators had been developed in Java. In this paper all portlets are presented. For three portlets the communication between them, Liferay and the PEHR are described in detail. To communicate with the PEHR a façade called IHE Connector had been implemented too. Despite the broad functionality of the Liferay Core some workarounds had to be implemented. The lack of information in the provided documentation of Liferay lead to delays in development. The Liferay IDE and Liferay itself showed an unstable state.

Robust molecular representations for modelling and design derived from atomic partial charges

Ab initio partial charge schemes are identified for molecular modelling purposes, and potential pitfalls of their application are discussed.

Multimodal evoked potential monitoring in asleep patients versus neurological evaluation in awake patients during carotid endarterectomy: a single-centre retrospective trial of 651 patients

BACKGROUND

A controversy exists regarding which monitoring technique is superior in cases in which general anesthesia (GA) is necessary for carotid endarterectomy (CEA). Multimodal evoked potential (mEP) monitoring was investigated under GA during CEA and compared with a historical control group undergoing neurological evaluations awake under loco-regional anesthesia (LA).

METHODS

We retrospectively studied 651 patients undergoing elective CEA. In groupHISTORY (N.=349; 1997-1999) LA was provided using superficial or deep/superficial cervical plexus blocks. In groupmEP, (N.=302; 2009-2013) GA was performed by administering remifentanil/propofol infusion. The multimodal EPs included the median-nerve-somatosensory and motor evoked potentials. The primary outcome was the rate of technical failure. The arterio-arterial shunt rate and immediate postoperative motor outcomes were also compared.

RESULTS

GroupmEP showed a significantly lower rate of technical failure (OR 0.17; CI 0.03-0.6; P=0.002). Because the groups differed systematically, logistic regression analysis was used to compare shunt rates and motor outcomes. Since shunt rates were 8.3% (groupmEP) versus 8.2% (groupHISTORY), but logistic regression model showed significant differences (OR 3.77; CI 1.67-8.95; P=0.001) correct comparison was impossible. Immediate postoperative deficits were 4.3% (groupmEP) and 4.9% (groupHISTORY); logistic regression analysis: transient OR 0.77, CI 0.28 to 0.22, P=0.61 and permanent OR 0.37, CI 0.02-7.74, P=0.49.

CONCLUSION

Monitoring mEPs was associated with less technical failure than awake evaluation and showed similar motor outcomes. Because the groups differed systematically, the interpretation of shunt rates was impossible. Monitoring mEP should be considered to detect intraoperative ischemia in cases in which patients undergo CEA under GA.

High-precision comparison of the antiproton-to-proton charge-to-mass ratio

Invariance under the charge, parity, time-reversal (CPT) transformation is one of the fundamental symmetries of the standard model of particle physics. This CPT invariance implies that the fundamental properties of antiparticles and their matter-conjugates are identical, apart from signs. There is a deep link between CPT invariance and Lorentz symmetry--that is, the laws of nature seem to be invariant under the symmetry transformation of spacetime--although it is model dependent. A number of high-precision CPT and Lorentz invariance tests--using a co-magnetometer, a torsion pendulum and a maser, among others--have been performed, but only a few direct high-precision CPT tests that compare the fundamental properties of matter and antimatter are available. Here we report high-precision cyclotron frequency comparisons of a single antiproton and a negatively charged hydrogen ion (H(-)) carried out in a Penning trap system. From 13,000 frequency measurements we compare the charge-to-mass ratio for the antiproton (q/m)p- to that for the proton (q/m)p and obtain (q/m)p-/(q/m)p − 1 =1(69) × 10(-12). The measurements were performed at cyclotron frequencies of 29.6 megahertz, so our result shows that the CPT theorem holds at the atto-electronvolt scale. Our precision of 69 parts per trillion exceeds the energy resolution of previous antiproton-to-proton mass comparisons as well as the respective figure of merit of the standard model extension by a factor of four. In addition, we give a limit on sidereal variations in the measured ratio of <720 parts per trillion. By following the arguments of ref. 11, our result can be interpreted as a stringent test of the weak equivalence principle of general relativity using baryonic antimatter, and it sets a new limit on the gravitational anomaly parameter of |α − 1| < 8.7 × 10(-7).

Near field stacking of zone plates for reduction of their effective zone period

Here we analyze the potential of a new fabrication method for high resolution zone plates with high aspect ratios based on near field stacking of frequency doubled atomic layer deposited (ALD) zone plates. The proposed method enables reduction of the effective zone period by a factor of four with two zone plate layers compared to the initial e-beam lithography exposed outermost zone period. It also overcomes the problem that very small zone widths with high aspect ratios have to be fabricated for high-resolution hard X-ray microscopy. Using rigorous coupled wave theory, we have analyzed the diffraction behavior of these near field stacked zone plates and investigated strategies to optimize fabrication parameters to compensate for separation of stacked zone plates. The calculations performed for 8 keV photon energy and effective outermost zone widths of 28 nm and 15 nm predict diffraction efficiencies ≥ 20% suggesting that such optics could find widespread practical applications.

Relations between the characteristics and psychological comorbidities of chronic pruritus differ between men and women: women are more anxious than men

BACKGROUND

Although sex and gender are becoming more important in diagnostics and therapy, there is still little knowledge about sex-specific differences in chronic pruritus (CP).

OBJECTIVES

To compare, taking into consideration the characteristics of pruritus, sex-specific differences in psychological symptoms in patients with CP.

METHODS

Sociodemographic data, data on the clinical characteristics of the skin and CP were documented over a 1-year period in all patients attending the Competence Center Chronic Pruritus of the University Hospital Münster for the first time. All patients completed the Hospital Anxiety and Depression Scale. Student's t-tests for independent study groups and linear regression analyses were applied.

RESULTS

A total of 619 patients (278 men, 341 women) were included in the analysis. Women were more anxious than men, but were not more depressed. A linear regression analysis indicated that depression and anxiety scores in women were related to the average intensity of pruritus during the previous 4 weeks and to a more generalized pruritus at the beginning of CP; older age in women also correlated with the scores on the depression subscale. Interestingly, the associations were different in men: scores on the depression scale were associated with the diagnosis of CP pruritus with multiple scratch lesions.

CONCLUSIONS

There are sex-specific differences in the relationship between the psychological symptoms and clinical characteristics of CP; higher anxiety scores were achieved by women. Whether psychological symptoms can be reversed when CP and scratch lesions improve is an issue that needs further exploration.

T cells kill bacteria captured by transinfection from dendritic cells and confer protection in mice

Dendritic cells (DCs) phagocytose, process, and present bacterial antigens to T lymphocytes to trigger adaptive immunity. In vivo, bacteria can also be found inside T lymphocytes. However, T cells are refractory to direct bacterial infection, leaving the mechanisms by which bacteria invade T cells unclear. We show that T cells take up bacteria from infected DCs by the process of transinfection, which requires direct contact between the two cells and is enhanced by antigen recognition. Prior to transfer, bacteria localize to the immunological synapse, an intimate DC/T cell contact structure that activates T cells. Strikingly, T cells efficiently eliminate the transinfecting bacteria within the first hours after infection. Transinfected T cells produced high levels of proinflammatory cytokines and were able to protect mice from bacterial challenge following adoptive transfer. Thus, T lymphocytes can capture and kill bacteria in a manner reminiscent of innate immunity.

Micro- and Macrointegration Profiles for Medical Devices and Medical IT Systems

Collecting, saving, and providing patient data are essential processes of documentation in a hospital. Many IT systems have evolved to provide solutions in this area. The automatic transfer of medical device data to these information systems is a new challenge for hospital IT systems. Some vendors are focused on the integration of medical IT systems and medical devices. They provide great solutions with magnificent features. Nevertheless, those integration solutions are proprietary and isolated, limiting the operator's selection of his medical devices and medical IT systems. Standardizing communication processes within the operating room and between medical devices and medical IT systems brings benefits for both patient and hospital staff. This work identifies and proposes micro- and macrointegration profiles as a basis for new IHE Integration Profiles for both medical IT systems and medical devices of the operating room.

Influence of random zone positioning errors on the resolving power of Fresnel zone plates

Fresnel zone plates produced by electron beam lithography and planar etching techniques provide a resolving power of about 10 nm. An alternative zone plate fabrication approach is based on alternately coating a micro-wire with two different materials. With this process, very thin zone layers with very high aspect ratios can be deposited. However, depending on the fabrication method, random zone positioning errors may introduce strong aberrations. We simulate the effect of positioning errors using different random fluctuations and study their influence on zone plate resolution. We find that random errors significantly decrease the contrast transfer of X-ray microscopes. Additionally, we derive an upper bound for the mean acceptable variance of the deposition rate.

An Explanation of the Ageing Mechanism of Li-Ion Batteries by Metallographic and Material Analysis

Li-ion batteries are a key technology for both electro-mobility and stationary energy storage systems. In order to be able to represent and improve their service life in these applications, a better understanding of the processes which lead to the degradation of the individual cells is essential. The work presented in this article focuses on the comparative post mortem analysis of type 18650 commercially available cells containing the state of the art active materials (Cathode: LiMn2O4 (LMO) and Li(Ni1/3Mn1/3Co1/3)O2 (NMC), Anode: Graphite). These cells were subjected to various different ageing procedures. Amongst other effects, the cells investigated revealed signs of crack formation in the LMO- and NMC-particles, a loss in the mechanical integrity of the cathode active mass and plastic deformation of cell structure together with pronounced delamination between the active mass layers, the separator and the current collector.