Validation of DNA methylation biomarkers for diagnosis of acute lymphoblastic leukemia

DNA methylation biomarkers capable of diagnosis and subtyping have been found for many cancers. Fifteen such markers have previously been identified for pediatric acute lymphoblastic leukemia (ALL). Validation of these markers is necessary to assess their clinical utility for molecular diagnostics. Substantial efficiencies could be achieved with these DNA methylation markers for disease tracking with potential to replace patient-specific genetic testing.

Are vitamins A and D important in the development of food allergy and how are they best measured?

Food allergy has a dramatic impact on a child's (and their family's) quality of life and places a major financial burden on the community. It has been hypothesized that the increase in food allergy may relate to the concordant rise in prevalence of vitamin D insufficiency. More recently a second hypothesis has implicated vitamin A sufficiency in the development of immune tolerance. Together, these hypotheses have prompted investigation into the circulating levels of vitamins A and D in relation to food allergy prevalence. This review aims to examine the relationship between vitamins A and D and food allergy. The first part of this review presents the available epidemiological data which proposes a dramatic increase of food allergy and related anaphylaxis during the last two decades. There is some indirect evidence that variation in food allergy prevalence within countries might be linked with ambient ultra violet radiation exposure and thus potentially with vitamin D levels. Only a few studies to date have directly examined the relationship between measured serum vitamin D levels and either food sensitization or allergy. The significance of vitamin A in food allergy prevalence is only provided through a hypothetical association due to its role in the immune system. The second part of this review discusses the relevant aspects of the analytical methods to assess vitamin A and D levels in children. The primary methods utilized relate to measuring the main circulating forms of vitamins A and D in blood i.e. retinol and 25-hydroxy-vitamin-D3 respectively. Chromatographic separation coupled with mass spectrometric detection is considered the gold standard method for both vitamins. These analytical methods should be fully validated for the use in pediatric populations to ensure they are fit for their clinical purpose.

Fuzzy system with tabu search learning for classification of motor imagery data

This paper introduces an approach to classify EEG signals using wavelet transform and a fuzzy standard additive model (FSAM) with tabu search learning mechanism. Wavelet coefficients are ranked based on statistics of the Wilcoxon test. The most informative coefficients are assembled to form a feature set that serves as inputs to the tabu-FSAM. Two benchmark datasets, named Ia and Ib, downloaded from the brain-computer interface (BCI) competition II are employed for the experiments. Classification performance is evaluated using accuracy, mutual information, Gini coefficient and F-measure. Widely-used classifiers, including feedforward neural network, support vector machine, k-nearest neighbours, ensemble learning Adaboost and adaptive neuro-fuzzy inference system, are also implemented for comparisons. The proposed tabu-FSAM method considerably dominates the competitive classifiers, and outperforms the best performance on the Ia and Ib datasets reported in the BCI competition II.

Vitamins D and A can be successfully measured by LC-MS/MS in cord blood diluted plasma

OBJECTIVES: In widely used protocols for the collection and isolation of cord blood mononuclear cells, investigators are left with substantial volumes of diluted plasma which could be used for other measurements. The aim of this study was to ascertain the validity of umbilical cord blood (UCB) diluted plasma samples for vitamin D, A and E analysis compared to UCB serum samples. DESIGN & METHODS: Twenty UCB matched samples of diluted plasma and serum were collected. The samples were analysed by two liquid chromatography-tandem mass spectrometry (LC-MS/MS) methods on two separate occasions. RESULTS: The results of 25(OH)D3 obtained by the two laboratories demonstrated close agreement with a mean difference of 0.14nmol/L [95% confidence interval (95% CI), -6.8 to 7.1]. Both methods demonstrate close agreement for 25(OH)D3 in UCB serum versus diluted UCB plasma; mean difference 2.2nmol/L [95% CI, -9.5 to 13.9] and 4.1nmol/L [95% CI, -14.5 to 6.1] for the results from Lab A and Lab B, respectively. Vitamin A was quantified by Lab A in UCB serum and diluted UCB plasma; mean difference 0.07μmol/L [95% CI, -0.41 to 0.28]. Results of 25(OH)D3 epimer and vitamin E in the diluted UCB plasma were below the limit of quantification, and could not be compared with UCB serum. CONCLUSIONS: Diluted UCB plasma can be used for the quantification of retinol and 25(OH)D3 by LC-MS/MS. By contrast, quantification of 25(OH)D3 epimer and vitamin E in diluted UCB plasma is not supported by this study due to limitations in analytical sensitivity.

Analysis of fetal heart rate asymmetry before and after 35 weeks of gestation

In this study, we have investigated the evidence of fetal heart rate asymmetry and how the fetal heart rate asymmetry changes before and after 35 weeks of gestation. Noninvasive fetal electrocardiogram (fECG) signals from 45 pregnant women at the gestational age from16 to 41 weeks with normal single pregnancies were analysed. A nonlinear parameter called heart rate asymmetry (HRA) index that measures time asymmetry of RR interval time-series signal was used to understand the changes of HRA in early and late fetus groups. Results indicate that fetal HRA measured by Porta's Index (PI) consistently increases after 35 weeks gestation compared to foetus before 32 weeks of gestation. It might be due to significant changes of sympatho-vagal balance towards delivery with more sympathetic surge. On the other hand, Guzik's Index (GI) showed a mixed effect i.e., increases at lower lags and decreases at higher lags. Finally, fHRA could potentially help identify normal and the pathological autonomic nervous system development.

A summative scoring system for evaluation of human kinematic performance

Evaluation of human kinematic performance is essential in rehabilitation and skill assessment. These services are in high demand where the improvements made due to exercises need to be regularly assessed. In some relevant industries there is a need to evaluate their employee capabilities quantitatively for accident compensation and insurance purposes. In particular, these assessments are preferred to be based on more quantifiable measures in a standardized form ensuring accuracy, reliability, ease of use and anywhere anytime information to the clinician. Therefore, it is necessary to have an efficient mechanism for evaluation and assessment of human kinematic movements as the current motion matching and recognition algorithms fall short due to characteristically strict specifications required in numerous health care applications. In this paper, we propose a summative approach using a double integral to define a closeness between two trajectories typically generated by human movement. This approach can be considered as a spatial scoring mechanism in the evaluation of human kinematic performance as well as in movement recognition applications. Several experiments based on computer simulations as well as real data were set up to examine the performance of the proposed approach as a scoring mechanism for the evaluation of human kinematic performances. The results demonstrated better characterization of the movement assessment and motion recognition ability, with a recognition rate of 86.19%, than the currently used methods such as Gaussian mixture models and pose normalization employed in motion recognition tasks. Finally, we use the scoring mechanism to analyze the proximity in human kinematic performance.

Cane toad or computer mouse? Real and computer-simulated laboratory exercises in physiology classes

Traditional practical classes in many countries are being rationalised to reduce costs. The challenge for university educators is to provide students with the opportunity to reinforce theoretical concepts by running something other than a traditional practical program. One alternative is to replace wet labs with comparable computer simulations. These virtual experiments involve no harm to animals and require little ongoing expenditure. This study documents second-year physiology students' perceptions of and attitudes to simulations by incorporating several computer simulations into the practical program. Computer simulations met the conceptual and, to some extent, the motivational goals of university practical programs. While students enjoyed both wet labs and computer-simulated exercises, overwhelmingly the wet lab provided the more memorable and stimulating learning experience. Based on this study, students suggested that computer simulations could be effectively used to complement rather than replace practical classes where students gain laboratory skills.

Comonitoring of adenosine and dopamine using the wireless instantaneous neurotransmitter concentration system : proof of principle : laboratory investigation

Object

The authors of previous studies have demonstrated that local adenosine efflux may contribute to the therapeutic mechanism of action of thalamic deep brain stimulation (DBS) for essential tremor. Real-time monitoring of the neurochemical output of DBS-targeted regions may thus advance functional neurosurgical procedures by identifying candidate neurotransmitters and neuromodulators involved in the physiological effects of DBS. This would in turn permit the development of a method of chemically guided placement of DBS electrodes in vivo. Designed in compliance with FDA-recognized standards for medical electrical device safety, the authors report on the utility of the Wireless Instantaneous Neurotransmitter Concentration System (WINCS) for real-time comonitoring of electrical stimulation–evoked adenosine and dopamine efflux in vivo, utilizing fast-scan cyclic voltammetry (FSCV) at a polyacrylonitrile-based (T-650) carbon fiber microelectrode (CFM).
Methods

The WINCS was used for FSCV, which consisted of a triangle wave scanned between −0.4 and +1.5 V at a rate of 400 V/second and applied at 10 Hz. All voltages applied to the CFM were with respect to an Ag/AgCl reference electrode. The CFM was constructed by aspirating a single T-650 carbon fiber (r = 2.5 μm) into a glass capillary and pulling to a microscopic tip using a pipette puller. The exposed carbon fiber (the sensing region) extended beyond the glass insulation by ~ 50 μm. Proof of principle tests included in vitro measurements of adenosine and dopamine, as well as in vivo measurements in urethane-anesthetized rats by monitoring adenosine and dopamine efflux in the dorsomedial caudate putamen evoked by high-frequency electrical stimulation of the ventral tegmental area and substantia nigra.
Results

The WINCS provided reliable, high-fidelity measurements of adenosine efflux. Peak oxidative currents appeared at +1.5 V and at +1.0 V for adenosine, separate from the peak oxidative current at +0.6 V for dopamine. The WINCS detected subsecond adenosine and dopamine efflux in the caudate putamen at an implanted CFM during high-frequency stimulation of the ventral tegmental area and substantia nigra. Both in vitro and in vivo testing demonstrated that WINCS can detect adenosine in the presence of other easily oxidizable neurochemicals such as dopamine comparable to the detection abilities of a conventional hardwired electrochemical system for FSCV.
Conclusions

Altogether, these results demonstrate that WINCS is well suited for wireless monitoring of high-frequency stimulation-evoked changes in brain extracellular concentrations of adenosine. Clinical applications of selective adenosine measurements may prove important to the future development of DBS technology.

Clinical practice guidelines for nurse-administered procedural sedation and analgesia in the cardiac catheterization laboratory: a modified Delphi study

Aim : To develop clinical practice guidelines for nurse-administered procedural sedation and analgesia in the cardiac catheterization laboratory.

Background : Numerous studies have reported that nurse-administered procedural sedation and analgesia is safe. However, the broad scope of existing guidelines for the administration and monitoring of patients who receive sedation during medical procedures without an anaesthetist present means there is a lack of specific guidance regarding optimal nursing practices for the unique circumstances where nurse-administered procedural sedation and analgesia is used in the cardiac catheterization laboratory.

Methods : A sequential mixed methods design was used. Initial recommendations were produced from three studies conducted by the authors: an integrative review; a qualitative study; and a cross-sectional survey. The recommendations were revised according to responses from a modified Delphi study. The first Delphi round was completed by nine senior cardiac catheterization laboratory nurses. All but one of the draft recommendations met the predetermined cut-off point for inclusion with 59 responses to the second round. Consensus was reached on all recommendations.

Implications for nursing : The guidelines that were derived from the Delphi study offer 24 recommendations within six domains of nursing practice: Pre-procedural assessment; Pre-procedural patient and family education; Pre-procedural patient comfort; Intra-procedural patient comfort; Intra-procedural patient assessment and monitoring; and Postprocedural patient assessment and monitoring.

Conclusion : These guidelines provide an important foundation towards the delivery of safe, consistent and evidence-based nursing care for the many patients who receive sedation in the cardiac catheterization laboratory setting.

Distance learning for laboratory practical work in microcontrollers

This paper presents a simple and relatively straightforward solution to the problems of equity in laboratory practical exposure between distance-education students and their traditional, on-campus, fellow cohort. This system has been implemented for the past five years in a university that is amongst the leaders in distance education delivery and has proved to be extremely successful and very well accepted by all students. While the intention was to allow distance education students easy access to the required laboratory practical content of the course, the solution found has proved to have many advantages for the on-campus students. Although this specific implementation is based upon microcontroller technology units in an engineering degree course, the methodology is easily transferable to other disciplines and courses.

A case for a mobile architecture and built environment laboratory

Deakin University and other research and industry partners have recently won a grant for the establishment of a Mobile Architecture and Built Environment Laboratory (MABEL). MABEL provides the first means of integrated, on-site measurement of the key aspects of the built environment (power, sound, light and comfort) using the latest instrument technology. There exists an ongoing need to establish a versatile and comprehensive in-situ testing facility for built internal environments, for the provision of research, education, training and technology diffusion. The ability to make on-site measurements across the environmental spectrum is unique and important. Individual measurements might demonstrate improved lighting performance, reduced power consumption, and improved ventilation or better building acoustics. More importantly, an integrated perspective will address an interaction in terms of energy efficiency and overall occupant comfort. H is recognised that many of the parameters we can measure with existing instrumentation remain unresolved regarding their diagnostic significance on occupant health, comfort and productivity. Also, developed standards for in-situ measurement are at an emerging state, in the delivery of reliable and useful assessment methods. This paper discusses the inception and role of the MABEL facility for building research, learning and teaching.

The need for best practice standards in electronic governance of patient medical records to facilitate innovation

Background : Optimising the use of electronic data offers many opportunities to health services, particularly in rural and remote areas. These include reducing the effect of distance on access to clinical information and sharing information where there are multiple service providers for a single patient. The increasing compilation of large electronic databases of patient information and the ease with which electronic information can be transferred has raised concerns about the privacy and confidentiality of such records.
Aims & rationale/Objectives : This review aims to identify legal and ethical standards for areas of electronic governance where a lack of clarity may currently impede innovation in health service delivery.
Methods : This paper describes best practices for storage and transfer of electronic patient data based on an examination of Australian legislative requirements and a review of a number of current models. This will firstly allow us to identify basic legal requirements of electronic governance as well as areas of ambiguity not fully addressed by legislation. An examination of current models will suggest recommendations for best practice in areas lacking sufficient legal guidance.
Principal findings : We have identified the following four areas of importance, and shall discuss relevant details:
1) Patients' right of ownership to electronic patient records. 2) Custodial issues with data stored in centralised health care institutions 3) IT Security, including hierarchical level access, data encryption, data transfer standards and physical security 4) Software applications usage.
Discussion : Our examination of several models of best practice for the transfer of electronic patient data, both in Australia and internationally, identifies and clarifies many unresolved issues of electronic governance. This paper will also inform future policy in this area.
Implications : Clarification will facilitate the future development of beneficial technology-based innovations by rural health services.
Presentation type : Poster

NewsLink Indiana : a learning laboratory for the news industry

The broadcast news industry has many questions about convergence and how best to operate in a world of rapidly changing digital technology. Some of the key issues the industry ponders are how to innovate in a climate of increased competition, how best to structure a converged media operation and how to produce quality journalism yet keep costs under control. This paper tracks the introduction of a "learning laboratory" at Ball State University in Indiana designed to answer these and other questions. The paper outlines the theories and concepts behind the development of a converged newsroom staffed by professionals and students in an immersion education program. It uses qualitative methods initially because these are most appropriate for the project at this stage of its development.