A field study on correlations between macroscopic gut health scoring, histological measurements and performance parameters in broilers.

Optimal intestinal health is a prerequisite for sustainable poultry production. Intestinal health can be evaluated by scoring macroscopic intestinal abnormalities and by histological measurements. The aim of this study was to evaluate correlations between macroscopic gut appearance scoring (GAS), coccidiosis lesion scoring, histological measurements and performance parameters in broilers under field conditions. Therefore, a cross-sectional study was performed on 50 broiler farms where birds were sampled at 28 days of age. The GAS was determined by scoring the absence or presence of 10 macroscopically visible parameters of the gastrointestinal tract, yielding a GAS between 0 and 10, with 0 meaning no gut abnormalities. On individual bird level, when birds had a GAS score of 6 or higher, significantly shorter villi were found in the duodenum. Also, CD3+ T-lymphocyte area percentage in the duodenal mucosa was significantly negatively correlated to villus length. On farm level, the average feed conversion ratio (FCR) was 1.59 ± 0.04 [1.52-1.73]. However, no correlations were found between the GAS at the age of 28 days and the prevalence of coccidiosis, nor did coccidiosis lesion scoring correlate with the FCR. Also, a higher GAS could not be associated with a higher FCR. In conclusion, on all farms a certain degree of macroscopic visible gut and coccidiosis lesions were present in birds of 28 days of age, while this did not correlate with the FCR. This suggests that broilers are able to cope with a certain level of gut damage before it influences the overall performance.

Privacy Protection through pseudonymisation in eHealth.

The ISO TC215 WG4 pseudonymisation task group has produced in 2008 a first version of a technical specification for the application of pseudonymisation in Healthcare Informatics 0. This paper investigates the principles set out in the technical specification as well as its implications in eHealth. The technical specification starts out with a conceptual model and evolves from a theoretical model to a real life model by adding assumptions on the observability of personal data.

Seasonal variation in plasma L-tryptophan availability in healthy volunteers. Relationships to violent suicide occurrence.

OBJECTIVE: To investigate the seasonal variation in levels of plasma L-tryptophan and competing amino acids (CAAs) in healthy humans in relation to climatic variables, total serum protein levels, and violent suicide occurrence. METHODS: Twenty-six healthy volunteers (13 men and 13 women; mean [+/- SD] age, 38.7 +/- 13.4 years) had monthly blood samplings for assays of L-tryptophan, valine, leucine, isoleucine, tyrosine, and phenylalanine during 1 calendar year. RESULTS: Significant annual rhythms were detected in L-tryptophan, the L-tryptophan/CAA ratio, phenylalanine, valine, and leucine, and semiannual rhythms in L-tryptophan values and in L-tryptophan/CAA ratios. Plasma L-tryptophan and the L-tryptophan/CAA ratio were significantly lower in the spring than in the other seasons. The peak-trough differences in the yearly variation expressed as a percentage of the mean were 17.1% and 16.1% for L-tryptophan values and L-tryptophan/CAA ratios, respectively. The amplitude of the yearly variation in all CAAs was low, ie, less than 7%. An important part of the variance in L-tryptophan availability (ie, 12% to 14%) could be explained by the composite effects of present and past climatic factors; higher ambient temperature and relative humidity in the face of lower air pressure are the most important predictors of low L-tryptophan availability. Important and positive time relationships were noted between total serum protein level and all amino acid concentrations, and a significant time relationship was also noted between the seasonal variation in L-tryptophan availability and the occurrence of violent suicide in Belgium. CONCLUSION: Our results show a bimodal seasonal pattern in the availability of plasma L-tryptophan that matches seasonal patterns in the prevalence of violent suicide in the local population and depression in other studies.

Seasonality in violent suicide but not in nonviolent suicide or homicide.

OBJECTIVE: Previous studies have reported seasonal or monthly variation in suicide. The present study was conducted in order to determine seasonality and other significant rhythms in violent and nonviolent suicide, alone and together, and homicide. METHOD: Data on suicide, violent suicide, nonviolent suicide, and homicide (categorized according to ICD-9) for all of Belgium for the period 1979-1987 were analyzed by means of spectral analyses. RESULTS: There was a significant seasonality for suicide but not homicide. Seasonality was present in violent but not in nonviolent suicide. The number of violent suicides increased with age and was more prominent in men. The violent suicide chronograms of younger and elderly persons were quite distinct in the occurrence of peaks in March-April and August, respectively, and lows in December-January. There was no significant relationship between violent suicide and homicide. CONCLUSIONS: Seasonality in suicide is determined by significant circannual rhythms in violent suicides, which differ between younger and elderly persons.

Privacy enhancing techniques - the key to secure communication and management of clinical and genomic data.

OBJECTIVES: To introduce some of the privacy protection problems related to genomics based medicine and to highlight the relevance of Trusted Third Parties (TTPs) and of Privacy Enhancing Techniques (PETs) in the restricted context of clinical research and statistics. METHODS: Practical approaches based on two different pseudonymisation models, both for batch and interactive data collection and exchange, are described and analysed. RESULTS AND CONCLUSIONS: The growing need of managing both clinical and genetic data raises important legal and ethical challenges. Protecting human rights in the realm of privacy, while optimising research potential and other statistical activities is a challenge that can easily be overcome with the assistance of a trust service provider offering advanced privacy enabling/enhancing solutions. As such, the use of pseudonymisation and other innovative Privacy Enhancing Techniques can unlock valuable data sources.

Determination of user requirements for the secure communication of electronic medical record information.

Health professionals need to have accurate patient data in order to make the right diagnosis and to give an optimal treatment. In many cases, the 'medical' record, whether in electronic form or paper form is distributed over several health care providers and health care enterprises. Technically, there are several ways to provide access to remote record information or parts thereof. Legislation however puts restrictions on the communication of personal information in order to protect the privacy of the patient. This paper gives an overview of requirements and constraints when communicating electronic medical record information and summarises the findings of the SEMRIC project in determining requirements from a number of practical cases.

The PRIDEH project: taking up privacy protection services in e-health.

PRIDEH (Privacy Enhancement in Data Management in e-Health) is a project that runs for two years and is partly funded by the European Commission. The focus of PRIDEH is on the stimulation of the take-up of privacy enhancing technologies within the health domain. Privacy enhancing technologies build upon available cryptographic and communication technologies. The concept of privacy enhancing services delivery through the use of intermediary trusted third parties has already been described in literature but rarely turned into practice. A number of limited PET (Privacy Enhancing Technologies) applications exist in closed domains. The very few existing solutions are not based on an independent TTP (Trusted Third Party) concept which renders their trustworthiness questionable. PRIDEH wants to enhance the take-up of PET delivery based on sound TTP principles in the domain of healthcare.

Electronic signature and certification models in health care.

Recently, Belgian legislation has enabled the practical use of electronic signatures. Several implementation options are still open and different models for deployment on a wide scale are possible. This document describes two models that can be applied to the healthcare domain and summarises the recommendations as issued by the Belgian Health Telematics Standards Committee

Spectral resolution of cardio-circulatory variations in men measured by autorhythmometry over 2 years.

An analogue of the periodogram method for unequally spaced data is presented with a view to resolving the frequency structure of the observations. The algorithm is explicitly based on the sequential least squares procedure. In particular, the key concept is that the within-plot spectral analysis can be augmented by the between-plot information to make inferences about common characteristics. It is also shown how the between-plot random variations can be incorporated into the multiple harmonic regression model. A detailed spectral analysis investigates the periodic fluctuations in four cardio-circulatory variables, measured by autorhythmometric observation by eight men at rest and extending over a time span of 2 years. The spectral curves show the existence of circadian and circaseptan rhythmicities. The amplitude modulation of the dian rhythm by circaseptan variation is assimilated with the rhythmicity of work during the week. The blood-pressure variables situate their maximum annual peak in the winter period. These quasi-periodic fluctuations appear to be related to the amount of physical activity performed in time by the subjects.

Rheological modelling of physiological variables during temperature variations at rest.

The evolution with time of cardio-respiratory variables, blood pressure and body temperature has been studied on six males, resting in semi-nude conditions during short (30 min) cold stress exposure (0 degree C) and during passive recovery (60 min) at 20 degrees C. Passive cold exposure does not induce a change in HR but increases VO2, VCO2, Ve and core temperature Tre, whereas peripheral temperature is significantly lowered. The kinetic evolution of the studied variables was investigated using a Kelvin-Voigt rheological model. The results suggest that the human body, and by extension the measured physiological variables of its functioning, does not react as a perfect viscoelastic system. Cold exposure induces a more rapid adaptation for heart rate, blood pressure and skin temperatures than that observed during the rewarming period (20 degrees C), whereas respiratory adjustments show an opposite evolution. During the cooling period of the experiment the adaptative mechanisms, taking effect to preserve core homeothermy and to obtain a higher oxygen supply, increase the energy loss of the body.

Seasonality in severity of depression: relationships to suicide and homicide occurrence.

Some previous studies have reported seasonal or monthly variations in the occurrence of depressive syndromes. The present study was carried out in order to investigate seasonality in severity of depression. Toward this end, the authors measured the Zung Self-Rating Depression (ZD) and Anxiety (ZA) Scales scores in 104 consecutively admitted depressed patients between November 1983 and April 1985. The data were analyzed by means of spectral analysis of a single time series. Up to 47.9% of the variance in the weekly average of the ZD scores could be explained by two significant rhythms of 51 (circannual) and 7 weeks. Peaks in ZD scores were observed in April-May, with lows occurring in August-September. Up to 30.8% of the variance in the weekly average of ZA scores was explained by a circannual rhythm. Our results show that there is a true seasonality in the severity of illness of depressed subjects. There were significant correlations between the weekly average in severity of illness and the chronograms of suicide (positively) and homicide (negatively) occurrence in Belgium.

Seasonal variation and meteotropism in various self-rated psychological and physiological features of a normal couple.

Recently, true seasonal variation with significant periodicities (circannual, semiannual, circatrimensual, circabimensual) and a significant meteotropism have been observed in a number of self-rated characteristics of normal man (arousal, mood, physiology and social behaviour). In order to replicate these findings, two normal controls (a married couple) were asked daily to complete a self-rating scale concerned with the characteristics mentioned above during one calendar year. By means of time series analysis, significant rhythmicities with recurrent cycles in the autorhythmometric data of all of the above characteristics were found. An important part of the variance in these characteristics was found, using multiple regression, to be related to various weather variables, such as mean atmospheric pressure, temperature, relative humidity, wind speed, minutes of sunlight/day and precipitation/day. These results support the hypothesis that temporal variations in human psychological and physiological characteristics may be dictated by the composite effects of past and present atmospheric activity.

Synchronized annual rhythms in violent suicide rate, ambient temperature and the light-dark span.

To investigate whether violent and nonviolent suicide and homicide are related to atmospheric or geomagnetic activity, we investigated the relationships between weekly number of suicides or homicides for all Belgium for the period 1979-1987, and ambient temperature, relative humidity, air pressure, hours of sunlight and precipitation per day, wind speed and geomagnetic index. The occurrence of violent suicide was significantly and positively related to ambient temperature, sunlight duration, an increase in temperature over the few past weeks, and negatively to relative humidity. Higher ambient temperature and an increase in air temperature over the few past weeks were the most significant climatic predictors of violent suicide rate. A highly significant common annual rhythm with a common acrophase of 190 degrees was detected in violent suicide rate, ambient temperature and sunlight duration. No significant time-relationships between nonviolent suicide or homicide and any of the weather variables were found. It is concluded that i) violent suicide may be related to short-term fluctuations in the weather and in particular to temperature; and ii) the annual rhythm in violent suicide may be synchronized by the annual rhythms in ambient temperature and light-dark span.

The periodicities in and biometeorological relationships with bed occupancy of an acute psychiatric ward in Antwerp, Belgium.

Recently, some investigators have established a seasonal pattern in normal human psychology, physiology and behaviour, and in the incidence of psychiatric psychopathology. In an attempt to elucidate the chronopsy and meteotropism in the latter, we have examined the chronograms of, and the biometeorological relationships to bed occupancy of the psychiatric ward of the Antwerp University Hospital during three consecutive calendar years (1987-1989). Weather data for the vicinity were provided by a local meteorological station and comprise mean atmospheric pressure, air temperature, relative humidity, wind speed and minutes of sunlight and precipitation/day. The number of psychiatric beds occupied during the study period exhibited a significant seasonal variation. Peaks in bed occupancy were observed in March and November, with lows in August. An important part of the variability in the number of beds occupied could be explained by the composite effects of weather variables of the preceding weeks. Our results suggest that short-term fluctuations in atmospheric activity may dictate some of the periodicities in psychiatric psychopathology.

Components of biological variation, including seasonality, in blood concentrations of TSH, TT3, FT4, PRL, cortisol and testosterone in healthy volunteers.

OBJECTIVE: There are few detailed studies of annual or seasonal variations in hormone concentrations in man. This study examines the components of biological variation, including seasonality, in plasma TSH, total T3 (TT3), free T4 (FT4), PRL, cortisol and testosterone in healthy volunteers. DESIGN: Monthly blood samplings for the assay of the above hormones were collected during one calendar year. SUBJECTS: Thirteen normal men and 13 normal women participated in the present study (mean age 38.7 +/- 13.4 years). MEASUREMENTS: Assays of TSH, TT3 and FT4 were carried out by means of immunoradiometric assays (IRMA), PRL by ELISA, cortisol by a fluorescence immunoassay, and testosterone with RIA. The time series were analysed by means of (bivariate or multivariate) spectral and cosinor analyses. RESULTS: Significant annual, four-monthly and biannual rhythms were detected in serum TSH; the lowest TSH values were observed in spring. A significant annual rhythm was detected in TT3, with lower values in spring and summer than in the other seasons. The peak-trough differences in the yearly variation expressed as a percentage of the mean were 29.1% and 8.2% for TSH and TT3, respectively. The yearly variation in plasma cortisol was significantly different between men and women: in men, 5.9% of the variation was explained by an annual rhythm, while in women 14.7% was explained by the fourth and seventh harmonical wave. The peak-trough differences in the yearly variation in plasma cortisol were 17.6% and 31.8% in men and women, respectively. There were no significant seasonal rhythms in PRL, FT4 or testosterone. The intraindividual/interindividual CV values were: TSH 29.3/48.4%, TT3 9.4/ 18.5%, FT4 7.1/9.1%, PRL 39.2/65.0%, cortisol 21.7/ 46.2%, and testosterone 12.6/40.8%. CONCLUSIONS: The degree of individuality measured in the plasma hormones is such that conventional population-based reference ranges may not correctly identify major alterations in these hormones in individual subjects.

Components of biological, including seasonal, variation in hematological measurements and plasma fibrinogen concentrations in normal humans.

This study has been carried out in order to examine the components of biological and, in particular, seasonal variation in hematologic measurements in normal humans. Toward this end, 26 normal volunteers had monthly blood samplings during one calendar year for determination of number of red blood cells (RBC) and platelets, hemoglobin (Hb), hematocrit (Ht), mean corpuscular volume (MCV), MC Hb (MCH), MC Hb concentration (MCHC), RBC distribution width (RDW), mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), and plasma fibrinogen concentrations. The data were analyzed by means of spectral analyses of a group of time series or a single time series, and by means of repeated measures analyses of variance. Most of the hematologic variables show seasonal rhythms, such as annual rhythms or harmonics, which are expressed as a group phenomenon. An important part of the variance ( > 15%) in Ht, MCV, MCH, MCHC, RDW, number of platelets, MPV and plasma fibrinogen was explained by a yearly variation. The peak-trough differences (expressed as a percentage of the mean) in the yearly variations in number of RBC, Ht, MCV, MCH, MCHC and RDW were very low (all < 8.5%). Number of platelets (14.4%) and plasma fibrinogen values (28%) showed a high-amplitude yearly variation. All hematological variables, except MCHC, show a high interindividual variability which exceeds by far the intraindividual variability.

Seasonal variation in peripheral blood leukocyte subsets and in serum interleukin-6, and soluble interleukin-2 and -6 receptor concentrations in normal volunteers.

This study has been carried out in order to investigate seasonal variation in peripheral blood immune cells, such as leukocytes, monocytes, neutrophils, lymphocytes, CD3+ T, CD4+ T, CD8+ T, CD25+ T, CD20+ B, and serum interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R) and sIL-2R levels in normal volunteers. Toward this end, 26 normal volunteers (13 men, 13 women) had monthly blood samplings during one calendar year for peripheral blood count, flow cytometric enumeration of peripheral leukocyte subsets and immunoassays of IL-6, sIL-6R and sIL-2R. It was found that most of the immune variables change rhythmically during the seasons as a group phenomenon. Statistically significant yearly variations with seasonal rhythms, i.e. annual rhythms or harmonics, such as semiannual, tetramensual and trimensual rhythms, were found in the number of leukocytes, neutrophils, monocytes, lymphocytes, CD4+ T, CD8+ T, CD25+ T, CD20+ B cells, in the CD4+/CD8+ ratio, and serum IL-6 and sIL-6R levels. It is concluded that the immune system is characterized by a multifrequency time-structure with significant high-amplitude yearly variations in the number of some peripheral blood leukocyte subsets.

Components of biological variation in prolyl endopeptidase and dipeptidyl-peptidase IV activity in plasma of healthy subjects.

We investigated the components of biological variation in plasma prolyl endopeptidase (PEP; EC 3.4.21.26) and dipeptidyl-peptidase IV (DPP IV; EC 3.4..14.5) activity in healthy individuals. We took monthly blood samples from 26 healthy volunteers for determination of plasma PEP and DPP IV activity during one calendar year. The estimated CVs for PEP activity were: total (CVt) = 25.0%, interindividual (CVg) = 13.9%, and intraindividual (CVi) = 16.8%. There was a statistically significant (P < 0.0001) seasonal pattern in plasma PEP activity, with significantly higher values in the fall than in the other seasons. The peak-trough difference in the yearly variation in PEP activity, expressed as a percentage of the mean, was as high as 56.8%. The estimated CVs for DPP IV activity were: CVt = 17.1%, CVg = 14.5%, and CVi = 8.2%. DPP IV activity was significantly (P < 0.0001) higher in summer than in the other seasons but the amplitude of the yearly variation was small.