A Decision Support System for Pathology Test Result Reviews in an Emergency Department to Support Patient Safety and Increase Efficiency.

The review of pathology test results for missed diagnoses in Emergency Departments is time-consuming, laborious, and can be inaccurate. An automated solution, with text mining and clinical terminology semantic capabilities, was developed to provide clinical decision support. The system focused on the review of microbiology test results that contained information on culture strains and their antibiotic sensitivities, both of which can have a significant impact on ongoing patient safety and clinical care. The system was highly effective at identifying abnormal test results, reducing the number of test results for review by 92%. Furthermore, the system reconciled antibiotic sensitivities with documented antibiotic prescriptions in discharge summaries to identify patient follow-ups with a 91% F-measure - allowing for the accurate prioritization of cases for review. The system dramatically increases accuracy, efficiency, and supports patient safety by ensuring important diagnoses are recognized and correct antibiotics are prescribed.

Divalent cation distribution in dinoflagellate chromosomes imaged by high-resolution ion probe mass spectrometry.

From a variety of analytical electron microscopy experiments, the chromosomes of dinoflagellates are known to contain sizeable amounts of cations, the latter thought to contribute to the neutralization of the negative charge carried by the phosphate groups in the DNA backbone. From previous Ca and Mg chelation experiments, it is also known that these cations are necessary for the compaction and preservation of the chromosome architecture. Similar conclusions have been recently presented by our group concerning mammalian mitotic chromosomes, in studies based on secondary ion mass spectrometry (SIMS) carried out with the University of Chicago high-resolution scanning ion microprobe (UC-SIM). We have now applied this instrument to image the distribution of DNA-bound Ca(2+) and Mg(2+) in dinoflagellate chromosomes, a goal that could not be attained earlier by analytical electron microscopy. Analyzed quantitatively and imaged here by SIMS for the first time, through their cation content, are the chromosomes of the dinoflagellates Prorocentrum micans, Gymnodinium mikimotoi and Gymnodinium dorsum. The cell nuclei were isolated and prepared for SIMS analysis with a minimal protocol (mechanical fractionation in culture medium followed by ethanol drying), which did not expose the samples to artifact-creating, alien chemical agents. By this approach, we have confirmed the earlier findings by several authors, and contributed new structural information provided by our ion probe capability to erode the sample surface layer by layer (SIMS tomography). Dinoflagellates, due to the absence of histones, represent an ideal model system where cations may bind directly with DNA, allowing comparisons to be made with recently reported X-ray crystallography results at atomic resolution. Such comparisons yielded quantitative confirmation that the Ca(2+)+Mg(2+) concentrations found for e.g. P. micans are consistent with those anticipated to provide complete charge neutralization of naked DNA by cations, also resulting in maximal DNA compaction.

Autobiographical memory of adolescence and early adulthood events: an investigation in schizophrenia.

The reminiscence bump corresponds to a marked increase in autobiographical memories of events that occurred when normal people were aged 10 to 30 years, a critical period for the formation of identity. The reminiscence bump was studied in 27 patients diagnosed with schizophrenia and 27 control participants. They were asked to recall 20 specific autobiographical events that had occurred during their lifetime and to indicate the subjective states of awareness associated with the recalled memories using the Remember/Know procedure. Finally, participants were asked to state whether recalled memories related to private or public events. Patients diagnosed with schizophrenia recalled less specific memories than controls and exhibited an earlier reminiscence bump. They recalled more public, and less private events than controls, and they gave fewer Remember responses. The reminiscence bump peaked in the 16 to 25-year period for patients and the 21 to 25-year period for controls. These findings indicate that patients diagnosed with schizophrenia exhibit an early and abnormal reminiscence bump, with an impairment of conscious recollection associated with memories highly relevant to personal identity. They suggest that schizophrenia is associated with an impairment of autobiographical memories of events that had occurred during the last stage of personal identity development.

The effect of non-insulin dependent diabetes mellitus on uncontrolled hemorrhage in a rodent model.

OBJECTIVE: Diabetes mellitus (DM) is an independent risk factor for higher morbidity and mortality rates from trauma. We tested the null hypothesis that there would be no difference in the hemorrhage volumes and hemodynamic responses to uncontrolled hemorrhage between Zucker Diabetic Fat rats (ZDF) and euglycemic Sprague-Dawley rats (SD). METHODS: Twenty-four adult male rats (12 ZDF and 12 SD) were anesthetized with althesin via the intraperitoneal route. The femoral artery was cannulated by cut-down to monitor the heart rate (HR), mean arterial pressure (MAP) and to obtain blood samples for blood gas analysis. Twelve rats (6 ZDF and 6 SD) underwent uncontrolled hemorrhage by 50% tail amputation. Twelve rats (6 ZDF and 6 SD) served as non-hemorrhage controls. The HR, MAP, lactate (LAC), glucose levels (GL) and cumulative hemorrhage volume (CHV) were measured pre-hemorrhage and then every 15 min post-hemorrhage for 120 min. Data were reported as mean+/-S.E.M. Group comparisons were analyzed by ANOVA with repeated values; post hoc testing by Bonferroni (all tests were two-tailed, alpha = 0.05). RESULTS: Pre-hemorrhage the SD and ZDF were evenly matched for LAC, HR and MAP. CHV (cm3/100 g) was significantly (p = 0.008) greater in the ZDF (1.49+/-0.12) as compared to the SD (0.38+/-0.11). The ZDF had significantly (p < 0.001) higher LAC (7.96+/-0.61 mmol/L) than the SD (2.0+/-0.41 mmol/L). CONCLUSION: DM as compared to non-DM rats suffered a greater blood loss with a more severe lactic acidosis after a comparable uncontrolled vascular injury.

Those amazing dinoflagellate chromosomes.

Dinoflagellates are a very large and diverse group of eukaryotic algae that play a major role in aquatic food webs of both fresh water and marine habitats. Moreover, the toxic members of this group pose a health threat in the form of red tides. Finally, dinoflagellates are of great evolutionary importance, because of their taxonomic position, and their unusual chromosome structure and composition. While the cytoplasm of dinoflagellates is typically eukaryotic, the nucleus is unique when compared to the nucleus of other eukaryotes. More specifically, while the chromosomes of all other eukaryotes contain histones, dinoflagellate chromosomes lack histones completely. There are no known exceptions to this observation: all dinoflagellates lack histones, and all other eukaryotes contain histones. Nevertheless, dinoflagellates remain a relatively unstudied group of eukaryotes.

CHARACTERIZATION OF GYMNODINIUM MIKIMOTOI (DINOPHYCEAE) NUCLEI AND IDENTIFICATION OF THE MAJOR HISTONE-LIKE PROTEIN, HGm.

A simple and rapid method for isolation of nuclei from Gymnodinium mikimotoi Miyake et Kominami ex Oda is described along with chemical characterization of the nuclei. The isolated nuclei were completely free of whole cells, 99.96% free of cytoplasmic contamination, and were collected with a yield of 40% from harvested whole cells. Each nucleus contained 47 pg of DNA and the ratio of DNA to acid-soluble proteins to acid-insoluble proteins was 1:0.25:1.21, respectively. SDS electrophoresis of acid-extracted proteins showed one histone-like protein, which we termed HGm, with an apparent molecular mass of 12 kDa. V8 protease digestion analysis of HGm, the histone-like protein from Crypthecodinium cohnii (HCc), and two histone-like proteins from Gymnodinium dorsum, showed that the HGm digestion pattern was more similar to that of HCc than to that of either of the G. dorsum histone-like proteins.