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Intelligent medical information filtering.

This paper describes an intelligent information filtering system to assist users to be notified of updates to new and relevant medical information. Among the major problems users face is the large volume of medical information that is generated each day, and the need to filter and retrieve relevant information. The Internet has dramatically increased the amount of electronically accessible medical information and reduced the cost and time needed to publish. The opportunity of the Internet for the medical profession and consumers is to have more information to make decisions and this could potentially lead to better medical decisions and outcomes. However, without the assistance from professional medical librarians, retrieving new and relevant information from databases and the Internet remains a challenge. Many physicians do not have access to the services of a medical librarian. Most physicians indicate on surveys that they do not prefer to retrieve the literature themselves, or visit libraries because of the lack of recent materials, poor organisation and indexing of materials, lack of appropriate and available material, and lack of time. The information filtering system described in this paper records the online web browsing behaviour of each user and creates a user profile of the index terms found on the web pages visited by the user. A relevance-ranking algorithm then matches the user profiles to the index terms of new health care web pages that are added each day. The system creates customised summaries of new information for each user. A user can then connect to the web site to read the new information. Relevance feedback buttons on each page ask the user to rate the usefulness of the page to their immediate information needs. Errors in relevance ranking are reduced in this system by having both the user profile and medical information represented in the same representation language using a controlled vocabulary. This system also updates the user profiles, automatically relieving this burden from the user, but also allowing the user to explicitly state preferences. An initial evaluation of this system was done with health consumers using a web site on consumer health. It was found that users often modified their criteria for what they considered relevant not only between browsing sessions but also during a session. A user's criteria for what is relevant is constantly changing as they interact with the information. New revised metrics of recall and precision are needed to account for the partially relevant judgements and the dynamically changing criteria of users. Future research, development, and evaluation of interactive information retrieval systems will need to take into account the users' dynamically changing criteria of relevance.

Artificial Intelligence↗

Injury prevention during physical activity in the Australian Defence Force.

INTRODUCTION: Injuries sustained by Australian Defence Force (ADF) personnel during non-combat military training and sports activity are associated with increasing costs due to work days lost, medical treatment, compensation, and early retirement. In 2001, the ADF commissioned a systematic review of the evidence-base for reducing injuries associated with physical activity, while at the same time improving physical activity participation rates to sustain a trained, fit and deployable workforce. METHOD: Literature from on-line library databases, relevant unclassified military reports, and material from previously published sport-specific injury countermeasure reviews were systematically and critically analysed to address the study aims. RESULTS: Modification of intensity, frequency and duration of basic military training activities and improved equipment is likely to reduce injury occurrence. Sports injury countermeasures used for the civilian population have merit for the ADF physical activity program. Injury countermeasures should be designed to minimise any possible deterrent effect on the motivation to participate in regular physical activity. Increasing the participation of ADF personnel in physical activity in the presence of evidence-based injury prevention strategies has the potential to increase health, fitness and deployability with minimal impact on injury frequency. CONCLUSION: Recommendations arising from the review include injury intervention trials in basic military training and sports. These and other interventions should be supported by refinement to ADF injury surveillance systems. Research should focus on interventions with the greatest gain for fitness, deployability, and cost effectiveness.

Athletic Injuries↗

[Microdissection of chromosomes in veterinary medicine].

Microdissection of chromosomes and subsequent amplification of the DNA material by PCR allow the development of libraries, region-specific DNA probes or chromosome painting probes. Veterinary medicine will benefit from this method in instances where clarification of numercal or structural chromosome aberrations is needed.

Animals↗

An inventory of 1152 expressed sequence tags obtained by partial sequencing of cDNAs from Arabidopsis thaliana.

As part of the goal to generate a detailed transcript map for Arabidopsis thaliana, 1152 single run sequences (expressed sequence tags or ESTs) have been determined from cDNA clones taken at random in libraries prepared from different sources of plant material: developing siliques, etiolated seedlings, flower buds, and cultured cells. Eight hundred and ninety-five different genes could be identified, 32% of which showed significant similarity to existing sequences in Arabidopsis and an array of other organisms. These sequences in combination with their positioning on the Arabidopsis genetic map will not only constitute a new set of molecular markers for genome analysis in Arabidopsis but also provide a direct route for the in vivo analysis of their gene products. The sequences have been made available to the public databases.

Animals↗

Association between packed red blood cell transfusion and clinical deterioration in neonatal necrotizing enterocolitis: a systematic review and meta-analysis.

BACKGROUND: No systematic review has evaluated the existing evidence regarding the association between packed red blood cell (pRBC) transfusion and clinical worsening of necrotizing enterocolitis (NEC) in neonates. This systematic review and meta-analysis was conducted to address this knowledge gap. MATERIALS AND METHODS: We searched the Cochrane Library, EBSCO, Embase, Web of Science, Google Scholar, and PubMed for studies on pRBC transfusion and NEC published before May 10, 2025. Relevant articles were selected through title, abstract, and full-text screening. English-language case-control studies or cohort studies, or randomized controlled trials involving newborns with NEC that compared pRBC transfusion with no transfusion and reported changes in NEC clinical status were included. Review articles, systematic reviews, case reports, editorials, animal studies, duplicate publications, and studies with incomplete data were excluded. RESULTS: Five studies involving 971 neonates with NEC were included. The pooled analysis demonstrated a potential association between pRBC transfusion and clinical deterioration of NEC in neonates (odds ratio: 6.05, 95% confidence interval: 3.02-12.14). CONCLUSIONS: pRBC transfusion was associated with an exacerbation of NEC in neonates. However, these findings should be interpreted cautiously because of the small number of eligible studies included in this meta-analysis, and future large-scale, well-designed studies are needed to confirm the observed association.

Humans↗

DNA sequencing by primer walking with strings of contiguous hexamers.

When template DNA is saturated with a single-stranded DNA binding protein (SSB), strings of three or four contiguous hexanucleotides (hexamers) can cooperate through base-stacking interactions to prime DNA synthesis specifically from the 3' end of the string. Under the same conditions, priming by individual hexamers is suppressed. Strings of three of four hexamers representing more than 200 of the 4096 possible hexamers primed easily readable sequence ladders at more than 75 different sites in single-stranded or denatured double-stranded templates 6.4 kilobases to 40 kilobase pairs long, with a success rate of 60 to 90 percent. A synthesis of 1 micromole of hexamer supplies enough material for thousands of primings, so multiple libraries of all 4096 hexamers could be distributed at a reasonable cost. Such libraries would allow rapid and economical sequencing. Automating this strategy could increase the speed and efficiency of large-scale DNA sequencing by at least an order of magnitude.

Base Sequence↗

Purification of macroschizonts of a Sudanese isolate of Theileria lestoquardi (T. lestoquardi [Atbara]).

Research on malignant theileriosis is affected by the limited access to biological materials required for studies aiming at controlling the disease through the establishment of diagnostic tools and vaccines. The main aims of this work were to isolate, establish, and characterize a Theileria lestoquardi-infected cell culture (line) as a source of biological material and to generate a schizont cDNA library for further studies aiming at the identification of antigenic proteins. The T. lestoquardi isolate used originated from a sheep showing typical signs of malignant theileriosis in Atbara town in northern Sudan, and was maintained as an infected cell culture. A high-quality representative schizont cDNA library was established by isolating and purifying the schizonts using a nocodazole/aerolysin protocol followed by Percoll gradient ultracentrifugation. As a parameter to assess the quality of the schizont library, a provisional estimation of the percentage of recombinant phage clones originating from T. lestoquardi (Atbara) was undertaken. Ten clones with inserts ranging in size between 600 and 1200 bp were selected randomly, sequenced, and subjected to BLAST similarity searches. As 6 of the 10 sequenced clones showed similarities to T. parva, T. annulata, and other apicomplexan genes, it was concluded that the majority of the library phage clones originated from the parasite and not from host cell transcripts. The cDNA library will be used for screening of antigenic proteins using sera from infected sheep.

Animals↗

Isolation and characterization of piscine osteonectin and downregulation of its expression by PTH-related protein.

UNLABELLED: The skeleton is the main source of osteonectin mRNA in adults of the seawater teleost sea bream Sparus auratus. It is expressed by cells forming the basement membrane of calcifying tissue indicating that, as in mammals, it may play a role in osteoblast differentiation. PTHrP induced downregulation of osteonectin mRNA in vitro in scales, a mineralizing tissue with bone-like metabolism. This indicates a means to redirect calcium to activities such as vitellogenesis when this ion is in high demand. INTRODUCTION: Osteonectin is a unique matricellular calcium-binding glycoprotein and a major noncollagenous constituent of higher eukaryote bone. In terrestrial vertebrates, it has been associated with development, remodeling, cell turnover, and tissue repair, all processes involving substantial changes in extracellular matrix (ECM) structure. In skeleton biology, osteonectin has been described as a positive factor in the mineralization process as well as in osteoblastic cell lineage differentiation and is downregulated by the hypercalcemic hormone PTH. In this study, we report the cloning and characterization of bream S. auratus osteonectin cDNA and its tissue and cellular distribution. Its high expression by fish scales provides a unique in vitro bioassay with which to study regulation of osteonectin gene expression by the recently isolated piscine PTH-related peptide (PTHrP). MATERIALS AND METHODS: An intervertebral tissue cDNA library from S. auratus was the source of the full-length cDNA clone for osteonectin. Expression studies were performed by semiquantitative RT-PCR, Northern blot, and in situ hybridization analysis. Moreover, an in vitro bioassay with S. auratus scales was specifically developed for measuring the effect of PTHrP on osteonectin expression. RESULTS AND CONCLUSIONS: Phylogenetic analysis showed that S. auratus osteonectin is highly homologous with previously reported osteonectins, supporting the idea of a conserved function for this protein in the ECM. Its expression pattern in adult tissues from S. auratus was markedly biased toward skeletal structures of both dermal or endochondral origin. More specifically, the localization of the osteonectin mRNA in the basement membrane that separates the epithelia from the underlying mineralized connective tissue supports a role for this protein in calcified matrix turnover. Furthermore, the recently identified piscine hypercalcemic factor PTHrP downregulates osteonectin expression in scales, suggesting a catabolic action for this hormone on these structures.

Amino Acid Sequence↗

Sharps safety.

All employees need to be very careful handling sharps to minimize risks to themselves and coworkers. The attention, awareness and attitude that lend themselves to safe practice can only be developed through thorough training and following correct procedures. If you have an accident/injury, report it immediately and follow your hospital's Exposure Control Plan. Many resources are available to further your learning in this area. If you are uncomfortable with your knowledge of infection control, Universal Precautions, sharps handling, etc., check with your supervisor, hospital library, and infection control staff for reference materials to increase your level of understanding.

Education, Continuing↗

The value of systematic reading. Retaining and applying current information is vital in developing leadership ability.

Keeping up-to-date, having the right information, and growing in knowledge and awareness are more important than ever. Reading is one of the primary ways to develop professional expertise and leadership ability--and to stay competitive. Many persons are facing the new reality: Job security is an inner factor based on inner competence. Part of that competence has to do with one's ability and skill in continually learning. People who read not only develop more competence in their current abilities but, equally important, develop confidence in their ability to learn and meet the demands of accelerated change. Reading helps people stay up-to-date and broaden their perspectives. Reading also provides enjoyment. But if we do not remember and apply what we read, it has little value. People therefore must read widely and read deliberately for retention and application. To make reading a part of their lives, people must make a commitment to read every day, read material that interests them, visit bookstores and libraries, work at retention and application, discuss with others what they are reading, and test what they read against their own experience.

Administrative Personnel↗

[Guidelines for diagnosis and treatment of acute urinary tract problems in women].

BACKGROUND: Available guidelines for the management of symptoms of lower urinary tract infections (UTI) in women give conflicting recommendations. MATERIAL AND METHODS: We searched The Cochrane Library, Medline and other sources for evidence that met explicit inclusion criteria for the relevant options and outcomes identified. The validity of included studies was assessed. Draft recommendations were widely circulated and discussed in focus groups with patients and physician assistants. RESULTS: The probability that a woman with dysuria or frequency has bacteriuria, is 80%. The probability of UTI given a negative result of a dipstick test is 50%. Evidence suggests that antibiotics will rapidly relieve symptoms, but there are limited data from placebo-controlled randomised trials. Population based studies show that many women do not visit physicians for symptoms of UTI. Women with symptoms of UTI can be treated with antibiotics without examination of the urine. Women with earlier episodes of UTI can be offered treatment by telephone. Antibiotics for three days is sufficient based on eradication of bacteriuria. Women should be seen by a physician if the symptoms are atypical. INTERPRETATION: Implementing these guidelines could result in better service to women with UTIs. More evidence about the effects of antibiotics and other treatments is needed.

Anti-Bacterial Agents↗

[Guidelines for diagnosis and treatment of sore throat].

BACKGROUND: Available guidelines for the diagnosis and treatment of sore throat give conflicting recommendations. Our aim was to develop evidence-based guidelines. MATERIAL AND METHODS: We searched The Cochrane Library, Medline and other sources for systematic reviews and other evidence that met explicit inclusion criteria for all of the relevant options and outcomes we identified. The validity of included studies was assessed. Draft recommendations based on assessment of this evidence were widely circulated and discussed in focus groups with patients and physician assistants. RESULTS: Throat infections are self-limiting and complications rare. Penicillin shortens the duration of symptoms in tonsillitis caused by beta-haemolytic streptococci and reduces the risk of complications. Penicillin has adverse effects and increases the risk of reinfections. Patients with sore throat should usually be treated without antibiotics. Visiting a physician is normally unnecessary. Antibiotics should be considered in serious cases or if the patient prefers this, but should only be prescribed for throat infections caused by beta-haemolytic streptococci. The diagnosis should be based on clinical criteria and a rapid antigen test in cases of doubt. INTERPRETATION: Benefits of antibiotics must be weighed against harms. Patients should be given good information and involved in decision-making if they want antibiotics.

Anti-Bacterial Agents↗

[Guidelines for diagnosis and treatment of sore throat].

BACKGROUND: Available guidelines for the diagnosis and treatment of sore throat give conflicting recommendations. Our aim was to develop evidence-based guidelines. MATERIAL AND METHODS: We searched The Cochrane Library, Medline and other sources for systematic reviews and other evidence that met explicit inclusion criteria for all of the relevant options and outcomes we identified. The validity of included studies was assessed. Draft recommendations based on assessment of this evidence were widely circulated and discussed in focus groups with patients and physician assistants. RESULTS: Throat infections are self-limiting and complications rare. Penicillin shortens the duration of symptoms in tonsillitis caused by beta-haemolytic streptococci and reduces the risk of complications. Penicillin has adverse effects and increases the risk of reinfections. Patients with sore throat should usually be treated without antibiotics. Visiting a physician is normally unnecessary. Antibiotics should be considered in serious cases or if the patient prefers this, but should only be prescribed for throat infections caused by beta-haemolytic streptococci. The diagnosis should be based on clinical criteria and a rapid antigen test in cases of doubt. INTERPRETATION: Benefits of antibiotics must be weighed against harms. Patients should be given good information and involved in decision/making if they want antibiotics.

Anti-Bacterial Agents↗

Germ line insertions of moloney murine leukemia virus in the TLL mouse causes site-specific differences in lymphoma/leukemia frequency and tumor immunophenotype.

BACKGROUND: Moloney murine leukemia virus (Mo-MLV) has proven valuable for studies of the pathogenesis of malignant lymphoma. Inoculation of newborn mice induces T cell lymphoma with 100% incidence. The TLL (T cell lymphoma/leukemia)-strain was previously established and was shown to spontaneously develop T cell lymphoma at high frequency. MATERIALS AND METHODS: Differential screening of cDNA libraries was performed to discover an involvement of Mo-MLV and genomic sequencing was used to identify the chromosomal position of Mo-ML V proviral integration sites. Immunophenotypes of the tumors were established by flow cytometty. Disease frequency curves were created according to the Kaplan-Meier method. RESULTS: Two independent Mo-MLV germ line integrations were characterized on chromosomes 2 and 14, giving rise to two substrains of mice denoted TLL-2 and TLL-14. The chromosomal position of the integrated provirus affected the frequency of disease, as well as the immunophenotype of the tumors. CONCLUSION: The data suggest that factors influencing the transcriptional activity of the chromosomal regions, leading to differences in proviral expression, could underlie the observed difference in tumor frequency.

Animals↗

Isolation of differentially expressed human fovea genes: candidates for macular disease.

PURPOSE: In humans, the fovea is the region of the retina responsible for acute vision. Disorders affecting the fovea are responsible for the majority of cases of untreated blindness in the developed world, yet are poorly understood at the molecular level. Our goal is to identify genes that are preferentially expressed within the human fovea as compared to the midperipheral retina (differential fovea clones). MATERIALS AND METHODS: An unamplified fovea cDNA library was differentially screened with cDNA probes derived from either human fovea or midperipheral retina. Rounds of secondary screening and northern analysis were used to verify the expression pattern of a selective number of clones isolated. RESULTS: Forty-one differential fovea clones were isolated from a screening of 10,000 phage clones (clones). Of these clones, 31.5 % correspond to known sequences present in GenBank/EMBL and 70.7% represent novel human fovea expressed sequence tags (ESTs). Northern analysis of selected clones demonstrated that they represent genes expressed at higher levels in the human fovea than in the midperipheral retina. CONCLUSIONS: Genes that are more highly expressed in the fovea as opposed to the midperipheral retina are likely to represent essential genes for fovea function. Using our fovea cDNA library, we are able to isolate differential human fovea clones at an incidence of 41/10,000 clones screened. We demonstrate that there is a high level of differential gene expression within different regions of the human retina.

Adolescent↗

Clonally-related immunoglobulin VH domains and nonrandom use of DH gene segments in rheumatoid arthritis synovium.

BACKGROUND: Synovia of patients with long-standing rheumatoid arthritis (RA) are typically infiltrated with B lymphocytes and plasma cells that secrete large amounts of immunoglobulin. The CDR3 of an immunoglobulin heavy chain is composed of the VH-DH-JH join, with interposed N region addition, and thus defines clonal relatedness. Furthermore, the CDR3 lies at the center of the antigen binding site, so its length and composition influence antigen binding. We sought definitive evidence of an antigen-driven B cell response (i.e., clones derived from the same VH, DH, and JH gene segments with shared somatic mutations) in RA synovial mRNA transcripts, and to characterize CDR3 intervals at the target of inflammation in this autoimmune disease. MATERIALS AND METHODS: We screened a cDNA library generated from unselected cells from the knee joint of a 62-year-old white female with long-standing RA. This technique does not have the potential bias of selecting for antibodies that express a particular reactivity such as rheumatoid factor. C gamma recombinants were sequenced and progenitor VH, DH, and JH gene segments were assigned and somatic mutations determined by comparison to germline sequences. Analyses of DH reading frame utilization and hydropathy characteristics of CDR3s were performed. RESULTS: Two of 67 recombinants were derived from the same VH (V3-11) and JH gene segments, demonstrated shared mutations, and contained nearly identical VH-DH-JH joins, including N region addition. Three other recombinants contained identical sequence throughout the variable domain. We also found preferential utilization of a limited number of VH and DH gene segments and marked preference for a DH reading frame encoding predominantly hydrophilic residues. CONCLUSIONS: Analysis of expressed heavy chain variable domains strongly supports the hypothesis that the B cell response in RA synovium is at least in part antigen driven and oligoclonal.

Amino Acid Sequence↗

Distribution of a centrosomal antigen during morphogenesis in the ciliated protozoan Euplotes.

Ciliates assemble basal bodies in great number at many stages of the life-cycle. In order to understand their assembly mechanisms, we screened a library of monoclonal antibodies directed against pericentriolar material. One of these antibodies, CTR210, was used previously to follow steps of this assembly process: in Paraurostyla, new basal bodies appear along a scaffold of linear structures recognized by this antibody. The very unusual behavior of this antigen deserved confirmation in other species. In the present study, we show by immunofluorescence that, in another phylogenetically very distant species, Euplotes, basal bodies are assembled in the same pathway during division. In addition, this antibody recognizes a filamentous ring located at the division furrow and linking many basal body assemblages. By cell fractionation and cytoskeletal extraction, we obtained fractions enriched in basal bodies and associated material. Such fractions still display a high complexity in protein composition. These fractions were used to characterize the main target of the antibody as a doublet of 45 kDa. These results confirm previous results in terms of functionality of the protein recognized by the antibody, but raise new questions in terms of the assignment of the recognized protein to the HSP70 family as hypothesized previously.

Animals↗

Using UMLS to map from a library to a clinical classification: Improving the functionality of a digital library.

The Metathesaurus of the Unified Medical Language System (UMLS) offers the possibility of mapping between various medical vocabularies. The Primary Care Electronic Library (PCEL) contains a database of over six thousand Medical Subject Headings (MeSH terms) describing the resources of the electronic library. We were interested to know if it was possible to map from MeSH to the Systemized Nomenclature of Medicine Clinical Terms (SNOMED CT). Such a mapping would aid healthcare professionals to retrieve relevant data from our digital library as it would enable links between clinical systems and indexed material.

Databases, Bibliographic↗