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Generation of the natural killer cell repertoire: the sequential vs. the two-step selection model.

Natural killer (NK) cells are lymphocytes which can kill tumor and virus-infected cells, and mediate acute rejection of bone marrow grafts. NK-cell killing is directed primarily at target cells which do not express sufficient levels of self-major histocompatibility complex (MHC) class-I molecules. Inhibition of lysis of self-MHC-expressing target cells is mediated via inhibitory receptors on the NK cell, which bind to MHC molecules. Each NK cell expresses only a subset of all its inhibitory receptor gene repertoire, which may bind to only a subset of the self-MHC molecules expressed by other cells of the organism. Two conceptual models have been proposed to explain the process of NK cell 'education' in which these cells adapt, during their development, to the self-MHC environment: the two-step selection and the sequential models. In this manuscript we develop mathematical and computational models of the process of NK cell development and education, which implement the two conceptual models. We use this theoretical framework to examine the available data on NK cell repertoire compositions, and evaluate the degree these data support either of the two conceptual models. We show that the data published so far on NK cell receptor expression patterns is insufficient to refute either model, since data on NK cell receptor binding affinities to MHC is also needed. However, the models allow us to make predictions on these binding affinities, which can later be tested experimentally.

Animals↗

Enhancing the visual realism of hysteroscopy simulation.

Visualization is a very important part of a high fidelity surgical simulator. Due to modern computer graphics hardware, which offers more and more features and processing power, it is possible to extend the standard OpenGL rendering methods with advanced visualization techniques to achieve highly realistic rendering in real-time. For an easy and efficient use of these new capabilities, a stand-alone graphics engine has been implemented, which exploits these advanced rendering techniques and provides an interface in order to ensure the interoperability with a software framework for surgical simulators.

Computer Simulation↗

An implementation framework for GEM encoded guidelines.

Access to timely decision support information is critical for delivery of high-quality medical care. Transformation of clinical knowledge that is originally expressed in the form of a guideline to a computable format is one of the main obstacles to the integration of knowledge sharing functionality into computerized clinical systems. The Guideline Element Model (GEM) provides a methodology for such a transformation. Although the model has been used to store heterogeneous guideline knowledge, it is important to demonstrate that GEM markup facilitates guideline implementation. This report demonstrates the feasibility of implementation of GEM-encoded guideline recommendations using Apache Group s Cocoon Web Publishing Framework. We further demonstrate how XML-based programming allows for maintaining the separation of guideline content from processing logic and from presentation format. Finally, we analyze whether the guideline authors original intent has been sufficiently captured and conveyed to the end user.

Artificial Intelligence↗

Learning support for the consultation: information support and decision support should be placed in an educational framework.

BACKGROUND: Advances in information technology mean that it is now possible to provide contextually relevant, evidence-based information during the course of the consultation. As a consequence, the practitioner has to consider the new information (from the computer) in the situation of the present consultation and in the light of his or her own experience. This task has to be carried out in a short time, in the presence of the patient. METHOD: Drawing on experience of the development of one decision support system, this paper places that task for the practitioner in an educational framework. We begin by reviewing theories of professional experience and knowledge and go on to look at schema theory and the role of cognitive dissonance and reflection in learning. CONCLUSION: This paper considers the provision of real time decision support in the light of learning and the experienced practitioner. We conclude that framing the implementation of decision support in this way provides useful insights. The key process is learning by the practitioner, in the course of the consultation. This process should be supported by decision support and information support software. There are implications here for the design of such software, and also for the way in which practitioners are trained to use it.

Cognitive Dissonance↗

A model for prion protein dimerisation based on alpha-helical packing.

Residues 109-122 of the human prion protein (PrP) are highly conserved across species, and are predicted to be alpha-helical in PrPc, the cellular form. A computational search of the potential for alpha-helical dimerisation has been made for residues 109-122. The conformation which consistently scores highest in terms of burying non-polar surface area is a tight association involving alanine, glycine and valine residues. A model of heterodimerisation for PrPc and PrPSc (the misfolded form) is presented in which species barrier mutations would arise from interaction specificities that would follow, at least in part, the same framework as formation of a putative homodimer.

Alanine↗

A computational procedure for optimal engineering interventions using kinetic models of metabolism.

The identification of optimal intervention strategies is a key step in designing microbial strains with enhanced capabilities. In this paper, we propose a general computational procedure to determine which genes/enzymes should be eliminated, repressed or overexpressed to maximize the flux through a product of interest for general kinetic models. The procedure relies on the generalized linearization of a kinetic description of the investigated metabolic system and the iterative application of mixed-integer linear programming (MILP) optimization to hierarchically identify all engineering interventions allowing for reaction eliminations and/or enzyme level modulations. The effect of the magnitude of the allowed changes in concentrations and enzyme levels is investigated, and a variant of the method to explore high-fold changes in enzyme levels is also analyzed. The proposed framework is demonstrated using a kinetic model modeling part of the central carbon metabolism of E. coli for serine overproduction. The proposed computational procedure is a general approach that can be applied to any metabolic system for which a kinetic description is provided.

Computer Simulation↗

Algorithms for computing the time-corrected instantaneous frequency (reassigned) spectrogram, with applications.

A modification of the spectrogram (log magnitude of the short-time Fourier transform) to more accurately show the instantaneous frequencies of signal components was first proposed in 1976 [Kodera et al., Phys. Earth Planet. Inter. 12, 142-150 (1976)], and has been considered or reinvented a few times since but never widely adopted. This paper presents a unified theoretical picture of this time-frequency analysis method, the time-corrected instantaneous frequency spectrogram, together with detailed implementable algorithms comparing three published techniques for its computation. The new representation is evaluated against the conventional spectrogram for its superior ability to track signal components. The lack of a uniform framework for either mathematics or implementation details which has characterized the disparate literature on the schemes has been remedied here. Fruitful application of the method is shown in the realms of speech phonation analysis, whale song pitch tracking, and additive sound modeling.

Algorithms↗

[The physician and the computer. 30. Evaluation of time, different aspects of the same problem].

The authors mention different ways in which a give problem can be described within the framework of the theory of sets, logic, mathematical analysis, statistic and cybernetics. As an example of the confrontation of the mentioned aspects they discuss different approaches to the evaluation of time as a variable--temporal logic, Markov chains, theory of catastrophes which play a part in medicine, in particular in prognostic considerations. These different aspects make possible solutions which may differ and their application depends in particular on the purpose for which they are intended.

Logic↗

Substitution of magnetic resonance imaging for computed tomography. An exploratory study.

Despite the importance of understanding factors related to physician adoption and use of diagnostic technologies, relatively few studies have been published. Results of a two-year study of the adoption of magnetic resonance imaging (MRI) and its substitution for computed tomography scanning (CT) are presented. The literature on physician adoption and use of technology is used to provide a framework for this study. Differences in adoption and substitution among medical specialties, early versus late adopters, and high versus low users of MRI are examined. Results show that neurologists and internists more rapidly adopt MRI and substitute it for CT than do orthopedists and other surgical specialists. Referral of higher numbers of patients is the best predictor of more rapid substitution. Physicians who were late adopters more quickly substituted MRI for CT. The cost and social implications of empirical versus "ideal" substitution rates are discussed along with how various regulatory, technology assessment, and financial strategies influence substitution. The role of individual physicians, radiologists, and specialty societies in determining substitution rates is also discussed.

California↗

Neurobiological approach to computing devices.

According to the old metaphor of classical cybernetics the brain can be considered as a computer. Newer theoretical endeavours reverse the question and ask: what could neurobiology offer to engineers of near-future generation computer systems? Three not completely disjoint abstract functions of the nervous system, namely pattern formation, pattern recognition and action, can be treated in a unified conceptual framework. Storage and retrieval mechanisms of information are connected to fault-tolerant, adaptive parallel structures. "Learning" and "plastic behaviour" are interpreted in terms of the theory of non-linear dynamic systems. As neural development and plasticity can be approached by deterministic models superimposed by random influence, noise might also have a positive role to play during the operation of technical computing devices. Molecular computation is discussed in relation to eventual hardware realization of "neurobiology-based" computers.

Cybernetics↗

Photo-modulated ion channels based on covalently linked gramicidins.

The covalent coupling of two gramicidin A monomers proved to be a useful tool for the rational design of ion channels with predictable electrophysiological properties (Stankovic, C.J., Heinemann, S.H., Delfino, J.M., Sigworth, F.J. and Schreiber, S.L. (1989) Science 244, 813-817; Stankovic, C.J., Heinemann, S.H. and Schreiber, S.L. (1990) J. Am. Chem. Soc. 112, 3702-3704). Herein we report on our first efforts to equip such channels with an artificial gating mechanism. Gramicidin monomers were covalently linked with 3,3'-azobis(benzeneacetic acid). Based on computer modeling of the beta-helix channel motif, this linker in its dark-adapted (trans) form does not allow for the formation of unimolecular ion channels, while the photo-activated (cis) form was expected to provide this possibility. The electrophysiological assays showed that (A) the trans-isomer does form characteristic ion channels, and (B) irradiation transforms these channels into a new distinct, flickering channel type in a reversible manner. The results are discussed in the framework of intermolecular gramicidin aggregates.

Azo Compounds↗

Integration of multidisciplinary sensory data: a pilot model of the human brain project approach.

The paper provides an overview of neuroinformatics research at Yale University being performed as part of the national Human Brain Project. This research is exploring the integration of multidisciplinary sensory data, using the olfactory system as a model domain. The neuroinformatics activities fall into three main areas: 1) building databases and related tools that support experimental olfactory research at Yale and can also serve as resources for the field as a whole, 2) using computer models (molecular models and neuronal models) to help understand data being collected experimentally and to help guide further laboratory experiments, 3) performing basic neuroinformatics research to develop new informatics technologies, including a flexible data model (EAV/CR, entity-attribute-value with classes and relationships) designed to facilitate the integration of diverse heterogeneous data within a single unifying framework.

Amino Acid Sequence↗

Modeling of neural systems by use of neuronal modes.

A methodology for modeling spike-output neural systems from input-output data is proposed, which makes use of "neuronal modes" (NM) and "multi-input threshold" (MT) operators. The modeling concept of NM's was introduced in a previously published paper in order to provide concise and general mathematical representations of the nonlinear dynamics involved in signal transformation and coding by a class of neural systems. This paper presents and demonstrates (with computer simulations) a method by which the NM's are determined using the 1st- and 2nd-order kernel estimates of the system, obtained from input-output data. The MT operator (i.e., a binary operator with multiple real-valued operands which are the outputs of the NM's) possesses an intrinsic refractory mechanism and generates the sequence of output spikes. The spike-generating characteristics of the MT operator are determined by the "trigger regions" defined on the basis of data. This approach is offered as a reasonable compromise between modeling complexity and prediction accuracy, which may provide a common methodological framework for modeling a certain class of neural systems.

Computer Simulation↗

Effects of 3D sampling in (k, t)-space on temporal qualities of dynamic MRI.

3D (kx, ky, t)-space analysis is invoked to provide insights into dynamic magnetic resonance imaging (DMRI) with arbitrary k-space sampling trajectories. The effects of 3D sampling in (kx, ky, t) are analyzed theoretically and verified with computer simulation. The analyses show that a 3D sampling pattern that is more isotropic in (kx, ky, t)-space and denser around the (kx=0, ky=0, t)-line likely results in improved temporal qualities of DMRI. The isotropy of 3D sampling is quantified using Voronoi 3D cells and the isoperimetric theorem. This 3D sampling perspective provides a theoretical framework for understanding the temporal qualities of various DMRI methods.

Anisotropy↗

A moment-based three-dimensional edge operator.

This paper presents a three-dimensional edge operator aimed at the detection of anatomical structures in medical imaging. It uses the spatial moments of gray level surface, and operates in three dimensions with any window size. It allows us to estimate the location and the contrast surface, as well as the surface orientation. The computation of the discrete version is reported. Bias and errors due to the spatial sampling and noise are analyzed both at a theoretical and experimental level. The moment-based operator is compared with other well-known edge operators on simple shaped primitives for which the analytical solution is known. The 3D rendering of real data is then provided by merging the operator in a ray-tracing framework.

Artifacts↗

Navigation-assisted construction of an external ear canal using an autogenous foreskin graft.

Classic microtia is combined with external ear canal atresia and middle ear malformation. In order to evaluate whether an operation to improve hearing ability and the use of computer-assisted surgery are indicated, preoperative high-resolution navigation CT is mandatory. We combined atresia surgery and tympanoplasty with auricular reconstruction in the case of an 8-year-old boy with bilateral microtia, aural atresia and malformation of the middle ear. After creating an auricle framework with rib cartilage and transplanting it under the skin of the mastoid plane, we shifted it forward in the second step, and the new auditory canal was drilled under computer-assisted navigation and facial nerve monitoring. In the same operation, tympanoplasty was accomplished, and a silastic cylinder, wrapped into pieces of rib cartilage, was inserted into the constructed canal and removed 2 months later. For lining the new auditory canal, we used the patient's prepuce, harvested by elective circumcision.

Child↗

Linear regression calibration: theoretical framework and empirical results in EPIC, Germany.

Large scale dietary assessment instruments are usually based on the food frequency technique and have therefore to be tailored to the involved populations with respect to mode of application and inquired food items. In multicenter studies with different populations, the direct comparability of dietary data is therefore a challenge because each local dietary assessment tool might have its specific measurement error. Thus, for risk analysis the direct use of dietary measurements across centers requires a common reference. For example, in the European prospective cohort study EPIC (European Prospective Investigation into Cancer and Nutrition) a 24-hour recall was chosen to serve as such a reference instrument which was based on a highly standardized computer-assisted interview (EPIC-SOFT). The 24-hour recall was applied to a representative subset of EPIC participants in all centers. The theoretical framework of combining multicenter dietary information was previously published in several papers and is called linear regression calibration. It is based on a linear regression of the food frequency questionnaire to the reference. The regression coefficients describe the absolute and proportional scaling bias of the questionnaire with the 24-hour recall taken as reference. This article describes the statistical basis of the calibration approach and presents first empirical results of its application to fruit, cereals and meat consumption in EPIC Germany represented by the two EPIC centers, Heidelberg and Potsdam. It was found that fruit could be measured well by the questionnaire in both centers (lambdacirc; = 0.98 (males) and lambdacirc; = 0.95 (females) in Heidelberg, and lambdacirc; = 0.86 (males) and lambdacirc; = 0.7 (females) in Potsdam), cereals less (lambdacirc; = 0.53 (males) and lambdacirc; = 0.4 (females) in Heidelberg, and lambdacirc; = 0.53 (males) and lambdacirc; = 0.44 (females) in Potsdam), and that the assessment of meat (lambdacirc; = 0.72 (males) and lambdacirc; = 0.65 (females) in Heidelberg, and lambdacirc; = 0.49 (males) and lambdacirc; = 0.42 (females) in Potsdam) has a center-specific bias. The application of the calibration approach to the questionnaire data will change the ranking of the two centers following the data of the reference instrument, and not well-measured food items will exhibit considerably less variation compared to the original data. We conclude that calibration is a necessary step in multicenter studies. However, this exercise shows that the current statistical framework is not yet sufficiently developed for a broad application.

Adult↗