ITEMAS ontology for healthcare technology innovation.

BACKGROUND: The Platform for Innovation in Medical and Health Technologies (ITEMAS) is a network of 66 healthcare centres focused on fostering innovation in medical and health technologies as an essential tool for increasing the sustainability of the Spanish healthcare system. The present research is focused on defining a formal representation that details the most relevant concepts associated with the creation and adoption of innovative medical technology in the Spanish healthcare system. METHODS: The methodology applied is based on the methontology process, including peer-review identification and selection of concepts from the ITEMAS innovation indicators and innovation management system standards. This stage was followed by an iterative validation process. Concepts were then conceptualised, formalised and implemented in an ontology. RESULTS: The ontology defined describes how relationships between employees, organisations, projects and ideas can be applied to generate results that are transferrable to the market, general public and scientific forums. Overall, we identified 136 concepts, 138 object properties and 30 properties in a five-level hierarchy. The ontology was tested and validated as an appropriate framework for calculating the ITEMAS innovation indicators. CONCLUSIONS: The consensus concepts were expressed in the form of an ontology to be used as a single communication format between the members of the ITEMAS network. Healthcare centres can compare their innovation results and obtain a better understanding of their innovation context based on the reasoning techniques of artificial intelligence. As a result, they can benefit from advanced analytical capabilities to define the most appropriate innovation policies for each centre based on the common experience of the large number of healthcare centres involved. The results can be used to create a map of agents and knowledge to show capabilities, projects and services provided by each of the participating centres. The ontology could also be applied as an instrument to match needs with existing projects and capabilities from the community of organisations working in healthcare technology innovation.

Isolation of Lyme disease Borrelia from puffins (Fratercula arctica) and seabird ticks (Ixodes uriae) on the Faeroe Islands.

This is the first report on the isolation of Lyme disease Borrelia from seabirds on the Faeroe Islands and the characteristics of its enzootic cycle. The major components of the Borrelia cycle include the puffin (Fratercula arctica) as the reservoir and Ixodes uriae as the vector. The importance of this cycle and its impact on the spread of human Lyme borreliosis have not yet been established. Borrelia spirochetes isolated from 2 of 102 sampled puffins were compared to the borreliae previously obtained from seabird ticks, I. uriae. The rrf-rrl intergenic spacer and the rrs and the ospC genes were sequenced and a series of phylogenetic trees were constructed. Sequence data and restriction fragment length polymorphism analysis grouped the strains together with Borrelia garinii. In a seroepidemiological survey performed with residents involved in puffin hunting on the Faeroe Islands, 3 of 81 serum samples were found to be positive by two commonly used clinical tests: a flagellin-based enzyme-linked immunosorbent assay (ELISA) and Western blotting. These three positive serum samples also had high optical density values in a whole-cell ELISA. The finding of seropositive Faeroe Islanders who are regularly exposed to I. uriae indicate that there may be a transfer of B. garinii by this tick species to humans.

[Borrelia burgdorferi, taxonomy, pathogenicity and spread]. / Borrelia burgdorferi, taxonomie, pouvoir pathogène et expansion.

Borrelia burgdorferi sensu lato is a bacterial complex of at least 10 species, most of which are non pathogenic for humans. Non pathogenic species seem to be more vector-specific, their distribution being restricted to that of this vector. In opposition, the three species pathogenic for humans, Borrelia burgdorferi sensu stricto (B.b.s.s.), Borrelia garinii (B.g.), and Borrelia afzelii (B.a.), are transmitted by several species of ticks more diversified in their host choice. Each of these three species is associated with a preferential organotropism: articulation for B.b. s.s., neurologic system for B.g. and skin for B.a. Strains belonging to these three species are much more frequently isolated from vectors and have a much larger area of expansion than the non pathogenic species. Indeed, their geographical distribution corresponding to that of their vector comprises one or two continents. B.g. and B.a., transmitted by Ixodes ricinus and Ixodes persulcatus, are spread throughout Eurasia. B.b. s.s. is the only species spread on two continents separated by an Ocean: North America (vectors: I. scapularis and I. pacificus) and Europe (I. ricinus). Combining of epidemiological data and molecular analyses shows that B.b. s.s. probably originated in America and later on, very recently (after 1492), migrated to the European continent.

Molecular epidemiology of the aetiological agents of Lyme borreliosis.

Ten species are up to now recognized among Borrelia burgdorferi sensu lato complex. Among those, only three (Borrelia burgdorferi sensu stricto, B. garinii and B. afzelii) are reported to be pathogenic for humans and each responsible for a predominant clinical form of Lyme borreliosis. Each species is characterized by its vectors (Ixodidae), its host spectrum, its organotropism (for the pathogenic ones) and its geographical repartition. Borrelia are strictly parasitic and essentially clonal bacteria. Our goal was to explore the diversity of this bacterial complex. We selected, by several molecular markers, atypical isolates and compared them to already known species representative strains by RFLP or sequencing. The results show an unexpected diversity at a level which could be a species one leading to the conclusion that the structure of the Borrelia burgdorferi sensu lato complex is a high number of small (by their populations) clones among which emerge some large ones usually corresponding to the pathogenic species. Our data also allow to speculate on when, where and how these species evolved and migrated.

Borrelia burgdorferi sensu stricto, a bacterial species "made in the U.S.A."?

Among the three main species of Borrelia burgdorferi sensu lato associated with Lyme borreliosis, B. burgdorferi sensu stricto (B. burgdorferi) is the sole species present both in North America and in Europe, where Borrelia garinii and Borrelia afzelii also occur. The greater genetic diversity together with the greater clinical polymorphism observed in the Old World suggests that this is the birthplace of the complex B. burgdorferi sensu lato. However, the genetic proximity of some North American and European B. burgdorferi strains in quite mystifying. A previous study of the whole genome (M. Foretz, D. Postic, and G. Baranton, Int. J. Syst. Bacteriol. 47:11-18, 1997) compared the diversity of North American and European B. burgdorferi strains. To further investigate the geographical origin and the migration of B. burgdorferi, we have focused on the study of the single variable and highly adaptive gene ospC. Both approaches demonstrated the greater diversity of North American strains and the close relatedness between European strains and between some isolates from the two areas. We discuss the significance of these features and suggest that they might be evidence of the anteriority of North American B. burgdorferi strains.