Immune Responses

Abnormal immune responses can trigger a range of autoimmune diseases, in which an individual’s immune system is attacking normal tissues in the body. Well-known examples of autoimmune diseases are type 1 diabetes mellitus, lupus, and multiple sclerosis. 

Ideally, one would like to harness the immune system to attack abnormal substances or tissues like cancer, while sparing the normal (unaffected) tissue. Many tumor cells produce antigens (proteins) that theoretically ought to trigger an immune response: that is, one’s immune system ought to recognize cancer cells as somehow foreign or abnormal, and thereafter eliminate these cells from the body. The field of cancer immunotherapy is actively pursuing this study.

Tumor antigens may also be useful for diagnostic tests; high levels of tumor antigens could be taken as markers or indicators of cancer. In this assignment, you will be examining levels of tumor-associated antigens (TAAs) as determined from immunoassays (i.e., biochemical tests that measure the concentrations of the tumor-associated antigens in serum samples).

• Download the Excel file MHA610_assignment_3_data.xls, and open it.
• The spreadsheet contains data on 250 individuals: 90 normal individuals from San Diego (the controls), and 160 individuals from Korea and China, all of whom were diagnosed with hepatocellular carcinoma (HCC).
  • Serum samples were taken from the controls and from the cases at time of diagnosis of HCC. Levels of a panel of 12 tumor-associated antigens (TAAs) were assessed via immunoassays in all individuals;
    • The levels are given in the columns with headings Ab14, HCC1, IMP1, KOC, MDM2, NPM1, P16, P53, P90, RaIA, and Survivin. (These are the designations of the 12 TAAs, all of which were thought to be potentially predictive of cancer.)
• The underlying question is whether we can effectively discriminate between the cases and controls on the basis of the levels of these TAAs. This is sometimes termed a classification problem in the statistics and biostatistics literature: we wish to classify individuals as normal or cancer patients on the basis of their TAA levels.
• We will examine these data in Statdisk. Use the MHA610_Week 3_Assignment_Data.CSV file to upload this information into Statdisk.
  • If you choose the latter option, Start Statdisk, then choose File>Open and select the .csv file you created (unless you changed the name, it ought to be MHA610_assignment_3_data.csv)
  • Check the box that specifies the data contains column titles or headers, select Comma separated for how the data are delimited, click finish, and the dataset will have been successfully imported into Statdisk.
  • NOTE: you may want to read through the remainder of the assignment first, before proceeding with this step. This may save you some work afterwards!
• Note that Statdisk operates on columns of data, and that both cases and controls are contained in each column of TAA levels. It will be necessary to separate the cases and controls for further analyses. This can be accomplished either by copying within Statdisk or by reverting to the original Excel workbook, copying in Excel, exporting as a .csv file, and then importing into Statdisk. (Don’t say you weren’t warned!)
• Explain if you would characterize any or all of the TAA levels as approximately normally distributed for the controls and for the cases.
  • Provide plots and statistics in support of your conclusions.
• Explain if any of the TAAs are useful for discriminating between the cases and controls.
  • Provide plots and statistics in support of your conclusions.
• All writing assignments should be at least 250-500 words in APA format supported by scholarly sources.

BONUS. In the above, we pooled all cases together.  Summarize whether you think this is legitimate or whether the levels of any of the TAAs appear to differ significantly between the cases from China and the cases from Korea. Provide evidence in support of your conclusion.

Carefully review the Grading Rubric for the criteria that will be used to evaluate your assignment.

Assignment: Application:
Using the Data/Information/Knowledge/Wisdom Continuum

Have you ever gone online to search for a journal article on a specific topic? It is amazing to see the large number of journals that are available in the health care field. When you view the library in its entirety, you are viewing untapped data. Until you actually research for your particular topic, there is little structure. Once you have narrowed it down, you have information and once you apply the information, you have knowledge. Eventually, after thoughtful research and diligent practice, you reach the level of wisdom—knowledge applied in meaningful ways.

Are there areas in your practice that you believe should be more fully explored? The central aims of nursing informatics are to manage and communicate data, information, knowledge, and wisdom. This continuum represents the overarching structure of nursing informatics. In this Assignment, you develop a research question relevant to your practice area and relate how you would work through the progression from data to information, knowledge, and wisdom.

To prepare:

• Review the information in Figure 6–2 in Nursing Informatics and the Foundation of Knowledge.
• Develop a clinical question related to your area of practice that you would like to explore.
• Consider what you currently know about this topic. What additional information would you need to answer the question?
• Using the continuum of data, information, knowledge, and wisdom, determine how you would go about researching your question.
  • Explore the available databases in the Walden Library. Identify which of these databases you would use to find the information or data you need.
  • Once you have identified useful databases, how would you go about finding the most relevant articles and information?
  • Consider how you would extract the relevant information from the articles.
  • How would you take the information and organize it in a way that was useful? How could you take the step from simply having useful knowledge to gaining wisdom?

By Day 7 of Week 4

Write a 3- to 4-page paper that addresses the following:

• Summarize the question you developed, and then relate how you would work through the four steps of the data, information, knowledge, wisdom continuum. Be specific.
  • Identify the databases and search words you would use.
  • Relate how you would take the information gleaned and turn it into useable knowledge.
• Can informatics be used to gain wisdom? Describe how you would progress from simply having useful knowledge to the wisdom to make decisions about the information you have found during your database search.

Your paper must also include a title page, an introduction, a summary, and a reference page.