Humana leverages the Web. Web-based applications facilitate systems integration.
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The WIT (What Is There) (http://wit.mcs.anl.gov/WIT2/) system has been designed to support comparative analysis of sequenced genomes and to generate metabolic reconstructions based on chromosomal sequences and metabolic modules from the EMP/MPW family of databases. This system contains data derived from about 40 completed or nearly completed genomes. Sequence homologies, various ORF-clustering algorithms, relative gene positions on the chromosome and placement of gene products in metabolic pathways (metabolic reconstruction) can be used for the assignment of gene functions and for development of overviews of genomes within WIT. The integration of a large number of phylogenetically diverse genomes in WIT facilitates the understanding of the physiology of different organisms.
The idea of a continuum of care is hardly new. In its purest form, it is simply the essence of good patient care. Today, the complex U.S. healthcare organization has emerged as a highly sophisticated but fragmented collection of service providers. We now must put energy and resources into rebuilding the comprehensiveness and continuity that represent high-quality care. The rationale for a continuum of care is that it is appropriate for patients' needs, demanded by today's consumers, an organized way of maximizing use of healthcare resources, and cost-effective for providers, patients, and payers. A continuum of care comprises services and integrating mechanisms. The services can be broken into seven basic categories: extended care, acute hospital care, ambulatory care, home care, outreach, wellness, and housing. The four basic integrating mechanisms are interentity planning and management, care coordination, case-based financing, and integrated information systems. Shaping a continuum mandates translating broad principles into pragmatic application suitable for the organization and community. The organization should define goals and objectives, identify a target population, assess services, evaluate integrating mechanisms, communicate, and prepare a business plan.
We have applied the systems approach, to the analysis of mechanisms whereby connective tissue (CT) is integrated into one functional system. The primary CT functions in health and in disease (biomechanical, trophic, protective, reparative, and morphogenetic) are carried out by means of cell-cell, cell-matrix and intertissue interactions based on feedback between these components. Both CT as a whole and its cellular and extracellular elements exhibit structural and functional heterogeneity which increases the capacity of CT for adaptation. The intercellular interactions take place via soluble and insoluble mediators, direct cellular contacts, and cell/matrix degradation products. Results of this study support the concept of internal "network" regulation of the CT composition, functions and growth through intercellular interactions at different structural levels. Feedback mechanisms between degradation and production of collagen and interactions between collagen, macrophages and fibroblasts play a special role in the self-regulation of reparative CT growth. Collagen restores an impaired self-regulation and exerts a marked therapeutic effect on wounds, burns, trophic ulcers, and other lesions. A similar function may be performed by other matrix components and degradation/secretion products of macrophages and fibroblasts.
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PURPOSE: Demonstrate the utility of System Dynamics computer modeling to study and gain insight into the impacts of physical activity and diet on weight gain and loss. METHODS: A holistic System Dynamics computer model is presented that integrates the processes of human metabolism, hormonal regulation, body composition, nutrition, and physical activity. These processes are not independent of one another, and the model captures the complex interdependencies between them in the regulation of body weight and energy metabolism. The article demonstrates how such an integrative simulation model can serve as a viable laboratory tool for controlled experimentation to investigate the impacts of physical activity and diet on body weight and composition. RESULTS: In one experiment, weight loss from a moderate level of daily exercise was slightly less than the loss from dieting. Although exercise did have a favorable impact on body composition by protecting against the loss in fat-free mass (FFM), it, however, failed to blunt the drop in resting energy expenditure (REE) that accompanies diet-based weight loss. The smaller loss in FFM did indeed induce a smaller drop in REE, however, the preservation of FFM also affected a relatively larger loss in FM, which, in turn, induced a larger adaptive reduction in the metabolic rate. The two adaptations almost totally offset one another, causing minimal differences in REE. In a second experiment, exercise regimens of moderate- to high-level intensity proved counterproductive as weight-reducing strategies. However, when the diet was changed from a balanced composition to one that was highly loaded with carbohydrates, it became possible to sustain the intense exercise regimen over the experimental period and achieve a significant drop in body weight. CONCLUSION: The results underscore the significant interaction effects between physical activity, diet, and body composition and demonstrate the utility of computer-based experimentation to study, gain insight into, and make predictions about their dynamics.
We describe a diagnostic support system for clinical psychiatry and its evaluation results. The system has two inter-related components: a rule-based reasoning part associated with uncertainty, and a deterministic part, that uses heuristics to perform categorical reasoning. The system includes the 30 groups of psychiatric diagnoses which are classified under the categories 290 to 319 of the DSM-III-R and the ICD-9. There are, in fact, 1508 rules relating 208 clinical findings with 257 diagnoses. The reasoning strategy is based on selecting and differentiating diagnostic categories in a hierarchical classification tree. The system is intended to be used for education of medical students, and to help non-specialist clinicians, residents in psychiatry, or experts with few years of experience in decision making. We tested the diagnostic performance of the system using case reports extracted from a specialized journal. In 52.8% of the cases, the correct diagnosis was ranked as the first hypothesis using only the rule-based part. In combination with the deterministic strategy, the correct diagnosis could be made for 73.6% of the analyzed cases.
The Scanning Tomographic Acoustic Microscope (STAM) is an instrument capable of performing subsurface imaging of microscopic specimens. Designed around the Scanning Laser Acoustic Microscope (SLAM), the STAM incorporates numerous hardware and software advances which allow automated imaging of the acoustic properties of thick specimens at high resolution. With these modifications the STAM is shown to be capable of image formation for tissue characterization and nondestructive evaluation (NDE) of microscopic specimens. This paper describes the design and operation of the STAM hardware, and software algorithms developed to permit high resolution imaging. Examples are provided to demonstrate the capability of multiple angle and multiple frequency tomographic reconstructions.
A homologous gene transfer system for Aspergillus awamori for site-specific integration is described, based on two components. First, a defined A. awamori pyrG mutant strain constructed by a selection strategy for gene-replacement in fungi. Second, a vector with a homologous pyrG selection marker containing a defined mutation at a site different from that of the mutations in the pyrG gene of the defined mutant strain. Defined mutation in the A. awamori pyrG gene, isolated from a genomic library by heterologous hybridisation with the A. niger pyrG gene as a probe, were introduced by specifically altering sequences at restriction sites in the coding region of the gene. After transformation of the A. awamori wild-type strain with vectors containing these mutated pyrG genes, and selection for 5-fluoro-orotic acid resistance (5-FOAR), on the average 60% of the 5-FOAR colonies originated from replacement of the wild-type pyrG gene by the mutated pyrG allele. After transformation of a mutant strain, carrying a mutation near the 5' end of the pyrG gene with vectors containing a mutation near the 3' end of the pyrG gene, 35% of the resulting transformants contained one copy of the vector at the pyrG locus.
To explore the integrity of the hypothalamic-pituitary-adrenal (HPA) system in major depressive disorder, 12 patients and normal controls matched for sex, age, and body weight received 100 micrograms synthetic human corticotropin-releasing hormone (hCRH) as an i.v. bolus dose. Compared to controls, depressed patients showed an elevation in baseline cortisol and a significant attenuation of net adrenocorticotropin (ACTH) responses, while cortisol secretion in response to hCRH was normal. These abnormalities in HPA axis function and apparent discordances in the interrelationships of ACTH and cortisol baseline and net stimulation responses between depressed patients and normal controls indicate, at least in part, a derangement of the glucocorticoid-dependent negative feedback circuitry and support the hypothesis that HPA hyperactivity in depression involves neurotransmitter-mediated hypothalamic hypersecretion of CRH.
A new system--called SYBAR--is introduced, that employs digital video for registration of the movements of a patient while simultaneously recording electromyogram signals of relevant muscles and ground reaction forces (for the lower extremities in gait studies). All information is stored in a multimedia record, which can be viewed by the clinician with a simple user interface. This setup allows an integrated and more detailed view of the movement of the patient and related information (i.e., muscle physiology). It is used by clinicians to assess the causes of movement disorders in their patients. This paper describes the SYBAR system and focuses on the employed methods of data synchronization for both the time and the spatial domains. It is concluded that, although SYBAR was developed for clinical gait studies, the technology can be applied in all situations in which the relation between physiological signals and human or animal behavior is studied.
The temperate bacteriophage phiSfi21 integrates its DNA into the chromosome of Streptococcus thermophilus strains via site-specific recombination. Nucleotide sequencing of the attachment sites identified a 40-bp identity region which surprisingly overlaps both the 18-terminal bp of the phage integrase gene and the 11-terminal bp of a host tRNAArg gene. A 2.4-kb phage DNA segment, covering attP, the phage integrase, and a likely immunity gene contained all the genetic information for faithful integration of a nonreplicative plasmid into the attB site. A deletion within the int gene led to the loss of integration proficiency. A number of spontaneous deletions were observed in plasmids containing the 2.4-kb phage DNA segment. The deletion sites were localized to the tRNA side of the identity region and to phage or vector DNA with 3- to 6-bp-long repeats from the border region. A similar type of deletion was previously observed in a spontaneous phage mutant.
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As the Clinton health care reform plan is debated, hospitals are preparing their revised strategic plans. Donald E.L. Johnson looks at integrated health care delivery systems in light of state and federal regulations.
The Davey-Stewartson 1 (DS1) system [Proc. R. Soc. London, Ser. A 338, 101 (1974)] is an integrable model in two dimensions. A quantum DS1 system with two color components in two dimensions has been reformulated. This two-dimensional problem has been reduced to two one-dimensional many-body problems with two color components. The solutions to the two-dimensional problem under consideration can be constructed from the resulting problem in one dimensions. For the latter problem with delta-function interactions and solution by the Bethe ansatz, we introduce symmetrical and antisymmetrical Young operators of the permutation group and obtain the exact solutions for the quantum DS1 system.
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