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At least 253 records · Page 14Linked to original sources

An evaluation of the applicability of quantitative clinical standards for the management of genital chlamydial infection using an electronic database.

A prototype electronic database was designed for use as a retrospective audit tool to provide data that allowed comparison of genital chlamydial infection management performance with a series of quantitative operational consensus standards. However, some of the terms used by the standards require further definition for translation into database fields to improve accuracy and general application as an audit tool. Construction of the database involved differentiation between prior and clinic diagnostic points, as well as a forward contact trail of specific quantitative indicators of contact tracing. More definition is needed of the meaning of diagnosis and contact in the standards. For clinic-diagnosed patients, the time to treatment was mainly dependent on clinical factors, not on the availability of a chlamydial test result. For about one-third of patients (with prior management), several standards cannot be applied because data are not available, and this raises the issue of data sharing between various agencies involved in chlamydial testing. More data from other clinics may help both to test the appropriateness of, and inform, some of the operational standards. The database could be developed as a real-time audit tool for use with electronic patient records.

Ambulatory Care↗

Challenges of target/compound data integration from disease to chemistry: a case study of dihydrofolate reductase inhibitors.

Despite the improvements in informatics associated with initiatives in the structure-based design and genomics fields, no straight-forward links are available between a given disease class and drug chemistry. This involves effective linking of disease to protein targets, and then mapping these targets to drug chemistry. In practice, protein-ligand structural analyses and high-throughput screening experiments generate the links between targets implicated in disease and chemical leads. Additionally, large volumes of relevant data are also being produced by high-throughput X-ray crystallography and in-silico docking initiatives. Each of these efforts takes a distinctly different approach to how data is managed and mined, resulting in difficulties in sharing data across each area. This review discusses the diverse approaches taken to data management in these areas, and the challenges associated with the construction of a data warehouse that meets all of the needs of each data type. Using the current work available for dihydrofolate reductase inhibitors, we demonstrate the challenges and opportunities associated with data mining from disease to drug chemistry.

Animals↗

Genetic analyses of focal aspects of infant temperament.

The authors explored the genetic and environmental underpinnings of individual differences in temperament with a sample of 604 3- to 16-month-old infant twins and their parents. Mothers completed Rothbart's Infant Behavior Questionnaire (IBQ), and a subsample of 140 9-month-old twins participated in behavioral assessment of temperament in the laboratory as well. For IBQ Smiling and Laughter and Duration of Orienting, both additive genetic and shared environmental effects were needed to best represent the data. Shared environmental effects fully accounted for cotwin similarity for IBQ Soothability, and conversely, additive genetic effects fully accounted for cotwin similarity for the IBQ Distress to Limitations, Distress to Novelty, and Activity Level scales. With the subsample, the authors fit a multivariate model to mother report, father report, and lab measures of stranger distress and found that genetic influences were most important for the covariation among these measures.

Arousal↗

[The research and development of computer workstation for Bayer Clinitek urine analyzer].

Computerization and networking is the developing trend of modern medical instruments. This paper describes the research and development work of computer workstation for Bayer Clinitek urine analyzer, including the system designing, hardware composing and software programming. The system can receive analyzing data automatically, manage sample database, print sample report and share data via the network, etc.

Computer Communication Networks↗

Methods for assessing rat sperm motility.

Computer-assisted sperm analysis (CASA) systems are becoming more widely used. With this spread of technology come more data from toxicology studies, designed to determine if treatment with putative toxicants affects sperm motion parameters. While these CASA methods provide us with more ways to evaluate toxicity and thus perhaps increase our chances of successfully protecting human health, there is also a greater likelihood that different laboratories will use different methods of collecting data on sperm motility. Different systems used with different methods in different laboratories will inevitably generate data that are difficult to compare. In a prospective attempt to address this issue of comparability and limit the problems, a group of individuals using CASA systems to analyze rat sperm motility convened to discuss methodologic issues, share data, and try to reach a consensus about methods for performing these studies. This article shares those meetings and data in the hope that common methods will enhance interlaboratory comparisons.

Animals↗

The challenge of documenting managed care cost savings and performance.

It is not too late for managed care to turn this situation around because the debate over health care reform and managing change is ongoing. It remains to be seen whether managed care companies will support independent third parties (i.e., researchers) in analyzing proprietary data and making value judgments about their effectiveness. There is a perception among managed care organizations that potentially negative findings could damage them in the marketplace. Nonetheless, smart organizations use negative findings as new opportunity targets for service improvement and product refinement. To what extent will managed care companies voluntarily release accurate data on performance factors in order for researchers to conduct cross-company analyses? Perhaps competitive markets such as managed care are not consistent with voluntary data sharing. On the other hand, mandatory reporting will not ensure data accuracy either. It is up to the managed care industry itself to develop a cooperative approach to data collection, analysis, and dissemination.

Cost Savings↗

Management factors associated with swine breeding-herd productivity in the United States.

A database containing 24 key production measurements was created by abstracting data files of 673 U.S. farms which participated in the PigCHAMP data-share program in 1995. Summary statistics for breeding-herd performance data were presented for the Cornbelt and the South or Eastern regions. Eight models were built to assess the association between production system, operation management factors and productivity outcomes. Lactation length, percentage of multiple matings, parity of culled sows, percent gilts in the breeding-female inventory, and female culling rate were the management factors identified as having important associations with productivity outcomes. For example, shorter lactation length, higher percentage of multiple matings, and lower culling rate were associated with more pigs weaned per mated female per year. In addition, a lower percentage of gilts in the breeding-female inventory and a higher percentage of multiple matings were associated with fewer average non-productive female days. We recommend that producers change their management systems to decrease lactation length, the percentage of gilts in the breeding-female inventory, and female culling rate, and increase percentage of multiple matings in order to improve breeding-herd productivity on swine farms.

Animal Husbandry↗

Business models for health care decision support.

CareScience, Inc. is a public company (NASDAQ: CARE) that originated ten years ago to commercialize risk adjustment and complication predictions developed by the Wharton School of Business and the University of Pennsylvania School of Medicine. Over the past decade, the company has grown to approximately 200 clients and 150 employees. Among the "firsts" recorded by the company, CareScience was the first to offer a clinical decision support system as an Application Service Provider (ASP), the first to offer peer-to-peer clinical data sharing among health care provider organizations and practitioners (Santa Barbara Care Data Exchange), and the first to provide a care management outsourcing arrangement.

Academic Medical Centers↗

State programs for pesticide residues in foods.

Two U.S. data collection and dissemination programs, FEEDCON and FOODCONTAM, are described. FEEDCON provides information on contamination levels in animal feeds of toxic chemical residues (pesticides, industrial chemicals, heavy metals, mycotoxins, natural plant toxins, salmonella, and therapeutic drug cross-contaminations). FEEDCON data are collected from approximately 40 state feed regulatory agencies, feed manufacturers, and related groups who subscribe ($100-$200 per year) to the program, which is sponsored by the Association of American Feed Control Officials. FOODCONTAM provides similar information, but is limited to pesticides, heavy metals and industrial chemicals (polychlorinated and polybrominated biphenyls, etc.) in human foods. Both programs have been developed and initiated under U.S. Food and Drug Administration contracts with the Mississippi State Chemical Laboratory. Program structures of both are outlined conceptually, and FOODCONTAM is described in detail. FOODCONTAM data-sharing program development is essentially complete, but expansion by incorporating FDA data with State Laboratory data is nearing reality.

Food Contamination↗

Data input module for Birth Defects Systems Manager.

The need for a computational bioinformatics infrastructure to manage the vast digital information from functional genomics and proteomics motivated us to develop Birth Defects Systems Manager (BDSM) as an open resource to facilitate analysis and discovery in developmental biology and developmental toxicity. This report describes the design, development and implementation of the data loading module of BDSM, referred to as LoadBDSM. It includes a shared data directory resource that can be granted various levels of security for different research groups or investigators to manage experimental datasets individually or in groups. LoadBDSM allows the upload of data and experiment details using controlled semantics for developmental exposure (toxicant, dosing scenario, intervention), biological sample (species, tissue, stage) and disease outcome (time, risk, phenotype). It adheres to existing controlled vocabulary plus rules of inference (ontologies) for experiment, data and metadata annotations. LoadBDSM extends the capabilities of BDSM to support the emergence of "embryo-formatics" defined here as the data, information and knowledge from genomic sciences applied to, or derived from, an embryological context. This includes, but is not limited to, delineating pathways and biological regulatory networks for specific chemicals or classes of developmental toxicants, developing novel biomarkers indicative of exposure and/or predictive of adverse effects, and integrating modern computing and information technology with data from molecular biology.

Abnormalities, Drug-Induced↗

Conceptual analysis for knowledge-base design.

Knowledge-base design requires a thorough analysis of the concepts to be represented. If the analysis is incomplete or inaccurate, the resulting knowledge base may contain arbitrary restrictions, inconsistent data, or limitations that make future extensions impossible. Conceptual analysis is even more critical for sharing knowledge bases between heterogeneous systems. Analyses that are adequate for independent systems may cause incompatibilities when the systems share data. This paper discusses the kinds of problems that require a careful conceptual analysis and the difficulties caused by an incorrect or incomplete analysis. It also shows how independently developed knowledge bases can be related to one another by reanalyzing and redefining the basic concepts and relations. Such analysis is essential for sharing knowledge between systems developed for different purposes, such as relational and object-oriented databases or expert systems and natural language processors.

Algorithms↗

Privacy-hardened and hallucination-resistant synthetic data generation with logic-solvers.

MOTIVATION: Machine-generated or synthetic data is a valuable resource for training artificial intelligence algorithms, evaluating rare workflows, and sharing data under stricter data legislations. However, current statistical and deep learning methods struggle with large data volumes, are prone to hallucinating scenarios incompatible with reality, and seldom quantify privacy meaningfully. RESULTS: Here, we introduce Genomator, a logic solving approach (SAT solving), which efficiently produces private and realistic representations of the original data. We demonstrate the method on genomic data, which arguably is the most complex and private information. We benchmark Genomator against state-of-the-art methodologies (Markov generation, Wasserstein Generative Adversarial Network and Conditional Restricted Boltzmann Machines), demonstrating a 40%-530% accuracy improvement and 57%-172% higher privacy. Genomator is also 3-100 times more efficient, making it the only tested method that scales to whole genomes. We show the universal trade-off between privacy and accuracy, and use Genomator's tuning capability to cater to all applications along the spectrum, from provable private representations of sensitive cohorts, to datasets with indistinguishable pharmacogenomic profiles. Demonstrating the production-scale generation of tuneable synthetic genomes hold great potential for balancing underrepresented populations in medical research and advancing global data exchange. AVAILABILITY AND IMPLEMENTATION: Genomator is available at https://github.com/csiro/genomator.

Algorithms↗

A biopsy of the use of the Baxter formula to resuscitate burns or do we do it like Charlie did it?

The Baxter formula is commonly used to calculate fluid requirements. Baxter reported that 12% of patients would require more than 4.3 mL/kg per percentage of total body surface area (%TBSA). We anecdotally observed that we frequently exceeded the predictions of the formula, and we wondered if this was unique to our practice. We studied our last 11 burn-related resuscitations and collected fluid resuscitation data from US burn centers. Twenty-eight centers were queried, and 6 centers shared data. We were therefore able to study the resuscitation data of 50 adult patients. For 29 patients (58%), 4.3 mL/kg/%TBSA was exceeded compared with the 12% reported by Baxter. These findings suggest that in actual practice, fluid volumes administered are larger than the Baxter formula predicts. This survey does not explain why. Possible reasons for the larger fluid volumes are as follows: (1) the sample is not representative; (2) the formula is used improperly; (3) burns have changed and require more fluids; (4) burn care has changed.

Adult↗

Combo acquisitions: balancing scan time reduction and image quality.

Recently a new technique for the combined acquisition of multicontrast images, termed "combo acquisition," was introduced. In combo acquisitions, the three concepts of 1) variable acquisition parameters, 2) k-space data sharing, and 3) multicontrast imaging are systematically integrated to reduce MRI scan time and improve data utilization in a clinical setting. In this study, two-contrast and three-contrast spin-echo (SE) and turbo spin-echo (TSE) combo acquisition protocols that were designed and optimized in simulation experiments were implemented on a 1.5 T clinical scanner. Phantom and human brain data from volunteers and patients were acquired. Scan time reductions of 25-52% were achieved compared to standard acquisitions, largely confirming the simulation results. We evaluated the resulting images by quantitatively analyzing the preservation of contrast and the signal-to-noise ratio (SNR). In addition, data sets for 10 clinical cases obtained with TSE combo and corresponding standard acquisitions were graded by two experienced neuroradiologists in terms of the level of artifacts and image quality for comparison. Only minor image degradation with the combo scans was observed, indicating an inherent trade-off between scan time reduction and image quality. The specific aspects of combo acquisitions with respect to motion, flow, and k-space data weighting are discussed.

Algorithms↗

Representation of change in controlled medical terminologies.

Computer-based systems that support health care require large controlled terminologies to manage names and meanings of data elements. These terminologies are not static, because change in health care is inevitable. To share data and applications in health care, we need standards not only for terminologies and concept representation, but also for representing change. To develop a principled approach to managing change, we analyze the requirements of controlled medical terminologies and consider features that frame knowledge-representation systems have to offer. Based on our analysis, we present a concept model, a set of change operations, and a change-documentation model that may be appropriate for controlled terminologies in health care. We are currently implementing our modeling approach within a computational architecture.

Artificial Intelligence↗

A proposal for a standard CORBA interface for genome maps.

MOTIVATION: The scientific community urgently needs to standardize the exchange of biological data. This is helped by the use of a common protocol and the definition of shared data structures. We have based our standardization work on CORBA, a technology that has become a standard in the past years and allows interoperability between distributed objects. RESULTS: We have defined an IDL specification for genome maps and present it to the scientific community. We have implemented CORBA servers based on this IDL to distribute RHdb and HuGeMap maps. The IDL will co-evolve with the needs of the mapping community. AVAILABILITY: The standard IDL for genome maps is available at http:// corba.ebi.ac.uk/RHdb/EUCORBA/MapIDL.htm l. The IORs to browse maps from Infobiogen and EBI are at http://www.infobiogen.fr/services/Hugemap/IOR and http://corba.ebi.ac.uk/RHdb/EUCORBA/IOR CONTACT: manu@infobiogen.fr, tome@ebi.ac.uk

Animals↗

Secondary analysis: a method for learning research activities.

Secondary analysis may be an efficient, effective method of providing graduate students in nursing with experience in specified stages of the research process. The availability of archived data sets is increasing as are the numbers of researchers who recognize the value of sharing data with others. Thus, the development of nursing as a research-based practice can be enhanced by tapping into this source of data and asking relevant research questions that address issues in nursing.

Data Collection↗

Educational standards -- terminologies used.

Efficient and effective delivery of health care requires accurate and relevant knowledge, patient-centred clinical data and medical information which is available to different actors and institutions in health care. Sharing data and knowledge means understanding the underlying concepts, terms, etc. Therefore a basic requirement in medical education is terminology, coding and classification. Vocabularies, data sets, schemes are to be used for medical documentation, medical statistics, analysis and system operation. Communication between heterogeneous environments will be possible when common terminologies etc. are available and used during system development. The following chapters give an overview on this important field of health telematics.

Health Personnel↗