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At least 289 records · Page 16Linked to original sources
PubMed1994

An integrated system grows in Boston. Interview by Karen Gardner.

After news reports highlighting discussions among the major teaching hospitals in Boston last year, two leading academic medical centers--Massachusetts General Hospital (MGH) and Brigham and Women's Hospital--teamed up to form Partners Healthcare System Inc. Ferdinand Colloredo-Mansfield, the former chairman of MGH and the current co-chair of the new system, spoke recently with TRUSTEE editor Karen Gardner about the integration process now taking place between the two hospitals. Colloredo-Mansfeld, president of Cabot Partners, a real estate investment counseling firm in Boston, has been a trustee of MGH since 1982 and has served as chairman since 1992. He has also been an active participant in the process.

Academic Medical Centers↗
PubMed2005

Fluidized bed combustion systems integrating CO2 capture with CaO.

Capturing CO2 from large-scale power generation combustion systems such as fluidized bed combustors (FBCs) may become important in a CO2-constrained world. Using previous experience in capturing pollutants such as SO2 in these systems, we discuss a range of options that incorporate capture of CO2 with CaO in FBC systems. Natural limestones emerge from this study as suitable high-temperature sorbents for these systems because of their low price and availability. This is despite their limited performance as regenerable sorbents. We have found a range of process options that allow the sorbent utilization to maintain a given level of CO2 separation efficiency, appropriate operating conditions, and sufficiently high power generation efficiencies. A set of reference case examples has been chosen to discuss the critical scientific and technical issues of sorbent performance and reactor design for these novel CO2 capture concepts.

Adsorption↗
PubMed1997

A consultation system integrating Chinese medical practice in herbaltherapy, acupuncture and acupressure.

The paper presents an informatic system offering the acupuncturist, herbalist and acupressurist a rich source of clinical information. It adapts the theory of Chinese Medicine to Western medical practice and is solidly based on the ancient Chinese classics. The system provides an orientative diagnosis starting from the clinical picture of the patient consisting in syndrome differentiation. Based on the Yin-Yang and 5 Elements theory the remedy associated with the energetic imbalance is determinated. Then the tastes, nature and tropism implied by the principle of treatment are used to prescribe the herbal treatment. The treatment variants through acupuncture and acupressure are also indicated. The system is also useful in teaching Chinese Medicine.

Acupressure↗
PubMed1996

[How are psychological processes, the neuroendocrine system and immune system integrated?].

This short overview shows that there are bidirectional interactions between the central nervous system (CNS) and the immune system and deals with their anatomical and physiological correlates. Moreover, a number of immunological findings related to exogenous stress, depressive disorders and schizophrenias are discussed. An attempt is made to cautiously interpret the data presented and to demonstrate that the field of psychoneuroimmunology provides plenty of rewarding challenges for future research.

Antibody Formation↗
PubMed2006

Integrating systems biology and medical imaging: understanding disease distribution in the lung model.

OBJECTIVE: Many chronic diseases exhibit characteristic pulmonary distribution patterns, but the underlying biologic explanations remain elusive. On the basis of emerging evidence from systems biology, we propose that gradients of T helper immune function exist as an epiphenomenon of the hypoxic pulmonary vasoconstriction response. Regional variation of immune function may contribute to preferential distribution patterning of lung diseases. CONCLUSION: The lungs represent but one example in which the distribution of immune function throughout the body may explain disease location. This hypothetic framework can apply to diseases outside the realm of pulmonary biology and illustrates the potential benefit of integrating advances in systems biology and medical imaging.

Diagnostic Imaging↗
PubMed2006

The model organism as a system: integrating 'omics' data sets.

Various technologies can be used to produce genome-scale, or 'omics', data sets that provide systems-level measurements for virtually all types of cellular components in a model organism. These data yield unprecedented views of the cellular inner workings. However, this abundance of information also presents many hurdles, the main one being the extraction of discernable biological meaning from multiple omics data sets. Nevertheless, researchers are rising to the challenge by using omics data integration to address fundamental biological questions that would increase our understanding of systems as a whole.

Animals↗
PubMed1980

An integrated system for patient assessment and classification and nurse staff allocation for long term care facilities.

An integrated approach to patient classification and nurse staffing for long term care facilities is constructed, based on the quantification of patient care needs as reflected by formal assessment of a variety of key functioning status items, behavioral status indicators, and medically defined conditions. Nonlinear multiple regression techniques are employed in order to cluster these key assessment indicators in to an easily applied level of care classification method that can be used to determine placement of patients within the long term care system and to indicate the particular nursing care activities called for. Given the classification of patients into the various levels of care required (e.g., Chronic, Skilled Nursing Care, Intermediate A or B) a mixed integer/linear programming model is used to permit presentation of alternative nurse staffing strategies within a long term care facility or program. Extensions to the model portray the effects of changing budgetary, service, and legal restrictions.

Activities of Daily Living↗
PubMed2003

The base excision repair enzyme MED1 mediates DNA damage response to antitumor drugs and is associated with mismatch repair system integrity.

Cytotoxicity of methylating agents is caused mostly by methylation of the O6 position of guanine in DNA to form O6-methylguanine (O6-meG). O6-meG can direct misincorporation of thymine during replication, generating O6-meG:T mismatches. Recognition of these mispairs by the mismatch repair (MMR) system leads to cell cycle arrest and apoptosis. MMR also modulates sensitivity to other antitumor drugs. The base excision repair (BER) enzyme MED1 (also known as MBD4) interacts with the MMR protein MLH1. MED1 was found to exhibit thymine glycosylase activity on O6-meG:T mismatches. To examine the biological significance of this activity, we generated mice with targeted inactivation of the Med1 gene and prepared mouse embryonic fibroblasts (MEF) with different Med1 genotype. Unlike wild-type and heterozygous cultures, Med1-/- MEF failed to undergo G2-M cell cycle arrest and apoptosis upon treatment with the methylating agent N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). Similar results were obtained with platinum compounds' 5-fluorouracil and irinotecan. As is the case with MMR-defective cells, resistance of Med1-/- MEF to MNNG was due to a tolerance mechanism because DNA damage accumulated but did not elicit checkpoint activation. Interestingly, steady state amounts of several MMR proteins are reduced in Med1-/- MEF, in comparison with Med1+/+ and Med1+/- MEF. We conclude that MED1 has an additional role in DNA damage response to antitumor agents and is associated with integrity of the MMR system. MED1 defects (much like MMR defects) may impair cell cycle arrest and apoptosis induced by DNA damage.

Animals↗
PubMedDate not supplied

Physician and health system integration.

Incentives for vertical integration in the health care industry have led many hospitals to consolidate into health systems and profess a desire for closer alignment with affiliated physicians. In this study of fourteen organized delivery systems and their 11,000 physicians in sixty-nine medical groups, we found that many health systems did not align well with physicians. Even systems ostensibly committed to alignment emphasized structural relationships that did not enhance physician-system alignment and paid inadequate attention to issues of importance to physicians. This gap between the goal and reality of physician-system alignment appears to be the result of systems' responding to a changing mix of policies, not all of which foster integration.

Delivery of Health Care, Integrated↗
PubMed1992

An integrated system for quantitation of chemotaxis using a 48-well millipore filter assay.

We have established a computerized system for quantification of human neutrophil motility using a 48-well chemotaxis assay. The software is primarily written in the Unix C-shell and is designed to integrate with standard statistical and graphics packages and permit analysis either under Unix or MS-DOS. We demonstrate how simple image analysis techniques may be used to count neutrophils that have traversed a polycarbonate filter. Methods of optical optimization, cell counting and integration with the Statistical Analysis System (SAS) are presented.

Chemotaxis, Leukocyte↗
PubMed1993

A new integrated system for three-dimensional echocardiographic reconstruction: development and validation for ventricular volume with application in human subjects.

OBJECTIVES: The purpose of this study was to improve three-dimensional echocardiographic reconstruction by developing an automated mechanism for integrating spark gap locating data with corresponding images in real time and to validate use of this mechanism for the measurement of left ventricular volume. BACKGROUND: Initial approaches to three-dimensional echocardiographic reconstruction were often limited by inefficient reconstructive processes requiring manual coordination of two-dimensional images and corresponding spatial locating data. METHODS: In this system, a single computer overlays the binary-encoded positional data on the two-dimensional echocardiographic image, which is then recorded on videotape. The same system allows images to be digitized, traced, analyzed and displayed in three dimensions. This system was validated by using it to reconstruct 11 ventricular phantoms (19 to 271 ml) and 11 gel-filled excised ventricles (21 to 236 ml) imaged in intersecting long- and short-axis views and by apical rotation. To measure cavity volume, a surface was generated by an algorithm that takes advantage of the full three-dimensional data set. RESULTS: Reconstructed cavity volumes agreed well with actual values: y = 0.96x + 2.2 for the ventricular phantoms in long- and short-axis views (r = 0.99, SEE = 2.7 ml); y = 0.95x + 2.9 for the phantoms, reconstructed by apical rotation (r = 0.99, SEE = 2.7 ml); and y = 0.99x + 0.11 ml for the excised ventricles (reconstructed in long- and short-axis views; r = 0.99, SEE = 5.9 ml). The mean difference between three-dimensional and actual volumes was 3% of the mean (3.0 ml) for the phantoms and 6% (4.6 ml) for the excised ventricles. Observer variability was 2.3% for the phantoms and 5.6% for the excised ventricles. Application to 14 normal subjects demonstrated feasibility of left ventricular reconstruction, which provided values for stroke volume that agreed well with an independent Doppler measure (y = 0.97x + 0.94; r = 0.95, SEE = 3.2 ml), with an observer variability of 4.9% (2.4 ml). CONCLUSIONS: A system has therefore been developed that automatically integrates locating and imaging data in no more time than the component two-dimensional echocardiographic scans. This system can accurately reconstruct ventricular volumes in vitro over a wide range and is feasible in vivo, thus laying the foundation for further applications. It has increased the efficiency of three-dimensional reconstruction and enhanced our ability to address clinical and research questions with this technique.

Adult↗
PubMed1997

Management of Information in Radiation Oncology: An Integrated System for Scheduling, Treatment, Billing, and Verification.

An effective information system is an essential prerequisite to delivering quality patient care at competitive costs. From scheduling and billing to complex treatment machine control and verification, the quality of the information system strongly affects the efficiency and accuracy with which patient care is delivered. The standard paper-based information system used in many clinics suffers form inefficiencies and incompleteness in scheduling and billing, no centralized database and the inability to generate routine reports and communicate with other information systems. Many of these problems are resolved by the introduction of an electronic information system. The implementation, gains, and limitations of two electronic information systems are discussed. While limitations such as the lack of complete seamless integration of all information still exist, major improvements have been made in efficiency, accuracy, data integrity, and reporting and billing completeness.

Journal Article↗
PubMed1996

Health system integration: a means to an end.

The creation of integrated firms and contractual networks in health care often is a precondition for other forms of integration that could actually lower costs and improve quality of care. Although different types of integration activities are leading to innovations in the production of services and the care of populations, the continued influence of the "old" indemnity insurance/fee-for-service system creates important obstacles to those integration activities. If creation of integrated firms and contractual networks races ahead of other forms of integration, it could produce uncompetitive markets that reduce pressures to integrate in ways that can cut costs and improve quality of care. Purchasers' actions could play a major role in determining the future of various integration activities.

Community Health Planning↗