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Canadian anaesthesia physician resource planning--is it possible?

This study was undertaken with the objective of assessing current sources of information for anaesthesia Physician Resource Planning (PRP). Four major data bases, the annual reports of Health and Welfare Canada (H&W), the education statistics from the Canadian Post-M.D. Education Registry (CAPER), the Royal College of Physicians and Surgeons of Canada (RCPSC) and the Physician Resource Data System of the Canadian Medical Association (PRDS), were examined for the period 1982 to 1991. The ratio of the number of surgical (S) to anaesthesia (A) clinicians decreased over this period despite an increase in the S:A ratios for trainees and certificants. The number of female anaesthetists has progressively increased. A steady decline in the number of rural anaesthetists has occurred. Age distribution of active certified anaesthetists revealed marked inter-regional differences. Little change was noted in the total mean hours worked per week. Each database provided valuable, but limited, data. The PRDS data is useful in assessing trends (age, sex and practice activity). Information provided by H&W tends to underestimate anaesthesia resource information by at least 10%. While information obtained from RCPSC and CAPER is accurate, the current mode of presentation of data limits their usefulness. Integrating data from all the databases appears to provide a meaningful assessment for PRP rather than assessing each database in isolation. Interpretation of the information and its value must take into account the limitations of the data being provided. Assessing present and planning future needs based on the current information structure will prove extremely difficult.

Adult↗

Visual integration of data and basic motor skills under laparoscopy. Influence of 2-D and 3-D video-camera systems.

BACKGROUND: The qualities of visual perception and of motor reaction to the visual stimulus have never been studied in reference to the type of video-camera system (2-D vs 3-D) used during laparoscopy. METHODS: The study was designed in two parts. The first evaluated the ability of the eye to discriminate how objects are spaced relative to one another. The second investigated the motor reaction to the visual stimulus in an environment where depth was the preponderent cue. The tests were performed in a pelvi-trainer in which were inserted different modules built either for visual observation (Part 1) or for evaluation of motor ability (Part 2). Variables studied during Part 1 were the time required to do the test and the number of errors committed during its performance. The variable evaluated during Part 2 was the time needed to terminate the test. Each of these two parts of the study were completed alternating the 2-D and 3-D systems. A total of 304 observations were recorded. Statistics used were the paired t-test, the independent group t-test, and the Newman-Keuls multiple comparisons test. RESULTS: Results of Part 1 of the study confirm that visual perception varies significantly among individuals (n = 10) (p < 0.05) and that a true 3-D video-camera system facilitates visual perception when compared to a 2-D system (p < 0.001). Results of Part 2 of the study also show significant differences among participants (n = 9)(p < 0.05). The true 3-D system allowed significantly faster motor performances than the 2-D system (p < 0.001). CONCLUSION: Our experiment shows that the 3-D system allowed significant improvements in the execution of the evaluated parameters. Also noted were significant differences among participants in term of visual and motor skills.

Humans↗

Integrating neuroscientific data across spatiotemporal scales.

A major challenge confronting neuroscientists is associated with the multiple spatial and temporal scales of investigation of neural structure and function. I shall discuss the use of computational neural modeling as one method to bridge some of the different spatial and temporal levels. This approach will be illustrated using large-scale, neurobiologically realistic network models of auditory and visual pattern recognition that relate neuronal dynamics to fMRI data. It will be demonstrated that the models are capable of exhibiting the salient features of both electrophysiological neuronal activities and fMRI values that are in agreement with empirically observed data.

Animals↗

A multi-criteria approach to Great Barrier Reef catchment (Queensland, Australia) diffuse-source pollution problem.

This paper presents a multi-criteria based tool for assessing the relative impact of diffuse-source pollution to the Great Barrier Reef (GBR) from the river basins draining into the GBR lagoon. The assessment integrates biophysical and ecological data of water quality and pollutant concentrations with socio-economic information pertaining to non-point source pollution and (potential) pollutant impact. The tool generates scores for each river basin against four criteria, thus profiling the basins and enabling prioritization of management alternatives between and within basins. The results support policy development for pollution control through community participation, scientific data integration and expert knowledge contributed by people from across the catchment. The results specifically provided support for the Reef Water Quality Protection Plan, released in October 2003. The aim of the plan is to provide a framework for reducing discharge of sediment, nutrient and other diffuse-source loads and (potential) impact of that discharge and for prioritising management actions both between and within river basins.

Agriculture↗

A wiring of the human nucleolus.

Recent proteomic efforts have created an extensive inventory of the human nucleolar proteome. However, approximately 30% of the identified proteins lack functional annotation. We present an approach of assigning function to uncharacterized nucleolar proteins by data integration coupled to a machine-learning method. By assembling protein complexes, we present a first draft of the human ribosome biogenesis pathway encompassing 74 proteins and hereby assign function to 49 previously uncharacterized proteins. Moreover, the functional diversity of the nucleolus is underlined by the identification of a number of protein complexes with functions beyond ribosome biogenesis. Finally, we were able to obtain experimental evidence of nucleolar localization of 11 proteins, which were predicted by our platform to be associates of nucleolar complexes. We believe other biological organelles or systems could be "wired" in a similar fashion, integrating different types of data with high-throughput proteomics, followed by a detailed biological analysis and experimental validation.

Artificial Intelligence↗

Uranium transport around the reactor zone at Bangombé and Okélobondo (Oklo): examples of hydrogeological and geochemical model integration and data evaluation.

The sites at Bangombé and Okélobondo (Oklo) in Gabon provide a unique opportunity to study the behaviour of products from natural nuclear reactions in the vicinity of reactor zones which were active around two billion years ago. The Commission of the European Communities initiated the Oklo Natural Analogue Programme. One of the principal aims was to study indications of present time migration of elements from the reactor zones under ambient conditions. The hydrogeological and hydrochemical data from the Oklo sites were modelled in order to better understand the geochemical behaviour of radionuclides in the natural system, by using independent models and by comparing the modelling outcome. Two modelling approaches were used: M3 code (hydrochemical mixing and mass balance model), developed by the Swedish Nuclear Fuel and Waste Management Company (SKB) and HYTEC (reactive transport model) developed by Ecole des Mines de Paris. Two different reactor zones were studied: Bangombé, a shallow site, the reactor being at 11 m depth, and OK84 at Okélobondo, situated at about 450 m depth, more comparable with a real repository location. This allowed the validation of modelling tools in two different sedimentary environments: one shallow, with a more homogeneous layering situated in an area of meteoric alteration, and the other offering the opportunity to study radionuclide migration from the reaction zone over a distance of 450 m through very heterogeneous sedimentary layers. The modeling results indicate that the chemical reactions retarding radionuclide transport are very different at the two sites. At Bangombé, the decomposition of organic material consumes oxygen and at Okélobondo the oxygen is consumed by inorganic reactions resulting, in both cases, in uranium retardation. Both modelling approaches (statistic with M3 code and deterministic with HYTEC code) could describe this situation. The goal of this exercise is to test codes which can help to describe and understand the processes taking place at the sites, validate the models with in situ data, and thus build confidence in the tools used for future site characterization. Ultimately, this allows identifying and selecting processes and parameters that can be used as input into repository performance assessment calculations and modelling exercises.

Environmental Monitoring↗

The integration of data on physico-chemical properties, in vitro-derived toxicity data and physiologically based kinetic and dynamic as modelling a tool in hazard and risk assessment. A commentary.

Toxicity of a compound for an organism is dependent on the route of exposure, the amount (or concentration), the way in which the compound is taken up, distributes and is eliminated from the organism (ADME, kinetics) and the intrinsic properties (reactivity; mode of action, dynamics) of the compound towards the organism. These three elements: exposure, kinetics and dynamics form the basis of hazard and risk evaluations. Developments in our knowledge of the way in which physico-chemical properties of chemicals (on the one side) and physiological processes in the organism (on the other side) determine a compound's toxicity have greatly increased our understanding of toxicological processes and our ability to interpret experimental results. This has now resulted in the development of model systems in which the above-mentioned processes can be described mathematically. Biokinetic modelling is currently of great interest, but the further development of toxicodynamic modelling is equally important. The combination of both allows the estimation of a compound's critical amount/concentration on the critical site of action, which ideally would be the basis for hazard and risk assessments. In vitro systems have been extremely useful in studying the molecular basis of a chemical's biological activity, including its mechanism(s) of toxic action. Other achievements include the prediction of biological reactivity on the basis of a compound's physico-chemical properties and the construction of quantitative structure-activity relationships (QSARs). However, for the incorporation of in vitro-derived data as well as the results of QSARs, kinetic modelling is indispensable. Thus, biokinetic and toxicodynamic modelling are important (if not crucial) tools in toxicological research and there are increasing opportunities to incorporate the results of this work in hazard and risk assessments. Their implementation will allow a much more scientifically-based and a better structured risk assessment, which will be to a much lesser extent relying on animal experimentation.

Animal Testing Alternatives↗

ONCOMINE: a cancer microarray database and integrated data-mining platform.

DNA microarray technology has led to an explosion of oncogenomic analyses, generating a wealth of data and uncovering the complex gene expression patterns of cancer. Unfortunately, due to the lack of a unifying bioinformatic resource, the majority of these data sit stagnant and disjointed following publication, massively underutilized by the cancer research community. Here, we present ONCOMINE, a cancer microarray database and web-based data-mining platform aimed at facilitating discovery from genome-wide expression analyses. To date, ONCOMINE contains 65 gene expression datasets comprising nearly 48 million gene expression measurements form over 4700 microarray experiments. Differential expression analyses comparing most major types of cancer with respective normal tissues as well as a variety of cancer subtypes and clinical-based and pathology-based analyses are available for exploration. Data can be queried and visualized for a selected gene across all analyses or for multiple genes in a selected analysis. Furthermore, gene sets can be limited to clinically important annotations including secreted, kinase, membrane, and known gene-drug target pairs to facilitate the discovery of novel biomarkers and therapeutic targets.

Databases, Genetic↗

Conceptual tools for the integration of data.

We propose to start the analysis of complex systems by systematically identifying the feedback circuits that govern their dynamics. These circuits can be identified without any ambiguity by examining the Jacobian matrix of the system. They provide precious information regarding the number and nature of steady states. Logical descriptions use variables and functions that can take only a limited number of discrete values (in simple cases, only two, 0 or 1). We developed an asynchronous method with continuous time, generalized by using variables with more than two levels and logical parameters. Reverse logics is a synthetic, inductive method. It aims at proceeding rationally from the experimental facts towards models rather than from models to predictions.

Animals↗

Expression and functional profiling reveal distinct gene classes involved in fatty acid metabolism.

Cells respond to fatty acid exposure by metabolic reorganization and proliferation of peroxisomes. Described here is the development and application of a genome-wide screen to identify nonessential yeast genes necessary for efficient metabolism of myristic and oleic acids. Comparison of the resultant fitness data set with an integrated data set of genes transcriptionally responsive to fatty acids revealed very little overlap between the data sets. Furthermore, the fitness data set enriched for genes involved in peroxisome biogenesis and other processes related to cell morphology, whereas the expression data set enriched for genes related to metabolism. These data suggest that in response to fatty acid exposure, transcriptional control is biased towards metabolic reorganization, and structural changes tend to be controlled post-transcriptionally. They also suggest that fatty acid responsive metabolic networks are more robust than those related to cell structure. Statistical analyses of these and other global data sets suggest that the utilization of distinct control mechanisms for the execution of morphological versus metabolic responses is widespread.

Fatty Acids↗

Oral capecitabine vs intravenous 5-fluorouracil and leucovorin: integrated efficacy data and novel analyses from two large, randomised, phase III trials.

This study evaluates the efficacy of capecitabine using data from a large, well-characterised population of patients with metastatic colorectal cancer (mCRC) treated in two identically designed phase III studies. A total of 1207 patients with previously untreated mCRC were randomised to either oral capecitabine (1250 mg m(-2) twice daily, days 1-14 every 21 days; n=603) or intravenous (i.v.) bolus 5-fluorouracil/leucovorin (5-FU/LV; Mayo Clinic regimen; n=604). Capecitabine demonstrated a statistically significant superior response rate compared with 5-FU/LV (26 vs 17%; P<0.0002). Subgroup analysis demonstrated that capecitabine consistently resulted in superior response rates (P<0.05), even in patient subgroups with poor prognostic indicators. The median time to response and duration of response were similar and time to progression (TTP) was equivalent in the two arms (hazard ratio (HR) 0.997, 95% confidence interval (CI) 0.885-1.123, P=0.95; median 4.6 vs 4.7 months with capecitabine and 5-FU/LV, respectively). Multivariate Cox regression analysis identified younger age, liver metastases, multiple metastases and poor Karnofsky Performance Status as independent prognostic indicators for poor TTP. Overall survival was equivalent in the two arms (HR 0.95, 95% CI 0.84-1.06, P=0.48; median 12.9 vs 12.8 months, respectively). Capecitabine results in superior response rate, equivalent TTP and overall survival, an improved safety profile and improved convenience compared with i.v. 5-FU/LV as first-line treatment for MCRC. For patients in whom fluoropyrimidine monotherapy is indicated, capecitabine should be strongly considered. Following encouraging results from phase I and II trials, randomised trials are evaluating capecitabine in combination with irinotecan, oxaliplatin and radiotherapy. Capecitabine is a suitable replacement for i.v. 5-FU as the backbone of colorectal cancer therapy.

Administration, Oral↗

Integrating biosystematic data into conservation planning: perspectives from southern Africa's Succulent Karoo.

In this paper we explore the role that biosystematists can play in conservation planning. Conservation planning concerns the location and design of reserves that both represent the biodiversity of a region and enable the persistence of that biodiversity by maintaining key ecological and evolutionary processes. For conservation planning to be effective, quantitative targets are needed for the spatial components of a region that reflect evolutionary processes. Using examples from southern Africa's Succulent Karoo, we demonstrate how spatially explicit data on morphological variation within taxa provide essential information for conservation planning in that such variation represents an important surrogate for the spatial component of lineage diversification. We also provide an example of how the spatial components of evolutionary processes can be identified and targeted for conservation action. Key to this understanding are the recognition and description of taxonomic units at all spatial scales. Without the recognition of subspecific variation, it is difficult to formulate evolutionary hypotheses, let alone set quantitative targets for the conservation of this variation. Given the escalating threats to biodiversity, and the importance of planning for persistence by incorporating ecological and evolutionary processes into conservation plans, it is essential that systematists develop hypotheses on the spatial surrogates for these processes for a wide range of lineages. The important questions for systematists to be asking are (1) how is variation distributed in the landscape, and (2) how did it come about? Conservation planners too need to highlight these spatial components for conservation action.

Africa↗

Diabetes information systems: a rapidly emerging support for diabetes surveillance and care.

BACKGROUND: With the rapid advances in information technology in the last decade, various diabetes information systems have evolved in different parts of the world. Availability of new technologies and information systems for monitoring and treating diabetes is critical to achieving recommended metabolic control, including glycosylated hemoglobin levels. The first step is to develop a registry, including a patient identifier that can link multiple data sources, which can then serve as a springboard to electronic mechanisms for practitioners to gain information on performance and results. OBJECTIVE: The aim is to review the provisions for diabetes surveillance in different parts of the world. This is a systematic review of national and regional information systems for diabetes surveillance. LITERATURE REVIEW: A comprehensive review was undertaken using Medline literature review, internet search using the Google search engine, and e-mail consultation with opinion leaders. TOPICS REVIEW: National/regional-level diabetes surveillance systems in Europe, the United States, Australia/New Zealand, and Asia have been reviewed. State-of-the-art diabetes information systems linking multiple data sources, with extensive audit and feedback capabilities, have also been looked at. RESULTS: National/regional-level audit databases have been tabulated. Diabetes information systems linking multiple data sources have been described. Most of the developed countries have now implemented systems such as diabetes registers and audits for diabetes surveillance in at least some regions, if not nationally. Developing nations are beginning to recognize the need for chronic disease management. CONCLUSIONS: With the advancements in information technology, the diabetes registers have the potential to rise beyond their traditional functions with dynamic data integration, decision support, and data access, as demonstrated by some diabetes information systems. With the rapid pace of development in electronic health records and health information systems, countries that are beginning to build their health information technology infrastructure could benefit from planning and funding along these lines.

Diabetes Mellitus↗

Mapping ovarian cellular and molecular landscape across the lifespan of women: a scoping review.

BACKGROUND: With growing interest in ART, fertility preservation, and postmenopausal health of women, reproductive medicine is increasingly focused on characterizing oocytes and ovarian tissue composition, as well as understanding the molecular mechanisms that guide ovarian function throughout its lifecycle. High-throughput omics technologies have enabled the characterization of different molecular layers, leading to substantial advances in our understanding of their complex dynamics. However, not all molecular aspects are studied equally, and studies examining the same modalities often show inconsistencies, underscoring the need for data standardization and highlighting the potential for using transformative artificial intelligence and machine-learning (AI/ML) methods for ovary studies. OBJECTIVE AND RATIONALE: This study aims to evaluate how multi-omic studies have advanced our understanding of the ovarian lifecycle from fetal development to postmenopause. We systematically reviewed published studies that have investigated molecular/omic layers, including the genome, methylome, transcriptome, and proteome throughout ovarian development and aging. Our analysis identified key molecular and cellular patterns, highlighted inconsistencies across studies and addressed gaps in data analysis, interpretation, and reproducibility to guide future research. SEARCH METHODS: We conducted a systematic literature search of Medline (PubMed), Embase (Ovid), and Web of Science Core Collection (Clarivate) using a combination of controlled and free text terms for human ovary, oogenesis, folliculogenesis, ovary development and (epi)genome, transcriptome, proteome, and multi-omic mechanisms to find relevant articles published before August 2025. To focus the scope of the current review, studies of domesticated and farm animals, rodents and other model organisms, non-human primates, as well as those examining various human ovarian pathologies were excluded. OUTCOMES: The search identified 23 546 studies for screening, of which 637 full-text studies were assessed for eligibility. Subsequently, we extracted data from 121 studies. Most studies analyzed the transcriptome of oocytes, granulosa cells, and ovarian tissue from reproductive-age individuals (n&#x2009;=&#x2009;91), with fewer studies examining samples from individuals of advanced reproductive age (n&#x2009;=&#x2009;45) and fetal (n&#x2009;=&#x2009;16) samples. Transcriptome analyses were most common (n&#x2009;=&#x2009;103, 85%), followed by proteome (n&#x2009;=&#x2009;19, 16%) and epigenome (n&#x2009;=&#x2009;14, 12%) studies. We found substantial variation in how studies defined and reported participants' groups as well as in their sequencing technologies and data analysis methods, with a lack of standardized reporting of background clinical information, data analysis methods, and pipeline details. The key findings underscore the prevailing consensus on genes defining major ovarian cell types and their roles throughout the ovarian lifespan, from prenatal development to postmenopausal transformation. This review highlighted the underrepresentation of certain patient groups, particularly prepubertal and peri-/postmenopausal individuals, among researched populations, due to obvious clinical and ethical reasons. WIDER IMPLICATIONS: This scoping review offers a comprehensive overview and benchmark of the current state of high-throughput omics-based research on ovarian cellular composition and molecular dynamics. To address these shortcomings, we propose general recommendations for multi-omics ovary studies and emphasize the necessity for more thorough multi-omic data integration by effectively applying novel AI/ML approaches. They can potentially improve the quality of multi-omics analyses at both single-cell and tissue levels despite limited sample sizes and enable integration of molecular profiling data with clinical and radiology datasets, enabling a more comprehensive understanding of ovarian biology. Such advancements can enhance reproducibility of research findings and guide future research to deepen our understanding of ovarian biology and ultimately support the development of medical technologies for better preserving fertility and alleviating infertility. REGISTRATION NUMBER: A protocol was published a priori on the Open Science Framework (https://osf.io/z38gb/).

Female↗

Discrimination of mode of action of anxiolytics using an integrated computer data bank and Dynamic Brain Mapping (CNS effects of diazepam and lorazepam).

In a double-blind, placebo-controlled, crossover study, the CNS effects of intravenously administered diazepam and lorazepam were investigated in anxious subjects through the quantitative pharmaco-EEG (QPEEG) method. For up to 4 1/2 hours following administration the effects of each substance on brain function were measured using computer analyzed EEG recordings (CEEG) and a new technique called Dynamic Brain Mapping. The following observations were made: 1. Both active drugs produce statistically significant CNS effects as measured by CEEG changes. These changes were observed earlier with diazepam than with lorazepam. 2. Although both compounds are classified as anxiolytic by the routine computer EEG data base, the detailed brain mapping technology indicated that the CNS effects of diazepam and lorazepam were quantitatively and qualitatively different. 3. Clinical CNS side-effects (sedation) were seen more frequently with lorazepam than with diazepam. This was consistent with the EEG slowing producing properties of lorazepam. The EEG fast activity which is characteristic for all anxiolytics was established more with diazepam than lorazepam.

Adult↗