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Advanced course for doctors as Departmental IT Network Administrators in anesthesia and intensive care units.

The design and administration of a departmental computer network (Local Area Network) in anesthesiology and intensive care offer the opportunity to manage clinical information and control the work-flow. To improve the local network, after basic design, intelligence is necessary to maintain its efficiency. For this reason the role of a medical administrator of the network is fundamental because he is a qualified figure who recognizes the most important characteristics that a network must have, knows the users of the system, represents a valid consultant for the technician that has to build the network, and is able to face possible breakdowns. This paper illustrates the structure of a course to train a medical network administrator in anesthesiology and critical care.

Anesthesia Department, Hospital↗

[Stem cell network North Rhine-Westphalia].

The Stem Cell Network NRW is an initiative of the North Rhine Westphalian Ministry of Science and Research. A statewide organization involving research facilities in Aachen, Bielefeld, Bochum, Bonn, Cologne, Düsseldorf, Essen and Münster, it covers virtually the whole spectrum of scientific issues in the field of adult and embryonic stem cell research. The Network consists of two working groups. One focuses on biomedical, the other on ethical, legal and sociological issues. In these groups, top scientists, doctors, philosophers, theologians, sociologists and legal experts combine their expertise with a view to making stem cell research responsible and transparent. The Stem Cell Network NRW is a model example of the North Rhine Westphalian government's strategy of identifying, promoting and creating a common platform for the research disciplines of the future--for the benefit of science, business and above all society at large.

Adult↗

Surgical outcomes and complications of fixation strategies for distal tibial fractures: a systematic review and network meta-analysis.

BACKGROUND: Multiple fixation options exist for distal tibial fractures, but the optimal approach remains controversial. Common techniques includeopen reduction and internal fixation(ORIF), minimally invasive plate osteosynthesis (MIPO), external fixation combined with limited open reduction and internal fixation (EF + LORIF), intramedullary nailing (IMN), and retrograde tibial nailing (RTN). METHODS: PubMed, Embase, Web of Science, and the Cochrane Library were searched through March 19, 2026. Network meta-analysis (R v4.5.1) assessed operation time, fracture healing time, malunion, delayed union/nonunion, and infection, reporting MDs or RRs with 95% CIs. RESULTS: Eleven randomized controlled trials and 18 cohort studies (2145 patients) were included. MIPO was associated with a longer operative time and a longer time to union than IMN-IP (MD = 8.23, 95% CI 0.44-16.01; and MD = 1.02, 95% CI 0.10-1.93, respectively). For malunion, ORIF had a lower risk than MIPO (RR = 0.30, 95% CI 0.11-0.82), whereas MIPO had a higher risk than EF + LORIF (RR = 3.26, 95% CI 1.08-9.80) and IMN-SP (RR = 4.03, 95% CI 1.30-12.48). ORIF, EF + LORIF, and IMN-SP also showed lower malunion risk than IMN-IP. No significant differences were observed for delayed union and nonunion. Infection risk was generally higher with ORIF and MIPO than with several comparators, particularly EF + LORIF and intramedullary nailing-based strategies. CONCLUSIONS: No single strategy was consistently superior. Operation time and impaired union ( delayed union and nonunion) did not differ significantly among techniques. MIPO may be associated with longer time to union than IMN-IP and higher malunion risk than EF + LORIF and IMN-SP. Infection risk appeared higher with ORIF and MIPO in network estimates, although several comparisons remained uncertain. Findings should be interpreted in light of imprecision and study-level heterogeneity. PROTOCOL REGISTRATION: INPLASY2025120055.

Humans↗

The Medical Library Association Benchmarking Network: development and implementation.

OBJECTIVE: This article explores the development and implementation of the Medical Library Association (MLA) Benchmarking Network from the initial idea and test survey, to the implementation of a national survey in 2002, to the establishment of a continuing program in 2004. Started as a program for hospital libraries, it has expanded to include other nonacademic health sciences libraries. METHODS: The activities and timelines of MLA's Benchmarking Network task forces and editorial board from 1998 to 2004 are described. RESULTS: The Benchmarking Network task forces successfully developed an extensive questionnaire with parameters of size and measures of library activity and published a report of the data collected by September 2002. The data were available to all MLA members in the form of aggregate tables. Utilization of Web-based technologies proved feasible for data intake and interactive display. A companion article analyzes and presents some of the data. MLA has continued to develop the Benchmarking Network with the completion of a second survey in 2004. CONCLUSIONS: The Benchmarking Network has provided many small libraries with comparative data to present to their administrators. It is a challenge for the future to convince all MLA members to participate in this valuable program.

Advisory Committees↗

The cystic fibrosis therapeutics development network (CF TDN): a paradigm of a clinical trials network for genetic and orphan diseases.

Clinical trials have become critical to the advancement of medical science and to the evolution of patient care in medicine. The science of clinical research has advanced from early studies in which treatment was assessed without controls to sophisticated multinational collaborative randomized, double-blind, placebo controlled trials of therapeutic interventions. To facilitate the advancement of clinical research, clinical trials networks have been developed to conduct multicenter studies. This review describes the history of clinical trials, clinical trials networks, and the goals of such networks in the United States. The Cystic Fibrosis Therapeutics Development Network, a network that represents the paradigm for genetic and orphan diseases, is described in detail. This network has been extremely successful in its first 3.5 years of existence conducting 18 different clinical trials in patients with Cystic Fibrosis. Unique aspects of the network include the use of internet applications for study conduct and communication, the development of statistical methodology to enhance the efficiency of clinical trial design, the development of outcome measures specific to Cystic Fibrosis, and the development of infrastructure necessary for expediting protocol development. In the current environment, clinical research faces significant challenges related to ensuring the safe and ethical conduct of clinical research while promoting fast and efficient clinical trials. To succeed and move forward to provide treatments and find cures for diseases, clinical trials networks must continue to evolve. The Cystic Fibrosis Therapeutics Development Network represents a network that has met this challenge and will continue to provide a venue for the safe and efficient conduct of clinical trials in Cystic Fibrosis.

Clinical Trials as Topic↗

Vital connections.

Scientists are currently exploring the structure and behavior of complex biological systems, which consist of networks of interacting entities. A recent paper in Proceedings of the Royal Society of London Series B Biological Sciences describes the distinctive characteristics of aging-related proteins in the yeast protein-protein interaction network. In this Perspective, I discuss the implications of these findings for longevity research.

Protein Interaction Mapping↗

Distance learning, problem based learning and dynamic knowledge networks.

This paper is an attempt to develop a distance learning model grounded upon a strict integration of problem based learning (PBL), dynamic knowledge networks (DKN) and web tools, such as hypermedia documents, synchronous and asynchronous communication facilities, etc. The main objective is to develop a theory of distance learning based upon the idea that learning is a highly dynamic cognitive process aimed at connecting different concepts in a network of mutually supporting concepts. Moreover, this process is supposed to be the result of a social interaction that has to be facilitated by the web. The model was tested by creating a virtual classroom of medical and nursing students and activating a learning session on the concept of knowledge representation in health sciences.

Computer Communication Networks↗

Intelligence: success and fitness.

This chapter presents the consensus among psychometricians regarding the construct of general intelligence ('g') and its measurement. More than any other construct, g illustrates the scientific power of construct validation research. To date, g is carried by more assessment vehicles and saturates more aspects of life than any other dimension of human variation uncovered by psychological science. Phenomena most vital to the core of g's nomological network are reviewed (e.g. abstract learning, information processing, and dealing with novelty). This is followed by coverage of relevant but more peripheral phenomena (e.g. crime, health risk behaviour, and income). Because g constitutes such a ubiquitous aspect of the human condition, its omission in social science research often results in underdetermined causal modelling. Frequently, this constitutes a longstanding error in inductive logic, namely, the Fallacy of the Neglected Aspect. Attending to Carnap's Total Evidence Rule can help to forestall neglected aspects in scientific reasoning.

Child↗

Revising the distributive networks models of West, Brown and Enquist (1997) and Banavar, Maritan and Rinaldo (1999): metabolic inequity of living tissues provides clues for the observed allometric scaling rules.

Basic assumptions of two distributive network models designed to explain the 3/4 power scaling between metabolic rate and body mass are re-analysed. It is shown that these models could have consistently accounted for the observed scaling patterns if and only if body mass M had scaled as L4, where L is body length, in the model of Banavar et al. (1999, Nature 399, 130-132), or if spatial volume VF occupied by the distributive network had scaled as M3/4 in the model of West et al. (1997, Science 276, 122-126). Lack of agreement between these predictions and observational evidence invalidates both models rendering them mathematically controversial. It is further shown that consideration of distributive networks can nevertheless yield realistic values of scaling exponents under the major assumption that living organisms are designed so as to keep the mass-specific metabolic rate of important functional tissues in the vicinity of a size-independent optimum value. Mass-specific metabolic rate of subsidiary mechanical tissues can be small and vary with body mass. Different patterns of spatial distribution of metabolically active biomass within the organism result in different patterns of allometric scaling. From the available evidence the presumable optimum value of mass-specific metabolic rate of living matter is estimated to be in the vicinity of 1-10 W kg-1.

Animals↗

Computational tools for the modern andrologist.

With such a wide array of computational tools to solve inference problems, andrologists and their mathematical or statistical collaborators face perhaps bewildering choices. It is tempting to criticize a method with which one is unfamiliar for its apparent complexity. Yet, many methods are quite elegant; neural computation uses nature's own best biological classifier, for example, and genetic algorithms apply rules of natural selection. Computer scientists will likely find no one single best inference engine to solve all classification problems. Rather, the modeler should choose the most appropriate computational tool based on the specific nature of a problem. If the problem can be separated into obvious components, a Markov chain may be useful. If the andrologist would like to encode a well-known clinical algorithm into the computer, the programmer may use an expert system. Once a modeler builds an inference engine, that engine is not truly useful until other andrologists use it to make inferences with their own data. Because a wide variety of computer hardware and software exists, it is a significant endeavor to translate, or "port," software designed and built on one machine to many other different computers. Fortunately, the World Wide Web offers a means by which computational tools may be made directly available to multiple users on many different systems, or "platforms." The World Wide Web refers to a standardization of information traffic on the global computer network, the Internet. The Internet is simply the linkage of many computers worldwide by computer operators who have chosen to allow other users access to their systems. Because many different types of computers exist, until recently only communication in very rudimentary form, such as text, or between select compatible machines, was available. Within the last half-decade, computer scientists and operators began to use standard means of communication between computers. Interpreters of these standard languages, such as Mosaic and Netscape, are now widely available, and they allow the casual user to access the most sophisticated multimedia aspects of computer information on a variety of different systems. Andrologists may thus use the World Wide Web to make inference engines that they have programmed available to other clinicians and researchers. For example, we programmed a World Wide Web interface to the neural networks that we trained in order to solve a number of andrology classification problems. Interested users connect to our address (at this writing http:@godot.urol.uic.edu), and they may fill out electronic forms with their own patient data, press a "predict" button, and nearly immediately view the results of our neural networks' prediction on their own computers. With the explosion in computer hardware technology, mathematics and computer science that once seemed esoteric can now be investigated on computers available to nearly all andrologists. Rapid advances in computer network technology now render a tool developed by one andrologist immediately available to many. Clearly, andrologists may expect that computational investigations in their field will be a productive ground in the near and far future.

Algorithms↗

Molecular networks in model systems.

Model organisms, especially the budding yeast, are leading systems in the transformation of biology into an information science. With the availability of genome sequences and genome-scale data generation technologies, the extraction of biological insight from complex integrated molecular networks has become a major area of research. Here I examine key concepts and review research developments. I propose specific areas of research effort to drive network analysis in directions that will promote modeling with increasing predictive power.

Computational Biology↗

The establishment of an academic health sciences library in a developing country: a case study.

The development of a Faculty of Medical Sciences (FMS) and an academic health sciences library for the University of the West Indies (UWI) has proven to be a polemical and political issue due to the depressed economy of the country. Although FMS is still shrouded in politics and controversy after its inaugural year, the Medical Sciences Library (MSL) has expanded its dimensions and is actively developing a biomedical information network within the country. This will result in better dissemination and control of biomedical information. The library now participates in joint projects with other health sciences libraries in the country with the goal of joint automated listings of holdings and shared cataloging projects. This paper examines the development of the library and explains the difficulties experienced in its developmental stages due to politics, the delay in appointment of a medical sciences librarian, and the financial decline in the local economy.

Developing Countries↗

Innovation, ideology and innocence.

Innovative solutions are required to deal with the inadequacies of existing medical education programmes, in both the developed and developing countries, if we are to promote the evolution of more acceptable, more efficient and more effective health care. The newly formed Network of Community-oriented Educational Institutions for Health Sciences is attempting to promote a series of educational and organisational innovations, aimed at the preparation of health professionals who will be better equipped and better motivated to meet the real health needs of the populations they are to serve. Such innovations encounter many obstacles, of which ideologically-based inflexibility of thought is the most important. Ideologies are here defined, in Barnett's words, as "patterns of belief ... quasi-conceptual, quasi-affective sets assumed to be true", having the power to prohibit "rigorous or experimental examination of novel experience." Such systems of thought have 'negative, restrictive and pathological effects' on the development of innovative solutions to complex problems. A particularly destructive and inhibiting stereotype has flowed from an ideological commitment to the achievement of 'international excellence'. A state of what in this paper is called 'innocence' is regarded as mandatory for the implementation of studies based on a commitment to the empirical approach, to the null hypothesis and above all to the evaluation of the process and outcome of educational and other interventions in the health care system.

Communication↗

An in silico assessment of gene function and organization of the phenylpropanoid pathway metabolic networks in Arabidopsis thaliana and limitations thereof.

The Arabidopsis genome sequencing in 2000 gave to science the first blueprint of a vascular plant. Its successful completion also prompted the US National Science Foundation to launch the Arabidopsis 2010 initiative, the goal of which is to identify the function of each gene by 2010. In this study, an exhaustive analysis of The Institute for Genomic Research (TIGR) and The Arabidopsis Information Resource (TAIR) databases, together with all currently compiled EST sequence data, was carried out in order to determine to what extent the various metabolic networks from phenylalanine ammonia lyase (PAL) to the monolignols were organized and/or could be predicted. In these databases, there are some 65 genes which have been annotated as encoding putative enzymatic steps in monolignol biosynthesis, although many of them have only very low homology to monolignol pathway genes of known function in other plant systems. Our detailed analysis revealed that presently only 13 genes (two PALs, a cinnamate-4-hydroxylase, a p-coumarate-3-hydroxylase, a ferulate-5-hydroxylase, three 4-coumarate-CoA ligases, a cinnamic acid O-methyl transferase, two cinnamoyl-CoA reductases) and two cinnamyl alcohol dehydrogenases can be classified as having a bona fide (definitive) function; the remaining 52 genes currently have undetermined physiological roles. The EST database entries for this particular set of genes also provided little new insight into how the monolignol pathway was organized in the different tissues and organs, this being perhaps a consequence of both limitations in how tissue samples were collected and in the incomplete nature of the EST collections. This analysis thus underscores the fact that even with genomic sequencing, presumed to provide the entire suite of putative genes in the monolignol-forming pathway, a very large effort needs to be conducted to establish actual catalytic roles (including enzyme versatility), as well as the physiological function(s) for each member of the (multi)gene families present and the metabolic networks that are operative. Additionally, one key to identifying physiological functions for many of these (and other) unknown genes, and their corresponding metabolic networks, awaits the development of technologies to comprehensively study molecular processes at the single cell level in particular tissues and organs, in order to establish the actual metabolic context.

Arabidopsis↗

An optical lattice clock.

The precision measurement of time and frequency is a prerequisite not only for fundamental science but also for technologies that support broadband communication networks and navigation with global positioning systems (GPS). The SI second is currently realized by the microwave transition of Cs atoms with a fractional uncertainty of 10(-15) (ref. 1). Thanks to the optical frequency comb technique, which established a coherent link between optical and radio frequencies, optical clocks have attracted increasing interest as regards future atomic clocks with superior precision. To date, single trapped ions and ultracold neutral atoms in free fall have shown record high performance that is approaching that of the best Cs fountain clocks. Here we report a different approach, in which atoms trapped in an optical lattice serve as quantum references. The 'optical lattice clock' demonstrates a linewidth one order of magnitude narrower than that observed for neutral-atom optical clocks, and its stability is better than that of single-ion clocks. The transition frequency for the Sr lattice clock is 429,228,004,229,952(15) Hz, as determined by an optical frequency comb referenced to the SI second.

Journal Article↗

Health professions education for adapting to change and for participating in managing change.

This paper outlines a case for a new approach to the education of future professionals. The magnitude and potential seriousness of changes to be anticipated in the first half of the new century challenge institutions of higher education to prepare their students to become able to adapt themselves to change and to participate in the management of change--not only in relation to their own profession, but more widely for the benefit of society at large. The Network of Community-Oriented Educational Institutions for Health Sciences is planning three major programs which are designed to help meet this challenge in the 21st century. The first of these programs will set out to identify generic competencies that are needed for adapting to change and for participating in managing change. This is to include not only profession-specific changes, but also changes that affect the well-being of society as a whole. The second program will address the related need to develop educational interventions that are designed to foster competencies for interprofessional and intersectoral collaboration. The third of these programs accepts that serious attention to effective education for the professions will require institutionalization of recognition and reward of creativity and commitment in education.

Journal Article↗

Deterministic generation of single photons from one atom trapped in a cavity.

A single cesium atom trapped within the mode of an optical cavity is used to generate single photons on demand. The photon wave packets are emitted as a Gaussian beam with temporal profile and repetition rate controlled by external driving fields. Each generation attempt is inferred to succeed with a probability near unity, whereas the efficiency for creating an unpolarized photon in the total cavity output is 0.69 +/- 0.10, as limited by passive cavity losses. An average of 1.4 x 10(4) photons are produced by each trapped atom. These results constitute an important step in quantum information science, for example, toward the realization of distributed quantum networking.

Journal Article↗

Analyzing microarray data using cluster analysis.

As pharmacogenetics researchers gather more detailed and complex data on gene polymorphisms that effect drug metabolizing enzymes, drug target receptors and drug transporters, they will need access to advanced statistical tools to mine that data. These tools include approaches from classical biostatistics, such as logistic regression or linear discriminant analysis, and supervised learning methods from computer science, such as support vector machines and artificial neural networks. In this review, we present an overview of another class of models, cluster analysis, which will likely be less familiar to pharmacogenetics researchers. Cluster analysis is used to analyze data that is not a priori known to contain any specific subgroups. The goal is to use the data itself to identify meaningful or informative subgroups. Specifically, we will focus on demonstrating the use of distance-based methods of hierarchical clustering to analyze gene expression data.

Cluster Analysis↗