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[Incidence of Aedes (S) aegypti and other Culicidae in the municipality of Playa, La Habana City].

An analysis was made on the incidence of Culicidae present in Playa Municipality, Havana City, during the intensive stage of the anti-aegypti campaign from June to July, 1997, according to its requirements. Culex quinquefasciatus was the predominant species with a total of 269 focuses. It was collected in all the People's Councils and in every type of repository, excepting clay repositories. The second most abundant species was the Aedes aegypti with 199 focuses, followed by Aedes mediovittatus with 67. The Almendares-Sierra, Ampliación-Almendares and Miramar People's Councils showed the highest values of Culicidae infestation in the municipality. The Aedes aegypti prevailed in the first and Cx. quiquefasciatus in the second. The artificial repositories, low tanks and other repositories had the highest number of mosquito focuses in the municipality. The Cx quinquefasciatus preferred the artificial depositories, whereas the A. aegypti preferred the low tanks. Most of the positive depositories were colonized by only one species (92.7% of the total). 7.3% corresponded to mixed focuses. It was found that Cx. quinqufasciatus and A. aegypti were the most associated species.

Aedes↗

Crossing heterogeneous information sources for better analysis of health and social care data.

In this paper we describe a methodology that emerged during an implementation of a health-and-social-care-oriented data repository, which consists in grouping information from heterogeneous and distributed information sources. We developed this methodology by first constructing a concrete data repository, containing information about elderly patients flows in the UK's long-term care (LTC) system. In our specific case, the role of the data repository is to allow knowledge extraction about consumption and behavioural tendencies in the elderly people population within the LTC system. These tendencies can be depicted in terms of survival behaviour (modelling), cost evolution, and bed use. Other types of knowledge that can be extracted are typical patient profiles, placement policy in term of rules and criteria effectively applied and, specific features of the business process behind the long-term care provision. A well-constructed data repository can support the discovery (analysis) of hidden aspects about the way patients are placed and accepted in the LTC, and also how the allocated resources are consumed. We argue that the use of this methodology could save time in similar undertakings or in other fields than health and social care.

Humans↗

Developing a relational XML schema for sharing HIV clinical data.

Access to multi-site clinical data regarding treatment and outcomes of HIV-infected patients in routine care is required to support clinical research to improve the treatment of HIV. As part of the NIAID-funded CFAR Network of Integrated Clinical Systems (CNICS), we have developed a relational XML Schema to extend the existing observational research repository and to integrate real-time clinical information from electronic medical records (EMRs) at six Centers for AIDS Research (CFAR) into the repository. The schema will aid the expansion of the research repository beyond the initial sites, and the development process may facilitate the use of multi-site repositories to study other chronic diseases.

Databases as Topic↗

Opinion: a prototype for a computerized national mammography registry and tracking system using telecommunications and the Internet.

In this report, we analyze the feasability and discuss the potential benefits of using currently available technology for the wide-area registration and tracking of mammography patients. In our prototype, three dissimilar computer systems transmitted mammographic data (demographics and the results of mammograms) in a standardized format to a central data repository. Two of the three systems were dedicated computerized mammography systems and one was a general-purpose radiology information system. High-speed modems and the Internet were used to connect with the central repository, which could be queried in real time by remote users. Our results indicated that a busy mammography practice, using the slowest transmission method we tested (14-kilobaud modem), could transmit several days of mammographic data to a central repository in a matter of minutes. To implement systems that provide nation-wide mammographic tracking and follow up, more in-depth planning, development, and testing are necessary.

Computer Communication Networks↗

Integrating digital teaching-file systems with off-the-shelf presentation software to facilitate speaker-led conferences.

OBJECTIVE: Develop methods for automated transfer of images and associated text from a teaching-file repository into presentation material for speaker-led conferences. MATERIALS/METHODS: Our institution uses a Microsoft Windows (Microsoft Corp, Redmond, WA) software application to maintain a digital teaching-file database that can store and retrieve content in a case-centric fashion. Virtually any number of images can be stored with any given case. Cases and their associated images can be retrieved via a module that supports searches by American College of Radiology (ACR) code and by free-text Boolean queries on the history, findings, diagnosis, and discussion components of a case. In addition to the software system serving directly as an interactive teaching tool, the digital teaching file itself serves as an image repository and resource for attending radiologists who create their own presentations and lectures. To better support this use, software modules were developed for interprocess communication and automated creation of Powerpoint slides. These modules are fully integrated with the teaching-file software application. A single image or a set of selected images can be automatically made into individual slides with two mouse clicks. Images are automatically centered and optimally sized. A slide title is automatically rendered from the user's preference of the case history or diagnosis (stored with the case), or via the entry of freeform text. We describe the programming techniques that are used, as well as how several features of the operating system and Powerpoint itself can be integrated with a customized software application to facilitate this objective. RESULTS: The creation of presentation-ready Powerpoint slides is fully automated from within our teaching-file application, and the time required to create a presentation compared to the conventional method of manually seeking and inserting files from within Powerpoint itself, on a per-slide basis, is drastically reduced. The benefits are magnified by having all imagery stored within an organized and searchable database system so that desired images can be easily located. CONCLUSION: A digital teaching-file system can serve as a useful image repository for purposes ancillary to direct computerized instruction. Software that supports these uses, such as the automated creation of presentation material for speaker-led conferences, facilitates the radiologist's role as an educator.

Computer-Assisted Instruction↗

Plasma progestogen levels in pregnant mares following administration of exogenous progesterone.

Twelve pregnant mares were used in a switchback design with two groups of six mares each. On day 255 of gestation, group A was administered repository progesterone (250 mg, IM) and group B progesterone in sesame oil (250 mg, IM). Jugular vein plasma was taken 15 min pre-injection and post-injection at 30 min, 1, 3, 6, 9, 12, and 24 hours. Additional samples were taken on days 2, 3, 4, 6, and 8. Both groups were then assigned to the opposite treatment on day 270 of gestation. Concentrations of plasma progestogens after injection with progesterone in sesame oil were not different (P>.05) from values obtained using repository progesterone through the 8 days studied. Mean progestogen concentrations after injection of progesterone in sesame oil were, however, consistently higher through 48 hr than those given repository progesterone. Concentrations of progestogens were not different (P>.05) from pre-injection concentrations by day 6 post-injection using either vehicle.

Journal Article↗

Characterizing variation in sex steroid hormone pathway genes in women of 4 races/ethnicities: the Study of Women's Health Across the Nation (SWAN).

This report characterizes genotypes and haplotypes in 6 genes (27 single nucleotide polymorphisms [SNPs]) from the Sex Steroid Hormone Genetics Protocol developed though the DNA Repository of the Study of Women's Health Across the Nation (SWAN) Genetics Study. The SWAN Genetics Study is a component of a longitudinal study describing health-related attributes of the menopausal transition in African American, Caucasian, Chinese, Hispanic, and Japanese women. At baseline, SWAN recruited menstruating women, aged 42 to 52 years, who were not using exogenous hormones. During the sixth and seventh years of the study, buccal cells in a mouthwash slurry and whole blood were collected for a DNA repository. Immortalized cell lines were created and genotyped in 1,538 specimens from 1,757 women who participated in the SWAN Genetics Study. DNA from those cells was genotyped for genes in the sex steroid hormone pathway. SNPs were evaluated for genotype and allele frequencies (and differences) according to race/ethnicity and haplotyped in anticipation of studying their associations with health-related measures. We demonstrated that allele frequencies differed significantly by race/ethnicity. There was substantial linkage disequilibrium among many of the SNPs and only a few SNPs showed significant Hardy-Weinberg disequilibrium within race/ethnicity. Finally, there are a number of haplotype patterns that vary according to race/ethnicity, including a "yin-yang" pattern for 17HSD among Caucasian, Chinese, and Japanese women, but not among African American women. Repository specimens developed in anticipation of genomic or metabolomics studies can extend the contribution of the parent study by developing hybrid strategies that support both SNP association studies as well as coarse and fine mapping to evaluate possible genomic locations of causal variants.

Adult↗

Architectures and tools for innovative Health Information Systems: the Guide Project.

This paper describes the architecture of the Guide Project, a proposal for innovation of Health Information Systems, putting together medical and organizational issues through the Separation of Concerns paradigm. In particular, we focus on one building block of the architecture: the Guideline Management System handling the whole life cycle of computerized Clinical Practice Guidelines. The communication between the Guideline Management System and the other components of the project architecture is message-based, according to specific contracts that allow an easy integration of the components developed by different parties and, in particular, with legacy systems (i.e. existing electronic patient records). In turn, the Guideline Management System components are organized in a distributed architecture: an editor to formalize guidelines, a repository to store and publish them, an enactment system to implement guidelines instances in a multi-user environment and a reporting system able to completely trace any individual physician's guideline-based decision process. The repository is organized in different levels that can be international, national, regional, down to the specific health care organization, according to the healthcare delivery policy of a country. Different organizations can get Clinical Practice Guidelines from the repository, adapt and introduce them in clinical practice.

Computer Systems↗

A mountain-scale thermal-hydrologic model for simulating fluid flow and heat transfer in unsaturated fractured rock.

A multidimensional, mountain-scale, thermal-hydrologic (TH) numerical model is presented for investigating unsaturated flow behavior in response to decay heat from the proposed radioactive waste repository in the Yucca Mountain unsaturated zone (UZ), The model, consisting of both two-dimensional (2-D) and three-dimensional (3-D) representations of the UZ repository system, is based on the current repository design, drift layout, thermal loading scenario, and estimated current and future climate conditions. This mountain-scale TH model evaluates the coupled TH processes related to mountain-scale UZ flow. It also simulates the impact of radioactive waste heat release on the natural hydrogeological system, including heat-driven processes occurring near and far away from the emplacement tunnels or drifts. The model simulates predict thermally perturbed liquid saturation, gas- and liquid-phase fluxes, and water and rock temperature elevations, as well as the changes in water flux driven by evaporation/condensation processes and drainage between drifts. These simulations provide insights into mountain-scale thermally perturbed flow fields under thermal loading conditions.

Computer Simulation↗

Antimalarial activities of Tithonia diversifolia (Asteraceae) and Crossopteryx febrifuga (Rubiaceae) on mice in vivo.

Ethanolic extracts of the aerial part of Tithonia diversifolia and the stem bark of Crossopteryx febrifuga were investigated against early, residual (repository) and established malaria infections in vivo using Swiss albino mice at a dose range of 50-400 mg/kg per day. Chloroquine at 5 mg/kg per day was used as the positive control for the early and established infections while Pyrimethamine at 1.2 3/kg per day was used as the positive control for the residual infection test. Dose dependent chemo suppressive activities were obtained at the different levels of the infection tested. Tithonia diversifolia and Crossopteryx febrifuga gave some level of suppression of parasitaemia in the early and established infection stages. Tithonia diversifolia was active at 200 mg/kg per day in the repository test. The mean survival period of the mice treated with the extract in the established infection test was low, a possible indication of toxicity as a result of sub chronic administration of the extract. Crossopteryx febrifuga was inactive in the repository test. Beside the above limitations, the suppression of parasitaemia by the extracts at the highest dose was similar to chloroquine and pyrimathamine.

Administration, Oral↗

Biological and environmental specimen banking at the Centers for Disease Control and Prevention.

Scientific programs at the Centers for Disease Control and Prevention encompass diverse public health interests. These programs include investigations of newly emerging infectious diseases, assessments of chronic disease risk factors, and evaluations of environmental health hazards. Since the early 1960s, CDC has maintained a specimen bank to retain aliquots of biological specimens collected from a variety of epidemiologic investigations as well as from the National Health and Nutrition Examination Surveys (NHANES). CDC's National Institute of Occupational Safety and Health (NIOSH) also maintains a repository of environmental materials from its investigations. To extend its repository capabilities more effectively, CDC has begun developing a new facility that, when finished, will meet CDC's storage needs for both biological and environmental specimens. A highly complex but very flexible information management system for this project, enabling the storage of data related to studies for which these specimens were originally collected, has already been completed. Proper specimen collection, archiving, and short- or long-term storage of specimens for environmental health-related analyses is critical for the work of the staff of the Division of Environmental Health Laboratory Sciences, National Center for Environmental Health, who perform a variety of biochemical analyses on biological specimens, including quantitation of dioxins, furans, coplanar PCBs, pesticides, volatile organic compounds, metabolites, essential and toxic trace elements, vitamins, and lipids, and also conduct genetic screening. Information regarding these analytes is an essential part of the CDC Repository Database.

Biological Specimen Banks↗

The effect of coupled transport phenomena in the Opalinus Clay and implications for radionuclide transport.

In this study, the potential effects of coupled transport phenomena on radionuclide transport in the vicinity of a repository for vitrified high-level radioactive waste (HLW) and spent nuclear fuel (SF) hosted by the Opalinus Clay in Switzerland, at times equal to or greater than the expected lifetime of the waste canisters (about 1000 years), are addressed. The solute fluxes associated with advection, chemical diffusion, thermal and chemical osmosis, hyperfiltration and thermal diffusion have been incorporated into a simple one-dimensional transport equation. The analytical solution of this equation, with appropriate parameters. shows that thermal osmosis is the only coupled transport mechanism that could, on its own, have a strong effect on repository performance. Based on the results from the analytical model, two-dimensional finite-difference models incorporating advection and thermal osmosis, and taking conservation of fluid mass into account, have been formulated. The results show that, under the conditions in the vicinity of the repository at the time scales of interest, and due to the constraints imposed by conservation of fluid mass, the advective component of flow will oppose and cancel the thermal-osmotic component. The overall conclusion is that coupled phenomena will only have a very minor impact on radionuclide transport in the Opalinus Clay, in terms of fluid and solute fluxes, at least under the conditions prevailing at times equal to or greater than the expected lifetime of the waste canisters (about 1000 years).

Aluminum Silicates↗

Analysis of thermal-hydrologic-mechanical behavior near an emplacement drift at Yucca Mountain.

A coupled thermal, hydrologic and mechanical (THM) analysis is conducted to evaluate the impact of coupled THM processes on the performance of a potential nuclear waste repository at Yucca Mountain, Nevada. The analysis considers changes in rock mass porosity, permeability, and capillary pressure caused by rock deformations during drift excavation, as well as those caused by thermomechanically induced rock deformations after emplacement of the heat-generating waste. The analysis consists of a detailed calibration of coupled hydraulic-mechanical rock mass properties against field experiments, followed by a prediction of the coupled thermal, hydrologic, and mechanical behavior around a potential repository drift. For the particular problem studied and parameters used, the analysis indicates that the stress-induced permeability changes will be within one order of magnitude and that these permeability changes do not significantly impact the overall flow pattern around the repository drift.

Mechanics↗

The site-scale saturated zone flow model for Yucca Mountain: calibration of different conceptual models and their impact on flow paths.

This paper presents several different conceptual models of the Large Hydraulic Gradient (LHG) region north of Yucca Mountain and describes the impact of those models on groundwater flow near the potential high-level repository site. The results are based on a numerical model of site-scale saturated zone beneath Yucca Mountain. This model is used for performance assessment predictions of radionuclide transport and to guide future data collection and modeling activities. The numerical model is calibrated by matching available water level measurements using parameter estimation techniques, along with more informal comparisons of the model to hydrologic and geochemical information. The model software (hydrologic simulation code FEHM and parameter estimation software PEST) and model setup allows for efficient calibration of multiple conceptual models. Until now, the Large Hydraulic Gradient has been simulated using a low-permeability, east-west oriented feature, even though direct evidence for this feature is lacking. In addition to this model, we investigate and calibrate three additional conceptual models of the Large Hydraulic Gradient, all of which are based on a presumed zone of hydrothermal chemical alteration north of Yucca Mountain. After examining the heads and permeabilities obtained from the calibrated models, we present particle pathways from the potential repository that record differences in the predicted groundwater flow regime. The results show that Large Hydraulic Gradient can be represented with the alternate conceptual models that include the hydrothermally altered zone. The predicted pathways are mildly sensitive to the choice of the conceptual model and more sensitive to the quality of calibration in the vicinity on the repository. These differences are most likely due to different degrees of fit of model to data, and do not represent important differences in hydrologic conditions for the different conceptual models.

Calibration↗

A decision theory perspective on the disposal of high-level radioactive waste.

In this paper the problem of high-level nuclear waste disposal is viewed as a five-stage, cascaded decision problem. The first four of these decisions having essentially been made, the work of recent years has been focused on the fifth stage, which concerns specifics of the repository design. The probabilistic performance assessment (PPA) work is viewed as the outcome prediction for this stage, and the site characterization work as the information gathering option. This brief examination of the proposed Yucca Mountain repository through a decision analysis framework resulted in three conclusions: (1) A decision theory approach to the process of selecting and characterizing Yucca Mountain would enhance public understanding of the issues and solutions to high-level waste management; (2) engineered systems are an attractive alternative to offset uncertainties in the containment capability of the natural setting and should receive greater emphasis in the design of the repository; and (3) a strategy of "waste management" should be adopted, as opposed to "waste disposal," as it allows for incremental confirmation and confidence building of a permanent solution to the high-level waste problem.

Bayes Theorem↗

Resolution of the long-term performance issues at the Waste Isolation Pilot Plant.

The Waste Isolation Pilot Plant (WIPP) is a geological repository for disposal of U.S. defense transuranic radioactive waste. Built and operated by the U.S. Department of Energy (DOE), it is located in the Permian age salt beds in southeastern New Mexico at a depth of 655 m. Performance assessment for the repository's compliance with the 10,000-year containment standards was completed in 1996 and the U.S. Environmental Protection Agency (EPA) certified in 1998 that the repository meets compliance with the EPA standards 40 CFR 191 and 40 CFR 194. The Environmental Evaluation Group (EEG) review of the DOE's application for certification identified a number of issues. These related to the scenarios, conceptual models, and values of the input parameters used in the calculations. It is expected that these issues will be addressed and resolved during the first 5-year recertification process that began with the first receipt of waste at WIPP on March 26, 1999, and scheduled to be completed in March 2004.

Geological Phenomena↗

Genome resource banking for wildlife research, management, and conservation.

Cryobiology offers an important opportunity to assist in the management and study of wildlife, including endangered species. The benefits of developing genome resource banks for wildlife are profound, perhaps more so than for traditional uses in terms of livestock and human fertility. In addition to preserving heterozygosity and assisting in the genetic management of rare populations held in captivity, frozen repositories help insure wild populations against natural and human-induced catastrophes. Such banks also are an invaluable source of new knowledge (for basic and applied research) from thousands of species that have yet to be studied. However, it is crucial that genome resource banks for wildlife species be developed in a coordinated fashion that first benefits the conservation of biodiversity. Spurious collections will be of no advantage to genuine conservation. The Conservation Breeding Specialist Group (CBSG; of the International Union for the Conservation of Nature and Natural Resources' Species Survival Commission) has promoted international dialogue on this topic. CBSG working groups have recognized that such repositories be developed according to specific, scientific guidelines consistent with an international standard that ensures practicality, high-quality ethics, and cost-effectiveness. Areas requiring priority attention also are reviewed, including the need for more basic research, advocacy, and support for developing organized repositories of biomaterials representing the world's diverse biota.

Animals↗

Three perspectives on integrated clinical databases.

The dramatic transformation of health care organizations from independent local entities into regional and national integrated health care delivery enterprises has forced a reevaluation of the role of information systems. Until recently, nearly all clinical information systems were acquired to support financial and administrative services within single facilities. When independent facilities merge to form an integrated health system (IHS), they find that their unique computer systems do not allow for the sharing or combining of clinical data. However, new technologies are beginning to enable patient-specific data scattered among many information systems in many different hospitals and ambulatory care settings to be unified into a single database called a clinical data repository. The hope is that comprehensive electronic clinical records can enable IHSs to meet their goals of improving the quality and reducing the cost of health care. As the number of technological impediments to forming integrated clinical information systems rapidly decreases, nontechnologic issues surrounding the sharing of patient information become more prominent. The author focuses on the clinician's, the administrator's, and the patient's unique perspectives on the benefits and possible problems associated with clinical data repositories. He then describes how one IHS, together with an academic medical institution, has begun to grapple with many of these concerns through an effort called Project Spectrum. The goal of the project is the successful implementation of a comprehensive clinical data repository.

Clinical Medicine↗