Lipid screening in children and adolescents. Identifying patients with familial hypercholesterolemia. Institute for Clinical Systems Integration.
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By adoption of double-device systems, integral imaging can be enhanced in image depth, viewing angle, or image size. Theoretical analyses are done for the double-image-plane integral imaging systems. Both ray optics analysis and wave optics analysis confirm that the double-device integral imaging systems can pick up and display images at two separate image planes. The analysis results are also valuable in the understanding of the conventional integral imaging systems for image positions off the central depth plane.
Integrated health care systems: a concept being discussed throughout Russia and the world. A concept with three different applications and a confusing interaction with the concept of "capitation payments." The health reform debate in Russia and the NIS can only advance if greater clarity is found for these concepts, and if medical leaders are prepared for the substantial changes in provider behavior that are required with integrated health care systems fueled by capitation payments. This article explores the twin concepts of capitation and integrated health care systems, and then the leadership challenges for Russian health sector managers as they prepare for these challenges of the twenty-first century.
In this paper, we describe OntoFusion, a database integration system. This system has been designed to provide unified access to multiple, heterogeneous biological and medical data sources that are publicly available over Internet. Many of these databases do not offer a direct connection, and inquiries must be made via Web forms, returning results as HTML pages. A special module in the OntoFusion system is needed to integrate these public 'Web-based' databases. Domain ontologies are used to do this and provide database mapping and unification. We have used the system to integrate seven significant and widely used public biomedical databases: OMIM, PubMed, Enzyme, Prosite and Prosite documentation, PDB, SNP, and InterPro. A case study is detailed in depth, showing system performance. We analyze the system's architecture and methods and discuss its use as a tool for biomedical researchers.
Angus (A), Charolais (C), Hereford (H), Limousin (L), and Simmental (S) breeds were included in deterministic computer models simulating integrated cow-calf-feedlot production systems. Three mating systems were used: pure-breeding and two-and three-breed rotational crossbreeding. Breed information was taken from the literature. Herd sizes were unrestricted; however, 100 heifers were saved as replacements. Cows were removed for reproductive failure, age (greater than 10.5 yr), or death. Calves produced in the cow-calf segment were fed in a custom feedlot to four slaughter end points: 440 d, 457 d, 288-kg carcass weight, and low Choice. All animals were fed to requirements. Cull cows were slaughtered after weaning. Biological and economic efficiencies improved with crossbreeding; however, rankings of breed combinations depended on how efficiencies were measured (weight, lean, or value basis). Among purebreds, reproductive performance had a large influence on breed rankings at age and weight end points, whereas feedlot performance was important at the low Choice end point. Crossbred combinations involving British (A or H) and Continental (C or S) breeds were more efficient than other crossbred combinations at all end points. However, choosing specific breed combinations for integrated systems depends on slaughter end points, market end points (weight vs lean), and measures of efficiency (weight, lean, or value basis).
The development and implementation of the information systems necessary to support an effective and efficient continuum of care and to measure the quality and cost of that care present complex information systems integration challenges. The article discusses the integration challenges and concludes with a review of strategies that an integrated delivery system can adopt to begin to address them.
Integrated child health information systems consolidate data about multiple health care services a child receives into information useful to families, private health care providers, public health officials, and others. The challenges to successful integration faced by public health agencies are similar, yet system integration projects have historically struggled in isolation to overcome these barriers. All Kids Count created a community of practice called Connections to bring together 11 state and local public health agencies engaged in child health information system integration projects to learn from each other, capture best practices, and collaboratively address challenges. As demonstrated by All Kids Count Connections, communities of practice can be employed by geographically distributed public health agencies to address complex issues.
Healthcare integrated delivery systems (IDSs) evolve through four observed stages of development, with each successive stage having greater levels of interdependence among facilities and between facilities and physicians. The cottage industry stage is characterized by competition among hospitals and little interdependence. Healthcare organizations in the next stage, horizontally integrated systems, have pooled interdependencies, and in the third stage, vertically integrated systems, have predominately sequential interdependence with reciprocal interdependence between physicians and hospitals. In the fourth stage, community healthcare, community systems have reciprocal interdependence among their facilities and other organizations providing services along the continuum of care. This reciprocal interdependence is characteristic of the level of integration that must be addressed for system effectiveness. Greater levels of interdependence require stronger organizational integrating mechanisms and processes. "Integrative management" or "service-line management" is one vehicle for providing this integration. Although few empirical studies are available, this article relates the available empirical and conceptual literature to analyze the interdependencies at each level of IDS development, as well as the organizational design characteristics to address those interdependencies. It then examines the organization of the Veterans Health Administration (VHA) in terms of the four stages of IDS evolution, and suggests organization designs to address VHA's increased needs for integration.
Analysis of the huge volumes of data generated by large scale sequencing projects clearly requires the construction of new sophisticated computer systems. These systems should be able to handle the biological data as well as the results of the analysis of this data. They should also help the user to choose the most appropriate method for a simple task and to string together the methods needed to solve a global analysis task. In this paper we present the prototype of a software system that provides an environment for the analysis of large-scale sequence data. In a first approach this environment has been put to the test within the B. subtilis sequencing project. This system integrates both a descriptive knowledge of the entities involved (genes, regulatory signals etc.) and the methodological knowledge concerning an extendable set of analytical methods (i.e. how to solve a sequence analysis problem through task decomposition and method selection). A knowledge representation based on two existing object-oriented models, named Shirka and SCARP, is used to implement this integrated system. In addition, the present prototype provides a suitable user interface for both displaying the results generated by several methods and interacting with the objects. We present in this paper an overview of the knowledge-based models used to build this integrated system, and a description of the way in which biological entities and sequence analysis tasks are represented. We give illustrations of the co-operation between user and system during the problem solving process. Such a system constitutes a computer workbench for molecular biologists studying the genetic programs of living organisms.
Administration of high doses of the histamine antagonist methapyrilene to rats causes periportal liver necrosis. The mechanism of toxicity is ill-defined and here we have utilized an integrated systems approach to understanding the toxic mechanisms by combining proteomics, metabonomics by 1H NMR spectroscopy and genomics by microarray gene expression profiling. Male rats were dosed with methapyrilene for 3 days at 150 mg/kg/day, which was sufficient to induce liver necrosis, or a subtoxic dose of 50 mg/kg/day. Urine was collected over 24 h each day, while blood and liver tissues were obtained at 2 h after the final dose. The resulting data further define the changes that occur in signal transduction and metabolic pathways during methapyrilene hepatotoxicity, revealing modification of expression levels of genes and proteins associated with oxidative stress and a change in energy usage that is reflected in both gene/protein expression patterns and metabolites. The difficulties of combining and interpreting multiomic data are considered.