Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “integration”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 595 records · Page 33Linked to original sources
PubMed1992

Empirical perspectives on services integration and aging: a review.

This article combines a review of social service literature with interviews of key informants on the issue of integrating services for the elderly into human services across the life span. Empirical findings concerning the relative benefits and drawbacks of age-integrated vs. specialized service organizational structures are emphasized. Surprisingly few empirical studies were identified. Instead of empirically based reports, the literature is largely comprised of polemics, which essentially restate long-standing positions on the preferred handling of integration. A persistent difficulty in discussions of federal and state service integration objectives has been the wide differences in definitions of "integration." The lack of data demonstrating that older persons benefit in integrated service systems, along with substantial progress in development of specialized services for the aged, suggest that aging advocates should be cautious in embracing age-integrated service integration proposals. Research within management information systems oriented toward client outcomes is necessary to gain valid knowledge of the merits of various integrated service models.

Aged↗
PubMed2004

Relationship between orthographic-motor integration and computer use for the production of creative and well-structured written text.

BACKGROUND: Orthographic-motor integration refers to the way in which orthographic knowledge is integrated with fine-motor demands of handwriting. A strong relationship has shown to exist between orthographic-motor integration and students' ability to produce creative and well-structured written text (De La Paz & Graham, 1995). This relationship is thought to be due to the cognitive load resulting from lack of automaticity in orthographic-motor integration so that writers do not have sufficient resources to accomplish the more demanding aspects of writing. Interventions to improve children's orthographic-motor integration result in improved written text (Jones & Christensen, 1999). AIM: This study first extended findings related to handwritten text to the relationship between typing and the length and quality of computer-based written text. Second, it examined the efficacy of an intervention to develop proficiency in typing skills on the length and quality of students' written language. SAMPLE: Participants in the first study were 276 Grade 8 and 9 students. In the second study 35 students in Grades 8 and 9 who exhibited very low levels of proficiency in typing were the participants. METHODS: In Study 1, orthographic-motor integration related to typing as well as handwriting was assessed for all students. They were asked to complete a piece of handwritten and computer-based text. Students in the intervention study completed the same measures as Study 1, at pre- and post-test. During the intervention half the students completed a daily typed journal and half completed a program designed to facilitate their typing skills. RESULTS: There was a significant relationship between orthographic-motor integration -- handwriting and the length and quality of handwritten text, and a stronger relationship between orthographic-motor integration -- typing and length and quality of computer-based text. Both intervention groups in the second study showed significant differences in writing skills from pre- to post-test. However, the typing skills group showed significantly better scores on typing and quality of typewritten text than the journal group at post-test. The impact of the intervention was specific to typewritten text. There was no difference in length or quality of handwritten text. CONCLUSION: It is suggested that developing proficiency in orthographic-motor integration related to typing allows writers to employ their cognitive resources more flexibly when working on a computer, so that they can devote attention to higher-order processes involved in ideation, syntactic and semantic monitoring and pragmatic awareness.

Adolescent↗
PubMed2004

Distinct genomic integration of MLV and SIV vectors in primate hematopoietic stem and progenitor cells.

Murine leukemia virus (MLV)-derived vectors are widely used for hematopoietic stem cell (HSC) gene transfer, but lentiviral vectors such as the simian immunodeficiency virus (SIV) may allow higher efficiency transfer and better expression. Recent studies in cell lines have challenged the notion that retroviruses and retroviral vectors integrate randomly into their host genome. Medical applications using these vectors are aimed at HSCs, and thus large-scale comprehensive analysis of MLV and SIV integration in long-term repopulating HSCs is crucial to help develop improved integrating vectors. We studied integration sites in HSCs of rhesus monkeys that had been transplanted 6 mo to 6 y prior with MLV- or SIV-transduced CD34(+)cells. Unique MLV (491) and SIV (501) insertions were compared to a set of in silico-generated random integration sites. While MLV integrants were located predominantly around transcription start sites, SIV integrants strongly favored transcription units and gene-dense regions of the genome. These integration patterns suggest different mechanisms for integration as well as distinct safety implications for MLV versus SIV vectors.

Animals↗
PubMed2002

DNA-PK and ATM are required for radiation-enhanced integration.

Ionizing radiation is known to improve transfection of exogenous DNA, a process we have termed radiation-enhanced integration. Previous observations have demonstrated that Ku proteins are critical for radiation-enhanced integration. Since Ku proteins form the DNA-binding domain of DNA-PK and since DNA-PK is important in nonhomologous DNA end joining, it was hypothesized that DNA-PK function might be important for radiation-enhanced integration. The ATM protein has been shown to be important in the recognition of a variety of types of DNA damage and to associate with DNA-PK under certain conditions. It was thus hypothesized that ATM might also play a role in radiation-enhanced integration. To test these hypotheses, radiation-enhanced integration was measured in hamster cells that are defective in the catalytic subunit of DNA-PK and in human cells containing mutant ATM. Radiation-enhanced integration was not detected in any of the cell lines with mutant PRKDC (also known as DNA-PKcs), but it was present in cells of the same lineage with wild-type PRKDC. Radiation-enhanced integration was defective in cells lacking kinase activation. ATM-deficient cell lines also showed defective radiation-enhanced integration. These data demonstrate that DNA-PK and ATM must both be active for radiation-enhanced integration to be observed.

Animals↗
PubMed2004

Developing integrated health and social care services for older persons in Europe.

PURPOSE: This paper is to distribute first results of the EU Fifth Framework Project 'Providing integrated health and social care for older persons-issues, problems and solutions' (PROCARE-http://www.euro.centre.org/procare/). The project's first phase was to identify different approaches to integration as well as structural, organisational, economic and social-cultural factors and actors that constitute integrated and sustainable care systems. It also served to retrieve a number of experiences, model ways of working and demonstration projects in the participating countries which are currently being analysed in order to learn from success-or failure-and to develop policy recommendations for the local, national and European level. THEORY: The paper draws on existing definitions of integrated care in various countries and by various scholars. Given the context of an international comparative study it tries to avoid providing a single, ready-made definition but underlines the role of social care as part and parcel of this type of integrated care in the participating countries. METHODS: The paper is based on national reports from researchers representing ten organisations (university institutes, consultancy firms, research institutes, the public and the NGO sector) from 9 European countries: Austria, Denmark, Finland, France, Germany, Greece, Italy, the Netherlands, and the UK. Literature reviews made intensive use of grey literature and evaluation studies in the context of at least five model ways of working in each country. RESULTS: As a result of the cross-national overview an attempt to classify different approaches and definitions is made and indicators of relative importance of the different instruments used in integrating health and social care services are provided. CONCLUSIONS: The cross-national overview shows that issues concerning co-ordination and integration of services are high on the agenda in most countries. Depending on the state of service development, various approaches and instruments can be observed. Different national frameworks, in particular with respect to financing and organisation, systemic development, professionalisation and professional cultures, basic societal values (family ethics), and political approaches have to be taken into account during the second phase of PROCARE during which transversal and transnational analysis will be undertaken based on an in-depth analysis of two model ways of working in each country. DISCUSSION: Far from a European vision concerning integrated care, national health and social care systems remain-at best-loosely coupled systems that are facing increasing difficulties, given the current challenges, in particular in long-term care for older persons: increasing marketisation, lack of managerial knowledge (co-operation, co-ordination), shortage of care workers and a general trend towards down-sizing of social care services continue to hamper the first tentative pathways towards integrated care systems.

Journal Article↗
PubMed2000

Fully integrated care for frail elderly: two American models.

PURPOSE: Integrated care for the frail elderly and other populations with complex, chronic, disabling conditions has taken centre stage among policymakers, planners and providers in the United States and other countries. There is a growing belief that integrated care strategies offer the potential to improve service co-ordination, quality outcomes, and efficiency. Therefore, it is critical to have a conceptual understanding of the meaning of integrated care and its various organisational models, as well as practical examples of how such models work. This article examines so-called "fully integrated" models of care in detail, concentrating on two major, well-established American programs, the social health maintenance organisation and the program of all-inclusive care for the elderly. THEORY: A major challenge to understanding the performance and outcomes of fully integrated care and other organisational models is the lack of a meaningful, analytical paradigm. This article builds upon the work of Walter Leutz, to develop a framework by which new and existing programs can be analysed. This framework is then applied to the two American models that are the focus of this article. METHODS: Existing data about integrated care in general, and the two model programs in particular, were collected and analysed from reports published by governmental and non-governmental organisations, and journal articles retrieved from Medline, HealthStar and other sources. RESULTS AND CONCLUSIONS: This analysis strongly suggests that fully integrated models of care, such as the social health maintenance organisation and program of all-inclusive care for the elderly, are not only feasible, but offer significant potential to improve the delivery of health and social care for frail elderly patients. In addition, the authors identify the factors that are the most critical to the success of fully integrated care, and offer lessons for their development and implementation. Finally, issues are raised concerning the transferability of this complex model to other countries, as well as the vital importance of evidence-based evaluation research in furthering the evolution of integrated care.

Journal Article↗
PubMed2004

Conceptualizing and validating the human services integration measure.

PURPOSES: This paper proposes both a model and a measure of human service integration through strategic alliances with autonomous services as one way to achieve comprehensive health and social services for target populations. THEORY: Diverse theories of integrated service delivery and collaboration were combined reflecting integration along a continuum of care within a service sector, across service sectors and between public, not-for-profit and private sectors of financing services. METHODS: A measure of human service integration is proposed and tested. The measure identifies the scope and depth of integration for each sector and service that make up a total service network. It captures in quantitative terms both intra and inter sectoral service integration. RESULTS: Results are provided using the Human Service Measure in two networks of services involved in promoting Healthy Babies and Healthy Children known to have more and less integration. CONCLUSIONS: The instrument demonstrated discriminate validity with scores correctly distinguishing the two networks. The instrument does not correlate (r=0.13) with Weiss (2001) measure of partnership synergy confirming that it measures a distinct component of integration. DISCUSSION: We recommend the combined use of the proposed measure and the Weiss (2001) measure to more completely capture the scope and depth of integration efforts as well as the nature of the functioning of a service program or network.

Journal Article↗
PubMedDate not supplied

The power of product integrity.

In the dictionary, integrity means wholeness, completeness, soundness. In products, integrity is the source of sustainable competitive advantage. Products with integrity perform superbly, provide good value, and satisfy customers' expectations in every respect, including such intangibles as their look and feel. Consider this example from the auto industry. In 1987, Mazda put a racy four-wheel steering system in a five-door family hatchback. Honda introduced a comparable system in the Prelude, a sporty, two-door coupe. Most of Honda's customers installed the new technology; Mazda's system sold poorly. Potential customers felt the fit--or misfit--between the car and the new component, and they responded accordingly. Companies that consistently develop products with integrity are coherent, integrated organizations. This internal integrity is visible at the level of strategy and structure, in management and organization, and in the skills, attitudes, and behavior of individual designers, engineers, and operators. Moreover, these companies are integrated externally: customers become part of the development organization. Integrity starts with a product concept that describes the new product from the potential customer's perspective--"pocket rocket" for a sporty, subcompact car, for example. Whether the final product has integrity will depend on two things: how well the concept satisfies potential customers' wants and needs and how completely the concept has been embodied in the product's details. In the most successful development organizations, "heavyweight" product managers are responsible for leading both tasks, as well as for guiding the creation of a strong product concept.

Consumer Behavior↗
PubMed1993

Coordinating patient care services in regional health systems: the challenge of clinical integration.

Regional health systems attempting to achieve the vertical integration of health services ultimately must achieve clinical integration. The thesis of this article is that vertical integration in health care involves the coordination of inputs (equipment, supplies, human resources, information, and technology) and intermediate outputs (preventive, diagnostic, acute, chronic, and rehabilitative services) to attain the end goal of optimal personal health. Given this perspective on vertical integration, the coordination of specialty services and primary care within a system structure--that is, the clinical integration of patient care--is central to the realization of vertically integrated regional health systems. Institution-level and environmental factors that facilitate and challenge the attainment of clinical integration are elucidated, and a set of clinical integrating mechanisms are outlined with presentation of real-world examples of those mechanisms. The analysis concludes by summarizing the next steps in realizing the vision of clinically integrated, regional systems of health care.

Comprehensive Health Care↗
PubMed2000

Cryodamage to plasma membrane integrity in head and tail regions of human sperm.

AIM: To investigate the effect of cryopreservation on the plasma membrane integrity in the head and tail regions of individual sperm, and the relationship between intact cryopreserved sperm and its motility and zona-free hamster oocyte penetration rate. METHODS: The eosin Y exclusion and the hypoosmotic swelling tests were combined to form a single test (HOS-EY test) to identify the spermatozoa with four types of membrane integrity. RESULTS: After cryopreservation, there was a marked decline in the percentage of spermatozoa with Type IV membrane integrity (head membrane intact/tail membrane intact), and a significant increase in those with Type I (head membrane damaged/tail membrane damaged) and Type III (head membrane damaged/tail membrane intact) membrane integrity (n = 50, P < 0.01). The value of Type II integrity had a wide range of variability, whereas Type II (head membrane intact/tail membrane damaged) was uncommon after thawing. A high correlation was observed between the percentage of Type IV integrity and sperm motility ( n = 50, r = 0.74, P < 0.01). However, the values of Type IV integrity were usually lower than those of post-thaw motility in most cryopreserved samples. The value of Type IV integrity did not correlate with the sperm penetration rate (n = 25, r = 0.22, P > 0.05). CONCLUSION: (1) The HOS-EY test has the advantage of showing four patterns of membrane integrity in individual spermatozoon; (2) Cryopreservation causes a significant membrane rupture in the head and tail regions of spermatozoa; Type III is the main transitional state of membrane cryodamage; (3) Cryodamage to head and tail membrane may occur independently; the presence of an intact tail membrane does not necessarily indicate the intactness of head membrane. (4) Intact membranes are closely related to post-thaw motility, but do not reflect the fertilizing potential.

Adult↗
PubMed1999

[Development of integrated traditional Chinese and western medicine and change of medical policy in China].

"Sect of Integration of Chinese and Western Medicine" came into the world four hundred years ago when Traditional Chinese Medicine (TCM) contacted Western Medicine (WM) at the beginning of the 17th century. It collected historical experiences showing that the cooperation of TCM and WM is more efficient for the cure and prevention of disease than each of them separately. Now the recognition that the cooperation of eastern and western medicine is more efficient to cure disease is spreading widely. This study will help Korean eastern and western medicine to find their directions. First, the concept of "sect of Integration of Chinese and Western Medicine" which was established between the beginning of the 17th century and the middle of the 20th century, and Integration of Traditional Chinese and Western Medicine (ITCWM) which was formed after the middle of the 20th century will be discussed. The relationship of "sect of Integration of Chinese and Western Medicine" and ITCWM and political consideration for the establishment of ITCWM will also be discussed. Finally, the current status of ITCWM in China will be discussed. New trends of thought appeared in Chinese medicine, owing to the cultural background of modern China, the development of WM, and the academic background of the intellectual class. "Sect of Integration of Chinese and Western Medicine" and ITCWM are different in historical and social background. However, purpose, foundation of thoughts and logical idea are fundamentally the same. It can be said that "sect of Integration of Chinese and Western Medicine" provided academic mood to open the way for ITCWM and ITCWM is a succession of "sect of Integration of Chinese and Western Medicine". The concept of ITCWM has many ways of explanation. However, it can be said to build up the foundation of new medical area including Chinese special way of medical treatment and new methods of modern medicine, succeeding a legacy of TCM. ITCWM began before the establishment of People's Republic of China. Mao Ze-dong (1893-1976), a powerful politician, and Li Ding-ming (1881-1947) who had many experiences and insight for TCM and WM played important roles at this stage. The period from the New China to the Great Proletarian Cultural Revolution (1966-1975) is the term for the establishment of the shape of ITCWM. "The effort of research and development on TCM-WM integration" was adapted as one of hygienic policies for curing of epidemic disease and succession and development of the heritage of TCM to establish new medical area. TCM class for western medical doctors was opened and mass media was used to spread out ITCWM throughout China. During the period of the Great Proletarian Cultural Revolution, ITCWM had to be stepped back and stagnant. Only the TCM class of western medical doctors and some clinical applications were barely kept moving on and alive. From the period of the Great Proletarian Cultural Revolution to the end of the 1980s, there are the movement of re-preparation of ITCWM, education of successors, and the establishment of the Institute of ITCWM. Hospitals began to establish department of ITCWM. Furthermore, it was clearly indicated in the constitutional law that "We not only have to develop modern medicine but also traditional medicine". The equality of TCM and WM was legally established in this time. From the 1990s, "equality of TCM and WM" was adapted as one of the hygienic policies, and department of ITCWM was opened in traditional Chinese medical school and western medical school. ITCWM has been settled down as a new academic field through education, training, research, academic activity, and publishing text books. In conclusion, the motive of the development of ITCWM was the policy such as "the effort of research and development on TCM-WM integration" abd "equality of TCM and WM" aimed at the development of Chinese medical area. It is no doubt helpful to organize systems and policy-making for the cooperation of eastern and western medicine in Korea.

China↗
PubMed2004

Approaches and informatics tools to assist in the integration of similar clinical research questionnaires.

OBJECTIVE: The integration of similar clinical research questionnaires is a complex process that can benefit from informatics approaches and tools that provide a systematic structure for performing mapping and integration. This systematic approach is necessary to address complex issues in integration such as data heterogeneity, differing levels of granularity of questions and responses, and other issues involving semantic differences. Informatics tools and approaches have been successfully applied to various standard clinical vocabulary integration processes but not for questionnaire integration or mapping. METHODS: A systematic approach to questionnaire integration was developed in the context of a collaboration of researchers using Trial/DB, a database designed to support clinical research. This approach was applied to the integration of questionnaires involving breast cancer risk factors from each of three research sites. RESULTS: From 375 questions on the three original questionnaires, we identified 65 concepts that were measured by two or three of the sites. An algorithm was developed and used to formalize the process of mapping questions and answers across the questionnaires. The approach was applied to previously collected data and prospective data in disparate data-base systems to import and merge the data from these three sites into Trial/DB. CONCLUSION: Informatics tools that support a systematic approach to mapping questionnaires can be used throughout the research process from questionnaire integration and creation, legacy data integration to data library maintenance and curation.

Biomedical Research↗
PubMed2005

Integration of the hepatitis B virus X fragment in hepatocellular carcinoma and its effects on the expression of multiple molecules: a key to the cell cycle and apoptosis.

We investigated hepatitis B virus (HBV) DNA integration and expression of several proteins involved in the cell cycle and apoptosis, including cyclin A, retinoblastoma protein (pRB), Fas-associated death domain protein (FADD), tumor necrosis factor receptor-associated death domain protein (TRADD), and nuclear factor kappaB (NF-kappaB) in HBV-associated hepatocellular carcinoma (HCC) and liver cirrhosis (LC). Archival HCC and LC specimens were obtained from 35 patients each with HBV infection; 5 normal liver specimens used as controls were also obtained. Polymerase chain reaction and Southern blot hybridization were used to detect the integration of HBV DNA in the HCC and LC specimens. The protein levels were determined by Western blot assay. The difference in HBV DNA integration between HCC and LC and correlation between HBV-encoded X protein (Hbx) integration and protein expression were analyzed statistically. HBV DNA was detected in 33 (94%) of the HCC and LC specimens. HBx integration differed in the HCC [24 (69%)] and LC [14 (40%)] specimens (p=0.015). Sixty percent of the HCC specimens and 6% of the LC specimens had increased cyclin A expression. Also, 34, 37, 69, and 77% of the HCC specimens were positive for pRB, FADD, TRADD, and NF-kappaB expression, whereas 80, 60, 100, and 100% of the LC specimens were positive for pRB, FADD, TRADD, and NF-kappaB expression. Significant correlations between HBx integration and the level of expression of cyclin A (r=0.452; p=0.006), pRB (r=-0.419; p=0.012), and TRADD (r=0.470; p=0.004) were discovered. Therefore, integration of HBV DNA occurred frequently in HCC and LC cases with chronic HBV infection, whereas HBx integration occurred more often in HCC than in LC cases (p=0.015). HBx integration and altered expression of genes is a key to apoptosis and may play important roles in HBV-induced hepatocarcinogenesis.

Apoptosis↗
PubMed2006

Morphological integration in the carnivoran skull.

The correlated evolution of traits may be a principal factor in morphological evolution, but it is typically studied in genetic or developmental systems. Most studies examining phenotypic trait correlations, through analysis of morphological integration, consider only few taxa, with limited ability to test hypotheses of the influence of trait integration on morphological variation and diversity. The few comparative studies in less inclusive groups have yielded varying relationships of integration to the key factors of phylogeny and diet. In this paper, I present analyses of cranial morphological integration in 30 species from the mammalian order Carnivora, spanning eight extant families and a wide range of ecological and morphological diversity. Fifty-five cranial landmarks were captured through three-dimensional digitization of 15-22 specimens for each species. Using a node-based phylogenetic distance matrix, a significant correlation was found between similarity in patterns of integration and phylogenetic relatedness within Felidae (cats) and Canidae (dogs), but not within more inclusive clades, when size-related variation was removed. When size was included, significant correlations were found across all Caniformia, Musteloidea, Mustelidae, and Felidae. There was a significant correlation between phylogeny and morphological integration only within the higher-level clade Feliformia (cats, civets, mongooses, and hyaenas) when a branch-length-based phylogenetic distance matrix was analyzed, with and without size. In contrast, diet was significantly correlated with similarity in morphological integration in arctoid carnivorans (bears, raccoons, and weasels), but had no significant relationship with integration in feliforms or canids. These results support the proposition that evolutionary history is correlated with cranial integration across large clades, although in some smaller clades diet also exerts significant influence on the correlated evolution of traits.

Animals↗
PubMed1995

The effects of hospital-physician integration strategies on hospital financial performance.

STUDY QUESTION: This study investigated the longitudinal relations between hospital financial performance outcomes and three hospital-physician integration strategies: physician involvement in hospital governance, hospital ownership by physicians, and the integration of hospital-physician financial relationships. DATA SOURCES AND STUDY SETTING: Using secondary data from the State of California, integration strategies in approximately 300 California short-term acute care hospitals were tracked over a ten-year period (1981-1990). STUDY DESIGN: The study used an archival design. Hospital performance was measured on three dimensions: operational profitability, occupancy, and costs. Thirteen control variables were used in the analyses: market competition, affluence, and rurality; hospital ownership; teaching costs and intensity; multihospital system membership; hospital size; outpatient service mix; patient volume case mix; Medicare and Medicaid intensity; and managed care intensity. DATA COLLECTION/EXTRACTION: Financial and utilization data were obtained from the State of California, which requires annual hospital reports. A series of longitudinal regressions tested the hypotheses. PRINCIPAL FINDINGS: Considerable variation was found in the popularity of the three strategies and their ability to predict hospital performance outcomes. Physician involvement in hospital governance increased modestly from 1981-1990, while ownership and financial integration declined significantly. Physician governance was associated with greater occupancy and higher operating margins, while financial integration was related to lower hospital operating costs. Direct physician ownership, particularly in small hospitals, was associated with lower operating margins and higher costs. Subsample analyses indicate that implementation of the Medicare prospective payment system in 1983 had a major impact on these relationships, especially on the benefits of financial integration. CONCLUSIONS: The findings support the validity of hospital-physician financial integration efforts, and to a lesser extent the involvement of physicians in hospital governance. The results lend considerably less support for strategies built around direct physician ownership in hospitals, particularly since PPS implementation. RELEVANCE/IMPACT: These findings challenge prior studies that found few financial benefits to hospital-physician integration prior to PPS implementation in 1983. The results imply that financial benefits of integration may take several years after implementation to emerge, are most salient in a managed care or managed competition environment, and vary by hospital size and multihospital system membership.

Analysis of Variance↗
PubMed1997

Development of multisensory neurons and multisensory integration in cat superior colliculus.

The development of multisensory neurons and multisensory integration was examined in the deep layers of the superior colliculus of kittens ranging in age from 3 to 135 d postnatal (dpn). Despite the high proportion of multisensory neurons in adult animals, no such neurons were found during the first 10 d of postnatal life. Rather, all sensory-responsive neurons were unimodal. The first multisensory neurons (somatosensory-auditory) were found at 12 dpn, and visually responsive multisensory neurons were not found until 20 dpn. Early multisensory neurons responded weakly to sensory stimuli, had long latencies, large receptive fields, and poorly developed response selectivities. Most surprising, however, was their inability to integrate combinations of sensory cues to produce significant response enhancement (or depression), a characteristic feature of the adult. Responses to combinations of sensory cues differed little from responses to their modality-specific components. At 28 dpn an abrupt physiological change was noted. Some multisensory neurons now integrated combinations of cross-modality cues and exhibited significant response enhancements when these cues were spatially coincident and response depressions when the cues were spatially disparate. During the next 2 months the incidence of multisensory neurons, and the proportion of these neurons capable of adult-like multisensory integration, gradually increased. Once multisensory integration appeared in a given neuron, its properties changed little with development. Even the youngest integrating neurons showed superadditive enhancements and spatial characteristics of multisensory integration that were indistinguishable from the adult. Nevertheless, neonatal and adult multisensory neurons differed in the manner in which they integrated temporally asynchronous stimuli, a distribution that may reflect the very different behavioral requirements at different ages. The possible maturational role of corticotectal projections in the abrupt gating of multisensory integration is discussed.

Acoustic Stimulation↗
PubMed2026

Genomic and transcriptomic features of HBV integration in treatment-na&#xef;ve, HBeAg-positive children with chronic HBV infection.

BACKGROUND: Hepatitis B virus (HBV) integration represents a major obstacle to curing HBV; however, the landscape of HBV integration and local immune response to transcriptionally active viral integration in children with chronic HBV infection remain unclear. Herein, we aimed to elucidate this landscape in this population. METHODS: Genomic analyses using a probe-based capture strategy were performed on 18 children and 28 adults with chronic HBV infection. Spatial transcriptomics (ST) was performed on 12 children from our cohort and 3 adults from a public database. FINDINGS: All patients were hepatitis B e antigen (HBeAg)-positive and treatment-na&#xef;ve. Genomically, children exhibited significantly lower clonal expansion level of HBV-integrated hepatocytes than adults, despite comparable unique breakpoint counts. After adjusting for confounding variables, age was identified as an independent risk factor for total frequency of unique integration breakpoints (b = 3.22, P = 0.005). Spatially, ST revealed that spots with transcriptionally active viral integration exhibited a sparse distribution and accounted for a low proportion of all spots in children. Notably, at these spots, children showed reduced adaptive immune cells (e.g., CD8+ T cells) but increased innate components (myeloid cells, Kupffer cells, activated dendritic cells) and APC co-stimulation, whereas adults exhibited a uniform reduction of immune cell populations. INTERPRETATION: Compared with adults, children exhibit lower clonal expansion of HBV-integrated hepatocytes and distinct immune profiles in response to transcriptionally active viral integration, offering new insights into their differing clinical course. FUNDING: Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education).

Humans↗
PubMed2000

The impact of federal systems integration initiatives on services for mentally ill homeless persons.

Nearly everyone writing on homelessness over the past 15 years has called for comprehensive integrated systems of care to address the multiple and complex needs of people who become homeless, especially those with mental illness. What is often overlooked is that calls for systems integration are far from new. Although the names have changed over the years, the underlying concepts have not. The purposes of this paper are fourfold: (1) to clarify the distinction between services integration and systems integration; (2) to map the evolution of federal programs to demonstrate that most of these really have been focused on services integration rather than systems integration; (3) to assess the extent that data from these programs supports the idea of systems integration; and (4) to show how the current ACCESS demonstration for persons who are homeless and mentally ill is likely to provide answers that prior programs have not. Without these new data, systems integration, as one solution to the problems of homelessness, remains a theory without empirical evidence; albeit a theory with persuasive conceptual underpinnings.

Continuity of Patient Care↗