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PubMed1997

A UMLS-based method for integrating information databases into an Intranet.

The Internet and the World Wide Web provide today end-users with capabilities to access universally to information in various and heterogeneous databases. The biomedical domain benefits from this new technology, specially for information retrieval by searching and browsing various sites. Nevertheless, end-users may be disoriented by specific ways to access information on different servers. In the framework of an Intranet design and development, we present a method for integrating information databases based on knowledge sources of the UMLS. The method provides designers of a Web site with facilities to implement an easy and homogeneous access to information. The pages are built dynamically and displayed according to a style sheet and their content stored in a database during the design phase. The database also describes the links between pages. Moreover, this organization provides administrators with powerful capabilities to manage Web sites.

Databases as Topic↗
PubMed1995

Telemammography: implementation issues.

Telemammography has the potential to improve access to centralized expertise for the interpretation of breast imaging studies. Digital mammography has more demanding spatial resolution requirements than other forms of medical imaging because of the need to detect microcalcifications, the fine details of lesion margins, and subtle architectural distortion. The resolution requirements for mammography have important implications for image acquisition and display technologies. The large size of the resulting image data sets places significant demands on local and wide area networks as well as storage media. Image data compression will be particularly important for telemammography to help make systems practical and affordable. This article describes how existing technologies can be adapted to implement telemammography systems in the near future.

Algorithms↗
PubMedDate not supplied

[Estimate of underreporting of infectious diseases through a sentinel network of pediatricinas in the area of local health unit of Florence].

The aim of this study was to evaluate the underreporting of some infectious diseases in the pediatric population in the Local Health Unit of Florence in the period 15.09.1997-14.09.1998. Data from the current notification system and from an a hoc sentinel network were used. Nine family pediatricians voluntarily participated in the sentinel network, notifying all cases of measles, mumps, pertussis, rubella, scarlet fever and chickenpox diagnosed in the population of children under their professional responsibility, in the period of the study. Chickenpox was the most frequent disease (2,043 cases equal to 73.5% of total notifications). The notification rate for chickenpox obtained with the sentinel network was 41.6 per 1,000 children, meanwhile the notification rate obtained with the current notification system was 23.7 per 1,000. The notification rate for scarlet fever was 24.1 per 1,000 with the sentinel network and 6.0 per 1000 with the current notification system. The underreporting for the two diseases was respectively 43% and 75%. Voluntary participation of physicians in sentinel network guarantees data of good quality, making these networks very useful tools for the epidemiologic evaluation of infectious diseases with benign prognosis.

Adolescent↗
PubMed2003

Patient confidentiality, data security, and provider liabilities in diabetes management.

From inception, the electronic patient record has raised issues of data protection and patient confidentiality. These privacy issues have become more complicated with the introduction of electronic links to patient information held in databases sited on local and wide area networks. The first purpose of this paper is to review, from the provider's perspective, the issues surrounding patient confidentiality, data security, and consequential provider liabilities. The second is to propose possible immediate strategies and long-term solutions. Clinical procedures in diabetes practice create patient data from confidential information. This information is owned by the patient, received by the provider, enriched by a professional interpretation, and merged with other data into health records. Ownership, privacy, accountability, and responsibility issues are raised. Consequential data security and patient privacy are easily met by storage in a locked box or file cabinet. Conversion of such records into digital data in databases on local and wide area networks markedly increases the provider's exposure to liabilities. Current methods for securing remote data exist. These involve user authentication and secure transmission, but remote data storage is far less secure than a locked box. New tools for the secure storage of patient data are outlined. These involve encryption and decryption by the provider alone. A suite of computer protocols is presented that can restore security equivalent to a "locked box" and thus reduce liabilities for the provider. Providers should protect the privacy of their patients by encrypting all data that are stored in remote repositories. The tools to do this are urgently needed. A standardized digital protocol for verifying user identities, preserving patient confidentiality, and controlling data security by encryption will fully mitigate provider liabilities. Standardization and economies of scale promise future cost containment.

Confidentiality↗
PubMed1996

Information technology, Part 3. The technology hierarchy.

The era of the networked society--and medical care depending on networked intelligence--is dawning. Physicians need to plan for office practice information systems in common, with an eye to conveying data electronically between all the locations of care and all the providers involved in caring for defined populations of people. The shared database will become the most important asset of the collection of providers who make up the delivery system that creates it. This will be accomplished by layering technology on local and wide-area networks of group practices, hospitals, health plans, and payers and developing standards that make data accessible in the same format to all users, no matter where they are.

Computer Communication Networks↗
PubMed1999

Clathrin assembly lymphoid myeloid leukemia (CALM) protein: localization in endocytic-coated pits, interactions with clathrin, and the impact of overexpression on clathrin-mediated traffic.

The clathrin assembly lymphoid myeloid leukemia (CALM) gene encodes a putative homologue of the clathrin assembly synaptic protein AP180. Hence the biochemical properties, the subcellular localization, and the role in endocytosis of a CALM protein were studied. In vitro binding and coimmunoprecipitation demonstrated that the clathrin heavy chain is the major binding partner of CALM. The bulk of cellular CALM was associated with the membrane fractions of the cell and localized to clathrin-coated areas of the plasma membrane. In the membrane fraction, CALM was present at near stoichiometric amounts relative to clathrin. To perform structure-function analysis of CALM, we engineered chimeric fusion proteins of CALM and its fragments with the green fluorescent protein (GFP). GFP-CALM was targeted to the plasma membrane-coated pits and also found colocalized with clathrin in the Golgi area. High levels of expression of GFP-CALM or its fragments with clathrin-binding activity inhibited the endocytosis of transferrin and epidermal growth factor receptors and altered the steady-state distribution of the mannose-6-phosphate receptor in the cell. In addition, GFP-CALM overexpression caused the loss of clathrin accumulation in the trans-Golgi network area, whereas the localization of the clathrin adaptor protein complex 1 in the trans-Golgi network remained unaffected. The ability of the GFP-tagged fragments of CALM to affect clathrin-mediated processes correlated with the targeting of the fragments to clathrin-coated areas and their clathrin-binding capacities. Clathrin-CALM interaction seems to be regulated by multiple contact interfaces. The C-terminal part of CALM binds clathrin heavy chain, although the full-length protein exhibited maximal ability for interaction. Altogether, the data suggest that CALM is an important component of coated pit internalization machinery, possibly involved in the regulation of clathrin recruitment to the membrane and/or the formation of the coated pit.

Adaptor Proteins, Vesicular Transport↗
PubMed1996

Factors affecting performance of PACS.

We experimentally constructed a personal-computer-based Picture Archiving and Communication System (PACS) for color images of dermatology clinics. This system should especially satisfy such a demand as to be able to retrieve an image within a few seconds from the database residing in a remote server. Our two objectives in the experiment were: To examine how much time was consumed in each part of PACS while it does a series of jobs, from the requesting of an image to its display on the screen of the workstation of the user. The other objective was to see if a personal-computer-based PACS could satisfy our criteria. Total retrieving time, data reading time, data transporting time and image displaying time were measured. Total retrieving time can be divided into three procedures: Data reading time, data transporting time, image displaying time. Data reading time was about 0.6 second for reading an image with the size of 1 mega bytes (MB). Data reading time and the size of data were linearly correlated. Data transporting time was about 11 seconds for transporting an image with the size of 1 MB through EtherTalk, and 66 seconds through LocalTalk. Data transporting time and the size of the data were also linearly correlated. Data reading time and data transporting time was able to be reduced largely by compression technique. However, smaller data give other important effects to the network system besides reducing the time of data reading, data transporting and data displaying. Most Local Area using image Network (LAN) systems, such as EtherTalk, adopt Carrier Sense Multiple Access with Collision Detection (CSMA/CD) for the way of accessing to other computer. In CSMA/CD, transporting performance suddenly declines if the congestion of signal in a network gets beyond a critical level. This situation fatally impairs the performance of a network. We concluded that data compression plays an important role to improve the performances of PACS, especially those of a server and the network system. A personal-computer-based PACS with EtherTalk and an image compression/decompression hardware, e.g., CL550A chip, satisfies our criteria.

Dermatology↗
PubMed2004

An assessment of PKI and networked electronic patient record system: lessons learned from real patient data exchange at the platform of OCHIS (Osaka Community Healthcare Information System).

To enhance medical cooperation between the hospitals and clinics around Osaka local area, the healthcare network system, named Osaka Community Healthcare Information System (OCHIS), was established with support of a supplementary budget from the Japanese government in fiscal year 2002. Although the system has been based on healthcare public key infrastructure (PKI), there remain security issues to be solved technically and operationally. An experimental study was conducted to elucidate the central and the local function in terms of a registration authority and a time stamp authority in contract with the Japanese Medical Information Systems Organization (MEDIS) in 2003. This paper describes the experimental design and the results of the study concerning message security.

Access to Information↗
PubMed1998

Experience implementing a DICOM 3.0 multivendor teleradiology network.

OBJECTIVE: The ISIS Center at Georgetown University received a grant from the U.S. Army to act as systems integrator for a project to design, develop, and implement a commercial off-the-shelf teleradiology system to support the U.S. troops in Bosnia-Herzegovina. The goal of the project was to minimize troop movement while providing primary diagnosis to military personnel. This paper focuses on Digital Imaging Communications in Medicine (DICOM) 3.0 related issues that arose from this type of teleradiology implementation. The objective is to show that using the DICOM standard provides a good starting point for systems integration but is not a plug-and-play operation. METHODS: Systems were purchased that were based on the DICOM 3.0 standard. The modalities implemented in this effort were computed radiography (CR), computed tomography (CT), film digitization (FD), and ultrasonography (US). Dry laser printing and multiple-display workstations were critical components of this network. The modalities and output devices were integrated using the DICOM 3.0 standard. All image acquisition from the modalities is directly to a workstation. The workstation distributes the images to other local and remote workstations, to the dry laser printer, and to other vendors' workstations using the DICOM 3.0 standard. All systems were integrated and tested prior to deployment or purchase. Local and wide area networking were also tested prior to implementation of the deployable radiology network. RESULTS: The results of the integration of the multivendor network were positive. Eventually, all vendors' systems did communicate. Software configuration and operational changes were made to many systems in order to facilitate this communication. Often, software fixes or patches were provided by a vendor to modify their DICOM 3.0 implementation to allow better communications with another vendor's system. All systems were commercially available, and any modifications or changes provided became part of the vendor's commercially available package. CONCLUSION: Seven DICOM interfaces were implemented for this project, and none was achieved without modification of configuration files, changes or patches in vendor software, or operational changes. Some of the problems encountered included missing or ignored required data elements, padding of data values, unique study identifiers (UID), and the use of application entity titles. The difficulties with multivendor connectivity lie in the understanding and interpretation of standards such as DICOM 3.0. The success of this network proves that these problems can be overcome and a clinically successful network implemented utilizing multiple vendors' systems.

Computer Communication Networks↗
PubMed1997

A proposed classification of veterinary epidemiosurveillance networks.

With the signing of the General Agreement on Tariffs and Trade and the establishment of the World Trade Organisation, the trading environment for animal products has changed. Disease control measures can no longer be applied as trade barriers unless supported by scientific epidemiological data. In this context, it has become necessary, if not obligatory, to gain accurate and up-to-date knowledge about the epidemiological status of important infectious animal diseases. The role of veterinary epidemiosurveillance networks is therefore gaining importance. Furthermore, epidemiosurveillance contributes to the protection of animal populations from exotic or emerging diseases, as well as to the development and evaluation of disease control programmes. Despite the large diversity of surveillance networks, the authors propose a method of network classification. The criteria for classification are as follows: the type of disease being monitored (i.e., surveillance of exotic versus endemic diseases). The number of diseases concerned (i.e., focused networks versus broad-based networks). The area being covered (i.e., local, national or international networks). The population being monitored (i.e., whether the network is targeted at suspect or susceptible animals). The sampling strategy of the network (i.e., sample-based networks versus exhaustive networks). The method of collecting data (i.e., passive data collection versus active collection). The type of network management (i.e., autonomous management versus that which is integrated with other programmes). This classification is discussed and illustrated by examples published in the literature. It may aid in the future development of a grid for the evaluation of veterinary epidemiosurveillance networks.

Animals↗
PubMed2005

Processing of conflicting cues in an attention-shift paradigm studied with fMRI.

We investigated the effects of conflicting cues in visual attention on brain function, based on a modified version of the Posner cue-target paradigm. The classic paradigm utilizes either a peripheral or centrally placed cue that involuntary or voluntary results in a shift of attention to the cued side. The modified paradigm involves presenting both a peripheral and central cue at the same time, but where the two cues convey conflicting information regarding direction of attention. Functional magnetic resonance imaging (fMRI) were used to record neuronal activation in localized brain areas and networks when the subjects performed the attention task. We hypothesized that the 'exogenous invalid/endogenous valid' condition would activate the anterior attention system to a larger extent than the 'exogenous valid/endogenous invalid' condition, reflecting a need for top-down information processing in this condition. The results for performance data showed that the peripheral cue took precedence over the centrally placed cue when the two cues were in conflict, since reaction times were significantly longer in the "exogenous invalid/endogenous valid" condition. The fMRI data showed an increase in activation in the visual cortex, the left parietal lobule, and in the left cingulate gyrus in both the exogenous valid/endogenous invalid and exogenous invalid/endogenous valid conditions. For the exogenous invalid/endogenous valid condition, there were, in addition, significant activations also in the inferior and middle frontal gyri, and in the precentral gyrus. We interpret these findings as reflecting that these brain areas particularly involved in top-down modulation of attention that interferes with a bottom-up, exogenous-driven effect.

Adult↗