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The evolution of the Washington University School of Medicine BACS integrated library system toward information management functions is outlined. The creation of a machine-readable database and its extension through telecommunications have consequences that reach beyond the functions of the library as we have perceived them. It is argued that libraries are flexible institutions that, with automation, are likely to enlarge rather than to diminish.
Deterministic computer models were used to simulate the cow-calf segment of an integrated production system. Angus, Charolais, Hereford, Limousin, and Simmental breeds were included in three mating systems: pure-breeding (PB) or two- (2R) or three-breed (3R) rotational crossbreeding. Breed data were taken from the literature. Herds were evaluated over the production year. Sires represented breed averages and were available from sources outside their herds, and 100 replacement heifers were saved annually. Females in 3R had the highest average energy requirements (8,144 Mcal of ME.cow-1.yr-1) and production costs ($322.31.cow-1.yr-1), and PB females had the lowest average requirements (7,748 Mcal of ME.cow-1.yr-1) and costs ($313.2.cow-1.yr-1). Purebred systems were the least biologically and economically efficient (64.9 Mcal of ME/kg of steer equivalent, $2.35/kg of steer equivalent), respectively, and 3R systems were the most efficient (56.6 Mcal of ME/kg of steer equivalent, $1.95/kg of steer equivalent). On average, 3R systems were more efficient biologically and economically than 2R systems. However, some 2R systems were as efficient as some 3R systems. Crossbred combinations containing Angus and(or) Hereford ranked more biologically and economically efficient than other breed combinations. Conversely, British purebreds ranked more biologically efficient, whereas Continental purebreds ranked more economically efficient.
We established a Thermus thermophilus strain in which the pyrE gene (coding for orotate phosphoribosyltransferase of the pyrimidine biosynthetic pathway) was totally deleted. We also constructed an integration vector, which consisted of the Escherichia coli plasmid vector pBluescript and a 2.1-kb segment of the T. thermophilus leu operon sequence, for the integration of a foreign gene into a chromosome of the thermophile. pyrE and leuB genes were used as probes to test the integration vector. The integration vector pINV, bearing the pyrE gene, transformed the delta pyrE strain at a frequency of 6 x 10(-5) through a single crossover event. The leuB gene could also be used as another marker of the integration vector system. The vector could be integrated at the expected site. By digesting the chromosomal DNA of the T. thermophilus transformants with a unique restriction enzyme, the vector could be recovered into E. coli after the recircularization in vitro. The kanamycin nucleotidyltransferase gene could be successfully expressed in the thermophile by using pINV.
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A new type of modulational instability for coherent as well as partially coherent light in systems with integrating nonlinearity caused by an irreversible process is investigated both experimentally and theoretically. In such systems plane waves never reach the stationary limit and exhibit a nontrivial time dependence resulting in new features of the modulational instability. For example, the modulational frequency of the nonexponentially increasing perturbation with maximum gain decreases while the wave is propagating. The threshold for vanishing modulational instability due to a finite degree of spatial coherence depends only on system parameters and not on the light intensity.
The National Center for Health Statistics (NCHS) is the nation's principal health statistics agency, with a primary mission to collect, disseminate, and analyze health data. NCHS has a clear commitment to a wide range of improvements in surveillance and public health information systems. Building on its long history of conducting multipurpose surveys where the needs and interests of a variety of programmatic interests have to be accommodated, NCHS is working on a number of fronts to improve and better integrate data systems so that they will be more useful for public health surveillance. Examples include the redesign of the National Health Interview Survey, the integration of the Department of Health and Human Services' health surveys, the retooling of the vital statistics system, and the movement to subnational data collection.
Even without passage of Federal healthcare reform legislation, the healthcare market is responding to cost-control pressures by becoming more integrated and business-driven. As mergers and collaborations increase, automated system infrastructures must be developed to support the information needs of newly formed integrated healthcare delivery systems. Strategic plans must include provisions for creating new information systems or expanding existing systems so they can support seamless integration and access to patient data among varying providers.
BACKGROUND AND AIM: Frequent blood glucose (BG) monitoring and insulin administration are necessary in intensive insulin regimes. A new integrated system, InDuo is a compact and portable combined insulin doser and BG monitor, designed to overcome some of the limitations of current insulin therapy. The aim of the study was to compare InDuo and a non-integrated system (HumaPen Ergo and Accu-Chek Sensor Meter) for efficacy and safety, and to evaluate patients preference. MATERIALS AND METHODS: The trial design was a multicentre, randomised, 12-week, open-label, comparative, two period crossover. One hundred and ten patients with diabetes, treated with a basal bolus regime, were included. The subjects were assigned to use either InDuo or the non-integrated system. After six weeks of treatment, the subjects were transferred to the alternative system. To assess efficacy, fasting plasma glucose (FBG), 7-point blood glucose profile, serum fructosamine and HbA1c were measured. Serum fructosamine and FBG were measured at baseline and at six and 12 weeks; HbA1c was measured at baseline and week 12. Safety endpoints were number and severity of hypoglycaemic episodes, adverse events and adverse device effects. Patient preference was assessed by a comparative device questionnaire at 12 weeks. RESULTS: Analysis with an ANOVA mixed model showed no difference after each treatment between serum fructosamine or between FBG levels. HbA1c decreased during the trial from 7.5 % +/- 1.2 to 7.1 % +/- 0.8 at 12 weeks. The safety profiles were similar for both treatments for hypoglycaemic episodes. The incidence of adverse events was also similar. There were 10 adverse device effects reported: eight for the Innovo device in the InDuo, one for the InDuo device and one for the Accu-Chek Sensor Meter. The comparative device questionnaire at 12 weeks showed patients strongly preferred InDuo to HumaPen Ergo and Accu-Chek Sensor Meter (all p < 0.0001). Of those preferring InDuo, more than 60 % classified their choice as very or extremely strong. Both memory functions in InDuo(R) (i. e., for insulin dosage and for blood glucose readings) were used by more than 70 % of the patients. CONCLUSION: Treatment with the InDuo system was as effective and safe as treatment with the non-integrated system. Almost 75 % preferred using InDuo to the non-integrated HumanPen Ergo and Accu-Chek Sensor Meter.
We discuss control of low-dimensional systems which, when uncontrolled, are integrable in the Hamiltonian sense. The controller targets an exact solution of the system in a region where the uncontrolled dynamics has invariant tori. Both dissipative and conservative controllers are considered. We show that the shear flow structure of the undriven system causes a Takens-Bogdanov bifurcation to occur when control is applied. This implies extreme noise sensitivity. We then consider an example of these results using the driven nonlinear Schrödinger equation.
The Unified Medical Language System (http://umlsks.nlm.nih.gov) is a repository of biomedical vocabularies developed by the US National Library of Medicine. The UMLS integrates over 2 million names for some 900,000 concepts from more than 60 families of biomedical vocabularies, as well as 12 million relations among these concepts. Vocabularies integrated in the UMLS Metathesaurus include the NCBI taxonomy, Gene Ontology, the Medical Subject Headings (MeSH), OMIM and the Digital Anatomist Symbolic Knowledge Base. UMLS concepts are not only inter-related, but may also be linked to external resources such as GenBank. In addition to data, the UMLS includes tools for customizing the Metathesaurus (MetamorphoSys), for generating lexical variants of concept names (lvg) and for extracting UMLS concepts from text (MetaMap). The UMLS knowledge sources are updated quarterly. All vocabularies are available at no fee for research purposes within an institution, but UMLS users are required to sign a license agreement. The UMLS knowledge sources are distributed on CD-ROM and by FTP.
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Having accurate measures and high-quality health information is critically important for all providers today. Integrated delivery systems are faced with increasing demands for numerous redundant, sometimes conflicting, performance measurement and reporting data from managed care customers, regulators, and accreditors. When implemented independently within each organizational subunit, these measurement systems are costly and difficult to manage. Centralization of all measurement services can maximize the productivity of the costly resources required to deliver them and can achieve efficiencies, cost savings, and a better balance between internal and external resources while collecting information that is of a higher quality for managerial and clinical decision making.
Lederle's Medical Research Integrated Database Information Retrieval (MRIDIR) system provides timely and facile access to a growing body of computerized, in-house data relating to pharmaceutical discovery and development. It was created in response to a proliferation of special-purpose programs, each dealing with a specific dataset and each with its own query syntax. Written in FORTRAN and interfacing to the System-1022 Database Management System, MRIDIR provides relational links between these datasets and, from the user's viewpoint, integrates them into a single database with a simple query language. A special dataset called the "data dictionary" describes these linkages, and alterations to the database structure (eg, addition of new datasets) are smoothly accomplished through changes to the data dictionary.
The integrated microbial genomes (IMG) system is a new data management and analysis platform for microbial genomes provided by the Joint Genome Institute (JGI). IMG contains both draft and complete JGI genomes integrated with other publicly available microbial genomes of all three domains of life. IMG provides tools and viewers for analyzing genomes, genes and functions, individually or in a comparative context. IMG allows users to focus their analysis on subsets of genes and genomes of interest and to save the results of their analysis. IMG is available at http://img.jgi.doe.gov.
Today's hospital managers require management systems that provide better operational and financial information. The standard response to meeting this need for more sophisticated management information has been the implementation of a fragmented set of information systems products. The result of this has been that managers are getting inconsistent information on the performance of their operations. This article describes the approach taken to respond to the need for better information through the development and implementation of an integrated productivity management, cost accounting, and flexible budgeting system.
The aim of this review is to present the status of digital image acquisition and archiving outside of radiology and to describe the technical concepts and possibilities of how a "radiology" Picture Archiving and Communication System (PACS) can become a multi-departmental (MD-)PACS. First the principles of system integration technology are explained and illustrated by the description of a typical radiology system integration. Then four types of modality integration approaches are defined: the direct modality integration (Type-I), the integration via DICOM acquisition software (Type-II) the integration via specialised systems either with (Type-III) or without PACS connection (Type-IV). The last section is dedicated to the presentation of the PACS requirements of selected interdisciplinary modality types [Endoscopy, Ultrasound and Electrocardiography (ECG)] and clinical disciplines (Pathology, Dermatology, Ophthalmology and Cardiology), which are then compared with the technical possibilities of a MD-PACS.
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