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L.A. County plans its disaster response.

The Los Angeles County Fire Department is one of many agencies making great strides in the development of urban search and rescue programs. Much of the department's USAR training, equipment, and strategies have been tested on real incidents. Each incident presents new challenges and teaches new lessons. Before the establishment of the three-tiered USAR system, those personnel nearest an incident handled it. Many never saw a similar incident again. The lessons they learned were often lost because there was no system to collect their experiences, retrieve the information, and make it available to other emergency responders in the form of training programs. A major advantage of tiered response is the system's ability to ensure rapid response by trained, experienced, and well-equipped personnel. Rather than repeating mistakes and forgetting successful rescue methods, the system allows the retrieval of the experiences of personnel and their use in the development of training materials. Urban search and rescue specialists have the ability to build on earlier experiences to raise the overall level of skills. The net result is more effective training, increased efficiency, and enhanced safety for rescuers and victims. The field of urban search and rescue is still in its infancy. Many new and innovative strategies, techniques, and tools are on the horizon. In recent years, there has been growing interest in this specialty across the nation. We expect this trend to continue as breakthroughs occur. More than ever, it is important for all concerned agencies to share information and to work together to improve our ability to save lives.

Disaster Planning↗

Data extraction and ad hoc query of an entity-attribute-value database.

Entity--attribute--value (EAV) tables form the major component of several mainstream electronic patient record systems (EPRSs). Such systems have been optimized for real-time retrieval of individual patient data. Data warehousing, on the other hand, involves cross-patient data retrieval based on values of patient attributes, with a focus on ad hoc query. Attribute-centric query is inherently more difficult when data are stored in EAV form than when they are stored conventionally. The authors illustrate their approach to the attribute-centric query problem with ACT/DB, a database for managing clinical trials data. This approach is based on metadata supporting a query front end that essentially hides the EAV/non-EAV nature of individual attributes from the user. The authors' work does not close the query problem, and they identify several complex subproblems that are still to be solved.

Clinical Trials as Topic↗

On the nature of global classification.

Molecular sequencing technology has brought biology into the era of global (universal) classification. Methodologically and philosophically, global classification differs significantly from traditional, local classification. The need for uniformity requires that higher level taxa be defined on the molecular level in terms of universally homologous functions. A global classification should reflect both principal dimensions of the evolutionary process: genealogical relationship and quality and extent of divergence within a group. The ultimate purpose of a global classification is not simply information storage and retrieval; such a system should also function as an heuristic representation of the evolutionary paradigm that exerts a directing influence on the course of biology. The global system envisioned allows paraphyletic taxa. To retain maximal phylogenetic information in these cases, minor notational amendments in existing taxonomic conventions should be adopted.

Biological Evolution↗

[Guide to a new database system of literatures on dental materials and devices. (2)].

A new database system of literatures on dental materials and devices was developed by the Committee for the Database, the Japanese Society for Dental Materials and Devices, with the cooperation of the members. The procedure for the information retrieval using on-line system (N 1 network system) was shown with examples.

Databases, Bibliographic↗

A temporal constraint structure for extracting temporal information from clinical narrative.

INTRODUCTION: Time is an essential element in medical data and knowledge which is intrinsically connected with medical reasoning tasks. Many temporal reasoning mechanisms use constraint-based approaches. Our previous research demonstrates that electronic discharge summaries can be modeled as a simple temporal problem (STP). OBJECTIVE: To categorize temporal expressions in clinical narrative text and to propose and evaluate a temporal constraint structure designed to model this temporal information and to support the implementation of higher-level temporal reasoning. METHODS: A corpus of 200 random discharge summaries across 18 years was applied in a grounded approach to construct a representation structure. Then, a subset of 100 discharge summaries was used to tally the frequency of each identified time category and the percentage of temporal expressions modeled by the structure. Fifty random expressions were used to assess inter-coder agreement. RESULTS: Six main categories of temporal expressions were identified. The constructed temporal constraint structure models time over which an event occurs by constraining its starting time and ending time. It includes a set of fields for the endpoint(s) of an event, anchor information, qualitative and metric temporal relations, and vagueness. In 100 discharge summaries, 1961 of 2022 (97%) identified temporal expressions were effectively modeled using the temporal constraint structure. Inter-coder evaluation of 50 expressions yielded exact match in 90%, partial match with trivial differences in 8%, partial match with large differences in 2%, and total mismatch in 0%. CONCLUSION: The proposed temporal constraint structure embodies a sufficient and successful implementation method to encode the diversity of temporal information in discharge summaries. Placing data within the structure provides a foundational representation upon which further reasoning, including the addition of domain knowledge and other post-processing to implement an STP, can be accomplished.

Database Management Systems↗

[Drinking water data collection and information system in North Rhine-Westphalia. Integration of water supply zones].

To comply with the drinking water regulation act of 2001 and as basis for reports to the European Community, North Rhine-Westphalia has defined water supply zones and collected the necessary data from local health authorities. The software used for drinking water surveillance by the local health authorities and on state level has been adapted to the new requirements. In principle, a supply zone in NRW means a region where the water comes from one water-works. Under certain conditions exceptions are possible. 53 out of 54 local health authorities supplied data about water supply zones up to summer 2006. There are 410 water supply zones which get their water from around 550 water-works. The number of people per supply zone varies between a few hundred and nearly 900,000. Most of the supply zones fall within the responsibility of one health authority. Only 37 supply zones out of 410 contain regions of more than one local health authority. 27 % of the supply zones get water from three or more water-works, 73% get water from one or two water-works. Looking at the other side of the medal, the structure is also relatively simple. More than 80% of the water-works deliver water into only one supply zone. The definition of water supply zones as chosen in NRW has proved to be a good basis for a clear description of the drinking water supply. Besides, the definition enables the state to produce reports which can link water quality, regions and the supplied persons.

Database Management Systems↗

XML schemas for common bioinformatic data types and their application in workflow systems.

BACKGROUND: Today, there is a growing need in bioinformatics to combine available software tools into chains, thus building complex applications from existing single-task tools. To create such workflows, the tools involved have to be able to work with each other's data--therefore, a common set of well-defined data formats is needed. Unfortunately, current bioinformatic tools use a great variety of heterogeneous formats. RESULTS: Acknowledging the need for common formats, the Helmholtz Open BioInformatics Technology network (HOBIT) identified several basic data types used in bioinformatics and developed appropriate format descriptions, formally defined by XML schemas, and incorporated them in a Java library (BioDOM). These schemas currently cover sequence, sequence alignment, RNA secondary structure and RNA secondary structure alignment formats in a form that is independent of any specific program, thus enabling seamless interoperation of different tools. All XML formats are available at http://bioschemas.sourceforge.net, the BioDOM library can be obtained at http://biodom.sourceforge.net. CONCLUSION: The HOBIT XML schemas and the BioDOM library simplify adding XML support to newly created and existing bioinformatic tools, enabling these tools to interoperate seamlessly in workflow scenarios.

Algorithms↗

Picture archiving and communication systems.

Picture archiving and communication systems (PACS) are extremely versatile systems that facilitate the transfer of digital images and patient data throughout a healthcare enterprise. PACS are most commonly used in radiology departments to process images from diagnostic imaging modalities, such as digital radiography devices and magnetic resonance imaging (MRI) systems. In this article, we evaluate three such systems from three of the largest PACS suppliers--the Agfa IMPAX, GE PathSpeed, and Siemens Sienet. The ultimate goal of any PACS is to improve workflow within the enterprise. Our testing focused on whether, and to what degree, the systems could meet this goal. We found that all three PACS are fairly complete and able to support image distribution and improve workflow compared with film-based processes. However, we did identify significant differences--along with some noteworthy limitations--with respect to system design and operation, external integration capabilities, and supplier support and professional services. We have ranked the systems for each of these factors to help healthcare facilities identify the system that will best meet their needs. Also in this Evaluation, we present an overview of the technology, a Glossary of PACS terminology (see page 400), selection guidance, and discussions of PACS-related topics, including data compression options, the role of the DICOM standard, and concerns about data security in many of today's systems.

Automation↗

[Some technical problems in setting up hospital PACS].

Having introduced PACS in brief, this paper presents some technical problems such as the selection of scale, function, database and monitor. And many solutions for these problems are given and compared with each other.

Data Collection↗

Towards interoperability of information sources within a hospital Intranet.

Information is usually available in heterogeneous data format and various legacy sources. Interoperability appears to be a major approach for applications to access information. The project ARIANE is devoted to provide end-users with an easy to use and natural access to information databases. In this frame we defined actors able to operate the mediation between end-users and information servers: a "broker" which selects appropriate resources and "mediators" which access data suppliers. We have implemented a web-oriented stand-alone prototype accessing three types of information sources: a bibliographical server, a SQL database server and a hypertext server. Both broker and mediators exploit the Unified Medical Language System knowledge sources, especially the Information Sources Map which allows a way to identify information servers.

Computer Communication Networks↗

[Electronic distribution of patient records and images through PACS: implementation of data protection at the University Hospital in Freiburg].

In large installations of a Picture Archiving and Communication System (PACS), data protection becomes an issue. Above all, not every employee should have access to all data stored in the system. At the Freiburg University Hospital, we developed a concept of dynamic assignment of authorization, assuring that every physician is authorized to the data of all patients under his care. We describe the technical implementation of data protection developed for the integration of PACS and electronic patient records in Freiburg. The system was installed in January 2001 and the experience of its two years in operation is reported.

Computer Security↗

Security requirements in EHR systems and archives.

EHR system is a system for recording, retrieving, and manipulating information in electronic health care records. Archive is an organisation that intends to preserve health records for access and use for an identified group of consumers. There exist many combinations of EHR-systems and archives. EHR-system can be a single on-line system with integrated archiving functions or archive and EHR-system are co-operative or federated systems. This paper describes both common security requirements for EHR-systems and archives and security requirement specific for archives. Requirements are derived from ethical and legal principles. From principles a set of security requirements are derived. Safeguards for implementing security are discussed. In practise EHR-system and archive share many security services. This document is proposing that inside a security domain both the archive and EHR-system have a common security policy. In addition to this the archiving organisation needs a documented policy for information preserving and a policy for access and distribution of information between other archives.

Access to Information↗

PathAligner: metabolic pathway retrieval and alignment.

MOTIVATION: Analysis of metabolic pathways is a central topic in understanding the relationship between genotype and phenotype. The rapid accumulation of biological data provides the possibility of studying metabolic pathways at both the genomic and the metabolic levels. Retrieving metabolic pathways from current biological data sources, reconstructing metabolic pathways from rudimentary pathway components, and aligning metabolic pathways with each other are major tasks. Our motivation was to develop a conceptual framework and computational system that allows the retrieval of metabolic pathway information and the processing of alignments to reveal the similarities between metabolic pathways. RESULTS: PathAligner extracts metabolic information from biological databases via the Internet and builds metabolic pathways with data sources of genes, sequences, enzymes, metabolites etc. It provides an easy-to-use interface to retrieve, display and manipulate metabolic information. PathAligner also provides an alignment method to compare the similarity between metabolic pathways. AVAILABILITY: PathAligner is available at http://bibiserv.techfak.uni-bielefeld.de/pathaligner.

Algorithms↗

The impact of PACS on the information flow.

It is likely that changes in hospital operational practices made possible by the introduction of a whole hospital PACS will require the present information and data patterns to be changed significantly. Some of the factors which will affect the flow of data and information are considered, and the implications of comparing the costs of installing 'whole hospital' PACS systems in different institutions are discussed.

Computer Communication Networks↗