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IMIRS: a high-resolution 3D reconstruction package integrated with a relational image database.

Recent advances in electron cryomicroscopy instrumentation and single particle reconstruction have created opportunities for high-throughput and high-resolution three-dimensional (3D) structure determination of macromolecular complexes. However, it has become impractical and inefficient to rely on conventional text file data management and command-line programs to organize and process the increasing numbers of image data required in high-resolution studies. Here, we present a distributed relational database for managing complex datasets and its integration into our high-resolution software package IMIRS (Image Management and Icosahedral Reconstruction System). IMIRS consists of a complete set of modular programs for icosahedral reconstruction organized under a graphical user interface and provides options for user-friendly, step-by-step data processing as well as automatic reconstruction. We show that the integration of data management with processing in IMIRS automates the tedious tasks of data management, enables data coherence, and facilitates information sharing in a distributed computer and user environment without significantly increasing the time of program execution. We demonstrate the applicability of IMIRS in icosahedral reconstruction toward high resolution by using it to obtain an 8-A 3D structure of an intermediate-sized dsRNA virus.

Animals↗

A neuroinformatics database system for disease-oriented neuroimaging research.

Clinical databases are continually growing and accruing more patient information. One of the challenges for managing this wealth of data is efficient retrieval and analysis of a broad range of image and non-image patient data from diverse data sources. This article describes the design and implementation of a new class of research data warehouse, neuroinformatics database system (NIDS), which will alleviate these problems for clinicians and researchers studying and treating patients with intractable temporal lobe epilepsy. The NIDS is a secured, multi-tier system that enables the user to gather, proofread, analyze, and store data from multiple underlying sources. In addition to data management, the NIDS provides several key functions including image analysis and processing, free text search of patient reports, construction of general queries, and on-line statistical analysis. The establishment of this integrated research database will serve as a foundation for future hypothesis-driven experiments, which could uncover previously unsuspected correlations and perhaps help to identify new and accurate predictors for image diagnosis.

Biomedical Research↗

Computer and information technology: hardware.

Computers open the door to an ever-expanding arena of knowledge and technology. Most nurses practicing in perianesthesia setting were educated before the computer era, and many fear computers and the associated technology. Frequently, the greatest difficulty is finding the resources and knowing what questions to ask. The following is the first in a series of articles on computers and information technology. This article discusses computer hardware to get the novice started or the experienced user upgraded to access new technologies and the Internet. Future articles will discuss start up and usual software applications, getting up to speed on the information superhighway, and other technologies that will broaden our knowledge and expand our personal and professional world.

Computer Communication Networks↗

Grid technologies empowering drug discovery.

Grid technologies enable flexible coupling and sharing of computers, instruments and storage. Grids can provide technical solutions to the volume of data and computational demands associated with drug discovery by delivering larger computing capability (flexible resource sharing), providing coordinated access to large data resources and enabling novel online exploration (coupling computing, data and instruments online). Here, we illustrate this potential by describing two applications: the use of desktop PC grid technologies for virtual screening, and distributed X-ray structure reconstruction and online visualization.

Computational Biology↗

Slovene smart card and IP based health-care information system infrastructure.

Slovenia initiated a nation-wide project to introduce smart cards in the health sector in 1995 and its full-scale deployment started in September 2000. Although the basic aim of the project was to support insurance related procedures, the system was designed in a flexible and open manner to present an infrastructure for the whole health sector. The functionality of the current system is described in this paper along with lessons learned so far. The upgrade of the system is outlined, with emphasis on technical details, the objective being to provide a real-time EDI based environment for a general set of applications in the medical sector, supported by the flexibility and security of modern smart card technologies. Integration with similar systems in other EU countries is discussed.

Computer Communication Networks↗

The role of methodologies to improve efficiency and effectiveness of care delivery processes for the year 2013.

This paper aims at further expanding the vision of future health care delivery systems presented by Haux et al. (2002). Starting from the observation that information and communication technology (ICT) is deeply transforming the shape of organizations as expected, we argue that the coordination of work activities is a fundamental need for any organization. This is even more important for health care organizations since there is an increasing pressure to increase quality of care they deliver without further increasing its costs. However ICT by itself will not cause the desired changes without rethining the way of managing best practice biomedical knowledge and care delivery processes. Thus the paper focuses on the need of developing intense research efforts in the fields of knowledge management and workflow modelling, which have been identified as fundamental to provide suitable solutions to the problems of designing and building innovative health care information systems. Moreover, the paper discusses the role of mobile communication systems. Moreover, the paper discusses the role of mobile communication and speech understanding technologies to support a satisfactory user-system interaction in daily work.

Biomedical Research↗

Wireless and PDA: a novel strategy to access DICOM-compliant medical data on mobile devices.

The medical procedures at the patient bedside are out of the scope of current HIS/RIS systems, which means that patient record and image data access during the medical visit or the execution, recording and confirmation of the medicine prescriptions, still do not enjoy computerized support. As a consequence, the necessary inclusion of new data to the patient record, still needs to be carried out through notations on paper and later typed, causes delays on the availability of this information (Mobile computing in a hospital: the Ward-In-Hand project. SAC 2000-ACM Symposium on Applied Computing, Março, 2000, Villa Olmo, Como, Italy). This paper presents a software technology where the medical and nursing staff will be equipped with a handheld computer connected by radio to a central server that provides access to the electronic patient records and that will actively inform about tasks pending distribution. The server acts as a database for multimodal electronic patient record information, storing patient data from computerized tomography (CT), ultrasonography (US), magnetic resonance (MRI) images and also medical findings, observations and prescriptions coded as DICOM Structured Reports (Digital Image and Communications in Medicine). The prototype described in this article implements a medical images and structured reports server that makes the search and recovery of data stored in the DICOM standard possible.

Brazil↗

The DERWeb project--dental education resources on the Internet.

The delivery of dental education, in common with other forms of higher education, has altered considerably over the last decade. The introduction of the World Wide Web enabled resources for dental education to be delivered in a new and innovative manner. DERWeb was funded by HEFC-JISC. The primary resource consists of a library of 1600 clinical dental images each with keywords and a description. Selected images were used to create teaching materials to demonstrate to dental educators world wide how the image library could be used by individual institutions. Hands-on courses were held to demonstrate the new resource and to evaluate computer skills in the dental community. Since the commencement of the project in September 1994 DERWeb has become one of the leading resources for dental education world wide. The site has been accessed by 79 countries with approximately 107000 accesses in October 1996. DERWeb also designs and maintains the British Dental Association pages together with other professional organisations. Its resources also include dental contact addresses and links to quality dental sites world wide. Further funding has enabled DERWeb to expand further and explore new technologies to develop interactivity on the Web.

Computer Communication Networks↗

Evaluating the options for developing databases to support research-based medicine at the NHS Centre for Reviews and Dissemination.

The paper presents the results of a questionnaire survey and user interface review group experiments to determine the value and ease of use of the Database of Abstracts of Reviews of Effectiveness (DARE) and the NHS Economic Evaluations Database (NEED). The results are interpreted with other recent studies of the use of electronic databases, including the NHS Research Register User Requirements Specification. The study found that most frequent users of the DARE database tend to use the CD-ROM version. Librarians were found to have the greatest awareness of the databases, with relatively low levels of use by operational NHS Staff. Untrained users found the online databases difficult to access and had erroneous perceptions of the database content which were only realised when queries returned unexpected answers. Experienced users of online information systems tended to want more sophisticated search facilities than inexperienced users. Nearly all users in the review groups wanted to access the databases in conjunction with other information sources, such as the Cochrane Library, Medline and the ACP Journal Club, highlighting the need for cross organisational strategies for the dissemination of research-based information.

CD-ROM↗

Exploring novel chemotherapy treatments using the WWW.

A JAVA application, The Oncologists Workbench, which allows oncologists to estimate the influence of new cancer treatment schedules is being developed. The requirement for a rational approach to the design of chemotherapeutic regimens is well established [1]. Our prototype allows oncologists using the World Wide Web (WWW) to graphically construct treatment regimens while considering various toxic side effects. A simulation engine makes predictions of tumour growth based on previous clinical knowledge of response to treatment. The oncologist can then examine the predicted tumour response information with a specially constructed interactive viewer. These interlinked tools allow oncologists to develop and predict the effectiveness of novel chemotherapeutic regimens. This work is part of an ongoing collaboration between oncologists, mathematicians and computer scientists to provide tools for improving cancer chemotherapy.

Antineoplastic Agents↗

Computer assisted medical diagnosis using the Web.

The ADM (Aide au diagnostic Medical) project was started 15 years ago and was the first telematic project for physicians in France using the MINITEL terminal. The knowledge base contains information on more than 10000 diseases from all pathological fields, using more than 100000 signs or symptoms. The ADM system has two main functionalities for physicians: consultation of diseases descriptions and list of diseases containing one or more symptoms. The ADM knowledge base is supported by a relational database management system (DBMS ORACLE) and we developed a Web interface using the Perl language to produce HTML pages for the web server. We will describe our experience on redesigning a large existing medical knowledge base for diffusion on the web Internet.

Artificial Intelligence↗

The Internet and randomised controlled trials.

Several factors constrain the implementation of Randomised Controlled Trials (RCTs). To obtain large sample sizes a multicentred multinational trial may be necessary or a long sampling period. The larger the trial the larger is the unit cost. To allow larger sample sizes, shorter sampling periods and lower unit costs, new methods are needed. The Internet and in particular the WWW provides such an opportunity. The WWW can provide global access, fast interaction and automation. A prototype Internet Trials Service (ITS) is currently being tested with a real international clinical trial (the Growth Restriction Intervention Trial--GRIT). The ITS is hosted on a Web server. It provides a series of HTML documents that describe the GRIT protocol. Registered centres may enter patients into the GRIT trial via ITS. Java applets are used to collect trial data before returning the study number and randomisation. ITS assumes all trial data will be intercepted by a sniffer. Therefore no information is sent that could specifically identify a patient, this must be sent later by more secure means. ITS assumes that trial centres can be spoofed. To authenticate the patients entered into the trial and the trial data sent, a regular audit report is sent to each centre by secure means for confirmation. By using Java, a full functional data entry system can be developed that runs locally within any Java enabled browser. It can perform data validation locally and also provide a sophisticated user interface.

Child Development↗

Standardization in health informatics in Canada.

Around the world, informatics has been cited as a key enabler of health sector reform. Recent reform programs in Canada, reflecting this global consensus, have emphasized the importance of quality information and information technology in meeting their goals. Standards are an important building block for achieving the required comprehensive and integrated health information infrastructure. This paper describes the current status of, and future plans for, health informatics and related standards in Canada.

Canada↗