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At least 1,009 records · Page 56Linked to original sources
PubMed2005

Integrated microfabricated systems including a purification module and an on-chip nano electrospray ionization interface for biological analysis.

We report here on an integrated microfabricated device dedicated to the preparation of biological samples prior to their on-line analysis by electrospray ionization-mass spectrometry (ESI-MS). This microfluidic device is fabricated using the negative photoresist SU-8 by microtechnology techniques. The device includes a chromatographic module plus an ESI interface for MS. The chromatographic module is dedicated to sample purification and is based on a polymer monolithic phase which includes hydrophobic moieties. The ESI interface is integrated onto the chip and is based on a capillary slot. We present here the integration of these different modules onto a single system that is fabricated via a SU-8-based microtechnology route. We present also their testing for the purification of peptide samples. This started with a partial integration step with the combination of at least two of the modules (microsystem + monolith; microsystem + nib) and their test before the fabrication and testing of fully integrated microsystems.

Microscopy, Electron, Scanning↗
PubMed2006

The model for end-stage liver disease-based Japan Integrated Scoring system may have a better predictive ability for patients with hepatocellular carcinoma undergoing locoregional therapy.

BACKGROUND: The Japan Integrated Scoring (JIS) system was revealed as a better model for outcome prediction compared with the Cancer of Liver Italian Program system for hepatocellular carcinoma (HCC), and the Model for End-Stage Liver Disease (MELD) was better as a prognostic predictor for patients with cirrhosis compared with the Child-Turcotte-Pugh (CTP) system, which is a parameter used in the JIS system. The objective of the current study was to investigate the performance of the modified MELD-based JIS system. METHODS: In the modified JIS system, the CTP class in the original JIS was replaced with MELD cut-off scores of <10, 10 to 14, and >14. The modified JIS system was compared with the original system in 276 patients with HCC who underwent locoregional therapy (transarterial chemoembolization or percutaneous injection). RESULTS: The mean +/- standard error original JIS score was 1.8 +/- 1.0 (range, 0-4), compared with 2.0 +/- 1.1 (range, 0-5) for the modified JIS system (P < .001). Using mortality as the endpoint, the area under receiver operating characteristic curve (AUC) for the modified JIS system was 0.804 compared with 0.741 for the original JIS system (P = .008) at 12 months, and the AUC was 0.853 and 0.765, respectively (P < .001), at 24 months. Survival analysis showed that the modified JIS system had a better discriminatory ability for patients in different score groups and was more accurate for outcome prediction in the Cox multivariate model. CONCLUSIONS: The current results indicated that the MELD-based, modified JIS system has improved predictive ability compared with the original system and is a more feasible model for clinical staging in patients with HCC who are undergoing locoregional therapy.

Aged↗
PubMed2004

Systems-level integration of interval timing and reaction time.

Reaction time (RT) procedures are a prominent tool for the study of information processing by humans and other animals. The interpretation of how RT changes after manipulating the appropriate experimental variables has contributed to the contemporary understanding of a variety of cognitive constructs, including attention and memory. With the use of properly designed tasks, evaluating how RT is modified in response to various neural perturbations has become common within the realms of behavioral and cognitive neuroscience. One interesting observation made during both human and animal RT experiments is that the RT to a signal often speeds-up as more time is allotted to prepare for the signal's onset-referred to as the preparatory interval (PI) effect. In the human RT literature, the PI effect has been used as evidence for time estimation playing a fundamental role in the determination of RT. On the other hand, our theoretical understanding of time estimation remains largely divorced from the RT findings in the animal cognition literature. In order to bridge these different perspectives, we provide here a review of the behavioral parallels between RT and interval-timing experiments. Moreover, both the PI effect and interval timing are shown to be jointly influenced by neuropathologies such as Parkinson's disease in humans or dopamine-depleting brain lesions in experimental animals. The primary goal of this review is to consider human and animal RT experiments within the broader context of interval timing. This is accomplished by first integrating human RT theory with scalar timing theory-the leading model of interval timing. Following this, both RT and interval timing are discussed at a brain systems level insofar as these two processes share common neural substrates. Our conclusion is that interval timing and RT processes are in fact two sides of the same coin.

Animals↗
PubMed1993

[Reconstruction of a malformed external ear by an endoprosthesis of porous polyethylene with an integrated suction system].

Complete reconstruction of the external ear is one of the most difficult tasks in plastic and reconstructive surgery. The risk of frame protrusion inherent in all alloplastic materials is reduced by using a new premoulded endoprosthesis with an integrated suction system. It consists of tissue-compatible porous polyethylene. A conventional suction drainage can be attached to a hollow canal system within the endoprosthesis that empties from defined spaces corresponding to the natural concavities of the external ear. In combination with a preceding expansion the overlying skin is then adapted evenly and completely to the frame by suction. As a result of this vacuum seromas and haematomas can be prevented. Furthermore, infections and pressure necroses due to matress sutures cannot develop. The use of this endoprosthesis obviates the removal of autogenous cartilage and all the complications and scars that are connected with this procedure. The frame itself is stable and has a relief that is largely similar to the natural form of the auricle. Thus, an aesthetically satisfying result can be achieved also in the hand of the surgeon who is not often engaged in this field of plastic surgery.

Adolescent↗
PubMedDate not supplied

A regional integrated information system to assure maternal-child health services: a progress report.

Priorities for improving the health of our nation include rebuilding the public health infrastructure through increasing assessment, policy development, and assurance capacities in our communities. Capacity building necessitates formalizing and strengthening public health practice linkages to achieve Year 2000 objectives. Determining progress in achieving objectives requires development of public health infrastructure surveillance and data system capabilities. The Tracking Center of Tracking and Outreach Program for St. Louis (TOPS), through unique collaboration among academic and practice partners, laid the foundation for a Regional Integrated Information System (RIIS) by developing a centralized maternal-child health data base for prenatal and pediatric care providers. The RIIS model provides an example of a capacity building system designed to provide public health surveillance, assessment, planning, and evaluation capabilities. Medical Subject Headings (MeSH): health information systems, prenatal care, immunization, maternal-child health care, public health surveillance.

Child↗
PubMed2002

Straight talk: new approaches in healthcare. Physician practice turnaround in an integrated delivery system.

This is the second installment in a series of group discussions by top executives on key issues in healthcare today. Straight Talk is present by Modern Healthcare and PricewaterhouseCoopers. This session tackles the subject of physician practice turnaround in an Integrated Delivery System. The discussion was held on March 5, 2002 at Modern Healthcare's Chicago headquarters, moderated by Charles S. Lauer.

Chicago↗
PubMed1996

Integrated delivery systems: has their time come in Canada?

In the 1990s every Canadian province is struggling to reduce health care expenditures without jeopardizing access to health care or quality of care. The authors propose a new model for health care delivery: the Canadian Integrated Delivery System (CIDS). A CIDS is a network of health care organizations; it would provide, or arrange to provide, a coordinated continuum of services to a defined population and would be held clinically and fiscally accountable for the outcomes in and health status of that population. A CIDS would serve 100,000 to 2 million people; the care it would provide would be funded on a capitation basis. For providers, there would be explicit financial incentives to minimize costs. At the same time, service quality and consumer choice of primary care practitioner would be maintained. Primary care physicians and specialists would work with other health care service providers to offer a full spectrum of care. CIDS providers would form strategic alliances with community agencies, hospitals, the private sector and other health care services not managed by the CIDS, as needed. For physicians, affiliation with a CIDS that provided strong clinical leadership could be beneficial to their income stability and autonomy. Pilot projects of this model in several communities would determine whether this concept is feasible in the Canadian health care context.

Canada↗
PubMed1998

Determining when integrated delivery systems should belong to GPOs.

Membership in national group purchasing organizations (GPOs) is a proven way for healthcare organizations to access supply price discounts through collectively negotiated contracts. Yet, for various reasons, both suppliers and healthcare materials managers have expressed dissatisfaction with GPOs. Integrated delivery systems (IDSs), in particular, may find that negotiating with suppliers independently is a more cost-effective alternative. Whether an IDS should participate in group purchasing or negotiate with suppliers on its own depends on the following factors: whether the IDS would find it relatively simple to get its clinicians to standardize on certain key supplies; whether the IDS has sufficient staff to devote to contracting; whether the benefits offered by the GPO do not outweight the costs of membership; and whether all of the supplier products and services the GPO makes available also are available through second-tier suppliers eager to negotiate directly with the IDS.

Consumer Behavior↗
PubMed2003

Integrated nanoliter systems.

Microfluidic chip platforms for manipulating liquid volumes in the nanoliter range are slowly inching their way into mainstream genomic and proteomic research. The principal challenge faced by these technologies is the need for high-throughput processing of increasingly smaller volumes, with ever higher degrees of parallelization. Significant advances have been made over the past few years in addressing these needs through electrokinetic manipulation, vesicle encapsulation and mechanical valve approaches. These strategies allow levels of integration density and platform complexity that promise to make them into serious alternatives to current robotic systems.

Chemistry Techniques, Analytical↗
PubMed2004

The role of research in integrated healthcare systems: the HMO Research Network.

Science is the basis of medicine. Good science leads to better decisions and more effective systems to support those decisions. Most individuals associate science primarily with academic institutions. However, top-quality research relevant to managing the health of populations and the care of specific clinical conditions is increasingly being carried out by investigators working in integrated healthcare systems. This introduction outlines the activities of the HMO Research Network, whose researchers have made and continue to make important contributions to the field of health research. Its objective is to inform readers of the activities and value of systems-based health research. We describe the importance and extent of the research conducted by HMO Research Network members, as well as the advantages of conducting research in such settings.

Delivery of Health Care, Integrated↗
PubMed1980

Head fixation system for integration of radiodiagnostic and therapeutic procedures.

A head fixation system is described enabling exact transfer of positions between neuroradiological and therapeutic procedures. The key item of the system is a base plate that is rigidly attached to the patient's head, either by a plastic mould or screws onto the calvarium. The base plate may easily and accurately be attached to diagnostic or therapeutic units. Coordinates of target points in the various units are directly related through the exact application of the base plate. Procedures for the exact comparison of spatial information have been worked out. The system has been used for diagnostic procedures such as plain skull radiography, cerebral angiography, CT scanning, position emission tomography, and gamma camera examinations, as well as for therapeutic procedures such as stereotaxic biopsy and radiation treatment.

Head↗
PubMed1989

A report-coding system for integration into a digital radiology department.

Report-coding systems allow the radiologist to generate a typewritten radiographic report with a computer. Typically, the report is generated by selecting bar codes, speaking key words, or selecting items on a screen. MAMM REPORT is a report-coding system for mammography, developed by radiologists, that runs on a microcomputer (Amiga, Commodore Co., West Chester, PA). MAMM REPORT speaks questions to the radiologist, who responds by pressing one of two buttons on a computer mouse, thus generating the report. MAMM REPORT allows labeling of digital images and reduction of data required to store the report in computer memory (data compression). Data compression is useful for improving computer operating speed. Digital image labeling and data compression facilitate use of MAMM REPORT on a future digital radiology workstation for an all-digital radiology department. Sixty mammographic reports, reviewed by a radiologist who is not a specialist in mammography, were entered into MAMM REPORT. The mammography specialists who dictated the original reports then judged whether the reports generated by MAMM REPORT would be acceptable replacements on the basis of descriptions of findings, diagnoses, and recommendations for further study. Data compression was measured by calculating the ratio of the number of bytes for storage of the reports in original form to a standard storage form (Huffman encoding) and to the MAMM REPORT coded form. All 60 coded reports were acceptable replacements for the original reports. For computer storage, MAMM REPORT produced a compression ratio of 135 to 1 and Huffman encoding, 1.1 to 1. Huffman encoding did not compress most reports because of their brevity. The results indicate that report coding can produce data compression of radiographic reports. The standard method of text storage, Huffman encoding, is not suitable for application to mammographic reports, which tend to be brief.

Electronic Data Processing↗
PubMed2005

Different types and aspects of quality systems and their implications. A thematic comparison of seven quality systems at a university hospital.

Policy makers and managers face a difficult challenge in keeping up with the changing organisations and methods of health care. Organised systematic quality work, that is, quality systems, can make this task easier. The aim here was to study different quality systems, identify common characteristics, find types of quality systems and discuss the practical implications of the results. The study was designed as a qualitative study of seven clinics with quality systems at a large university hospital in Sweden. Purposefully selected, 19 managers or quality co-ordinators were interviewed. The interviews were audio taped, transcribed verbatim and analysed thematically. Six organisational aspects were present in the interviews: resources, administration, culture, co-operation, goal achievement and development of competence. The aspects were used to categorise the clinics' systems into three types: local, centralised and integrated systems. The responses indicated that local systems had a decentralised organisation, allowing for a high degree of adaptability. Centralised systems were reported to be more top-down orientated, allowing for a highly predictable output. Integrated systems were reported to have a management style that emphasized co-operation, allowing for both good adaptability and predictability. Policy makers and managers could use the described aspects and types of quality systems to help decide what type of quality system to implement in a specific setting, as a base line for evaluation, or as a framework for developing existing quality systems.

Hospitals, University↗
PubMed2006

Novel blastospore-based transformation system for integration of phosphinothricin resistance and green fluorescence protein genes into Beauveria bassiana.

A novel system was developed for efficient transformation of the fungal biocontrol agent Beauveria bassiana. Competent blastospores were prepared and stored in LiAc- and glycerol-inclusive suspension at -76 degrees C for sequential use in transformation. The system was successfully applied to integrating phosphinothricin resistance gene bar and enhanced green fluorescence protein gene egfp into B. bassiana via blastospore absorption of a plasmid vectoring bar and egfp. A frequency of 24 transformants per microgram of DNA was achieved. The blastospore-based transformation system has proven to be very convenient and would be highly potential for use in genetic manipulation of B. bassiana and other filamentous species.

Aminobutyrates↗
PubMed1992

The Integral Implant System: prosthetic considerations.

Patients who are totally edentulous and who have been doomed to discomfort, pain, and dysfunction because of the inability to use complete dentures have been rehabilitated using various implant systems. Implants should only be considered after exhaustive medical history taking and diagnostic wax-ups. A variety of prosthetic techniques can be employed to restore various forms of edentulism. The Integral Implant System has proven to be a highly successful foundation to restore the patient to optimum function.

Dental Implantation, Endosseous↗
PubMed1997

The relationship and tensions between vertical integrated delivery systems and horizontal specialty networks.

UNLABELLED: This activity is designated for physicians, medical directors, and healthcare policy makers. GOAL: To clarify the issues involved with the integration of single-specialty networks into vertical integrated healthcare delivery systems. OBJECTIVES: 1. Recognize the advantages that single-specialty networks offer under capitated medical care. 2. Understand the self-interests and tensions involved in integrating these networks into vertical networks of primary care physicians, hospitals, and associated specialists. 3. Understand the rationale of "stacking" horizontal networks within a vertical system.

Community Networks↗
PubMedDate not supplied

Case study. Challenges and opportunities for integrated health systems in rural communities.

You might not think of Holland, Michigan (pop. 35,000), as an HMO hotbed. But it has an HMO that was started by the local hospital and that now is part of the Butterworth Regional Health Network in Grand Rapids. Holland is one of five communities profiled in this first of a series on how managed care and integration are coming to rural America.

Health Maintenance Organizations↗