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At least 1,063 records · Page 59Linked to original sources
PubMed1995

A microprocessor card software server to support the Quebec health microprocessor card project.

The Quebec Health Smart Card Project is advocating the use of a memory card software server[1] (SCAM) to implement a portable medical record (PMR) on a smart card. The PMR is viewed as an object that can be manipulated by SCAM's services. In fact, we can talk about a pseudo-object-oriented approach. This software architecture provides a flexible and evolutive way to manage and optimize the PMR. SCAM is a generic software server; it can manage smart cards as well as optical (laser) cards or other types of memory cards. But, in the specific case of the Quebec Health Card Project, SCAM is used to provide services between physicians' or pharmacists' software and IBM smart card technology. We propose to expose the concepts and techniques used to provide a generic environment to deal with smart cards (and more generally with memory cards), to obtain a dynamic an evolutive PMR, to raise the system global security level and the data integrity, to optimize significantly the management of the PMR, and to provide statistic information about the use of the PMR.

Computer Security↗
PubMed1995

Estimating the cost of lung cancer diagnosis and treatment in Canada: the POHEM model.

Because lung cancer is a major health care problem in Canada, it would be useful to identify the direct health care costs of diagnosing and treating this disease and to create an analytic framework within which diagnostic and therapeutic options can be assessed. This paper describes a method of modelling the costs of care for lung cancer. The perspective of the costing model is that of the government as payer in a universal health care system. Clinical algorithms were developed to describe the management of non-small cell (NSCLC) and small cell (SCLC) lung cancer. Patients were allocated to the treatment algorithms in the model, based on a knowledge of the stage distribution of cases within provincial cancer registries and an estimate of the use of therapeutic modalities, according to lung cancer experts. A microsimulation model (POHEM) developed at Statistics Canada was used to integrate data on risk factors, disease onset and progression, health care resource utilization and direct medical care costs. The model incorporates survival data on patients, according to cell type and stage, based on published studies. Relapse and terminal care costs were assigned during the year of death, in order to determine the cost of continuing care and the cumulative cost of lung cancer management over time. Patients surviving five years were assumed to be cured. The model estimates that the total five year cost to provide care to the 15,624 cases of lung cancer diagnosed in Canada in 1988 was in excess of $328 million. Over 82% of this total was spent in the first year for diagnostic tests, therapy (surgery, chemotherapy, radiation therapy, or combinations of these), hospitalization and follow-up costs. The average five year cost per case was $21,000, and ranged from a high of $29,860 for limited disease SCLC, to a low of $16,500 for Stage IV NSCLC. The actual cost of providing care, including the management of complications, is unknown and our estimates should be regarded as an idealized estimate of the cost of lung cancer management. However, the POHEM model has a level of sophistication which, we believe, reasonably reflects the cost per case and total costs of treating lung cancer by stage and therapeutic modality in Canada.

Age of Onset↗
PubMed1996

The role of MCM/P1 proteins in the licensing of DNA replication.

The DNA replication licensing system ensures that eukaryotic chromosomes replicate precisely once per cell cycle. A central component of the licensing system, RLF-M, has recently been shown to consist of a complex of Mcm/P1 proteins. This result allows us to integrate data about the MCM/P1 family obtained in different eukaryotes, ranging from yeast to man, into a general picture of the way that chromosome replication is controlled.

Cell Cycle Proteins↗
PubMed1996

Development and implementation of clinical management guidelines.

Memorial Sloan-Kettering Cancer Center is in the process of developing a disease management system that is prospective, longitudinal, and has built-in outcome measures. These will include not only the traditional clinical outcomes of response and toxicity but also outcome measures related to patients' feelings about the healthcare environment, as well as costs. The system has three essential features: (1) standards of care, (2) information technology to integrate data, and (3) central coordination of the program through the establishment of disease management teams. This article highlights the key features of the system.

Clinical Medicine↗
PubMed1996

Immunoregulatory mechanisms involved in elicitation of allergic contact hypersensitivity.

At first sight, the pathophysiology of contact hypersensitivity (CHS) seems to be well understood. Whereas this may apply to some extent to the sensitization phase of CHS, very little is actually known about the elicitation phase of this response. Although the mechanisms of T-cell priming (sensitization) may be more interesting for immunologists, those involved in the elicitation of T cell-mediated secondary responses are more relevant for clinical management because clinically manifest allergic contact dermatitis always reflects the effector phase of CHS. This review summarizes the role of different cellular components and soluble mediators on the elicitation of CHS. In addition, recent studies revealed that, besides selective activation of antigen-specific T cells, epicutaneous application of haptens has a number of direct effects on the cutaneous immune system. The most relevant of these are induction of cytokine and chemokine secretion and endothelial activation. In an attempt to integrate data on this issue, it is proposed that the capacity of contact allergens to directly induce proinflammatory signals in the skin is of relevance and perhaps essential for elicitation of clinically manifest CHS responses. Moreover, the proinflammatory effect of allergens themselves may explain the strict dose dependency of CHS responses and the relatively high concentrations of allergens needed for elicitation of CHS because allergens evoke nonspecific irritation only when applied in relatively concentrated form.

Allergens↗
PubMed1996

A compartmental model for alveolar clearance of pertechnegas.

UNLABELLED: The washout of an inhaled water soluble radiotracer from the lungs is a measure of alveolar integrity. Data evaluation of 99mTc-DTPA studies were previously performed mainly with monoexponential fitting with or without background subtraction. The introduction of 99mTc-pertechnegas for the assessment of alveolar permeability necessitates the investigation of adequate data evaluation schemes for this radiotracer. METHODS: We developed a three-compartmental model to describe 99mTc-pertechnegas kinetics after inhalation. Monoexponential fitting of the first 5 min was investigated as simplification for clinical use. Different background corrections based on blood samples or representative regions of interest were compared. RESULTS: Correction of intra- and extravascular background by subtraction of calibrated curves, which are derived from blood or background areas, resulted in monoexponential washout curves. Clearance rates based on the three-compartmental model were nearly the same as those derived from a monoexponential fit after blood-activity subtraction (r = 0.96). A monoexponential analysis of the first 5 min without any background correction correlates well with the first component of the biexponential analysis (r = 0.97). CONCLUSION: A dynamic study of more than 45 min allows quantitative determination of the transfer rate of 99mTc-pertechnegas from the alveoli into the blood using compartmental analysis. A simplified monoexponential analysis of the first 5 min allows assessment of lung clearance without any background correction.

Administration, Inhalation↗
PubMed1997

The significance of central pathology review in clinical studies of transitional cell carcinoma in situ.

PURPOSE: The causes of interobserver variation in the pathological diagnosis of urothelial neoplasia were studied. MATERIALS AND METHODS: A central review was performed on pathological specimens in a multi-institutional clinical study of patients with in situ transitional cell carcinoma of the bladder. RESULTS: A significant discrepancy in pathological diagnosis was noted between the original report and the central review in 60 of 159 biopsies (38%) and in 73 of 217 cytology specimens (34%). Biopsy discrepancies were almost equally divided between upgrades and downgrades, whereas 89% of cytology discrepancies involved an upgrade in diagnosis by the central reviewer. The most significant factor causing variability in biopsy diagnoses was the multiplicity of classifications used by the originating pathologists. Other factors included fixation and biopsy artifacts. Cell degeneration secondary to treatment was the most important factor resulting in cytology under grading. At originating institutions the correlation of diagnoses between concurrent biopsy and cytology specimens was poor. CONCLUSIONS: The lack of a well accepted standard for the histopathological diagnosis of transitional cell carcinoma in situ poses a major problem for multi-institutional studies of this disease. Organizers must include a histopathological standard in the study plan and publicize it to all participants, particularly pathologists. Central review of pathological specimens is essential to maintain data integrity.

Biopsy↗
PubMed1997

Mary J. Nielubowicz Award. Bringing nurses on-line: implementing nursing informatics.

Processing the vast amount of information required to provide quality nursing and health care today is an immense task. The Surgeon General of the Navy recently updated the Department's "Vision for the Future." He challenged Navy medicine to become a leader in technology integration. Shifting toward a managed-care environment makes it imperative for health care organizations and their personnel to integrate data, information, and systems at all levels. Implementation of a coordinator to assist nursing users with this technology is proving essential. This essay describes how one nursing directorate at a Naval hospital implemented a full-time staff member as Nursing Informatics Coordinator to serve in this role. Receiving and using data and information in the practice of nursing is vital to the profession. Specific factors identifying the reasons for development of this role, impact achieved, opportunities encountered, and the future of the position are addressed.

Awards and Prizes↗
PubMed1997

Effects of lipoproteins on cyclo-oxygenase and lipoxygenase pathways in human platelets.

The products of arachidonic acid (AA) metabolism in platelets play an important role in platelet shape change, adhesion and aggregation which may participate in the pathogenesis of ischemic heart disease and thrombosis. Since lipoproteins are also involved in the pathogenesis of thrombo-embolic disorders, the effect of human lipoproteins (HDL, LDL, VLDL) on AA metabolism in human platelets was investigated. Lipoproteins were separated by density gradient zonal ultracentrifugation. The effects of lipoproteins on production of AA metabolites in human platelets i.e., thromboxane A2 (TXA2) and hydroxy-eicosatetraenoic acids (HETEs) were examined using radiometric thin layer chromatography coupled with automated data integrator system. In human platelets, HDL inhibited 12-HETE and TXA2 formation in a concentration-dependent manner. LDL had a strong inhibitory effect on TXA2 production and a weak inhibitory effect on 12-HETE production. VLDL had no effect on platelet AA metabolism. These findings point to a new facet of lipoproteins action and suggest that lipoproteins may have a physiological role in the regulation of AA metabolism in platelets.

Adult↗
PubMed1998

Meta-analyses of studies of the diagnostic accuracy of laboratory tests: a review of the concepts and methods.

OBJECTIVE: To provide practicing pathologists and other laboratory professionals with the necessary background for reading and evaluating published reports of meta-analyses of studies of the diagnostic accuracy of laboratory tests. STUDY SELECTION: English language literature, 1980 to present, pertaining to the rationale, objectives, and interpretation of meta-analyses of randomized controlled trials, and meta-analyses of studies of the diagnostic accuracy of laboratory tests. CONCLUSIONS: Meta-analysis has several applications in the investigation of the diagnostic accuracy of laboratory tests. It can improve the quality of future primary studies by drawing attention to the methodologic deficiencies of existing reports; it can identify reasons for the variation in the results of those reports; and it can generate valid summary estimates of the diagnostic accuracy of laboratory tests based on all completed investigations, providing that the available primary studies are of high scientific validity. Several statistical techniques for integrating data from reports on diagnostic test accuracy have either been developed or are under development, but meta-analysis is often limited by the poor quality of the primary studies and the effect of publication bias. Meta-analysis can evolve into a reliable tool for assessing the accuracy of laboratory tests if both investigators and editors strive to improve the quality of the primary studies and to reduce the extent of publication bias in this area of the literature.

Clinical Laboratory Techniques↗
PubMed1998

Linking information needs with evaluation: the role of task identification.

Action Identification Theory was used to explore user's subjective constructions of information tasks in a primary care setting. The first part of the study involved collecting clinician's descriptions of their information tasks. These items were collated and then rated by another larger group of clinicians. Results clearly identified 6 major information tasks, including communication, patient assessment, work monitoring, seeking science information, compliance with policies and procedures, and data integration. Results discussed in terms of implications for evaluation and assessing information needs in a clinical setting.

Communication↗
PubMed1998

WWW accessible system for national/regional registries of clinical results of cord blood transplants: a tool to facilitate cooperative clinical research.

A system, accessible via internet, has been developed to support the Spanish Registry of Cord Blood Transplants (RETSCU). The system includes a database of clinical results directly accessible by transplant centers (TCs) and cord blood banks (CBBs) (restricted to own cases regarding primary data and unrestricted regarding statistics derived from validated data) and gives open access to Web pages containing results approved for publication. It also includes internal mail for two-way and broadcast messages. Patients' data are essentially those included in Eurocord forms. Additional features of the system are: confidentiality; inalterability of validated primary data; identifiability of data sources. The Unix central computer is accessible via the WWW. For security, data transmission is encrypted and passwords are required for access. Copies are regularly updated. Data can be loaded from CBBs and TCs. The procedure for creating and updating records is user-friendly, with the possibility of errors being minimized by extensive automated checks. Validation of patients' records by a manager is required before making data available for general statistical analysis. TCs and CBBs may retrieve data on their own cases, regardless of validation, as individual records or in tables directly transferable to common statistical programs. Statistical analysis may be done on validated data from all the patients in the Registry or from groups selected according to HLA compatibility and disease, type of transplant (related/unrelated), or protocol. Several similarly designed and managed national/regional Registries might be networked and their data integrated into a multinational Registry. Our system would require some additional developments to be used in this way.

Hematopoietic Stem Cell Transplantation↗
PubMed2001

Policy-oriented integrated analysis of land-use change: an analysis of data needs.

Integrated analysis of land-use change in support of informed policy-making for sustainable land use at various spatial levels makes heavy requirements for quality data. This paper aims to structure the principal methodological and practical issues of data needs for this task. The data needs for local level analyses of land-use change are given special attention. The paper adopts an integrated economic-environmental modeling framework and suggests the main types of data needed. Four main data dimensions are distinguished: system of spatial reference, system of temporal reference, definitions, and data collection procedures (sources, collection instruments and techniques, recording and retrieval systems, data format, frequency of data collection). To evaluate the suitability of current data sets as well as to guide the collection of new ones, a scheme based on substantive and practical criteria is employed. The former include compatibility, consistency, and reliability of data, while the latter include availability, ease and cost of data collection/retrieval, and transferability of data. The evaluation indicates the broad gaps in current data sets along the four main data dimensions. Based on this evaluation, the paper suggests framework guidelines to address the main data issues identified.

Conservation of Natural Resources↗
PubMed2000

Integrative analysis of protein interaction data.

We have developed a method for the integrative analysis of protein interaction data. It comprises clustering, visualization and data integration components. The method is generally applicable for all sequenced organisms. Here, we describe in detail the combination of protein interaction data in the yeast Saccharomyces cerevisiae with the functional classification of all yeast proteins. We evaluate the utility of the method by comparison with experimental data and deduce hypotheses about the functional role of so far uncharacterized proteins. Further applications of the integrative analysis method are discussed. The method presented here is powerful and flexible. We show that it is capable of mining large-scale data sets.

Animals↗
PubMed2025

Augmented kurtosis-based projection pursuit: a novel, advanced machine learning approach for multi-omics data analysis and integration.

Due to the heterogeneity of multi-omics data, exacting their maximum information potential remains a challenge. Whereas some solutions have been offered, most cannot overcome the large linear dynamic range associated with such data, while others require large biological effect sizes to produce meaningful models. Here, we (i) perform a comprehensive benchmarking of multi-omics data analysis tools, and (ii) introduce kurtosis-based projection pursuit analysis, augmented with classification and regression trees (kPPA-CART) as a robust, easy-to-implement alternative. Using ground truth data, we demonstrate that kPPA-CART exhibits superiority in inferring biological significance from low-intensity (low-count) features and studies with small biological effect sizes. Applying it to experimental breast cancer data from The Cancer Genome Atlas, we identify novel genes that cluster the samples into subtypes that mimic the canonical PAM50 classes with notable improvements. Validating with external metastatic breast cancer data from the AURORA US consortium, kPPA-CART identifies genes that are associated with poor event-free survival and additional clustering associated with increased tumor mutational burden. Finally, we provide an R package and an online implementation of kPPA-CART.

Humans↗
PubMed2005

Event based self-supervised temporal integration for multimodal sensor data.

A method for synergistic integration of multimodal sensor data is proposed in this paper. This method is based on two aspects of the integration process: (1) achieving synergistic integration of two or more sensory modalities, and (2) fusing the various information streams at particular moments during processing. Inspired by psychophysical experiments, we propose a self-supervised learning method for achieving synergy with combined representations. Evidence from temporal registration and binding experiments indicates that different cues are processed individually at specific time intervals. Therefore, an event-based temporal co-occurrence principle is proposed for the integration process. This integration method was applied to a mobile robot exploring unfamiliar environments. Simulations showed that integration enhanced route recognition with many perceptual similarities; moreover, they indicate that a perceptual hierarchy of knowledge about instant movement contributes significantly to short-term navigation, but that visual perceptions have bigger impact over longer intervals.

Animals↗
PubMed2005

High-quality rendering with depth cueing of volumetric data using Monte Carlo integration.

Visualizing efficiently volumetric data still remains a challenge in many fields such as medical imaging and scientific visualization. Monte Carlo volume rendering is a novel and efficient visualization technique for very large datasets. However, when taking into account depth cueing, the volume rendering integral becomes complex, and it is difficult to sample efficiently and in a viewing-independent manner. In this paper, we propose an efficient volume rendering method by dividing the volume rendering integral into four sub-integrals and enabling sampling in each sub-integral to be "best" while achieving viewing independency. As a result, we get a better estimation of the integral than the classical sampling method. The results show that thus rendered images exhibit high quality.

Algorithms↗
PubMed1982

An integrated approach to scanning microscope data acquisition.

This paper describes an integrated data acquisition system built for a cryogenic STEM which is currently under construction in the authors' laboratory. Advantage was taken of modern digital and microprocessor techniques to construct a versatile and expandable system in the minimum time. The system is able to operate in conjunction with an external image processing computer or as an independent system with built-in image processing facilities.

Computers↗