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PubMed2001

Intranet meets hospital information systems: the solution to the integration problem?

Based on the results of an extensive market analysis and technology assessment, this paper summarizes the state of the art in web technology and compares it with the needs of integration in hospital information systems. Web technology and intranet have evolved to a core technology for distributed computing and distributed information systems. The advantage of platform independent distribution of information has led to euphoric visions of future integrated systems. However, true integration takes more than transparent access to heterogeneous information sources. To overcome the essential problems related to integration of autonomous systems it is important to find a common ontological basis for future component based systems.

Computer Communication Networks↗

PubMed2006

Federating distributed and heterogeneous information sources in neuroimaging: the NeuroBase Project.

The NeuroBase project aims at studying the requirements for federating, through the Internet, information sources in neuroimaging. These sources are distributed in different experimental sites, hospitals or research centers in cognitive neurosciences, and contain heterogeneous data and image processing programs. More precisely, this project consists in creating of a shared ontology, suitable for supporting various neuroimaging applications, and a computer architecture for accessing and sharing relevant distributed information. We briefly describe the semantic model and report in more details the architecture we chose, based on a media-tor/wrapper approach. To give a flavor of the future deployment of our architecture, we de-scribe a demonstrator that implements the comparison of distributed image processing tools applied to distributed neuroimaging data.

Databases as Topic↗

PubMed2005

Information assimilation and distribution challenges and goals for real and virtual journals.

The distribution of biomedical information was transfigured over three centuries ago with the introduction of scientific journals. This enabled the widespread dissemination of data to global audiences and greatly facilitated not only the advance of science but amplified the interaction between investigators despite their different locations. This process continued to expand in a linear fashion prior to the emergence of the Internet. The latter system has prompted a phenomenal augmentation of information accessibility, and its ever-expanding use has resulted in an exponential increase in the demand for digital technology and online resources. This technology has achieved unprecedented acceptance in the scientific domain and enabled publishers to expeditiously produce and distribute journal contents online. Such unparalleled access to information has sparked incendiary debate within the scientific community and among journal publishers in regard to numerous issues. It is thus much debated as to who has the right to "own" or control intellectual property, whether information should be made freely available to the online global community, how to gauge the legitimacy and authenticity of published research, and the need to reexamine the feasibility and profitability of paper journals in consideration of the digital, online formats that continue to gain popularity. To assess the current status of the situation, a meeting of journal editors, research scientists, and publishing executives was held in Constance, Germany, on June 26, 2004, to discuss these issues and formulate strategies and recommendations for the future of biomedical publishing. Herewith we provide a summation (manifesto) of the meeting's proceedings and provide a consensus opinion with the aim of illuminating the subject and also proposing some putative solutions for the major challenges that currently confront the scientific and publishing community.

Forecasting↗

PubMed1997

Security threats and solutions in distributed, interoperable health information systems using middleware.

Increasingly, distributed, interoperable healthcare information systems, which meet the shared care paradigm, work across the boundaries of policy, organisational, and technological domains and are based on middleware concepts. Especially in healthcare with its sensitive personal and medical data, such systems require advanced data security measures. In the paper, a common object-oriented security model for middleware systems and advertisements for implementation are proposed, corresponding the security requirement of both the user and the application environment.

Computer Communication Networks↗

PubMed1993

Effect of emergency department information on patient satisfaction.

STUDY HYPOTHESIS: Patient satisfaction with emergency department care is enhanced by information distributed to patients on ED arrival. PARTICIPANTS AND SETTING: A convenience sample of 200 alert, English-speaking, adult ED patients. DESIGN AND INTERVENTION: ED information was distributed on alternate days to all ED patients. The ED information described ED function and patient evaluation time. Patients not receiving ED information served as controls. A research assistant administered a satisfaction questionnaire to all patients immediately after discharge. MEASUREMENTS AND MAIN RESULTS: Patients who received ED information rated their overall satisfaction higher than did the control group (P < .0001). Other items rated significantly higher were physician skill and competence (P = .0112), physician concern and caring (P = .0062), whether the patient would use the same ED again (P < .0001), appropriateness of ED time (P = .01), information received (P < .0001), ability of staff to decrease anxiety (P < .0001), physician's explanation of illness and treatment (P = .0366), and ease and convenience of care (P = .0014). CONCLUSION: ED information has a significant effect on patients' perceptions of the quality of care and overall satisfaction.

Adult↗

PubMed2001

A field theory of consciousness.

This article summarizes a variety of current as well as previous research in support of a new theory of consciousness. Evidence has been steadily accumulating that information about a stimulus complex is distributed to many neuronal populations dispersed throughout the brain and is represented by the departure from randomness of the temporal pattern of neural discharges within these large ensembles. Zero phase lag synchronization occurs between discharges of neurons in different brain regions and is enhanced by presentation of stimuli. This evidence further suggests that spatiotemporal patterns of coherence, which have been identified by spatial principal component analysis, may encode a multidimensional representation of a present or past event. How such distributed information is integrated into a holistic precept constitutes the binding problem. How a precept defined by a spatial distribution of nonrandomness can be subjectively experienced constitutes the problem of consciousness. Explanations based on a discrete connectionistic network cannot be reconciled with the relevant facts. Evidence is presented herein of invariant features of brain electrical activity found to change reversibly with loss and return of consciousness in a study of 176 patients anesthetized during surgical procedures. A review of relevant research areas, as well as the anesthesia data, leads to a postulation that consciousness is a property of quantum-like processes, within a brain field resonating within a core of structures, which may be the neural substrate of consciousness. This core includes regions of the prefrontal cortex, the frontal cortex, the pre- and paracentral cortex, thalamus, limbic system, and basal ganglia.

Brain↗

PubMed1997

Information retrieval in digital libraries: bringing search to the net.

A digital library enables users to interact effectively with information distributed across a network. These network information systems support search and display of items from organized collections. In the historical evolution of digital libraries, the mechanisms for retrieval of scientific literature have been particularly important. Grand visions in 1960 led first to the development of text search, from bibliographic databases to full-text retrieval. Next, research prototypes catalyzed the rise of document search, from multimedia browsing across local-area networks to distributed search on the Internet. By 2010, the visions will be realized, with concept search enabling semantic retrieval across large collections.

Abstracting and Indexing↗

PubMed1998

Laparoscopic surgery. Transition to the future.

The twenty-first century will usher in a fundamentally new approach to the practice of medicine. It will be based heavily on information technologies, broadly defined as the devices that acquire information; those that process, transmit, and distribute information; and those that use information to provide therapy. Although conventional surgery will continue to have a presence, there will be radically different surgical approaches and technologies that may become the predominant form of surgery. The medical record may become a three-dimensional visual representation of the individual patient (like the Visible Human Project), which can be the vehicle that integrates the entire spectrum of health care. Examples of the technologies and infrastructures that support this new approach to medicine are discussed and illustrated, with emphasis on how technologies improve individual patient care.

Forecasting↗

PubMed1990

[The information value of the clinical data related to the vital prognosis in severe combined trauma].

Data are reported on a study of the informative value of ten clinical and laboratory parameters, which have a bearing on the vital prognosis of severe combined trauma. The presentation is part of a more comprehensive study, aimed at creating an expert system for prognosticating this type of pathology. Case material from the Clinic of Anesthesiology, Resuscitation and Intensive Treatment at the "Pirogov" Emergency Hospital in Sofia was used (1986-1988). Included in the study were 455 patients with severe combined traumatic injuries, of whom 210 died and 245 survived. The following methods were used for quantitative assessment of the informative value: for determining the descriptive informative value--informative criterion by Mel'nikov and informative criterion by Bykhovskiĭ [correction of Bihovski]; for the distributing informative value--the method of Kulback and modification of this method, as described by Genkin-Gubler. Simultaneous use of all four methods allowed to precise the values being obtained and to perform with maximal exactness the intervals relevant to the prognosis. This furnished the opportunity to distribute the individual parameters in highly informative groups, designated for entrance to the projected expert system.

Acute Disease↗

PubMedDate not supplied

[System of distributed storage and analysis of genomic information].

A distributed computing system is developed to search and analyze genetic databases using parallel computing technologies. Queries are processed by a local network PC cluster. A universal task and data exchange format is developed for effective query processing. A multilevel hierarchic task batching procedure is elaborated to generate multiple subtasks and distribute them over cluster units under dynamic priority levels and with dynamic distribution of replicated source data subbases. Primary source data preparation and generation of annotation word indices are used to significantly reduce query processing time.

Databases, Genetic↗

PubMed2000

National crisis, supranational opportunity: the Irish construction of abortion as a European service.

In the late 1980s, the anti-abortion movement successfully sought injunctions against pregnancy counselling centres and students' unions in Ireland, preventing them from distributing information on how to obtain an abortion abroad. One of the defensive arguments that the students' unions employed was to claim that the distribution of abortion information was protected as an aspect of the free movement of services under European Community law. This paper addresses the implications of categorising abortion as a supranational economic service for feminist legal strategy. The advantages of categorising abortion as a service to which women have access as consumers are that it legitimates abortion and it provides a new strategy for making abortion claims. The disadvantages are that a woman's legal interest in abortion is based on her capacity to buy the service, fetal life is rendered devoid of value, and the service supplier has as much say about the abortion transaction as the woman consumer. If feminist legal strategy is to successfully use the legal construction of abortion as an economic service, it must work to minimise such negative implications.

Abortion, Legal↗

PubMed2004

Application of laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) to investigate trace metal spatial distributions in human tooth enamel and dentine growth layers and pulp.

Human tooth enamel provides a nearly permanent and chronological record of an individual's nutritional status and anthropogenic trace metal exposure during development; it might thus provide an excellent bio archive. We investigated the micro-spatial distribution of trace metals (Cu, Fe, Mg, Sr, Pb, and Zn) in 196 x 339 microm2 raster pattern areas (6.6 x 10(4) microm2) in a deciduous tooth using laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS). Ablated areas include prenatal and postnatal enamel, the neonatal line, the dentine-enamel junction (DEJ), dentine, and the dentine-pulp junction. Topographic variations in the surface elemental distribution of lead, zinc, strontium, and iron intensities in a deciduous tooth revealed heterogeneous distribution within and among regions. 43Ca normalized elemental intensities showed the following order: Sr>Mg>>Zn>Pb>Fe>Cu. Elevated zinc and lead levels were present in the dental pulp region and at the neonatal line. This study demonstrates the ability of LA-ICP-MS to provide unique elemental distribution information in micro spatial areas of dental hard tissues. Elemental distribution plots could be useful in decoding nutrition and pollution information embedded in their bio apatite structure.

Child↗

PubMedDate not supplied

Morphological evidence for parallel processing of information in rat macula.

Study of montages, tracings and reconstructions prepared from a series of 570 consecutive ultrathin sections shows that rat maculas are morphologically organized for parallel processing of linear acceleratory information. Type II cells of one terminal field distribute information to neighboring terminals as well. The findings are examined in light of physiological data which indicate that macular receptor fields have a preferred directional vector, and are interpreted by analogy to a computer technology known as an information network.

Acoustic Maculae↗

PubMed2002

Reconstruction of biologically equivalent dose distribution on CT-image from measured physical dose distribution of therapeutic beam in water phantom.

From the standpoint of quality assurance in radiotherapy, it is very important to compare the dose distributions realized by an irradiation system with the distribution planned by a treatment planning system. To compare the two dose distributions, it is necessary to convert the dose distributions on CT images to distributions in a water phantom or convert the measured dose distributions to distributions on CT images. Especially in heavy-ion radiotherapy, it is reasonable to show the biologically equivalent dose distribution on the CT images. We developed tools for the visualization and comparison of these distributions in order to check the therapeutic beam for each patient at the National Institute of Radiological Sciences (NIRS). To estimate the distribution in a patient, the dose is derived from the measurement by mapping it on a CT-image. Fitting the depth-dose curve to the calculated SOBP curve also gives biologically equivalent dose distributions in the case of a carbon beam. Once calculated, dose distribution information can be easily handled to make a comparison with the planned distribution and display it on a grey-scale CT-image. Quantitative comparisons of dose distributions can be made with anatomical information, which also gives a verification of the irradiation system in a very straightforward way.

Humans↗

PubMed1995

Database access method for autonomous distributed total hospital information system and its object-oriented design.

ADITHIS (Autonomous Distributed Total Hospital Information System) is an information system providing a distributed computing environment for a hospital. The access method to its database enables users to access any patient data stored in individual departmental databases. Its functional design based on the object-oriented approach and its characteristics are described.

Computer Communication Networks↗

PubMed1998

Integrating HIS-RIS-PACS: the Freiburg experience.

With the integration of different formerly isolated information systems, such as Hospital Information System (HIS). Radiology Information System (RIS), Picture Archiving and Communication System (PACS) and modalities, we evolve towards an architecture of distributed information processing in radiology, the data being stored in distributed databases. The frontier between the cooperative information systems becomes more subtle than in the past, and it seems more convenient to distinguish the different computer functionalities or services used in radiology than to detail the functions of RIS and PACS. This paper opens with a description of the different computer services used in radiology and how they relate one to another. It also shows how these functionalities could be integrated within a global Radiology Information and Archiving System. Finally, it shows the degree of systems interconnection that can be achieved presently, using the PACS-RIS installation at the University Hospital of Freiburg as an example.

Computer Communication Networks↗

PubMed1980

Sickle cell centers of tomorrow. Part I: Regional information centers.

Regional sickle cell organizations are needed to assemble, catalogue, and distribute information, to maintain teaching programs, to serve as referral agencies, and to aid individuals with sickle cell hemoglobinopathies in obtaining maximal benefit from existing community services. The governing body should be representative of the entire area. More than half of the voting members should be adults with the sickle cell trait or sickle cell disease and/or their relatives. A suggested minimal staff could consist of a secretary-librarian and a director. The usefulness of the "Center" to patients, especially at the time of their recurrent painful episodes, could be greatly extended by the maintenance of a 24-hour telephone answering service. Funding of the "Regional Sickle Cell Information Center" by the United Way is recommended.

Anemia, Sickle Cell↗

PubMed1989

[Prediction of postoperative pulmonary function in the patient undergoing pneumonectomy using combined pulmonary function test and ventilation/perfusion scintiphotography].

A method to predict postoperative lung function following pneumonectomy has been used in 11 patients. Preoperative unilateral lung function can be predicted by combining the preoperative information on lung volumes obtained by spirometry with the distributional information obtained from ventilation and perfusion scintigrams in order to estimate lung function after pneumonectomy. There was a high degree of correlation between predicted and measured lung function for both FEV1 (r = 0.81, p less than 0.050, and FVC (r = 0.81, p less than 0.05). The postoperative FEV1 and FVC were within 200 ml of the predicted value in most of the patients. A more accurate and easy prediction of postoperative lung function is obtained using unilateral perfusion rather than ventilation scintigrams. We suggest that the combined the results of simple spirometric data and a quantitative right-vs-left perfusion lung scan using radioactive Tc-99m provides a simple non-invasive and accurate method for the pre-operative functional evaluation of the high risk patient.

Adult↗