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At least 1,153 records · Page 64Linked to original sources
PubMed2002

Glucose transport in cultured animal cells: an exercise for the undergraduate cell biology laboratory.

Membrane transport is a fundamental concept that undergraduate students of cell biology understand better with laboratory experience. Formal teaching exercises commonly used to illustrate this concept are unbiological, qualitative, or intricate and time consuming to prepare. We have developed an exercise that uses uptake of radiolabeled nutrient analogues by attachment-dependent animal cells cultured on multiwell trays. This system can readily be manipulated within a typical 3-h laboratory period to yield reproducible, biologically relevant, quantitative data regarding key aspects of membrane transport. Each 24-well tray of cultures allows a group of two to four students to compare eight conditions in triplicate. If different groups of students test different conditions or different types of cells, data can be shared for an even broader experience. The exercise is also readily adaptable for open-ended student projects. Here we illustrate the exercise measuring uptake of the nonmetabolizable glucose analogue [(3)H]-2-deoxy-D-glucose. Students successfully tested the effects of competing sugars, putative inhibitors of the GLUT1 transporter, and changes in cell physiology that might be expected to affect glucose transport in epithelial cells and fibroblasts. In this exercise students find the nutritional and medical implications of glucose transport and its regulation intriguing. They also learn to handle radioisotopes and cultured cells.

Animals↗
PubMed2006

Remote anesthetic monitoring using satellite telecommunications and the Internet.

Remote collaboration for anesthesia requires considerable sharing of physiologic data, audio, and images on a consistent data platform. A low-bandwidth connection between Ecuador and the United States supported effective joint management of operative plan, airway, intraoperative decisions, and recovery. Transmission with a 64-Kbps InMarSat satellite telephone (Thrane & Thrane, Denmark) connection from hospitals in Macas and Sucúa, Ecuador, to Richmond, Virginia, included preoperative patient evaluations, video of endotracheal intubations, electrocardiogram waveforms, pulse oximetry measurements, arterial blood pressure readings, capnography readings, and auscultation of breath sounds.

Anesthesia↗
PubMed2006

Health Outcomes for Better Information and Care (HOBIC): integrating patient outcome information into nursing undergraduate curricula.

Nursing-sensitive outcomes provide common information across sectors, thus eliminating duplication that frequently occurs as individuals move across settings. These outcomes also facilitate increased trust among colleagues and support common understandings of patient care needs, thus enhancing continuity of care. Outcomes-oriented information is also likely to increase patient safety and improve overall quality of care. Shared standards and data support consistent decision-making, as nursing decisions can be tracked back over time to assess patient care outcomes. Consequently, nurses will have the means to determine the impact of their interventions on patient outcomes. At the same time, adoption of common approaches to patient assessment leads to greater professional accountability and moves nursing care from a task orientation to an outcomes focus. For administrators, such improvements in monitoring and evaluating patient outcomes translate into improvements in efficiencies and effectiveness, thus providing a return on investment in implementing these outcomes within their agency. For nurses, integration and utilization of outcomes information increases the visibility and significance of their decision-making and patient care. Together with patients, nurses can utilize the outcomes information to make evidence-based decisions and advocate for appropriate care. At an aggregate level, the use of outcomes information creates a continuous feedback loop that is essential to ensuring evidence-based care and the best possible patient outcomes, not only for individuals, but also for families, communities and populations. Outcomes-oriented care provides a gateway for transforming the way we care for patients; puts safe, ethical, high-quality care for patients first; embodies the principles of evidence-based practice; ensures that the value of nursing is clearly understood within the larger system; and ensures that the requirements for measurability and accountability can be achieved. This journey is continuous and is being expanded to engage all other health disciplines in understanding and documenting their contributions to patient care, both as individual practitioners and as members of a healthcare team. Preparing nursing students in an outcomes approach will facilitate systemwide adoption of HOBIC patient outcomes over time and provide a means to determine the impact of nursing care on our patients.

Computer User Training↗
PubMed2002

Leptin and insulin action in the central nervous system.

Body adiposity is known to be carefully regulated and to remain relatively stable for long periods of time in most mammalian species. This review summarizes old and recent data implicating insulin and leptin as key circulating signals to the central nervous system, particularly the ventral hypothalamus, in communicating the size and the distribution of body fat stores. This input ultimately alters food intake and energy expenditure to maintain constancy of the adipose depot. The key primary neurons in the arcuate nucleus containing NPY/AgRP and POMC/CART appear be critical constituents of the CNS regulating system, and are shown to contribute to anabolic and catabolic signaling systems to complete the feedback loop. New data to indicate shared intracellular signaling from leptin and insulin is provided. The satiety system for meals, consisting of neural afferents to the hindbrain from the gastrointestinal tract, is described and its effectiveness is shown to vary with the strength of the insulin and leptin signals. This provides an efferent mechanism that plays a key role in a complex feedback system that allows intermittent meals to vary from day to day, but provides appropriate long-term adjustment to need. Recently described contributions of this system to obesity are described and potential therapeutic implications are discussed.

Animals↗
PubMedDate not supplied

Pittsburgh Regional Healthcare Initiative: a systems approach for achieving perfect patient care.

The Pittsburgh Regional Healthcare Initiative (PRHI) is an innovative model for health system change based on regionwide shared learning. By linking patient outcomes data with processes of care and sharing that information widely, PRHI supports measurable improvements in regionwide clinical practice and patient safety. In addition, through the redesign of problem solving at the front lines of care, PRHI helps health care organizations to evolve toward becoming sustainable systems of perfect patient care. This paper describes PRHI's design for change, reviews the progress and limitations of the shared learning model, and offers a set of broader policy considerations.

Humans↗
PubMed2005

Systems for the management of pharmacogenomic information.

Recent breakthroughs in biological research have been made possible by remarkable advances in high-performance computing and the establishment of a highly sophisticated information technology infrastructure. This chapter gives an overview of the main and most important technologies needed for the management of pharmacogenomic information, namely database management systems and software and hardware architectures. Because pharmacogenomics deals with a great many of public and/or proprietary data, the most prominent ways for easy storage, retrieval, analysis, and exchange are presented. Processing these data requires the use of sophisticated software architectures. Several most recent practices useful for a pharmacogenomic environment are explained. Multitiered application design and web services are discussed and described independent of the major enterprise development platforms. Because life sciences are becoming increasingly quantitative and because state-of-the-art software architectures use many system resources, this chapter presents the most recent and powerful systems for parallel data processing and data storage. Finally, shared and distributed memory systems and combinations of them as well as different storage architectures such as directly attached storage, network-attached storage, and storage-area network are explained in detail.

Animals↗
PubMed2006

Phylogenetic mapping of recombination hotspots in human immunodeficiency virus via spatially smoothed change-point processes.

We present a Bayesian framework for inferring spatial preferences of recombination from multiple putative recombinant nucleotide sequences. Phylogenetic recombination detection has been an active area of research for the last 15 years. However, only recently attempts to summarize information from several instances of recombination have been made. We propose a hierarchical model that allows for simultaneous inference of recombination breakpoint locations and spatial variation in recombination frequency. The dual multiple change-point model for phylogenetic recombination detection resides at the lowest level of our hierarchy under the umbrella of a common prior on breakpoint locations. The hierarchical prior allows for information about spatial preferences of recombination to be shared among individual data sets. To overcome the sparseness of breakpoint data, dictated by the modest number of available recombinant sequences, we a priori impose a biologically relevant correlation structure on recombination location log odds via a Gaussian Markov random field hyperprior. To examine the capabilities of our model to recover spatial variation in recombination frequency, we simulate recombination from a predefined distribution of breakpoint locations. We then proceed with the analysis of 42 human immunodeficiency virus (HIV) intersubtype gag recombinants and identify a putative recombination hotspot.

Animals↗
PubMed1985

Networking of microcomputers in the radiology department.

A microcomputer may be installed in any of several areas in a radiology department or office to automate data processing. Such areas include the reception desk, the transcription office, the quality-control station, and remote or satellite radiography rooms. Independent microcomputers can be interconnected by networking, using small hardware and software packages and cables, to effect communication between them, afford access to a common data base, and share peripheral devices such as hard disks and printers. A network of microcomputers can perform many of the functions of a larger minicomputer system at lower cost and can be assembled in small modules as budgetary constraints allow.

Computers↗
PubMedDate not supplied

Prevention of drug-induced risks.

Effective prevention of drug-induced risks depends on an accurate understanding of their triggering or predisposing factors, and the quality of information on these available to prescribing practitioners and users. All preclinical and clinical data available on the proprietary medicinal product concerned should facilitate identification of a risk, and these data should be compared with existing data on drugs sharing the same mode of action or therapeutic strategy. This information should be based on a communication plan adapted to the context of the disease under treatment, the therapeutic alternatives available and the benefits expected.

Drug-Related Side Effects and Adverse Reactions↗
PubMed1999

A taxonomy of health networks and systems: bringing order out of chaos.

OBJECTIVE: To use existing theory and data for empirical development of a taxonomy that identifies clusters of organizations sharing common strategic/structural features. DATA SOURCES: Data from the 1994 and 1995 American Hospital Association Annual Surveys, which provide extensive data on hospital involvement in hospital-led health networks and systems. STUDY DESIGN: Theories of organization behavior and industrial organization economics were used to identify three strategic/structural dimensions: differentiation, which refers to the number of different products/services along a healthcare continuum; integration, which refers to mechanisms used to achieve unity of effort across organizational components; and centralization, which relates to the extent to which activities take place at centralized versus dispersed locations. These dimensions were applied to three components of the health service/product continuum: hospital services, physician arrangements, and provider-based insurance activities. DATA EXTRACTION METHODS: We identified 295 health systems and 274 health networks across the United States in 1994, and 297 health systems and 306 health networks in 1995 using AHA data. Empirical measures aggregated individual hospital data to the health network and system level. PRINCIPAL FINDINGS: We identified a reliable, internally valid, and stable four-cluster solution for health networks and a five-cluster solution for health systems. We found that differentiation and centralization were particularly important in distinguishing unique clusters of organizations. High differentiation typically occurred with low centralization, which suggests that a broader scope of activity is more difficult to centrally coordinate. Integration was also important, but we found that health networks and systems typically engaged in both ownership-based and contractual-based integration or they were not integrated at all. CONCLUSIONS: Overall, we were able to classify approximately 70 percent of hospital-led health networks and 90 percent of hospital-led health systems into well-defined organizational clusters. Given the widespread perception that organizational change in healthcare has been chaotic, our research suggests that important and meaningful similarities exist across many evolving organizations. The resulting taxonomy provides a new lexicon for researchers, policymakers, and healthcare executives for characterizing key strategic and structural features of evolving organizations. The taxonomy also provides a framework for future inquiry about the relationships between organizational strategy, structure, and performance, and for assessing policy issues, such as Medicare Provider Sponsored Organizations, antitrust, and insurance regulation.

American Hospital Association↗
PubMed1998

Challenges of developing a cervical screening information system: the Ontario pilot project.

OBJECTIVE: To create a cervical screening information and reporting system in 2 geographic areas of Ontario. DESIGN: A pilot project involving access to, and linkage of, cervical screening-related cytology, colposcopy and histopathology records for women in the study areas, followed by development and production of woman-specific and aggregate reports. SETTING: Hospital cytology and pathology departments, colposcopy clinics, private cytology laboratories, and the provincial cancer agency (Cancer Care Ontario, formerly the Ontario Cancer Treatment and Research Foundation). MAIN OUTCOME MEASURES: Access to required records; data quality (i.e., standardization, completeness, accuracy); quality of record linkage; utility of reports to evaluators, data sources and physicians. RESULTS: The pilot project was not completed because of a number of major challenges, including multiple data sources requiring separate investigation and negotiations for access; variations in reporting terminology and coding; incompatibility or lack of computer systems; incompleteness of identifiers for record linkage; variation in legislation permitting data access and sharing and in its interpretation; and major financial, resource and time requirements. CONCLUSIONS: Although sufficient will and resources can overcome technical obstacles, changes in legislation will be required to overcome other challenges. Strong links with all sectors involved in cervical screening and attention to changes in the health care system are essential.

Colposcopy↗
PubMed1999

AIDMAN--advanced informatics distributed medical access network.

We describe AIDMAN, a pilot project in which health clinics in remote areas of Greece are connected with mainland hospitals, to provide routine clinical service for both chronic health care and accident and emergency. Clinical practice is supported through the use of the Virtual Consultation Workstation that is being developed and evaluated specifically for the project and which is based on readily available commercial products and international standards. The communication infrastructure remains a major obstacle to any telemedicine project, and for this reason, satellite communication is used in the AIDMAN project to overcome the current lack of digital links and bandwidth. The proposed system will provide real time video, high definition image, shared applications and data over a link running at 128 kbps. In this paper we discuss the design of the AIDMAN system, the Virtual Consultation Workstation and the communication channel.

Computer Communication Networks↗
PubMed2002

Towards a sharable numeric and symbolic knowledge base on cerebral cortex anatomy: lessons learned from a prototype.

We propose a knowledge base that combines numeric and symbolic knowledge about sulco-gyral brain cortex. This knowledge base is implemented using Web technologies. It is intended to be easily reusable in various application contexts such as teaching, decision support in neurosurgery and sharing of neuroimaging data for research purposes. Our analysis shows that (1) a formal representation of taxonomy and mereotopology, and (2) use of identity criteria to represent symbolic concepts, are needed to serve those applications.

Artificial Intelligence↗
PubMed2002

[Contribution of DNA chips in lung cancer: an update].

Progress in techniques and computer processing over the last few years have led to the development of new methods of molecular biology. These new methods allow rapid data processing, often allowing data to be shared via networks. An example of this new technology is the transcriptome analysis via a microarray chip. This chip allows analysis of a very large number of RNA messenger transcripts that can be used for diagnostic or prognostic purposes. The first applications in lung cancer have been aimed to distinguish pulmonary adenocarcinoma from other adenocarcinomas. Another approach is to use these chips as a diagnostic tool to identify genes with expressions specific for non-small-cell lung cancer. The early results have been promising and encouraging for future developments, particularly in the domain of applied therapeutics.

Adenocarcinoma↗
PubMed2000

[A multiparametric monitoring network system based on windows operation system].

This paper introduces the general structure and implementary method both in hardware and software of a monitoring network system, which is developed for monitoring physiological multi-parameter under Windows operation system and based on personal computer. The parameters monitored by the system include Electrocardiogram (ECG), Noninvasive Blood Pressure (NIBP), Oxygen Saturation (SpO2), Respiration (RESP) and Body Temperature. Monitoring data can be shared by internal hospital network. The system has the advantages of easy operation and flexible structure. It is a new kind of hospital monitoring equipment.

Blood Pressure Determination↗
PubMed2003

Preparing MCOs to manage chronic kidney disease.

Managed care organizations have begun recognizing the critical need to start implementing changes that will significantly improve diagnosis and treatment of chronic kidney disease (CKD). Alan Wright's perspective on managed care's shifting focus relative to managing these patients, presented here, ignited a lively discussion among panel members in the roundtable discussion that follows this section. By drawing on the strength of the data and information shared by Drs. Amedia and Provenzano, this article highlights how managed care can address the need for early identification of patients at heightened risk for CKD and points out ways to avoid the hidden costs associated with the various conditions that are related to renal disease. In addition, this article delineates ways that MCOs can strengthen educational efforts aimed at primary care physicians about early diagnosis and management of these patients.

Cost of Illness↗