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PubMed2005

Internet-based Profiler system as integrative framework to support translational research.

BACKGROUND: Translational research requires taking basic science observations and developing them into clinically useful tests and therapeutics. We have developed a process to develop molecular biomarkers for diagnosis and prognosis by integrating tissue microarray (TMA) technology and an internet-database tool, Profiler. TMA technology allows investigators to study hundreds of patient samples on a single glass slide resulting in the conservation of tissue and the reduction in inter-experimental variability. The Profiler system allows investigator to reliably track, store, and evaluate TMA experiments. Here within we describe the process that has evolved through an empirical basis over the past 5 years at two academic institutions. RESULTS: The generic design of this system makes it compatible with multiple organ system (e.g., prostate, breast, lung, renal, and hematopoietic system,). Studies and folders are restricted to authorized users as required. Over the past 5 years, investigators at 2 academic institutions have scanned 656 TMA experiments and collected 63,311 digital images of these tissue samples. 68 pathologists from 12 major user groups have accessed the system. Two groups directly link clinical data from over 500 patients for immediate access and the remaining groups choose to maintain clinical and pathology data on separate systems. Profiler currently has 170 K data points such as staining intensity, tumor grade, and nuclear size. Due to the relational database structure, analysis can be easily performed on single or multiple TMA experimental results. The TMA module of Profiler can maintain images acquired from multiple systems. CONCLUSION: We have developed a robust process to develop molecular biomarkers using TMA technology and an internet-based database system to track all steps of this process. This system is extendable to other types of molecular data as separate modules and is freely available to academic institutions for licensing.

Automation↗

PubMed2001

Small numerators canceling small denominators: is Dyson's hierarchical model solvable?

We present an analytical method to solve Dyson's hierarchical model, involving the scaling variables near the high-temperature fixed point. The procedure seems plagued by small denominators as in perturbative expansions near integrable systems in Hamiltonian mechanics. However, in 36 cases considered, a zero denominator always comes with a zero numerator. We conjecture that these cancellations occur in general, allowing the application of the analytical method and suggesting that the model has remarkable features reminiscent of the integrable systems.

Journal Article↗

PubMed2000

Exercise and the immune system: regulation, integration, and adaptation.

Stress-induced immunological reactions to exercise have stimulated much research into stress immunology and neuroimmunology. It is suggested that exercise can be employed as a model of temporary immunosuppression that occurs after severe physical stress. The exercise-stress model can be easily manipulated experimentally and allows for the study of interactions between the nervous, the endocrine, and the immune systems. This review focuses on mechanisms underlying exercise-induced immune changes such as neuroendocrinological factors including catecholamines, growth hormone, cortisol, beta-endorphin, and sex steroids. The contribution of a metabolic link between skeletal muscles and the lymphoid system is also reviewed. The mechanisms of exercise-associated muscle damage and the initiation of the inflammatory cytokine cascade are discussed. Given that exercise modulates the immune system in healthy individuals, considerations of the clinical ramifications of exercise in the prevention of diseases for which the immune system has a role is of importance. Accordingly, drawing on the experimental, clinical, and epidemiological literature, we address the interactions between exercise and infectious diseases as well as exercise and neoplasia within the context of both aging and nutrition.

Acute-Phase Reaction↗

PubMed2004

[Problem-based learning in medical education. Integrated "Nervous System and Behavior" course at the Munich Ludwig Maximilian University].

The new curriculum for medical licensure in Germany focuses on interdisciplinary and problem-based learning. In recent years, first experiences with this learning model were gathered in several German medical schools conducting courses supplementing the traditional curriculum. This article describes the course "Nervous system and behavior" at Ludwig Maximilian University in Munich. This course was established in cooperation with Harvard University in Boston, USA (The Munich-Harvard Alliance) together with three other clinical courses and has run every semester since the winter of 1999. As this course integrates neuroscience disciplines with special emphasis on neurology and psychiatry, it may serve as a role model for the implementation of these subjects in a new curriculum. This article introduces the reader to its structure and elements as well as feedback from students.

Curriculum↗

PubMed2005

National plan for reliable tuberculosis laboratory services using a systems approach. Recommendations from CDC and the Association of Public Health Laboratories Task Force on Tuberculosis Laboratory Services.

Since the mid-1990s, public health laboratories have improved tuberculosis (TB) test performance, which has contributed to the resumption of the decline in TB incidence in the United States. However, to eliminate TB in the United States, further improvements are needed in laboratory services to support TB treatment, prevention, and control. A critical step is the development of an integrated system that ensures prompt and reliable laboratory testing and flow of information among laboratorians, clinicians, and TB-control officials. Challenges to developing such a system include 1) establishing lines of communication among laboratorians, clinicians, and TB-control officials; 2) expediting reporting of laboratory results, which can avoid delayed or inappropriate treatment and missed opportunities to prevent transmission; 3) developing evidence-based recommendations for use of new laboratory technologies; 4) maintaining staff proficiency in light of declining numbers of specimens to test, workforce shortages, and loss of laboratory expertise; and 5) upgrading laboratory information systems and connecting all partners. The report of the Association of Public Health Laboratories Task Force presents a framework to improve the future of TB laboratory services and describes the role of the laboratory in TB treatment and control, Task Force processes, general principles and benchmarks, and steps for the dissemination of the Task Force recommendations. This MMWR expands on the Task Force report by describing specific actions and performance measures to guide development and implementation of an integrated system for providing TB laboratory services. CDC and the Association of Public Health Laboratories have developed these guidelines so that laboratorians, clinicians, public health officials, administrators, and funding entities can work together to ensure that health-care providers and TB-control officials have the information needed to treat TB patients, prevent TB transmission, and ultimately eliminate TB in the United States.

Clinical Laboratory Information Systems↗

PubMed2026

Privacy, security, and reliability risks of artificial intelligence in healthcare: a systematic review of empirical evidence.

BACKGROUND: Artificial intelligence (AI) is increasingly integrated into healthcare information systems, supporting clinical decision-making, imaging analysis, and predictive modeling. While these applications offer operational and clinical benefits, they also introduce emerging risks to patient privacy, data security, and system reliability. OBJECTIVE: To systematically review empirical evidence on privacy breaches, security vulnerabilities, and misuse associated with AI applications in healthcare settings. METHODS: PubMed, Embase, Web of Science, Scopus, IEEE Xplore, and ACM Digital Library were searched for empirical studies published between January 2015 and November 2025 that evaluated AI use or misuse in clinical diagnosis, treatment, or decision-making. Two reviewers independently screened studies and extracted data using a standardized form. Findings were synthesized narratively due to heterogeneity in study designs, AI methods, and reported outcomes. RESULTS: Of 7,285 records identified through database searches and 205 through citation screening, 22 empirical studies met the inclusion criteria, spanning multiple clinical domains and data modalities, predominantly medical imaging applications. Five recurring threat categories were identified: patient re-identification, membership inference, unauthorized access and adversarial exploitation, input manipulation, and misuse or overinterpretation of AI outputs. Across studies, AI models were shown to encode latent biometric signals across diverse data types, limiting the effectiveness of traditional anonymization and synthetic data approaches. Adversarial attacks and input manipulation were also shown to compromise diagnostic performance and system integrity. CONCLUSION: This systematic review provides empirical evidence suggesting that contemporary AI systems in healthcare introduce privacy and security risks that may challenge traditional assumptions about data protection. These findings underscore the need for privacy- and security-by-design approaches and governance frameworks that address risks across the AI lifecycle.

Humans↗

PubMed2002

Relationships between otoacoustic emissions and auditory brainstem responses in neonates and young children: a correlation and factor analytical study.

OBJECTIVES: To establish relationships among transient evoked otoacoustic emission (TEOAE) and auditory brainstem response (ABR) variables in a sample of normal hearing neonates and young children, ranging in age from approximately 3 weeks to 4 years. STUDY DESIGN: Retrospective, non-randomized, cross-sectional analysis of clinical data obtained at a tertiary care medical center. METHODS: Pearson product moment and Spearman rank order correlation analyses to evaluate pairwise relationships between TEOAE variables, ABR variables and age; factor analysis, to identify the structural composition and dimensionality of these relationships. RESULTS: Significant pairwise correlations were obtained between variables within each test paradigm (TEOAEs, ABRs) and between ABR absolute and interpeak latencies with age. However, the most striking effect was the absence of strong correlations between ABR and TEOAE variables, indicating that these test measures provide independent information about auditory system integrity and sensitivity. Two factors, accounting for over 55% of the variance, characterized this data set: 1) a frequency-dependent OAE factor, which showed an inverse relation between biologic noise and whole wave percent reproducibility and half-octave band TEOAE amplitudes; and 2) a central nervous system (CNS) maturational factor, which showed an inverse relationship between age and certain absolute and interpeak ABR latency components. CONCLUSIONS: TEOAE and ABR test results provide unique and functionally independent information about normal auditory system integrity and sensitivity. Therefore, a combination of both tests is well suited for use within a pediatric test battery. These results confirm that biologic noise and age at test differentially affect OAE and ABR test measures, and both effects require consideration during data acquisition and interpretation.

Audiometry, Evoked Response↗

PubMedDate not supplied

Developing and implementing a relational database for heart failure outcomes in an integrated healthcare system.

A need to capture patient-specific data related to heart failure outcomes led to the development of a relational database to allow for data entry at the point of care. This database provided standardization of data collection at four of the system's acute care hospitals. The data are reported to the Heart Failure Clinical Effectiveness Team to track indicators for demonstration of best practice outcomes, internal benchmarking, and identification of opportunities for performance improvement on a healthcare system level. The database development, steps toward implementation, data collection tools, and the utilization of the outcomes data are discussed.

Databases, Factual↗

PubMed2004

[Guideline-based medical quality management in dialysis. Motivation and structuring of a quality-management system and integration of earlier disease stages of chronic renal failure].

BACKGROUND AND PURPOSE: Health services are challenged by increasingly complex medical processes and economic restraints in an aging population. Under these circumstances, medical quality management is developed and increasingly applied to survey especially complex and expensive clinical processes in the sense of controlling. In this process, practicability and relevance are fundamental. METHODS: This paper presents the well-established quality management system QiN (quality in nephrology) in the context of dialysis in end-stage renal disease. RESULTS: A quality-management system is well applicable in the case of dialysis. It can positively influence relevant indicators of process and outcome quality, as demonstrated here by the example of dialysis quantity. CONCLUSIONS: Outcome and process quality in dialysis are quantifiable via defined indicators oriented on evidence-based medicine. The program based on benchmarking of basic clinical indicators leads to improved care of dialysis patients. A quality-management program of this type can represent an essential component of interdisciplinary, structured treatment programs, thereby influencing the whole treatment process.

Humans↗

PubMed1997

A system for integrated collection and analysis of crystallographic diffraction data.

A set of linked software modules has been installed at the A1 station of CHESS, the Cornell High Energy Synchrotron Source, which, with the underlying hardware, allows crystallographic users of the facility to evaluate crystals, collect diffraction images and process the images rapidly and with assurance of the quality of the resultant data, thereby making most efficient use of their beam time. The system includes a CCD detector and its controlling software, with a graphical user interface, a convenient oscillation camera featuring automated alignment with the X-ray beam, a program for optimizing crystal rotation range, and the HKL data-reduction package. Principles embodied in this system are applicable to other facilities where crystallographic data are routinely collected.

Journal Article↗

PubMed2000

Effects of N-acetylcysteine on pulmonary macrophage activity after intestinal ischemia and reperfusion in rats / with invited commentaries.

BACKGROUND/AIMS: Intestinal ischemia and reperfusion (I/R) is considered to be a critical and triggering event in the development of distal organ dysfunction after a variety of insults. It appears that activated leukocytes, especially polymorphonuclear granulocytes (PMNs), and reactive oxygen species are important mediators in the process. In the present study, the aim was to evaluate the behavior of pulmonary macrophages, acute lung injury and pulmonary endothelial permeability after intestinal I/R, together with potential alterations in pulmonary endothelial and epithelial ultrastructure and cellular membrane system integrity. METHODS: Intestinal ischemia for 40 min was followed by reperfusion for 12 h in the rat. Macrophage uptake of radiolabeled bacteria, levels of pulmonary blood content assessed by radiolabeled red blood cells and pulmonary endothelial permeability of radiolabeled albumin, as well as pulmonary endothelial and epithelial ultrastructure and cellular membrane system integrity by the use of scanning electron microscopy and a tracer was evaluated after 12 h reperfusion. Treatment with the free radical scavenger N-acetylcysteine (NAC) administered prior to reperfusion was evaluated. RESULTS: Overactivation of pulmonary macrophages was noted after intestinal I/R, as was a significant decrease in pulmonary blood content. No increase in pulmonary albumin leakage or increase in pulmonary water content was found after intestinal I/R as compared to controls. Treatment with NAC prevented against intestinal I/R-induced overactivation of pulmonary macrophages and a decrease in pulmonary blood content. CONCLUSION: Reactive oxygen species may be involved in the regulation of pulmonary macrophage function and pulmonary circulation after intestinal I/R.

Acetylcysteine↗

PubMed1997

Evidence for an early motion system which integrates information from the two eyes.

In one type of cyclopean motion stimulus one eye views a counterphase flickering grating while the other eye views the same pattern in spatio-temporal quadrature. Algebraic summation of the two image sequences results in a drifting grating. Upon binocular (cyclopean) combination of the two patterns a drifting grating is perceived even though neither monocular pattern is moving. While this appears to support the position that the motion system is binocular, it has been suggested that such demonstrations involve higher level feature tracking rather than early motion system activation. The perceived direction of motion could result from the tracking of features after neural summation of left and right eye images. However, by adding a static, in-phase, pedestal grating to the left and right eye flickering test gratings, the direction information based on feature tracking is removed while leaving the motion energy information unchanged. We have found that when such stimuli are presented for several seconds, direction discrimination performance is significantly better than chance for pedestal grating contrasts several times the test grating contrast. Therefore, in the absence of a feature tracking cue, the direction of motion is identified using a binocular motion energy mechanism. The results do not exclude the existence of a binocular feature tracking system. Both systems are likely to exist.

Humans↗

PubMed1997

Outcomes for home and community nursing in integrated delivery systems.

In these tumultuous times in health care, nursing providers are under pressure to capture data that demonstrate the effectiveness of nursing interventions on client health. At the University of Iowa, researchers are attempting to develop a client outcome classification system that uses a standardized language across different health care settings to capture this vital information.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed1998

Impact of information systems on acute care hospitals: results from a survey in the United States.

These results are from a survey of acute care hospitals in the United States. A random sample of 813 hospitals was selected with 115 responding and 33 incorrect addresses resulting in a 15% response rate. The purpose of the study was to measure the impact and future potential of information systems integration in the financial, medical, and administrative systems of the hospitals. Impact of Information Systems is measured in many ways. Questions about employee moral, reductions in employees, goals being met and overall satisfaction with the systems are asked and results analyzed. This information will provide a benchmark for hospitals to determine their information systems position and technology transfer planning. These analyses will lead to setting goals.

Attitude of Health Personnel↗

PubMed1998

Decision-making with and without information technology in acute care hospitals: survey in the United States.

These survey results are from a national survey of acute care hospitals. A random sample of 813 hospitals was selected with 115 responding and 33 incorrect addresses resulting in a 15% response rate. The purpose of the study was to measure the extent of information systems integration in the financial, medical, and administrative systems of the hospitals. Decision making with and without information technology is explored based upon the survey data. The results indicate why and how meetings are held. Necessary changes in the decision-making environment are identified for decision making utilizing information technology to be successful. These results will provide a benchmark for hospitals to determine their technology transfer position and to set goals for computer assisted decision-making.

Benchmarking↗

PubMed1998

Internet usage and potential impact for acute care hospitals: survey in the United States.

These survey results are from a national survey of acute care hospitals. A random sample of 813 hospitals was selected with 115 responding and 33 incorrect addresses resulting in a 15% response rate. The purpose of the study was to measure the extent of information systems integration in the financial, medical, and administrative systems of the hospitals. Internet usage including homepages and advertising was measured. Other selected telecommunication applications are analyzed. As demonstration projects from the literature are compared to the survey results, the potential for hospitals is tremendous. Resulting cost savings could be equally impressive. This information will provide a benchmark for hospitals to determine their position relative to Internet technology and to set goals.

Advertising↗

PubMed1998

Information systems' approaches and designs and facility information: survey of acute care hospitals in the United States.

These survey results are based on a national survey of acute care hospitals. A random sample of 813 hospitals was selected with 115 responding and 33 incorrect address returns resulting in a 15% response rate. The purpose of the study was to measure the extent of information systems integration in the financial, medical, and administrative systems of the hospitals. The rate of adoption of information technology or technology transfer is discussed. Facility demographics are presented. Characteristics of information systems' approaches and designs are reviewed and their implications discussed. This information will provide benchmarks for hospitals to determine their information systems position and to set goals.

Benchmarking↗

PubMed1997

Survey of acute care hospitals in the United States relative to technology usage and technology transfer.

This is a national survey of acute care hospitals. A random sample of 813 hospitals was selected. The purpose of the study was to measure the extent of information systems integration in the financial, medical, and administrative systems of the hospitals. The response rate is expected to be approximately 30%. This information will provide a benchmark for hospitals to determine their technology transfer position and to set goals.

Benchmarking↗