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At least 1,567 records · Page 87Linked to original sources
PubMed2002

Delayed hypothermia prevents decreases in N-acetylaspartate and reduced glutathione in the cerebral cortex of the neonatal pig following transient hypoxia-ischaemia.

The effects of normothermia and delayed hypothermia on the levels of N-acetylaspartate (NAA), reduced glutathione (GSH) and the activities of mitochondrial complex I, II-III, IV and citrate synthase were measured in brain homogenates obtained from anaesthetized neonatal pigs following transient in vivo hypoxia-ischaemia. In the normothermic animals there was a significant decrease in complex I activity and in the levels of GSH and NAA when compared to the controls. Delayed hypothermia preserved NAA and GSH at control levels and enhanced the rate of complex II-III activity. There was correlation (R = 0.79) between GSH and NAA levels when data from all three experimental groups were analyzed. Citrate synthase activity was not significantly different in the three groups, indicating maintenance of mitochondrial integrity. These data suggest that delayed hypothermia affords protection of integrated mitochondrial function in the neonatal brain following transient hypoxia-ischaemia.

Animals↗
PubMed2000

Can radiologic images be incorporated into the electronic patient record?

As radiology makes advances toward filmlessness, all of medicine is headed, just as rapidly, toward paperless transmission of patient information. While there are obvious advantages to this electronic approach, and several standards to conform to for the transmission of textual (Health Level 7 [HL-7]) and image (Digital Imaging and Communications in Medicine [DICOM]) data, it is the integration of these two data sets that is clinically essential and yet poorly defined. This report defines an approach for, and the successful implementation of, the integration of radiologic image data with textual data contained within the electronic patient record (EPR) through the use of standard internet protocols. Incorporation of medical images in the EPR has proven to be critical to the successful deployment of picture archiving and communications systems (PACS) and the reduction of film consumption at Massachusetts General Hospital (MGH). Since the installation of the first internet-based Image Data Repository (IDR) at MGH in 1995, the system has adequately served to meet the needs of clinical requests by both radiology-only browser users and users of the EPR. It has drastically reduced the need for film and provided concurrent display of images and text throughout the institution and beyond.

Computer Systems↗
PubMed1998

[Cost-effectiveness--limits between optimization and rationing].

Although rationing is an important feature in the German health care system, this topic is not discussed in an explicit and structured way. Currently, most rationing decisions are not based on systematic data on costs and outcomes of diseases and medical interventions. A major task of future research will be to provide health policy makers with data on direct costs, indirect costs, effectiveness, and utility of medical interventions and to integrate these data into decision analysis models. Interdisciplinary work-groups should be set up, combining clinical and economic knowledge. On the other hand, official grants are needed to perform unbiased research in this field covering the various areas of medical care.

Cost-Benefit Analysis↗
PubMed2005

Research protocol: EB-GIS4HEALTH UK - foundation evidence base and ontology-based framework of modular, reusable models for UK/NHS health and healthcare GIS applications.

EB-GIS4HEALTH UK aims at building a UK-oriented foundation evidence base and modular conceptual models for GIS applications and programmes in health and healthcare to improve the currently poor GIS state of affairs within the NHS; help the NHS understand and harness the importance of spatial information in the health sector in order to better respond to national health plans, priorities, and requirements; and also foster the much-needed NHS-academia GIS collaboration. The project will focus on diabetes and dental care, which together account for about 11% of the annual NHS budget, and are thus important topics where GIS can help optimising resource utilisation and outcomes. Virtual e-focus groups will ensure all UK/NHS health GIS stakeholders are represented. The models will be built using Protege ontology editor http://protege.stanford.edu/ based on the best evidence pooled in the project's evidence base (from critical literature reviews and e-focus groups). We will disseminate our evidence base, GIS models, and documentation through the project's Web server. The models will be human-readable in different ways to inform NHS GIS implementers, and it will be possible to also use them to generate the necessary template databases (and even to develop "intelligent" health GIS solutions using software agents) for running the modelled applications. Our products and experience in this project will be transferable to address other national health topics based on the same principles. Our ultimate goal is to provide the NHS with practical, vendor-neutral, modular workflow models, and ready-to-use, evidence-based frameworks for developing successful GIS business plans and implementing GIS to address various health issues. NHS organisations adopting such frameworks will achieve a common understanding of spatial data and processes, which will enable them to efficiently and effectively share, compare, and integrate their data silos and results for more informed planning and better outcomes.

Journal Article↗
PubMedDate not supplied

The Virtual Hospital: an IAIMS integrating continuing education into the work flow.

Researchers at the University of Iowa are developing an integrated academic information management system (IAIMS) for use on the World Wide Web. The focus is on integrating continuing medical education (CME) into the clinicians' daily work and incorporating consumer health information into patients' life styles. Phase I of the project consists of loosely integrating patients' data, printed library information, and digital library information. Phase II consists of more tightly integrating the three types of information, and Phase III consists of awarding CME credits for reviewing educational, material at the point of patient care, when it has the most potential for improving outcomes. This IAIMS serves a statewide population. Its design and evolution have been heavily influenced by user-centered evaluation.

Attitude to Computers↗
PubMed2026

SIVA: diagonal integration of spatial multi-omics data via spatially informed variational autoencoders and anchor guidance.

MOTIVATION: Understanding cellular states and regulatory programs requires integrative analysis of multiple omics layers. Although recent spatial sequencing technologies allow molecular profiling of cells within their tissue context, paired spatial multi-omics assays are still limited by technical complexity and cost. This creates a pressing need for diagonal integration methods that enable joint analysis of unpaired spatial omics datasets. RESULTS: We propose SIVA, a deep generative framework based on Spatially-Informed Variational Autoencoders with Anchor Guidance, for diagonal integration of spatial multi-modal data. SIVA employs modality-specific variational autoencoders (VAEs) with a hybrid latent embedding that integrates Gaussian process and standard Gaussian priors, enabling joint modeling of spatially structured variation and dominant underlying data distributions across modalities. To facilitate cross-modal alignment in the absence of one-to-one cell correspondence, SIVA adopts a dual integration strategy combining global distribution alignment via Maximum Mean Discrepancy and local correspondence guidance using mutual nearest neighbor anchors. Extensive experiments across multiple cross-slice integration scenarios demonstrate that SIVA achieves robust and accurate integration of unpaired spatial omics datasets, consistently outperforming existing methods. AVAILABILITY AND IMPLEMENTATION: The source codes are available at https://github.com/PelenJiang/SIVA.

Autoencoder↗
PubMed2003

Does HIV status make a difference in the experience of lifetime abuse? Descriptions of lifetime abuse and its context among low-income urban women.

Women living in poor urban communities are doubly disadvantaged with regard to increased risk for two major public health crises in the United States today--HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome) and violence. This study moves beyond the comparison of rates of lifetime abuse among women to incorporate contextual information of the abusive situation and experiences of HIV-positive women and a sample of sociodemographically similar HIV-negative women. A total of 611 women, 310 of whom were diagnosed as HIV positive, provided interviews integrating quantitative data and qualitative text on their lifetime experience of abuse. Quantitative results yielded few statistically significant differences between the lifetime experiences of violence between HIV-positive women and their HIV-negative counterparts. Of the women, 62% reported intimate partner violence, and 38% reported experiencing nonpartner abuse as an adult. A majority of the abused women reported that their alcohol or drug use or their partner's alcohol or drug use was associated with the abuse experienced. Significant differences were found between HIV-positive women and HIV-negative women in the pattern of abuse experienced as a child, the frequency of abuse as an adult, and the involvement of women's drinking before or during a violent episode. Qualitative excerpts from the interviews were found to differ thematically and were integrated with the quantitative data to provide a more comprehensive understanding of the women's contextual situation in understanding interpersonal violence experienced by both HIV-positive and HIV-negative women.

Adult↗
PubMed1994

Nursing research: on what basis?

In the past 150 years nursing science has developed into a discipline of its own which has integrated features of various stages of theory development. So far most nursing theories, originally borrowed from other disciplines, have been adapted and moulded to suit the nursing context. The theories developed after Nightingale, such as developmental, need-oriented, interaction, system-oriented and simultaneity theories have come about this way. They have depicted the areas of interest in nursing which has thus been defined as the domain of main concepts and their interconnections. The methodological characteristics of research in science are derived on the basis of ontological and epistemological principles. The domain of nursing science is assumed to be an integral whole which is not divided into parts even for the purpose of research. Scientific data are obtained from this undivided world by means of man's human signification. In research, this undivided world is approached from the phenomenological tradition of science: particular topics are thematized as something, while the other aspects of the phenomenon are excluded. The accumulating scientific data are integrated to form a holistic body of knowledge which helps in understanding the phenomena in greater depth and from different perspectives. The historical development of nursing science reveals problems and conflicts which are derived from the tradition of empirical science of the last few decades. Research solutions following the empiricist tradition offer only limited opportunities to focus on the central research objects of nursing.(ABSTRACT TRUNCATED AT 250 WORDS)

Data Interpretation, Statistical↗
PubMed1994

Medical data and knowledge management by integrated medical workstations: summary and recommendations.

The health care professional workstation will function as an interface between the user and the patient data as well as an interface pertinent medical knowledge. Appropriate knowledge focus will require the workstation to recognize the concepts and structure of patient data, and understand the scope and access methods of knowledge sources. Issues are organized around five major themes: (i) structure, (ii) reliability and validation, (iii) views, (iv) location, and (v) ethical and legal. Conventional database representations can effectively address data structure and format variations that will inevitably persist in local data stores. The reliability of data and the validation of knowledge are critical issues that may determine the ultimate utility of clinical workstations. Alternative views of patient information and knowledge sources represent the true power of an intelligent data portal, represented by a well-designed clinical workstation. Both data and knowledge are optimally represented in decentralized information networks, although the confidentiality and ownership of this information must be respected. Evolutionary progress toward consistent representations of knowledge and patient data will be facilitated by the establishment of self-documentation standards for the developers of data encoding systems and knowledge sources, perhaps extended from the preliminary model afforded by the Unified Medical Language System (UMLS).

Computer Security↗
PubMed2003

Data security issues arising from integration of wireless access into healthcare networks.

The versatility of having Ethernet speed connectivity without wires is rapidly driving adoption of wireless data networking by end users across all types of industry. Designed to be easy to configure and work among diverse platforms, wireless brings online data to mobile users. This functionality is particularly useful in modern clinical medicine. Wireless presents operators of networks containing or transmitting sensitive and confidential data with several new types of security vulnerabilities, and potentially opens previously protected core network resources to outside attack. Herein, we review the types of vulnerabilities, the tools necessary to exploit them, and strategies to thwart a successful attack.

Computer Communication Networks↗
PubMed1990

Estimating respiratory volumes from rib cage and abdominal displacements during ventilatory and speech activities.

This methodological study examined the predictive strength associated with modeling respiratory volumes from chest-wall movements during selected ventilatory and speech activities. A linearized magnetometry system transduced the anterior-posterior diameters of the rib cage and abdomen, supplying kinematic data that were used to estimate respiratory volumes. Kinematic and airflow measures were acquired during (a) tidal ventilation, (b) vital capacity maneuvers, (c) Rainbow Passage reading at customary loudness, (d) Rainbow Passage reading at twice-customary loudness, (e) extemporaneous speech, and (f) /a/ prolongation. Multiple-regression statistics were applied to the body surface and integrated airflow data to obtain (a) intercepts, (b) volume-motion coefficients for the rib cage and abdomen, and (c) coefficients of determination. Volumes estimated by applying regression-derived intercepts and volume-motion coefficients to the respiratory kinematic data were then compared to integrated airflow signals. Two magnetometer-based, volume-estimation strategies were contrasted for the speech tasks, one based on volume-motion coefficients derived from that particular speech activity and one based on volume-motion coefficients derived from tidal ventilation. Regression-derived intercepts and volume-motion coefficients for the abdomen varied significantly across subjects but not tasks. Volume-motion coefficients for the rib cage varied significantly across both subjects and tasks. Coefficients of determination for the magnetometer-based volume estimates were affected significantly by subjects and tasks but not by volume-estimation strategies. The calibration, use, and potential limitation of respiratory kinematic devices for speech research are discussed.

Abdomen↗
PubMed2001

Schizophrenia--progressive and massive decline in response readiness by episodes.

OBJECTIVE: To relate the pattern of neuropsychological impairments among schizophrenic patients to case history data and disease characteristics in a cross-sectional study of unselected patients, and to integrate these data with two previous longitudinal studies of neuropsychological impairments among schizophrenic patients. METHOD: One hundred consecutive schizophrenic patients were studied with respect to clinical case history and current symptoms, medication and neuropsychological impairment using a comprehensive computerized test battery. RESULTS: The most salient finding was a marked slowing of response readiness, linearly related to the number of previous acute episodes. The resulting deficit was far beyond what has been obtained in any other group of subjects (average -6 SD for >five episode patients). The impairments in many of the other neuropsychological parameters could to some extent be explained with reference to response slowing, with one exception--verbal short-term memory. Adjustment for important confounding factors (age, duration of illness, medication) did not change the strong negative association between response readiness and number of previous episodes. CONCLUSION: These findings, together with findings of our two previous longitudinal studies and a recent replication, prompted us to suggest that each acute schizophrenic episode inflicts damage to a set of hypothetical structures, cognitive pattern generators. We assume that these structures translate intentions to logistic programs. When damaged, delays are introduced into executive functions and corollary discharge processes will run out of phase with intentions. This model implicates new ways of looking at the generative mechanisms of the illness, and on treatment strategies.

Adult↗
PubMed2002

BBS4 is a minor contributor to Bardet-Biedl syndrome and may also participate in triallelic inheritance.

Bardet-Biedl syndrome (BBS) is an uncommon multisystemic disorder characterized primarily by retinal dystrophy, obesity, polydactyly, and renal dysfunction. BBS has been modeled historically as an autosomal recessive trait, under which premise six independent BBS loci (BBS1-BBS6) have been mapped in the human genome. However, extended mutational analyses of BBS2 and BBS6, the first two BBS genes cloned, suggest that BBS exhibits a more complex pattern of inheritance, in which three mutations at two loci simultaneously are necessary and sufficient in some families to manifest the phenotype. We evaluated the spectrum of mutations in the recently identified BBS4 gene with a combination of haplotype analysis and mutation screening on a multiethnic cohort of 177 families. Consistent with predictions from previous genetic analyses, our data suggest that mutations in BBS4 contribute to BBS in <3% of affected families. Furthermore, integrated mutational data from all three currently cloned BBS genes raise the possibility that BBS4 may participate in triallelic inheritance with BBS2 and BBS1, but not the other known loci. Establishment of the loci pairing in triallelism is likely to be important for the elucidation of the functional relationships among the different BBS proteins.

Alleles↗
PubMed2006

A system for automated lexical mapping.

OBJECTIVE: To automate the mapping of disparate databases to standardized medical vocabularies. BACKGROUND: Merging of clinical systems and medical databases, or aggregation of information from disparate databases, frequently requires a process whereby vocabularies are compared and similar concepts are mapped. DESIGN: Using a normalization phase followed by a novel alignment stage inspired by DNA sequence alignment methods, automated lexical mapping can map terms from various databases to standard vocabularies such as the UMLS (Unified Medical Language System) and LOINC (Logical Observation Identifier Names and Codes). MEASUREMENTS: This automated lexical mapping was evaluated using three real-world laboratory databases from different health care institutions. The authors report the sensitivity, specificity, percentage correct (true positives plus true negatives divided by total number of terms), and true positive and true negative rates as measures of system performance. RESULTS: The alignment algorithm was able to map 57% to 78% (average of 63% over all runs and databases) of equivalent concepts through lexical mapping alone. True positive rates ranged from 18% to 70%; true negative rates ranged from 5% to 52%. CONCLUSION: Lexical mapping can facilitate the integration of data from diverse sources and decrease the time and cost required for manual mapping and integration of clinical systems and medical databases.

Algorithms↗
PubMed2005

Quebec mental health services networks: models and implementation.

PURPOSE: In the transformation of health care systems, the introduction of integrated service networks is considered to be one of the main solutions for enhancing efficiency. In the last few years, a wealth of literature has emerged on the topic of services integration. However, the question of how integrated service networks should be modelled to suit different implementation contexts has barely been touched. To fill that gap, this article presents four models for the organization of mental health integrated networks. DATA SOURCES: The proposed models are drawn from three recently published studies on mental health integrated services in the province of Quebec (Canada) with the author as principal investigator. DESCRIPTION: Following an explanation of the concept of integrated service network and a description of the Quebec context for mental health networks, the models, applicable in all settings: rural, urban or semi-urban, and metropolitan, and summarized in four figures, are presented. DISCUSSION AND CONCLUSION: To apply the models successfully, the necessity of rallying all the actors of a system, from the strategic, tactical and operational levels, according to the type of integration involved: functional/administrative, clinical and physician-system is highlighted. The importance of formalizing activities among organizations and actors in a network and reinforcing the governing mechanisms at the local level is also underlined. Finally, a number of integration strategies and key conditions of success to operationalize integrated service networks are suggested.

Journal Article↗
PubMed1999

Genome-scale Gene Expression Analysis and Pathway Reconstruction in KEGG.

The massively parallel hybridization technologies by DNA chips and microarrays make it possible to monitor expression patterns of the whole set of genes in a genome under various conditions. The vast amount of data generated by such technologies necessitates the development of a new database management system that integrates expression data with other molecular biology databases and various analysis tools. We report here an extension of our KEGG (Kyoto Encyclopedia of Genes and Genomes) and DBGET/LinkDB systems for analyzing gene expression data in conjunction with pathway information and genomic information. It is now possible to make use of expression data for the reconstruction of pathways from the complete genome sequences.

Journal Article↗
PubMed2002

Knowledge-based bioterrorism surveillance.

An epidemic resulting from an act of bioterrorism could be catastrophic. However, if an epidemic can be detected and characterized early on, prompt public health intervention may mitigate its impact. Current surveillance approaches do not perform well in terms of rapid epidemic detection or epidemic monitoring. One reason for this shortcoming is their failure to bring existing knowledge and data to bear on the problem in a coherent manner. Knowledge-based methods can integrate surveillance data and knowledge, and allow for careful evaluation of problem-solving methods. This paper presents an argument for knowledge-based surveillance, describes a prototype of BioSTORM, a system for real-time epidemic surveillance, and shows an initial evaluation of this system applied to a simulated epidemic from a bioterrorism attack.

Artificial Intelligence↗
PubMedDate not supplied

[Clinical approach of asthma (author's transl)].

The identification of asthma is based on the analysis of clinical data. The integration of such individual and subtle information into the field of epidemiology requires that these data be comparable, collective, and suitable for statistical use. With this in mind, only a broad conception of the asthmatic condition, with a specific definition, would eliminate the possibility of not recognizing an asthmatic subject in a given group. A fundamental basis is given in a general questionnaire which enables a qualitative and quantitative evaluation, the establishment of a scale of severity, and a nosologic classification of asthma. This questionnaire should eventually include specific questions adapted to the objectives of the investigation to be carried out.

Absenteeism↗