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PubMed2002

Deterministic modelling of integrated urban drainage systems.

Today, the main concepts required for describing the dynamics of drainage in an entire urban area are known and models are available that can reasonably simulate the behaviour of the urban water system. Still, such integrated modelling is a complex exercise not only due to the sheer size of the model, but also due to the different modelling approaches that reflect the history of the sub-models used and of the purpose they were built for. The paper reviews the state of the art in deterministic modelling, outlines experiences and discusses problems and future developments.

Cities↗

PubMed2005

HIV/AIDS and homelessness, Part 1: background and barriers to care.

Co-occurrence of homelessness and HIV/AIDS poses a complex and multidimensional challenge to the health care provider's clinical and system integration skills. Existing data support the high prevalence of HIV/AIDS among homeless persons and a high percentage of persons living with HIV/AIDS being either homeless or at imminent risk for homelessness. There are special considerations and challenges health care providers may face in caring for homeless persons with HIV/AIDS. An integrated, flexible, interdisciplinary, community-based system of care addressing the full array of medical, psychiatric/substance abuse, and housing services would optimize clinical care for this population. Areas that deserve particular attention include HIV/AIDS prevention, access to comprehensive HIV and health care, use of antiretroviral therapy, and adherence to treatment. Research is needed to better understand the multifaceted needs of this population and to develop prevention and treatment strategies applicable to daily clinical care.

Female↗

PubMed1990

Glucose homeostasis and endogenous opioid peptides.

The primary objective of this review is to give an overview of the relationship between opioid peptides and glucose homeostasis. Although extensive work has been done regarding the role of endogenous opioid peptides, the existing evidences seem preliminary. The probability of endogenous opioid systems representing a part of an integrated system involving different neurotransmitters appears to be the basis for some of the discrepant data. Much research work remains to be done before a clear understanding of the physiological and/or pathophysiological role of endogenous opioids in glucose homeostasis could emerge.

Animals↗

PubMed1977

Immunostimulation or immunodepression?

Our experimental studies and extensive literature survey established that the overall response of an experimentally modified host defense system is strongly dose-dependent, irrespective of either the modifying agent or the test model system. If a sufficiently broad dose range is used, an irregular, nonlinear, nonmonotonic response curve is formed, generally W- or M-shaped, depending on the parameters selected for the representation, with two peaks of relative maximal effect. Accordingly, a modifying agent may exhibit, in some cases, dual effect--stimulation and depression, each at different dose levels. This typical response is defined as characteristic of the entire host defense system and therefore implies a biologically integrated system. The described dose-response relationship mandates the use of multiple doses in evaluation experiments, to establish efficacy and especially to design optimal dose schedules for experimental and clinical application of any agent modifying the host defense system activity.

Adjuvants, Immunologic↗

PubMedDate not supplied

A servomechanical system to control high blood pressure using sodium nitroprusside.

A servomechanical device was used to control the intravenous administration of a sodium nitroprusside solution, without using electrical energy or a pump, the aim being the fast and smooth reduction of high arterial pressure (BP). The device senses BP via an intra-arterial catheter which leads to two containers, to one through a narrow tube (slow system) and to the other through a wide tube (fast system). The two systems integrate the BP with time constants that are the product of the tube resistance to flow and the compliance of the containers. The two systems lead to small bellows that interfere with the legs of a clamp regulating an intravenous nitroprusside drip. The distension of the bellows releases the clamp in proportion to the pressure in the slow system and to the difference in pressure between the fast and the slow systems. A screw-spring could determine the desired slow system pressure below which the flow of the nitroprusside solution was stopped. The whole device was applied 11 times in five anaesthetized dogs under a continuous intravenous metaraminol infusion. The BP was always reduced smoothly within 2 to 24 min to a value near that predetermined by the screw-spring. It is concluded that a purely mechanical system involving integral, proportional and derivative components may achieve fast and smooth reduction of elevated BP to a predetermined level, when using fast-acting hypotensive agents.

Animals↗

PubMed1993

Intracorporeal retrograde choledocholithotripsy or ESWL as a therapy for choledocholithiasis.

More than 90% of all common bile duct stones can be removed endoscopically following endoscopic sphincterotomy aided by the use of baskets, balloon catheters and mechanical lithotripsy. Oversized, very hard or impacted stones, however, often resist conventional endoscopic therapy. Promising new or improved approaches to the treatment of these stones are intracorporeal or extracorporeal shockwave lithotripsy. Shockwave lithotriptors for ESWL are currently available worldwide. However, to treat with the water-bath first generation devices general anaesthesia is required, since shockwaves are painful. Furthermore, an X-ray localization system is essential to visualize the stones after opacification of the bile duct via a nasobiliary catheter. On average, two shockwave treatments with a further one to four endoscopic sessions are required. Intracorporeal lithotripsy promises more comfort and less effort for the patient. Shockwaves are generated either by means of the spark gap principle (electrohydraulic probes) or by laser-induced plasma generation. Laser-induced shockwave lithotripsy appears to be the safer procedure, since with solid state lasers (Q-switched Nd: YAG, alexandrite) athermal, well controlled shockwaves can be generated without the risks of duct perforation (as described for the electrohydraulic system). Furthermore, a recently developed stone-tissue detection system integrated in a new dye laser system (Lithognost) enhances the safety of laser-induced lithotripsy. In consequence, laser lithotripsy without direct endoscopic control appears possible in selected cases.

Endoscopy, Digestive System↗

PubMed2006

Race/ethnicity, substance abuse, and mental illness among suicide victims in 13 US states: 2004 data from the National Violent Death Reporting System.

OBJECTIVE: To calculate the prevalence of substance abuse and mental illness among suicide victims of different racial/ethnic groups and to identify race/ethnicity trends in mental health and substance abuse that may be used to improve suicide prevention. METHODS: Data are from the National Violent Death Reporting System (NVDRS), a state-based data integration system that, for 2004, includes data from 13 US states. The NVDRS integrates medical examiner, toxicology, death certificate, and law enforcement data. RESULTS: Within participating states, for data year 2004, 6865 suicide incidents in which race/ethnicity are known were identified. This included 5797 (84.4%) non-Hispanic whites, 501 (7.3%) non-Hispanic blacks, 257 (3.7%) Hispanics, and 310 (4.5%) persons from other racial/ethnic groups. At the time of the suicide event, non-Hispanic blacks had lower blood alcohol contents than other groups. Non-Hispanic whites had less cocaine but more antidepressants and opiates. There were no differences in the levels of amphetamines or marijuana by race/ethnicity. Hispanics were less likely to have been diagnosed with a mental illness or to have received treatment, although family reports of depression were comparable to non-Hispanic whites and other racial/ethnic groups. Non-Hispanic whites were more likely to be diagnosed with depression or bipolar disorder and non-Hispanic blacks with schizophrenia. Comorbid substance abuse and mental health problems were more likely among non-Hispanic whites and non-Hispanic blacks, while Hispanics were more likely to have a substance abuse problem without comorbid mental health problems. CONCLUSION: The results support earlier research documenting differences in race/ethnicity, substance abuse, and mental health problems as they relate to completed suicide. The data suggest that suicide prevention efforts must address not only substance abuse and mental health problems in general, but the unique personal, family, and social characteristics of different racial/ethnic groups.

Adolescent↗

PubMed1995

Are the Twin Cities a Stage V marketplace?

The Twin Cities continues to be an outstanding laboratory for discovering what could be the future in many other markets. Over the last year or two it has been the site of massive consolidation among hospitals, physicians and health plans. Even as the entire infrastructure for healthcare financing and delivery has changed, the state has turned in a good performance in comparison with national cost averages. It is hard to beat premium levels that are 25%-35% lower than national benchmarks. And, these have been achieved by the marketplace, not by government. Nevertheless, employers aren't completely satisfied and the sources of discontent are very instructive. The natural course of market change throughout the country is consolidation from many fragmented competing groups down to a handful of large integrated systems. From an employer/consumer perspective, this natural evolution will reduce competition, concentrate power, eliminate choice, weaken the employer's negotiating leverage, discourage innovation, and reduce the responsiveness and sensitivity to customer service needs. Strategies have to be devised by those engaged in integrated health systems development to counter the perception that consolidation is only an attempt to grab market share. True integration should produce demonstrable improvements in the quality, coordination and delivery of care. But, the trick is understanding the employer and consumer perspective on "improvements". The financing and delivery of healthcare has literally been hidden inside a "black box" for as far back as anyone can remember.(ABSTRACT TRUNCATED AT 250 WORDS)

Capitation Fee↗

PubMed2004

Web-based electronic patient records for collaborative medical applications.

We developed a web-based system to interactively display electronic patient records (EPR), such as DICOM images, graphics, and structure reports and therapy records, for intranet and internet collaborative medical applications. This system has three major components, a C/S (client/server) architecture for EPR data acquisition and authoring, and a Web B/S architecture for data delivering. The Web viewer of this system integrates multi-media display modules and remote control module together to provide interactive EPR display and manipulation functions for collaborative applications. We have successfully used this system two times to provide teleconsultation for severe acute respiratory syndrome (SARS) patients in Shanghai Infection Hospital and Xinhua Hospital. During the consultation, both the physicians in infection control area and the experts outside the control area could use this system interactively to manipulate and navigate the EPR objects of the SARS patients to facilitate a more precise diagnosis. This paper gives a new approach to create and manage image-based EPR from actual patient records, and also presents a novel method to use Web technology and DICOM standard to build an open architecture for collaborative medical applications. The system can be used for both intranet and internet medical applications such as tele-diagnosis, teleconsultation, and distant learning.

China↗

PubMed2004

Computerized plastic surgery office.

PURPOSE OF REVIEW: Technology in general and computer capabilities in particular are growing at an exponential rate. Keeping current with the latest technological capacities and means of incorporating this technology into the facial plastic surgeon's office poses a significant challenge. This review will document the most appropriate method of incorporation and the latest available technological tools. RECENT FINDINGS: Recent developments in wireless networking, systems integration, digital photography and video, powerful inexpensive computer systems, and the growth of personal digital assistant integration have all contributed to a surge in technological advances. Implementing any or all can significantly benefit the busy facial plastic surgery office. SUMMARY: Keeping abreast of technological advances is a daunting task. Adaptation of these advances into the office can at times be overwhelming. This review will assist the practicing physician in incorporating selective technological tools to streamline his or her systems and increase efficiency.

Ambulatory Care Information Systems↗

PubMed1998

A decision tree system for finding genes in DNA.

MORGAN is an integrated system for finding genes in vertebrate DNA sequences. MORGAN uses a variety of techniques to accomplish this task, the most distinctive of which is a decision tree classifier. The decision tree system is combined with new methods for identifying start codons, donor sites, and acceptor sites, and these are brought together in a frame-sensitive dynamic programming algorithm that finds the optimal segmentation of a DNA sequence into coding and noncoding regions (exons and introns). The optimal segmentation is dependent on a separate scoring function that takes a subsequence and assigns to it a score reflecting the probability that the sequence is an exon. The scoring functions in MORGAN are sets of decision trees that are combined to give a probability estimate. Experimental results on a database of 570 vertebrate DNA sequences show that MORGAN has excellent performance by many different measures. On a separate test set, it achieves an overall accuracy of 95 %, with a correlation coefficient of 0.78, and a sensitivity and specificity for coding bases of 83 % and 79%. In addition, MORGAN identifies 58% of coding exons exactly; i.e., both the beginning and end of the coding regions are predicted correctly. This paper describes the MORGAN system, including its decision tree routines and the algorithms for site recognition, and its performance on a benchmark database of vertebrate DNA.

Algorithms↗

PubMed2026

Improving a Tn7-based luciferase reporter system for promoter activity studies.

Single-copy chromosomal integration systems are essential tools for stable gene expression in bacteria, minimizing variability associated with plasmid-based systems. The Tn7 transposon-based system is widely used for this purpose, and one important application is the generation of reporter systems, such as the bioluminescent luxCDABE operon (lux). However, current Tn7-lux vectors exhibit undesirable background expression due to cryptic promoter activity near the antibiotic resistance cassette. Here, we report the construction of an improved vector, pTn7-lux-B0015, incorporating a strong synthetic terminator upstream of the lux operon. This modification effectively eliminated basal luminescence in the absence of a promoter and enhanced the dynamic range and responsiveness of the reporter. Using a Xanthomonas citri type III secretion system promoter as a model, we demonstrate that pTn7-lux-B0015 enables more accurate detection of gene expression under relevant growth conditions. This vector provides a valuable tool for the development of precise and tunable bioluminescent reporters in bacterial systems.

Promoter Regions, Genetic↗

PubMed1990

The axial palatine system in fishes.

The premaxilla in fishes forms biomechanically integrated system and is composed of trunk, prevomer and frontal process. The palatine bone consists of paired vomeri and transverse laminae.

Animals↗

PubMed2000

Radiologist's clinical information review workstation interfaced with digital dictation system.

Efficient access to information systems integrated into the radiologist's interpretation workflow will result in a more informed radiologist, with an enhanced capability to render an accurate interpretation. We describe our implementation of radStation, a radiologist's clinical information review workstation that combines a digital dictation station with a clinical information display. radStation uses client software distributed to the radiologist's workstation and central server software, both running Windows NT (Microsoft, Redmond, WA). The client system has integrated digital dictation software. The bar-code microphone (Boomerang, Dictaphone Corp, Stratford, CT) also serves as a computer input device forwarding the procedure's accession number to the server software. This initiates multiple queries to available legacy databases, including the radiology information system (RIS), laboratory information system, clinic notes, hospital discharge, and operative report system. The three-tier architecture then returns the clinical results to the radStation client for display. At the conclusion of the dictation, the digital voice file is transferred to the dictation server and the client notifies the RIS to update the examination status. The system is efficient in its information retrieval, with queries displayed in about 1 second. The radStation client requires less than 5 minutes of radiologist training in its operation, given that its control interface integrates with the well-learned dictation process. The telephone-based dictation system, which this new system replaced, remains available as a back-up system in the event of an unexpected digital dictation system failure. This system is well accepted and valued by the radiologists. The system interface is quickly mastered. The system does not interrupt dictation workflow with the display of all information initiated with examination bar-coding. This system's features could become an accepted model as a standard tool for radiologists.

Data Collection↗

PubMed2005

A data integration methodology for systems biology: experimental verification.

The integration of data from multiple global assays is essential to understanding dynamic spatiotemporal interactions within cells. In a companion paper, we reported a data integration methodology, designated Pointillist, that can handle multiple data types from technologies with different noise characteristics. Here we demonstrate its application to the integration of 18 data sets relating to galactose utilization in yeast. These data include global changes in mRNA and protein abundance, genome-wide protein-DNA interaction data, database information, and computational predictions of protein-DNA and protein-protein interactions. We divided the integration task to determine three network components: key system elements (genes and proteins), protein-protein interactions, and protein-DNA interactions. Results indicate that the reconstructed network efficiently focuses on and recapitulates the known biology of galactose utilization. It also provided new insights, some of which were verified experimentally. The methodology described here, addresses a critical need across all domains of molecular and cell biology, to effectively integrate large and disparate data sets.

Chromatin Immunoprecipitation↗

PubMed2003

Evolving from bioinformatics in-the-small to bioinformatics in-the-large.

We argue the significance of a fundamental shift in bioinformatics, from in-the-small to in-the-large. Adopting a large-scale perspective is a way to manage the problems endemic to the world of the small-constellations of incompatible tools for which the effort required to assemble an integrated system exceeds the perceived benefit of the integration. Where bioinformatics in-the-small is about data and tools, bioinformatics in-the-large is about metadata and dependencies. Dependencies represent the complexities of large-scale integration, including the requirements and assumptions governing the composition of tools. The popular make utility is a very effective system for defining and maintaining simple dependencies, and it offers a number of insights about the essence of bioinformatics in-the-large. Keeping an in-the-large perspective has been very useful to us in large bioinformatics projects. We give two fairly different examples, and extract lessons from them showing how it has helped. These examples both suggest the benefit of explicitly defining and managing knowledge flows and knowledge maps (which represent metadata regarding types, flows, and dependencies), and also suggest approaches for developing bioinformatics database systems. Generally, we argue that large-scale engineering principles can be successfully adapted from disciplines such as software engineering and data management, and that having an in-the-large perspective will be a key advantage in the next phase of bioinformatics development.

Computational Biology↗

PubMed2002

Application of an integrated environmental monitoring system to an incineration plant.

An integrated environmental monitoring system is an innovative approach which allows remarkable understanding of impacts due to a contamination source. Here we report results from environmental monitoring near a typical Italian incinerator plant. By means of mathematical dispersion models, zones of maximum pollutant depositions were determined; according to these simulations, a defined monitoring network was established. Heavy metals, chosen as environmental indicators, showed a wide flux range in gas emissions from the incinerator, over different sampling years. In particular, emissions in the year 2000 were marked by high Pb and Cd concentrations. Correspondingly, soil samples also exhibited a greater concentration of the same metals in 2000, than in previous years. Principal component analysis allowed a better visualisation of these similarities, also showing an interesting correlation between heavy metals observed both in gas emissions and in soil samples. Soil distant from the incinerator was found to be less affected by heavy metal contamination. Also atmospheric wet and dry depositions indicated a significant dependence on distance from incinerator, though extremely variable metal fluxes were registered during different months. Finally, vegetation samples, seasonal or evergreen, did not provide evidence of a significant heavy metal enrichment, apart from an apparent dependence on contamination source distance.

Air Movements↗

PubMed2001

Issues and opportunities in public health informatics: a panel discussion.

A panel was convened at the American Medical Informatics Association Spring Congress to discuss issues and opportunities that arise when informatics methods, theories, and applications are applied to public health functions. Panelists provided examples of applications that connect efforts between public health and clinical care, emphasizing the need for integration of clinical data with public health data and the analysis of those data to support surveillance and informed decision making. Benefits to be gained by both medical informatics and public health at the interface were evident; both encounter the same major issues including privacy, systems integration, standards, and many more.

Congresses as Topic↗