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PubMed1996

Image-guided surgery.

Interventional video tomography (IVT), a new imaging modality, achieves virtual visualization of anatomic structures in three dimensions for intraoperative stereotactic navigation. Partial immersion into a virtual data space, which is orthotopically coregistered to the surgical field, enhances, by means of a see-through head-mounted display (HMD), the surgeon's visual perception and technique by providing visual access to nonvisual data of anatomy, physiology, and function. The presented cases document the potential of augmented reality environments in maxillofacial surgery.

Foreign Bodies↗

PubMed1994

How will computerization revolutionize managed care?

Computerization of behavioral health care information systems is revolutionizing how payors, managed care companies, and providers exchange information. In this article, an imaginary scenario is depicted of how patient data will be accessed and communicated to facilitate care management of behavioral health care services in the near future.

Ambulatory Care Information Systems↗

PubMed2003

DataGrid, prototype of a biomedical grid.

BACKGROUND: The availability of large amounts of data in heterogeneous formats and the rapid progress in fields such as computer based drug design, medical imaging and medical simulations have lead to a growing demand for large computational power and easy accessibility to heterogeneous data sources. OBJECTIVES: The goal is to address these needs by deploying computing grids. Grids provide both large scale and distributed storage facilities and an increased computing power. Moreover, Grids are a promising tool to foster the synergy between bioinformatics and computerised medical imaging. METHODS: A first biomedical grid is being deployed within the framework of the DataGrid IST project (http://www.edg.org). The goal of the project is to provide a novel environment to support globally distributed scientific exploration involving up to multi-Perabyte datasets. RESULTS AND CONCLUSIONS: The first biomedical applications deployed inside the project demonstrate the relevance of the grid paradigm for genomics and medical image processing. They also highlight the specific requirements of the biomedical community.

Biomedical Research↗

PubMed1998

[A topographic anatomical validation of the choice of the approach in reconstructive operations on the extracranial portion of the internal carotid artery].

The purpose of the research was to give a topographical substantiation of the choice of an approach to the extracranial internal carotid artery (ICA) in view of individual anatomical variability of ICA and various localizations of stenosis or occlusion. In 38 human corpses ICA was uncovered using operative methods proposed by Cooper. DePalma, Pauliukas and Nelson. A comparative estimation of the approaches was given with calculation of standard parameters of the operative wound. It was established that the approach to the subcranial ICA was dependent on the type of constitution, features of the anatomical shape of the mandible, distance between the mandibular angle and mastoid process. The statistical processing of the findings has shown that all the factors in question made up 91.5% which is enough for the mathematical description of the position of ICA. Regression models of accessibility of the ICA segment for each of the four investigated approaches were made. The PC program for Windows 95/NT which allows the estimation of accessibility of ICA in each patient before operation was created. These mathematical models were used in the clinic for surgical treatment of the ICA pathology in 24 patients. The difference between the calculated data of ICA accessibility and intraoperative measurements was +/- 3 mm. It demonstrates reliability of the estimation of the approach parameters before operation.

Cadaver↗

PubMed2003

IMGT-ONTOLOGY for immunogenetics and immunoinformatics.

IMGT, the international ImMunoGeneTics information system(R) (http://imgt.cines.fr), is a high quality integrated knowledge resource specializing in immunoglobulins (IG), T cell receptors (TR), major histocompatibility complex (MHC) and related proteins of the immune system (RPI) of human and other vertebrates, created in 1989, by the Laboratoire d'ImmunoGenetique Moleculaire LIGM. IMGT provides a common access to standardized data which include nucleotide and protein sequences, oligonucleotide primers, gene maps, genetic polymorphisms, specificities, 2D and 3D structures. IMGT consists of several sequence databases (IMGT/LIGM-DB, IMGT/MHC-DB, IMGT/PRIMER-DB), one genome database (IMGT/GENE-DB) and one three-dimensional structure database (IMGT/3Dstructure-DB), interactive tools for sequence analysis (IMGT/V-QUEST, IMGT/JunctionAnalysis, IMGT/PhyloGene, IMGT/Allele-Align), for genome analysis (IMGT/GeneSearch, IMGT/GeneView, IMGT/LocusView) and for 3D structure analysis (IMGT/StructuralQuery), and Web resources ("IMGT Marie-Paule page") comprising 8000 HTML pages. IMGT other accesses include SRS, FTP, search by BLAST, etc. By its high quality and its easy data distribution, IMGT has important implications in medical research (repertoire in autoimmune diseases, AIDS, leukemias, lymphomas, myelomas), veterinary research, genome diversity and genome evolution studies of the adaptive immune responses, biotechnology related to antibody engineering (scFv, phage displays, combinatorial libraries) and therapeutical approaches (grafts, immunotherapy). IMGT is freely available at http://imgt.cines.fr.

Animals↗

PubMed2000

Remote access to anatomical information: an integration between semantic knowledge and visual data.

A novel internet-based application is presented which provides access to anatomy knowledge through symbolic modality expressed by keywords taken from controlled or non-controlled terminology. The system is based on a database where anatomical concepts have been organized into a hierarchical framework. Along with term queries that allow retrieving concepts containing or exactly matching the used keyword, the system also provides semantic access to anatomical information. Queries can be setup, which retrieve concepts relying to a particular meaning and sharing a particular relationship. Moreover, the application has the capability to refine the search of the terms by querying the UMLS knowledge server. Anatomical image data have been integrated by using Visible Human Dataset. A set of these images has been indexed according to our anatomical classification and is used inside the application. The system has been implemented through Java client-server technology and works within standard Internet browsers.

Anatomy↗

PubMed1994

The complete sequencing of a 24.6 kb segment of yeast chromosome XI identified the known loci URA1, SAC1 and TRP3, and revealed 6 new open reading frames including homologues to the threonine dehydratases, membrane transporters, hydantoinases and the phospholipase A2-activating protein.

We report the entire sequence of a 26.4 kb segment of chromosome XI of Saccharomyces cerevisiae. Identification of the known loci URA1, TRP3 and SAC1 revealed a translocation compared to the genetic map. Additionally, six unknown open reading frames have been identified. One of them is similar to catabolic threonine dehydratases. Another one contains characteristic features of membrane transporters. A third one is homologous in half of its length to the prokaryotic hydantoinase HyuA and in the other half to hydatoinase HyuB. A fourth one is homologous to the mammalian phospholipase A2-activating protein. A fifth one, finally, is homologous to the hypothetical open reading frame YCR007C of chromosome III. The sequence has been deposited in the EMBL data library under Accession Number X75951.

Amidohydrolases↗

PubMedDate not supplied

Evolution of neuronetworks.

Since the 1970s, the care of critically ill neurologic and neurosurgical patients has emerged as a developing subspecialty. Management of these patients involves an enormous amount of data generation and analysis. Review of the history of neuroepidemiology and neurocritical care demonstrates the inevitability of their present unwiedly burden of information. Compelling advantages of computerization in direct patient care include aid in data acquisition, analysis and remote access. Infrastructure and resources used to collect data on individual patients may be augmented to archive data in clinical databases. Several investigators have initiated information management projects including automation of beside clinical documentation, development of systems for remote access to information and patient registries to study the natural history and outcome of specific neurological conditions. These are steps toward the development of integrated systems to aid in patient monitoring, data management, continuous quality improvement and the generation of hypotheses for further clinical investigation. Improvements in information management technology will allow increased efficiency in an era where information generation continues to increase exponentially.

Critical Care↗

PubMedDate not supplied

Sampling challenges in end-of-life research: case-finding for family informants.

BACKGROUND: Research on end-of-life care is hampered by challenges in accessing appropriate subjects for data collection. Although families of decedents are rich sources of research data, they are underutilized, most likely due to the access difficulties they present to investigators. OBJECTIVES: To describe case-finding strategies that can achieve a large and representative sample of family informants for research studies about end-of-life care. METHODS: Case-finding strategies were developed and honed over the course o fthree epidemiological studies on end-of-life care. Family location information was culled from death certificates and a combination of public and commercial sources. RESULTS: The researchers generated large random samples of study-eligible decedents and, using the case-finding strategies described, recruited family members of decedents as informants. By the third study, two-thirds of family members were located and interviewed within the narrow time frame of 2-5 months following the death of their loved one. DISCUSSION: Epidemiological studies on end-of-life, using large random samples of decedents and their family members, are feasible when armed with an array of effective case finding strategies.

Data Collection↗

PubMed2004

The Malaysian Telehealth Flagship Application: a national approach to health data protection and utilisation and consumer rights.

Telehealth refers to the integration of information, telecommunication, human-machine interface technologies and health technologies to deliver health care, to promote the heath status of the people and to create health. The Malaysian Telehealth Application will, on completion, provide every resident of the country an electronic Lifetime Health Record (LHR) and Lifetime Health Plan (LHP). He or she will also hold a smart card that will contain a subset of the data in the Lifetime Health Record. These will be the means by which Malaysians will receive "seamless continuous quality care" across a range of health facilities and health care providers, and by which Malaysia's health goal of a nation of "healthy individuals, families and communities" is achieved. The challenges to security and privacy in providing access to an electronic Lifetime Health Record at private and government health facilities and to the electronic Lifetime Health Plan at homes of consumers require not only technical mechanisms but also national policies and practices addressing threats while facilitating access to health data during health encounters in different care settings. Organisational policies establish the goals that technical mechanisms serve. They should outline appropriate uses and access to information, create mechanisms for preventing and detecting violations, and set sanctions for violations. Some interesting innovations have been used to address these issues against the background of the launching of the multimedia supercorridor (MSC) in Malaysia.

Computer Security↗

PubMed1997

Virtual reality for orthognathic surgery: the augmented reality environment concept.

PURPOSE: The objective of this study was to apply virtual reality technology to osteotomies of the facial skeleton. MATERIALS AND METHODS: Augmented reality can be considered a hybrid of virtual and real environment spaces, which are coregistered and simultaneously visualized. Using a see-through HMD (head-mounted display) and Interventional Video Tomography intraoperatively, partial visual immersion into a patient-related virtual data space augments the surgeon's perception as shown in an experimental study and clinical applications. RESULTS: Without limiting the surgical judgment, offering continuous observation of the operating field, the presented technology additionally provides visual access to invisible data of anatomy, physiology, and function and thus guarantees unencumbered and fluent surgery. CONCLUSION: Despite current shortcomings, augmented reality technology proved to be particularly well suited for use in osteotomies of the facial skeleton.

Anatomy, Cross-Sectional↗

PubMed1979

Data needs for research in road trauma.

This paper laments the existence of widespread "instant" expertise on road trauma; postulates the need for multidisciplinary epidemiological research teams to produce a more scientific approach to this problem, based on authoritative information and analysis; and suggests that any such teams will require accessible, comprehensive, compatible data. The paper describes some problems of existing data collections associated with the source of the data, the lack of compatibility and comprehensiveness, and the absence of data on exposure and on severity of injury. It is suggested that, in the context of these deficiencies, extensive development of new data is unrealistic. Instead, the paper concludes by recommending gradual expansion of currently available data on a national basis, under the control of the Australian Bureau of Statistics. It is suggested that Section 51 of the Constitution provides the necessary head of power for this development.

Accidents, Traffic↗

PubMed2005

Community-level child health: a decade of progress.

In the late 1980s, the leadership of the South Carolina Chapter of the American Academy of Pediatrics (AAP) developed a growing awareness that there was a population of children in the state who frequented emergency departments and public health clinics but were not considered patients in any medical professional's office. Coincidentally, the commissioner of the South Carolina Department of Health and Environmental Control was struggling to expand resources needed to care for these children, who were crowding his facilities in search of primary care. Department of Health and Environmental Control clinic staff increasingly were unable to provide core public health services because of the need to treat illnesses and conduct well-child visits. Concurrently, with mounting concerns over the inadequacy and/or unavailability of quality health care for all children, the AAP embarked on the Access to Care campaign, a multiyear effort to improve access to care. The South Carolina Chapter of the AAP and Department of Health and Environmental Control subsequently launched an initiative, the Partnerships for Children program, to ensure that South Carolina children who were medically disenfranchised could have a medical home and all other services necessary for health and well-being. Although structured somewhat differently in various communities and practices, each of the >75 partnerships statewide focused on using public health professionals for specific care coordination and support that complemented physician office visits and encounters. These partnerships have gained substantial leverage through the expanding resources of the AAP Access to Care campaign. In reviewing claims for children <3 years old who were enrolled in Medicaid before the establishment of the Partnerships for Children program, <45% had evidence of a well-child visit. Data in the fourth year of the program indicate that 84% of children in this age group have had at least 1 well-child visit. Other data suggesting improved access to care are equally reassuring. In this report, I describe the evolution of the Partnerships for Children program, identify key ingredients for its success, and provide examples of effective strategies that bring community resources into pediatric practices to allow for more efficient and productive delivery of primary care. I also indicate the important role of the AAP Community Access to Child Health infrastructure in the maintenance and further development of this initiative.

Child↗

PubMed2002

A context-sensitive methodology for automatic episode creation.

Episode creation, the task of classifying medical events and related clinical data to a high-level concept, such as a disease, illness or care, has been primarily an interest of healthcare payers for purposes of cost outcomes analysis. Traditional challenges in episode creation have included: inconsistencies in defining episodes; lack of sufficient information to infer episodes; and differences in methods for diagnosing and resolving episodes. However, with the advent of the electronic medical record, which contains multiple sources of patient-related information, data is now accessible to construct more accurate and refined episodes. This work presents a context-sensitive episode creation methodology that utilizes features extracted from different medical repositories (e.g., claims records, structured medical reports) to associate the data with their respective motivating episodes. The combinatorial approach used to find the optimal clustering of patient-related data into episode groups and the measure used to evaluate candidate episode sets are described.

Episode of Care↗

PubMed1998

The object technology framework: an object-oriented interface to molecular data and its application to collagen.

We describe the Object Technology Framework (OTF) software system developed at the University of California, San Francisco Computer Graphics Laboratory for creating C+2 classes that facilitate rapid biomolecular application development and the application of the OTF to collagen modeling. C+2 class libraries for accessing and manipulating data from standard scientific data sources can be generated using the program genlib and its class library toolkit Molecule, thereby facilitating development of new applications. Use of the OTF for generating ideal collagen structural models (gencollagen) is described. The source code for the OTF is freely available at http:/(/)www.cgl.ucsf.edu/off/ to interested application developers.

Collagen↗

PubMed1999

Deep within the filarial genome: progress of the filarial genome project.

Four years ago, a WHO/United Nations Development Programme/World Bank-sponsored genome project to study the filarial lymphatic nematode parasite Brugia malayi was initiated. The project took as its aims gene discovery for drug target and vaccine candidate identification, genome mapping, dissemination of genomic data to the world community and training of endemic country partners in genomic research. In this article, the principal investigators in the laboratories behind the project describe the background to the project, the data now emerging and goals for the future. Open access to filarial genome data is emphasized.

Animals↗

PubMed1996

Transmission of the results of tests for International Olympic Committee-defined drugs of abuse.

The hardware and software facilities for electronic storage, transfer and handling of data is such that multipurpose databases can be made accessible without geographic restriction at low cost. The versatile and flexible underlying structures allow for ease of access and retrieval of data and gives presentation formats fully comparable to printed counterparts. Because of the apparent ease of use and because of the wider distribution of the information, misinterpretation is more likely to occur than in oral or written presentation for more restricted and more culturally homogeneous audiences. This necessitates some degree of harmonisation/standardisation of data on transfer, while allowing local expression forms at sender and receiver ends (Fig. 1). This document is part of an ongoing international effort to agree on some sort of "standardisation" of the transmission and presentation of "laboratory results". It centers on the domain of drugs of abuse as defined by the International Olympic Committee.

Clinical Laboratory Information Systems↗

PubMed1998

Monitoring data and safety in the WHO Antenatal Care Trial.

A committee to monitor data and safety in a large clinical trial should have members with expertise in biostatistics, epidemiology and the clinical field relevant to the trial. Its mandate should cover both logistics and the safety of study subjects, issues which to some extent overlap. While a steering committee and field staff members ideally should be blinded to the experimental and control arms of a randomised clinical trial, the data and safety monitoring committee (DSMC) should have full access to interim trial data to fulfil its role as watchdog. One initial question to be resolved concerns if and when to advise stopping a trial because of danger to study subjects, or on the other hand obvious benefits, in one trial arm. The DSMC of the WHO Antenatal Care Trial decided not to establish any definite stopping rules before implementation. After a scrutiny of the adopted procedures for data collection and handling, the DSMC received monthly reports of recruitment, and individual summary reports of three adverse events by site and trial arm: maternal deaths, fetal deaths and cases of eclampsia. At the time of writing (December 1997) recruitment to the trial is almost complete, but data collection will continue throughout most of 1998, until every index pregnancy has ended in birth or miscarriage. So far, the balance of untoward events between the intervention and control arms have not given cause for alarm.

Argentina↗