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At least 1,711 records · Page 95Linked to original sources
PubMed2006

MobileMed: a PDA-based mobile clinical information system.

Patient clinical data are distributed and often fragmented in heterogeneous systems, and therefore the need for information integration is a key to reliable patient care. Once the patient data are orderly integrated and readily available, the problems in accessing the distributed patient clinical data, the well-known difficulties of adopting a mobile health information system, are resolved. This paper proposes a mobile clinical information system (MobileMed), which integrates the distributed and fragmented patient data across heterogeneous sources and makes them accessible through mobile devices. The system consists of four main components: a smart interface, an HL7 message server (HMS), a central clinical database (CCDB), and a web server. The smart interface and the HMS work in concert to generate HL7 messages from the existing legacy systems, which essentially send the patient data in HL7 messages to the CCDB to be stored and maintained. The CCDB and the web server enable the physicians to access the integrated up-to-date patient data. By proposing the smart interface approach, we provide a means for effortless implementation and deployment of such systems. Through a performance study, we show that the HMS is reliable yet fast enough to be able to support efficient clinical data communication.

Computer Communication Networks↗
PubMed2005

[DSMB. 1. What role, what responsibilities?].

In addition to the IRB (Institutional review board), the DSMB (data safety and monitoring board) takes an increasing role in the monitoring of clinical trials, especially in large multicenter trials. The DSMB is a an expert committee, independent from the investigators and the sponsor of the trial, which periodically examines the safety data accumulated during progress of the trial and ensures that the benefit/risk ratio remains acceptable for participating patients. The DSMB is also a safeguard for the scientific integrity of the trial. It is the only committee which can have access to unblinded data from the trial. The DSMB may recommend termination of the trial in three situations : (1) occurrence of unanticipated adverse events which may pose a serious risk for participating patients; (2) demonstration of efficacy before the planned accrual \; (3) and because of "futility" (the most difficult situation), i.e. in absence of a reasonable probability that the trial may reach a conclusion within its planned frame.

Clinical Trials Data Monitoring Committees↗
PubMed2022

Evaluation of cross-platform compatibility of a DNA methylation-based glucocorticoid response biomarker.

BACKGROUND: Identifying blood-based DNA methylation patterns is a minimally invasive way to detect biomarkers in predicting age, characteristics of certain diseases and conditions, as well as responses to immunotherapies. As microarray platforms continue to evolve and increase the scope of CpGs measured, new discoveries based on the most recent platform version and how they compare to available data from the previous versions of the platform are unknown. The neutrophil dexamethasone methylation index (NDMI 850) is a blood-based DNA methylation biomarker built on the Illumina MethylationEPIC (850K) array that measures epigenetic responses to dexamethasone (DEX), a synthetic glucocorticoid often administered for inflammation. Here, we compare the NDMI 850 to one we built using data from the Illumina Methylation 450K (NDMI 450). RESULTS: The NDMI 450 consisted of 22 loci, 15 of which were present on the NDMI 850. In adult whole blood samples, the linear composite scores from NDMI 450 and NDMI 850 were highly correlated and had equivalent predictive accuracy for detecting DEX exposure among adult glioma patients and non-glioma adult controls. However, the NDMI 450 scores of newborn cord blood were significantly lower than NDMI 850 in samples measured with both assays. CONCLUSIONS: We developed an algorithm that reproduces the DNA methylation glucocorticoid response score using 450K data, increasing the accessibility for researchers to assess this biomarker in archived or publicly available datasets that use the 450K version of the Illumina BeadChip array. However, the NDMI850 and NDMI450 do not give similar results in cord blood, and due to data availability limitations, results from sample types of newborn cord blood should be interpreted with care.

Adult↗
PubMed1995

Principles of multimodal imaging.

Current medical practice deals with a variety of multimodal information (X-ray film, ultrasound, CT, MR, ECG and EEG, laboratory results, medical records, etc.) Diagnosis and treatment demand an integrated view of this information including the patient's record and history. This paper describes multimodal imaging approaches to such a system with regard to (i) user interface, (ii) data management (including access control), (iii) registration and modality matching based on reference models, and (iv) interface to the modalities.

Data Display↗
PubMed2004

The use of a spatial information system in the management of HIV/AIDS in South Africa.

BACKGROUND: South Africa is experiencing an HIV/AIDS pandemic of shattering dimensions. The availability and provision of antiretroviral (ARV) drugs could bring relief to the situation, but the treatment is unfortunately complex with each patient being assigned a different antiretroviral therapy varying in diet-medication regiment. The context of South Africa, its variety of urban and rural settings adds to the challenge of administering and monitoring the HIV+ person throughout the treatment, which will last for the rest of their lives. The lack of physical infrastructure, reliable statistics and adequate resources hinder the efficient management of HIV/AIDS. RESULTS: The collection of reliable data will be a first step to assess the status of HIV/AIDS in communities. A number of hospitals have started this process using the conventional approach to collect information about their patients using a paper-based system. Since time is of essence in the fight against the pandemic, data exchange between various hospitals, municipalities and decision-making bodies is becoming more and more important. The logical response to such a need is a computerised system, which will collect and administer HIV/AIDS related information within the local context and allow a monitored access to the data from a number of stakeholders. CONCLUSIONS: The purpose of this study was to design and develop an HIV/AIDS database, which is embedded in a Spatial Information Management System. The pilot study area is the Gugulethu township in Cape Town where more than 27% of the 325 000 residents are HIV+. It is shown that the implementation of the HIV/AIDS database and the Spatial Information Management System can play a critical role in determining where and when to intervene, improving the quality of care for HIV+ patients, increasing accessibility of service and delivering a cost-effective mode of information.

Journal Article↗
PubMedDate not supplied

Promoting U.S. census data in an academic environment: opportunities and challenges.

"The library at Montana State University, Bozeman...has undertaken structured efforts to promote wider use of census data [in CD-ROM format] among the university community. Several workshops and instructional sessions are described...[and] handouts for some sessions are included. These...activities are described in the context of budgetary and service issues faced by libraries providing access to census data in electronic formats.... The success of these efforts is assessed, and libraries' response to new expectations for service is also discussed."

Americas↗
PubMed2003

Seizure identification by clinical description in temporal lobe epilepsy: how accurate are we?

OBJECTIVE: To determine the accuracy of the clinical history performed by epileptologists in the identification of seizures in patients with suspected temporal lobe epilepsy. METHODS: The clinical and EEG telemetry (EEGT) monitoring data of 88 patients with suspected refractory temporal lobe seizures referred for evaluation of epilepsy surgery were prospectively evaluated. All clinical events obtained by history in these patients were adjudicated as being a seizure or not by two blinded (without access to EEG data) independent epileptologists. Each clinical event was then matched with the corresponding clinical event recorded with EEG telemetry in the epilepsy monitoring unit (gold standard). Sensitivity, specificity, overall accuracy, predictive value, and interrater agreement for the clinical assessment were obtained. RESULTS: Of 357 clinically different events, 175 (49%) were reproduced in the epilepsy monitoring unit. Only 10 events were misidentified by history as being a seizure or not, resulting in an overall clinical accuracy of 94%. Epileptologists' sensitivity for seizure identification was 96% (95% CI 92, 98%) but specificity was only 50% (95% CI 22, 79%). Accuracy for complex partial seizures and generalized seizures was higher than for simple partial seizures (SPS). Misidentification occurred only with SPS and nonepileptic events. Agreement beyond chance among epileptologists was good. CONCLUSION: In this selected group of patients with temporal lobe epilepsy, seizure identification by clinical history is highly accurate. Epileptologists rarely miss seizures (high sensitivity) but more often overcall nonepileptic events as seizures (low specificity).

Adult↗
PubMed1985

Sensitivity of time allocation to concurrent-schedule reinforcement.

Four pigeons were trained on concurrent variable-interval schedules programmed on a center response key, with access to those schedules controlled by responses on left or right side keys. Two procedures were used. In one, the pigeon was given limited access, in that each side-key response produced 3-s access to a center-key schedule, and in the other procedure, access was unlimited. Data were analyzed using the generalized matching law. Comparison of sensitivities to reinforcement of interchangeover time for both procedures showed them to be of similar magnitude. Response sensitivities were also similar in magnitude for both procedures. From the limited-access procedure a second time measure that was available, switched-in time, was relatively uncontaminated by time spent emitting behavior other than key pecking. Sensitivities to reinforcement for the switched-in time measure were always smaller than interchangeover-time sensitivities for either procedure, and were approximately equal to response sensitivities for the limited-access procedure. Two other access times (5 and 7.5 s) were studied to validate the choice of 3 s as the main access time. These results indicate that when time spent emitting other behavior is excluded from interchangeover time, time and response sensitivities will be approximately equal.

Journal Article↗
PubMed2005

[The use of data from the literature on nutritional education projects: a qualitative study].

The study is based on the observation that data from the existing literature is underutilised during the project development stage. The objective is to carry out a study to track the current status quo on how the knowledge from the literature is used and incorporated. Semi-structured interviews of professionals working in nutritional education of youth were conducted to assess this aspect in the French-speaking community in Belgium. The study permitted the identification of which types of data are being used by the respondents, as well as which elements can have a positive or negative impact their incorporation. Moreover, it was observed that most of the field workers who participated in the study would prefer to have access to more data relevant to their local context than data on a specific topic. The study highlighted the need for more training to be provided to the nutritional educators working in the field, in particular in the areas of information needs and their interpretation of these needs in light of the data available.

Adult↗
PubMed2003

Cloning and disruption of the PpURA5 gene and construction of a set of integration vectors for the stable genetic modification of Pichia pastoris.

A pair of degenerate primers was used for amplification and cloning of a DNA fragment containing parts of the P. pastoris URA5 and SEC65 genes. Using additional information from a partial genomic sequence of P. pastoris, we cloned and sequenced a 1.9 kb chromosomal fragment containing the complete orotate-phosphoribosyltransferase-encoding URA5 gene. A disruption cassette was constructed by replacing a small part of the open reading frame with a kanamycin-resistance gene. The P. pastoris wild-type strain NRRL Y-11430 was transformed with the disruption cassette and an ura5 auxotrophic strain was identified. To generate marker constructs that can be reused in successive transformations of a single strain, we constructed two lacZ-PpURA3-lacZ and lacZ-PpURA5-lacZ cassettes and used them to disrupt PpOCH1. The PpURA3 and PpURA5 genes in the disruptants were then successfully recycled by selecting for resistance to 5'-fluoro-orotic acid. We also assembled a set of modular plasmids that can be used for the stable genetic modification of P. pastoris via a double cross-over event. The sequence presented here has been submitted to the EMBL data library under Accession No. AY303544.

Amino Acid Sequence↗
PubMed2005

The state of veterinary epidemiology and economics.

Recent developments in the fields of veterinary epidemiology and economics are critically reviewed and assessed. The impacts of recent technological developments in diagnosis, genetic characterisation, data processing and statistical analysis are evaluated. It is concluded that the acquisition and availability of data remains the principal constraint to the application of available techniques in veterinary epidemiology and economics, especially at population level. As more commercial producers use computerised management systems, the availability of data for analysis within herds is improving. However, consistency of recording and diagnosis remains problematic. Recent trends to the development of national livestock databases intended to provide reassurance to consumers of the safety and traceability of livestock products are potentially valuable sources of data that could lead to much more effective application of veterinary epidemiology and economics. These opportunities will be greatly enhanced if data from different sources, such as movement recording, official animal health programmes, quality assurance schemes, production recording and breed societies can be integrated. However, in order to realise such integrated databases, it will be necessary to provide absolute control of user access to guarantee data security and confidentiality. The potential applications of integrated livestock databases in analysis, modelling, decision-support, and providing management information for veterinary services and livestock producers are discussed.

Animal Diseases↗
PubMed2000

Accreditation of hospitals for percutaneous coronary intervention on the basis of volume or clinical outcome using MEDPAR data sets: effect on patient mortality, cost and treatment accessibility.

BACKGROUND: The risk of major complications of percutaneous coronary revascularization (PCR) is modestly lower in high-volume as opposed to low-volume hospitals, but this is not a consistent finding for all hospitals. There are also limitations comparing risk-adjusted outcomes between hospitals. We sought to ascertain the effect of credentialing hospitals for PCR, either on the basis of procedural volume or outcome, on clinical outcome, cost and accessibility to treatment, in states of varied population density. METHODS: We evaluated Medicare administrative data sets for all PCRs performed in 9 states during 1994Eth 1995. Based upon volume- and risk-adjusted in-hospital mortality during 1994, hospitals were OaccreditedO using varying volume and outcome thresholds, and the effect of accreditation using these thresholds was ascertained by analysis of 1995 outcomes. Sensitivity analyses were performed to assess the effect of altered assumptions. RESULTS: During 1994, one hundred and thirty-three hospitals performed 34,879 PCRs in Medicare patients, with an overall mortality of 1.36%. If credentialing were performed based upon 1994 volumes, a sizable clinical benefit could be expected only if large numbers of catheterization laboratories were OclosedO, e.g., if laboratories with < 200Eth 300 Medicare cases/year (< 400Eth 900 total cases) were OclosedO, mortality would be expected to decrease to 0.17Eth 1.07% (maximum and minimum effect). Costs could be minimized by closing laboratories with < 100 Medicare cases/year (best case scenario, $512Eth $905/patient). Such laboratory closures would require transfer to hospitals > 50 miles distant in 6Eth 38% of patients, but as many as 18Eth 94% of patients in low-density states. If credentialing were done on the basis of 1994 adjusted mortality, a somewhat lesser reduction of risk of death (best case scenario, 0.93%), but little improvement in cost, could be expected. CONCLUSIONS: If generalizable, these data suggest that to achieve a sizable reduction in procedure-related mortality by hospital-based credentialing, large numbers of catheterization laboratories would need to be closed and patient access to care would be adversely impacted. Cost savings of a very considerable magnitude may be more readily achieved.

Accreditation↗
PubMed1994

A gene from Saccharomyces cerevisiae which codes for a protein with significant homology to the bacterial 3-phosphoserine aminotransferase.

During the sequencing of the gene GSP2 from Saccharomyces cerevisiae, we have encountered an adjacent open reading frame having strong homology to the 3-phosphoserine aminotransferase (E.C.2.6.1.52) from other organisms. In this report, we present the sequence for this yeast SERC, and evidence that its deletion from the yeast genome leads to serine dependency. The sequence has been deposited in the GenBank data library under Accession Number L20917.

Amino Acid Sequence↗
PubMed1986

Average quantities accessible to the analysis of sedimentation equilibrium data for self-association systems.

This paper shows that analysis of sedimentation equilibrium data, searching for average molecular weights, gives quantities which are dependent on the total protein concentration of the samples, while knowledge of the molecular weight of the monomeric subunits allows a more meaningful search for the concentrations of the individual polymeric components of the system. From these the various average molecular weights can be construed, and the various dissociation equilibrium constants evaluated. Also, in this paper considerations are proposed on the meaning of nonideality terms in associating systems and possible ways for estimating them. As an example the proposed procedures have been applied to measurements of sedimentation equilibrium in carbonmonoxyhemoglobin.

Hemoglobins↗
PubMed2001

Structure of the yeast nucleosome core particle reveals fundamental changes in internucleosome interactions.

Chromatin is composed of nucleosomes, the universally repeating protein-DNA complex in eukaryotic cells. The crystal structure of the nucleosome core particle from Saccharomyces cerevisiae reveals that the structure and function of this fundamental complex is conserved between single-cell organisms and metazoans. Our results show that yeast nucleosomes are likely to be subtly destabilized as compared with nucleosomes from higher eukaryotes, consistent with the idea that much of the yeast genome remains constitutively open during much of its life cycle. Importantly, minor sequence variations lead to dramatic changes in the way in which nucleosomes pack against each other within the crystal lattice. This has important implications for our understanding of the formation of higher order chromatin structure and its modulation by post-translational modifications. Finally, the yeast nucleosome core particle provides a structural context by which to interpret genetic data obtained from yeast. Coordinates have been deposited with the Protein Data Bank under accession number 1ID3.

Amino Acid Sequence↗
PubMed2000

Patient-centered documentation: an effective and efficient use of clinical information systems.

After 2 years of experience with a basic computerized system for documenting care, the nursing leaders in an inner city hospital undertook a redesign process to create an effective and efficient system for documentation that also provided data for monitoring care processes, patient outcomes, and staff performance. The basic system was a source of frustration and dissatisfaction for nurses, physicians, and managers. The redesigned system has exceeded the expectations of staff and physicians and delighted managers. Managers can now access the clinical data collected by the staff to create meaningful reports describing the patient population, identifying patients needs, monitoring staff compliance with care standards, and tracking improvements in care processes.

Documentation↗