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PubMed2000

Evaluation of Web-based patient information resources: application in the assessment of a patient clinical information system.

The advent of Internet-based information systems has provided unprecedented opportunity for the widespread access to medical information. However, issues related to the evaluation of such systems to ensure their usability, effectiveness and to assess their effect on the provider-patient relationship pose a considerable challenge. This paper describes a framework for the distance evaluation of web-based information technologies. The methods are described in the context of an ongoing evaluation of a system known as PatCIS, designed to be accessed by patients from home for obtaining health information, and for management of chronic diseases. We employ a multi-method approach that involves collection of a rich data set, including Web-based questionnaires, automatic logging of user activity and e-mail communication with users. Our work in evaluation design is influenced from research in the areas of cognitive science and the field of usability engineering which aims to characterize the interaction of users with information technologies.

Attitude to Computers↗

PubMed1996

Platelet-activating factor is involved in the regulation of pathological leukocyte adhesion after liver transplantation.

An increased leukocyte adhesion and loss of integrity of endothelial cells is known to be a critical step in the reperfusion period after cold ischemia of transplanted livers. Platelet-activating factor (PAF) is discussed as one of the inflammatory mediators involved in mediating reperfusion injury, e.g., by regulation of leukocyte adhesion. In this study we investigated the effect of a synthetic PAF receptor antagonist, WEB 2086 (Boehringer Ingelheim, FRG), on microcirculation and adhesion of leukocytes to sinusoidal endothelium after liver transplantation in the rat. Livers from SPRD rats (n = 6 per group) were stored for 5 hr in ice-cold UW solution and orthotopically transplanted using the cuff technique. In a randomized and blinded fashion WEB 2086 (1 mg/kg body wt) or placebo was given twice intravenously, at the beginning of the recipient operation and 1 min prior to reperfusion of the liver graft. After in vivo staining of leukocytes with acridine orange, microcirculation and leukocyte-endothelium interaction of transplanted livers and livers from sham-operated animals were investigated 90 min and 5 hr after surgery by means of intravital microscopy. After 90 min of reperfusion, temporary leukocyte adhesion in periportal regions was increased after liver transplantation (22.0 +/- 2.5%; mean +/- SEM) in contrast to the sham group (14.2 +/- 1.8%). Administration of WEB 2086 reduced temporary leukocyte adhesion significantly (11.5 +/- 2.5%; P < 0.05), whereas no significant differences were observed with respect to permanent leukocyte adhesion. Five hours after recipient operation, a significant increase of permanent leukocyte adhesion was observed after transplantation (21.0 +/- 2.6%; P < 0.05) compared to sham-operated animals (12.1 +/- 1.7%). Application of WEB 2086 diminished permanent leukocyte adhesion significantly (12.2 +/- 1.3%; P < 0.05), whereas no differences were noticed between the different groups with respect to temporary leukocyte adhesion at this time. The results indicate that reduction of temporary leukocyte adhesion in the early reperfusion period by administration of PAF receptor antagonist WEB 2086 was followed by a reduction of permanent leukocyte adhesion in the late reperfusion period, e.g., at 5 hr. Thus, it is concluded that PAF is one of the mediators which is involved in the regulation of leukocyte adhesion after liver transplantation.

Animals↗

PubMedDate not supplied

Web site blues.

So far, Rachel Soltanoff's instincts had been right. As CEO in this fictional case study, she had successfully navigated TradeRite Software's transition from a news service for stockbrokers to a $70 million provider of shrink-wrapped software geared toward both brokers and the growing day-trader market. Now a well-financed start-up, Stock-net.com, was testing a very competitive product that traders could download directly over the Web. And TradeRite's Web site was nothing more than a collection of elaborate marketing brochures. Rachel knew she needed to start selling over the Web. But the e-commerce consultants she had hired to set up her Web store were behind schedule, and their 21-year-old CEO had just resigned. Her product manager, Lisa Bandini, was working overtime to transform TradeRite's entire product line into Web-aware applications to match Stocknet's, and Rachel had $2.5 million to launch them. But the consultants said it would take $5 million just to rent e-commerce capabilities. Ace sales VP Brian Rockart thought the company had already wasted too much time and money--money from his budget--on its Web site. Marketing VP Rob Collins thought TradeRite should focus on its core stockbroker customers. Chief Technical Officer Joe Martinez doesn't want to go ahead without a pilot project. Should Rachel try to convince Brian, Rob, and the rest of the senior management team that e-commerce is the way to go? Four commentators offer advice.

Commerce↗

PubMed2003

Using an Internet comanagement module to improve the quality of chronic disease care.

BACKGROUND: Web-based applications have the potential to support the ongoing care needs of patients with chronic disease. At the University of Washington, a diabetes care module was developed, and the feasibility of allowing patients with type 2 diabetes to comanage their disease from home was pilot tested. METHODS: The disease management module consisted of five Web sites that enabled patients to access their electronic medical records; upload blood glucose readings; enter medication, nutrition, and exercise data into an online diary; communicate with providers by using clinical e-mail; and browse an education site with endorsed content. All data could be viewed by patients and providers in online trended displays that a nurse practitioner case manager used to review cases weekly. RESULTS: "Proof-of-concept" was demonstrated by the three pilot participants who were the module's most active users. For example, one newly diagnosed patient was started on an oral hypoglycemic, underwent two upward dose adjustments, and achieved control (glycohemoglobin [HbA1c] from 8.0% to 6.1%). His treatment was conducted by exchanging 14 e-mails based on the 231 glucose-meter readings sent from home without requiring in-person follow-up visits. CONCLUSIONS: The Internet offers the opportunity to involve patients and providers in collaborative management of chronic diseases between office visits.

Adult↗

PubMed2005

PathwayExplorer: web service for visualizing high-throughput expression data on biological pathways.

While generation of high-throughput expression data is becoming routine, the fast, easy, and systematic presentation and analysis of these data in a biological context is still an obstacle. To address this need, we have developed PathwayExplorer, which maps expression profiles of genes or proteins simultaneously onto major, currently available regulatory, metabolic and cellular pathways from KEGG, BioCarta and GenMAPP. PathwayExplorer is a platform-independent web server application with an optional standalone Java application using a SOAP (simple object access protocol) interface. Mapped pathways are ranked for the easy selection of the pathway of interest, displaying all available genes of this pathway with their expression profiles in a selectable and intuitive color code. Pathway maps produced can be downloaded as PNG, JPG or as high-resolution vector graphics SVG. The web service is freely available at https://pathwayexplorer.genome.tugraz.at; the standalone client can be downloaded at http://genome.tugraz.at.

Computer Graphics↗

PubMed2005

Computer-assisted measurement of perceived stress: an application for a community-based survey.

The assessment of stress is a key issue in health promotion policies as well as in treatment strategies for patients. The aim of this study was to confirm the accessibility and reliability of computer-assisted data collection for perceived stress measurement, using the Japanese version of the Perceived Stress Scale (JPSS), within the setting of a community-based survey. There were two groups of participants in this survey. One group responded to a Web-based application, and the other to the VBA of a spreadsheet software. The total scores of JPSS were almost normally distributed. The means of total scores of JPSS were 23.6 and 23.1. These results were lower than the previous study of JPSS. Since Cronbach's alpha coefficients in both surveys were more than 0.8, high reliability was demonstrated despite a number of computer-illiterate and/or aged participants. They felt that the spreadsheet form was easier to respond to. Two components were extracted with the Varimax rotation of principal component analysis, and these were named "perception of stress and stressors" and "behavior to stress". This finding suggests that it is possible to determine sub-scales. From the viewpoint of preventive medicine, it is expected that the JPSS applications will be utilized to investigate the relationship between stress and other factors such as lifestyle, environment and quality of life.

Adult↗

PubMed2002

The Cadmio XML healthcare record.

The management of clinical data is a complex task. Patient related information reported in patient folders is a set of heterogeneous and structured data accessed by different users having different goals (in local or geographical networks). XML language provides a mechanism for describing, manipulating, and visualising structured data in web-based applications. XML ensures that the structured data is managed in a uniform and transparent manner independently from the applications and their providers guaranteeing some interoperability. Extracting data from the healthcare record and structuring them according to XML makes the data available through browsers. The MIC/MIE model (Medical Information Category/Medical Information Elements), which allows the definition and management of healthcare records and used in CADMIO, a HISA based project, is described in this paper, using XML for allowing the data to be visualised through web browsers.

Italy↗

PubMed1991

[Effects of the PAF antagonist WEB 2086 on hypoxia and angiotensin II-induced pulmonary vasoconstriction in the isolated perfused rat lung].

Using isolated blood-perfused lung preparations of rats, we tested the influence of the PAF antagonist WEB 2086 on vasoconstriction triggered by hypoxia or angiotensin II (A II). If a constant flow was pre-set, changes in the prepulmonarily measured pressure were directly related to the changes of resistance in the pulmonary flow. WEB 2086 reduced the hypoxically conditioned vasoconstriction (HPV) when using blood as perfusion medium, the effect being dependent on the dose (ED50 = 127.3 +/- 21.1 mg/l). HPV was lowered on the average by 82% if the full pharmacologic dose of 800 mg/l WEB 2086 was added to the perfusate. The A II response was weakened to a lesser degree (by 45%). If plasma was used as perfusate, the pressure increase in response to hypoxic stimulation or A II was less marked. However, the relative effect of the PAF antagonist was analogous (attenuation by 83% or 53%, respectively). In chronically hypoxic animals (3 weeks at 10% O2) the relative pressure drop in the lesser circulation after application of WEB 2086 (400 mg/l; HPV; blood as perfusate) was definitely more pronounced (p less than 0.001). The fact that WEB partly antagonises the pulmonary vasoconstriction triggered both by alveolar hypoxy and by angiotensin II, seems to indicate that in both constrictive stimuli PAF participates in the complex mediator mechanism or that WEB 2086 exercises a non-specific vasodilatory effect on the pulmonary flow.

Angiotensin II↗

PubMedDate not supplied

Regulatory and compliance activities to protect food-allergic consumers in Canada: research in support of standard setting and consumer protection.

An overview is presented of the activities of Health Canada and the Canadian Food Inspection Agency (CFIA) in the area of food allergens. Since the 1990s, changes were made in the Food and Drug Regulations in order to better protect allergic consumers by imposing labeling requirements to clearly identify sources of priority food allergens in prepackaged foods. Policies of application as well as risk management strategies are discussed with some statistics on allergen-related food recalls in Canada for the years 1997--2001. Health Canada's allergen method development program is a pioneering research initiative that was developed in the early 1990s in support of the changing Canadian regulatory environment. The objectives and some of the accomplishments of this program are presented. The development of the Canadian Compendium of Allergen Methodologies under a Web-based application to compile data on evaluated allergen detection methods will provide further support to compliance activities nationally, as well as to the international analytical community in both government and the food industry. Some emerging techniques for the confirmation of results generated by enzyme-linked immunosorbent assays are also discussed.

Allergens↗

PubMed2001

Web-based UMLS concept retrieval by automatic text scanning: a comparison of two methods.

The Web is increasingly the medium of choice for multi-user application program delivery. Yet selection of an appropriate programming environment for rapid prototyping, code portability, and maintainability remain issues. We summarize our experience on the conversion of a LISP Web application, Search/SR to a new, functionally identical application, Search/SR-ASP using a relational database and active server pages (ASP) technology. Our results indicate that provision of easy access to database engines and external objects is almost essential for a development environment to be considered viable for rapid and robust application delivery. While LISP itself is a robust language, its use in Web applications may be hard to justify given that current vendor implementations do not provide such functionality. Alternative, currently available scripting environments for Web development appear to have most of LISP's advantages and few of its disadvantages.

Artificial Intelligence↗

PubMed2000

Instructional technology in medical education: lessons learnt.

New instructional technologies, especially Web-based applications, may play an increasing role in medical education, particularly for distance and distributed learning. As medical educators turn to this medium, numerous benefits and opportunities, but also challenges and pitfalls, will arise. The successful development and implementation of instructional technologies in medicine require an appreciation of the medium's heterogeneous nature, its strengths, weaknesses and limitations. These in turn rely on partnerships with various experts and the early adoption of evaluation. We have summarized the lessons learnt from developing Web-based courses on palliative care in a framework for adopting instructional technologies. This framework incorporates development, implementation and evaluation.

Education, Distance↗

PubMed2002

Pise: software for building bioinformatics webs.

Pise is interface construction software for bioinformatics applications that run by command-line operations. It creates common, easy-to-use interfaces to these applications for the Web, or other uses. It is adaptable to new bioinformatics tools, and offers program chaining, Unix system batch and other controls, making it an attractive method for building and using your own bioinformatics web services.

Computational Biology↗

PubMed1999

Two-dimensional reaction of biological molecules studied by Weighted-Ensemble Brownian dynamics.

Computer simulations offer critical insights into the reaction of biological macromolecules, especially when the molecular shapes are too complex to be amenable to analytical solution. In this work, the Weighted-Ensemble Brownian (WEB) Dynamics simulation algorithm is adapted to a reaction of two unlike biological molecules, with the interaction modeled by a two-parameter system: a spherical molecular depositing on a target region of an infinite cylinder with a periodic boundary conditions. The original algorithm of Huber and Kim is streamlined for this class of reactive models. The reaction rate constant is calculated as a function of relative sizes of the reactive to non-reactive regions of the cylindrical molecule. An analytical expression for the rate constant is also obtained from the solution of the diffusion equation for the special case of a constant-flux boundary condition. Good agreement between analytical and simulation results validates the applicability of WEB Dynamics to a reaction of molecules of complicated shape. On the other hand, the simple form of our analytical expression is useful as a testing case for other simulation and numerical techniques.

Algorithms↗

PubMed2002

The generic genome browser: a building block for a model organism system database.

The Generic Model Organism System Database Project (GMOD) seeks to develop reusable software components for model organism system databases. In this paper we describe the Generic Genome Browser (GBrowse), a Web-based application for displaying genomic annotations and other features. For the end user, features of the browser include the ability to scroll and zoom through arbitrary regions of a genome, to enter a region of the genome by searching for a landmark or performing a full text search of all features, and the ability to enable and disable tracks and change their relative order and appearance. The user can upload private annotations to view them in the context of the public ones, and publish those annotations to the community. For the data provider, features of the browser software include reliance on readily available open source components, simple installation, flexible configuration, and easy integration with other components of a model organism system Web site. GBrowse is freely available under an open source license. The software, its documentation, and support are available at http://www.gmod.org.

Animals↗

PubMed2004

Effects of organizational scheme and labeling on task performance in product-centered and user-centered retail Web sites.

As companies increase the quantity of information they provide through their Web sites, it is critical that content is structured with an appropriate architecture. However, resource constraints often limit the ability of companies to apply all Web design principles completely. This study quantifies the effects of two major information architecture principles in a controlled study that isolates the incremental effects of organizational scheme and labeling on user performance and satisfaction. Sixty participants with a wide range of Internet and on-line shopping experience were recruited to complete a series of shopping tasks on a prototype retail shopping Web site. User-centered labels provided a significant benefit in performance and satisfaction over labels obtained through company-centered methods. User-centered organization did not result in improved performance except when the label quality was poor. Significant interactions suggest specific guidelines for allocating resources in Web site design. Applications of this research include the design of Web sites for any commercial application, particularly E-commerce.

Adolescent↗

PubMed2005

ASePCR: alternative splicing electronic RT-PCR in multiple tissues and organs.

RT-PCR is one of the most powerful and direct methods to detect transcript variants due to alternative splicing (AS) that increase transcript diversity significantly in vertebrates. ASePCR is an efficient web-based application that emulates RT-PCR in various tissues. It estimates the amplicon size for a given primer pair based on the transcript models identified by the reverse e-PCR program of the NCBI. The tissue specificity of each PCR band is deduced from the tissue information of expressed sequence tag (EST) sequences compatible with each transcript structure. The output page shows PCR bands like a gel electrophoresis in various tissues. Each band in the output picture represents a putative isoform that could happen in a tissue-specific manner. It also shows the EST alignment and tissue information in the genome browser. Furthermore, the user can compare the AS patterns of orthologous genes in other species. The ASePCR, available at http://genome.ewha.ac.kr/ASePCR/, supports the transcriptome models of the RefSeq, Ensembl, ECgene and AceView for human, mouse, rat and chicken genomes. It will be a valuable web resource to explore the transcriptome diversity associated with different tissues and organs in multiple species.

Algorithms↗

PubMed1992

Antagonisation of platelet activating factor--a new therapeutic concept for improvement of organ quality in lung preservation.

The release of platelet activating factor (PAF) is thought to be one of the most important pathophysiological pathways in the development of ischemic lung injury. We investigated the use of a PAF antagonist (PAF-a) in a canine model in reducing PAF-mediated pulmonary dysfunction following lung preservation and transplantation. Twelve combined heterotopic heart and orthotopic left lung allotransplantations were performed after 6 h of cold ischemia. Following administration of prostacyclin (PGI2), Euro-Collins solution (EC) was used for pulmonary artery flush in all donors, while in six animals the PAF-a, WEB 2170 BS, was administered to the donor (0.15 mg/kg for 30 min), to the storage solution (0.3 mg/kg) and to the recipient during reperfusion for a total of 6 h (0.3 mg/kg per h) EC/PAF-a). In all donors myocardial preservation was achieved using St. Thomas Hospital solution. Postoperatively, cardiorespiratory function was evaluated separately for donor and recipient organs at an FiO2 of 0.4 for a maximum of 12 h. The quality of lung preservation was assessed by means of postoperative oxygenation (pO2), pulmonary artery pressure (PAP) and pulmonary vascular resistance index (PVRI). In the EC/PAF-a group, pO2 of the donor lung was significantly elevated (P < 0.01) and PVRI was significantly lower (P < 0.05) when compared to the EC group, while PAP showed no significant differences between both groups and throughout the entire postoperative course. We concluded that a significant improvement in the current clinical standard for lung preservation could be obtained by the application of WEB 2170 BS in combination with EC flush as demonstrated by improved oxygenation and lower PVRI of the transplantated organs.

Animals↗

PubMed2005

Interoperability and HealthGRID.

OBJECTIVES: GRID technology, with initiatives like the GGF, will have the potential to allow both competition and interoperability not only among applications and toolkits, but also among implementations of key services. The pyramid of eHealth interoperability should be achieved from standards in communication and data security, storage and processing, to the policy initiatives, including organizational protocols, financing procedures, and legal framework. The open challenges for GRID use in clinical fields illustrate the potential of the combination of grid technologies with medical routine into a wider interoperable framework. METHODS: The Telemedicine Alliance is a consortium (ESA, WHO and ITU), initiated in 2002, in building a vision for the provision of eHealth to European citizens by 2010. After a survey with more that 50 interviews of experts, interoperability was identified as the main showstopper to eHealth implementation. RESULTS: There are already several groups and organizations contributing to standardization. TM-Alliance is supporting the "e-Health Standardization Coordination Group" (eHSCG). CONCLUSIONS: It is now, in the design and development phase of GRID technology in Health, the right moment to act with the aim of achieving an interoperable and open framework. The Health area should benefit from the initiatives started at the GGF in terms of global architecture and services definitions, as well as from the security and other web services applications developed under the Internet umbrella. There is a risk that existing important results of the standardization efforts in this area are not taken up simply because they are not always known.

Computer Security↗