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At least 577 records · Page 32Linked to original sources
PubMed2005

Team task analysis: identifying tasks and jobs that are team based.

This paper presents initial information on the development and validation of three team task analysis scales. These scales were designed to quantitatively assess the extent to which a group of tasks or a job is team based. During a 2-week period, 52 male students working in 4-person teams were trained to perform a complex highly interdependent computer-simulated combat mission consisting of both individual- and team-based tasks. Our results indicated that the scales demonstrated high levels of interrater agreement. In addition, the scales differentiated between tasks that were predetermined to be individual versus team based. Finally, the results indicated that job-level ratings of team workflow were more strongly related to team performance than were aggregated task-level ratings of team-relatedness or team workflow. These results suggest that the scales presented here are an effective means of quantifying the extent to which tasks or jobs are team based. A research and practical implication of our findings is that the team task analysis scales could serve as criterion measures in the evaluation of team training interventions or predictors of team performance.

Adult↗
PubMed2026

Whole-exome sequencing-centered genetic evaluation for early-onset obesity in Chinese children: a retrospective single-center cohort.

BACKGROUND: Genetic causes of early-onset obesity remain undercharacterized in East Asian children. This study evaluated a whole-exome sequencing (WES)-centered diagnostic workflow in Chinese children with obesity onset before 5 years. METHODS: Consecutive children with body mass index above the 95th percentile and obesity onset before 5 years who completed structured inpatient assessment at a single center between February 2022 and December 2023 were retrospectively analyzed. Phenotyping included clinical, biochemical, oral glucose tolerance, cortisol rhythm, and liver assessments. Genetic testing combined WES, mitochondrial DNA analysis, multiplex ligation-dependent probe amplification (MLPA) for obesity-related imprinting loci, WES-based copy-number variant and runs-of-homozygosity analyses, and Sanger validation. Variants were interpreted according to the American College of Medical Genetics and Genomics/Association for Molecular Pathology (ACMG/AMP) criteria. RESULTS: Among 23 children, clinically relevant genetic findings were identified in 6 (26.1%): melanocortin-4 receptor (MC4R) c.831T>A (p.C277*), maternal uniparental disomy of 15q11-13, and four phenotype-correlated variants of uncertain significance in UCP3, BBS1, NCOA1, and SH2B1. The definitive/likely diagnostic yield, restricted to pathogenic or confirmed imprinting findings, was 8.7% (2/23). Findings involved leptin-MC4R signaling, BBSome function, fatty-acid oxidation, and chromosomal imprinting. Genetically positive children showed numerically higher alanine aminotransferase (ALT) and aspartate aminotransferase (AST), but differences were not statistically significant. BBS1 p.T374S was relatively enriched in East Asian reference data. CONCLUSIONS: A WES-centered integrated workflow detected heterogeneous genetic mechanisms in Chinese children with early-onset obesity, but variant of uncertain significance (VUS)-associated findings should be distinguished from confirmed diagnoses. Orthogonal methylation/MLPA and runs of homozygosity (ROH) analyses were necessary for imprinting diagnosis. Larger multicenter studies and functional validation are needed.

Chinese children↗
PubMed2026

Hybridization capture increases on-target nanopore sequencing of plant RNA tobamovirus- derived cDNA libraries.

High-throughput sequencing (HTS) can support plant virus surveillance, but host nucleic acids often reduce on-target read recovery. We evaluated a targeted hybridization-capture workflow in which barcoded double-stranded cDNA (ds-cDNA) libraries generated from plant RNA extracts spiked with lyophilized tobamovirus-positive controls were enriched before Oxford Nanopore sequencing. Biotinylated probes targeted conserved regions of cucumber green mottle mosaic virus (CGMMV), species Tobamovirus viridimaculae; pepper mild mottle virus (PMMoV), species Tobamovirus capsici; and tobacco mosaic virus (TMV), species Tobamovirus tabaci. Across four pairs per virus, relative target-read abundance increased after capture from 0.76 ± 0.33% to 37.62 ± 15.72% for CGMMV, 8.16 ± 3.86% to 24.68 ± 12.34% for PMMoV, and 15.62 ± 10.40% to 36.83 ± 30.33% for TMV. Exact two-sided Wilcoxon signed-rank tests yielded P = 0.125 for each virus; with four nonzero differences in a common direction, this was the minimum attainable two-sided P value. Genome-coverage breadth was maintained. Retrospective duplex qPCR supported an increased virus-to-18S ratio for CGMMV, showed a variable PMMoV response, and showed a decreased virus-to-18S ratio for TMV because the 18S signal shifted earlier by as much as or more than the TMV signal. The findings provide proof-of-concept evidence for target-dependent library enrichment but do not establish analytical sensitivity, diagnostic performance, or field validity. Validation with naturally infected, low-titer, and mixed-infection samples and comparison with simpler targeted workflows are required.

biosecurity↗
PubMed2026

Association of MPO Expression with the Immune Microenvironment in Breast Cancer: Insights from Bioinformatics and Single-Cell Analyses.

Breast cancer remains a major cause of cancer-related mortality, and exploratory computational workflows can help prioritize immune-associated markers for further investigation. Here, we used the cancer genome atlas breast invasive carcinoma (TCGA-BRCA) bulk transcriptomic data and the public single-cell dataset GSE161529 to examine associations between myeloperoxidase (MPO) expression, clinical outcomes, immune infiltration, methylation, upstream-regulator annotations, single-cell expression patterns, virtual knockdown sensitivity outputs, drug-gene interaction retrieval, and absorption, distribution, metabolism, excretion, and toxicity (ADMET) annotation. MPO expression was lower in breast cancer tissues than in adjacent non-tumor tissues. Higher MPO expression was associated with a longer progression-free interval, whereas its associations with overall survival and disease-specific survival were not statistically significant. Receiver operating characteristic (ROC) analysis suggested tumor-normal separation within the analyzed public dataset, but this should not be interpreted as clinical diagnostic validation. Immune deconvolution and enrichment analyses indicated that MPO expression mainly tracked with immune- and myeloid-related transcriptional features, rather than establishing tumor-intrinsic regulation of the immune microenvironment. At single-cell resolution, the MPO signal was sparse, with only 85 MPO-positive cells detected before k-nearest neighbor (KNN)-based neighborhood expansion. Detectable MPO signal and MPO-associated scores were interpreted cautiously because they may be influenced by sparse expression, cell-type annotation uncertainty, dropout, doublets, or ambient RNA. In silico virtual knockdown suggested candidate immune- and inflammatory-related transcriptional changes, but these results were considered exploratory and require validation. Drug-gene interaction database (DGIdb)-based drug-gene retrieval and ADMET annotation were used only as preliminary chemical annotations and were not interpreted as therapeutic evidence. Overall, this study provides a reproducible in silico workflow for generating hypotheses about MPO-associated immune/myeloid features in breast cancer, which require external cohort validation and experimental confirmation.

Humans↗
PubMed2026

Population-scale detection of methylation outliers from long-read genome sequencing.

BACKGROUND: Aberrant DNA methylation can mediate the functional effects of rare genetic variation and contribute to imprinting disorders, repeat expansion diseases, and other pathogenic regulatory mechanisms. Long-read sequencing technologies now enable genome-wide detection of CpG methylation alongside genetic variation from a single assay. However, methods for systematic identification and interpretation of methylation outliers from long-read sequencing data remain limited. METHODS: We developed METAFORA, a computational workflow for detecting methylation outlier regions from PacBio and Oxford Nanopore long-read sequencing data. METAFORA constructs population-level methylation references, segments the genome into correlated CpG blocks, infers technical and biological sources of variation through hidden factor estimation, models uncertainty due to variable depth sequencing, and computes covariate-adjusted methylation outlier scores for individual samples. We applied METAFORA across large long-read sequencing cohorts and integrated methylation outliers with multi-omic data. METAFORA is implemented as a snakemake workflow available at https://github.com/tjense25/METAFORA. RESULTS: METAFORA identified methylation outlier regions associated with rare structural variants, tandem repeat expansions, and imprinting abnormalities. We found outlier regions were enriched for molecular outliers across transcriptomic and chromatin accessibility datasets, supporting their functional relevance in gene regulation. In a representative case, METAFORA identified an imprinting defect affecting the GNAS locus associated with an STX16 deletion. CONCLUSIONS: METAFORA enables scalable detection and interpretation of methylation outliers from long-read sequencing data and provides a framework for integrating epigenetic outliers with genomic and multi-omic analyses. These approaches may improve interpretation of rare regulatory variation and support discovery of clinically relevant epigenetic abnormalities in genomic medicine.

DNA methylation↗
PubMed1993

Electronic forms: a next step in hospital automation.

Information consists of two parts, facts and communication. It is not enough for one person to know a fact; the fact must be communicated for it to be of any value to anyone else. Forms were invented to do just that--communicate facts in a systematic manner from one party to the next. Automating forms with computers on a local area network or a wide area network allows for hospital personnel to input a patient's information once and electronically share the information from one department to another, simultaneously. Switching from a paper-based forms system to a fully automated workflow forms system or combining the two can save a healthcare institution money, errors, time and even lives. The levels of an automated forms system include: electronic forms design, demand printing, typewriter replacement, intelligent forms, intelligent mail and true workflow automation.

Communication↗
PubMed1997

Nursing process redesign with the implementation of a computer based patient record in the ambulatory setting.

Increasingly, health care organizations are considering moving to Computer Based Patient Records (CPR), a trend driven by managed care and capitated payments. Central to the change is recognition of the need for community based and clinically relevant information systems that span the care continuum. Thus, Aurora Health Care chose to start their CPR effort in the ambulatory setting as the focus of health care delivery in the evolving paradigm. This paper describes computerization of the ambulatory record in a 45 physician clinic and associated workflow redesign. Months were spent in the processes of: current state documentation and analysis, future state design, detail system design, and workflow reengineering. There was substantial impact on nursing care delivery with computer system interaction at the point of care in the exam room. Access to clinically relevant longitudinal data was found key to the implementation and evaluation of Care Management strategies.

Ambulatory Care Facilities↗
PubMed1998

Components of the optimal ambulatory care computing environment.

We present here a framework of core components of an ambulatory care computing environment, based on clinical and functional needs and workflow scenarios. We have established this framework through the use of two study devices: a vision of the clinical office of the future, and a survey of possible computer applications, both designed to help clinicians and practice directors communicate their information needs to systems designers. Clinicians prioritize applications based on strategic and practice goals: support for clinical users' workflow, improved quality of care, reduced cost of care, and the ability to measure performance and status. By reorganizing the needed functionality from a clinical viewpoint into a technical viewpoint, we are able to identify core information components for systems design. Based on this analysis, information needs in the ambulatory environment can be divided into five primary functions: patient data retrieval, documentation, communication, knowledge resources, and aggregate reporting. Three other fundamental processes--knowledge-based interventions, information integration, and confidentiality--run through all of these front-line functions. Component applications and data structures built with this framework in mind will afford a maximum combination of functionality and flexibility to handle future changes in the clinical environment.

Ambulatory Care↗
PubMed1999

Telemedical support of prehospital emergency care in mass casualty incidents.

In the German emergency medical service system (EMSS) medical treatment can be improved in most of mass casualty incidents (MCI). Currently, the incident commander who is responsible for classification of the victims (depending on their urgency and condition, the so called triage) and ordered transportation uses paper-based documentation. Triage tags are used to identify and classify patients and gather treatment information. This can cause problems in medical treatment and in transportation of injured victims. Object-oriented modelling, simulation, and visualisation of processes can show deficits in treatment and data processing and thereby help to optimise medical workflow and logistics. If documentation by paramedics and emergency physicians is done electronically, all patient records could be send to a telemedical centre for central data administration. A telemedical supported triage tag helps identifying victims and managing detailed identification protocols. The paper-based documentation in emergency would become obsolete, if hospitals can query all protocols, diagnoses, and findings from the telemedical centre. Safety and security aspects can be guaranteed. The complete medical treatment workflow can be supported by telemedicine. Therefore, in case of MCI, telemedicine can optimise medical treatment and exonerate the paramedics from unnecessary documentation.

Allied Health Personnel↗
PubMed1999

An object-oriented framework for the development of computer-based guideline implementations.

Clinical practice guidelines provide a means of directing medical care towards clinically appropriate and cost-effective interventions. A direct relationship exists between the integration of a guideline into clinical workflow and the effectiveness of the guideline in influencing clinicians' behavior. Computer-based guideline implementations, used at the point-of-care, accomplish this integration. Employing object-oriented technologies, we propose a framework of reusable components for the development of guideline implementation systems. We have identified eight information management services that are common to such systems. Our framework integrates these services and their respective reusable components into clinical workflow to promote the development of comprehensive guideline implementation systems, which should ultimately enhance guideline compliance and the overall quality of care.

Guideline Adherence↗
PubMed1999

Architecture for a multipurpose guideline execution engine.

Integration of guideline knowledge into the clinical workflow is essential, for improving adherence to guidelines. Guidelines in structured formats can be utilized by computer programs to provide decision support in clinical information systems, as well as to facilitate workflow. We have designed an architecture for a flexible guideline execution engine that can be utilized in clinical decision support applications. The engine may be utilized for other applications such as referral management, medical education, and conducting clinical trials. The engine executes guidelines that are defined in an extension of the Guideline Interchange Format (GLIF). GLIF was extended to support representation of constructs that are essential to the execution of the guideline. A prototype of the engine was implemented based on this architecture. The engine is being utilized in two clinical applications that draw on guidelines for decision support. The engine was also used for developing an educational application aimed at testing knowledge of guideline recommendations.

Computer Systems↗
PubMed2000

Standardized comparison of processing capacity and efficiency of five new-generation immunoassay analyzers.

BACKGROUND: With the trend toward laboratory and workstation consolidation, more studies are necessary to evaluate instrumentation, solutions for coping with workflow and test diversity, and opportunities for increasing the overall efficiency of laboratory testing. We assessed the processing capacity and efficiency of new-generation immunoassay analyzers by determining productivity parameters of five commercially available systems. METHODS: A workload protocol was developed and used to assess processing capacity and efficiency parameters of five immunoassay analyzers under standardized conditions in a real-life routine situation. We studied the ACS:Centaur((R)) (analyzer A), Architect(TM) i2000 (analyzer B), Elecsys((R)) 2010 tandem (analyzer C), Immulite((R)) 2000 (analyzer D), and Vitros ECi (analyzer E) on the basis of a standardized workload protocol that reflected a routine laboratory situation. This workload encompassed reflex and STAT testing, dilutions, and in-run calibration of a new reagent lot number. The analyzers were compared for hands-on labor time, unattended time (UT), throughput, and differentiated relative productivity indexes [RPI((UT)); number of reportable results/(processing time - sum of unattended time)]. The RPI data for analyzers linked to an automated (aut) sample-handling system [RPI((aut))] were also calculated. RESULTS: The evaluation produced a set of parameters for the productivity of the instruments. An overview of the most important parameters revealed the following: the throughput was 193, 123, 97, 109, and 46 tests/hour for instruments A, B, C, D and E, respectively; the RPI((10)) was 425, 238, 161, 445, and 151 tests/operator-hour; the RPI((30)) was 229, 136, 118, 264, and 86 tests/operator-hour; the RPI((10,aut)) was 1701, 637, 235, 964, and 223 tests/operator-hour; and the RPI((30, aut)) was 298, 150, 174, 400, and 114 tests/operator-hour. CONCLUSIONS: The combination of a standardized workload protocol and determination of parameters for productivity and labor efficiency, especially the differentiated RPIs, made it possible to make an objective comparison of the organizational consequences of the use of these instruments. The described parameters allow for a scientifically based choice, given a certain workflow and a particular laboratory organization.

Humans↗
PubMed2000

A modelization of the task allocation problem for prescribing activity in an ICU.

The improvement of coordination between Health Care Professionals belonging different specialities and who are extremely mobile, is a crucial problem in Medicine. A workflow System is one example of the new informatics tools which facilitate the transfer of information and responsibility between health care providers. Medical informatics systems in particular should be reactive enough to cope with the flexibility of real work situations: in this paper, we present the task allocation problem. We distinguish between the workflow control process and the notifying process, which concerns the sharing out of the tasks between the actors concerned. We focus on the impact of strategies of notification on the progress of coordinated work. We propose a simulator to model and study the different ways of sharing tasks between actors in an Intensive Care Unit's activity of prescription.

Computer Simulation↗
PubMed2000

Studying clinician-computer interaction in Web-based systems.

A growing of health-care organizations are in the process of modifying their clinical information systems (CIS) to support browser-based access. Consequently, care-providers are expected to modify their workflow to take advantage of the new technology. Intuitive interfaces, fast response and new functionality are few of the features used to promote endorsement of the change. In parallel, administrators are required to constantly assess user compliance and intervene where necessary to prevent rejection. Such monitoring translates to frequent surveys, analysis of logs and prudent utilization of user-groups. These methods tend to further burden users, suffer from "post-hoc" temporality and are difficult to maintain. In this paper we suggest an alternative approach to such data acquisition. "CareQuest" is an interactive Web-based service that can be woven into clinical applications without coding. It acquires information from the clinician at the relevant point in her workflow. It allows extensive interaction customization, data-driven response, real-time Web-based data-analysis, and full Web-based administration.

Evaluation Studies as Topic↗
PubMed2000

Picture archiving and communication systems.

Picture archiving and communication systems (PACS) are extremely versatile systems that facilitate the transfer of digital images and patient data throughout a healthcare enterprise. PACS are most commonly used in radiology departments to process images from diagnostic imaging modalities, such as digital radiography devices and magnetic resonance imaging (MRI) systems. In this article, we evaluate three such systems from three of the largest PACS suppliers--the Agfa IMPAX, GE PathSpeed, and Siemens Sienet. The ultimate goal of any PACS is to improve workflow within the enterprise. Our testing focused on whether, and to what degree, the systems could meet this goal. We found that all three PACS are fairly complete and able to support image distribution and improve workflow compared with film-based processes. However, we did identify significant differences--along with some noteworthy limitations--with respect to system design and operation, external integration capabilities, and supplier support and professional services. We have ranked the systems for each of these factors to help healthcare facilities identify the system that will best meet their needs. Also in this Evaluation, we present an overview of the technology, a Glossary of PACS terminology (see page 400), selection guidance, and discussions of PACS-related topics, including data compression options, the role of the DICOM standard, and concerns about data security in many of today's systems.

Automation↗
PubMed2000

Discrete event simulation in the health policy and management program.

Students in Health Policy and Management at the Faculty of Health Sciences of Maastricht University must learn to analyze and design workflow processes in health care. To attain this, a discrete event simulation training, using MedModel is used. This paper describes the training in two consecutive years. In both years the training was evaluated systematically. The evaluation results demonstrate that the simulation training increased the students' knowledge about analyzing and designing workflow processes in healthcare. Students considered the training as a very important part of their program.

Computer Simulation↗
PubMed2000

Digital doctoring.

PROBLEM: Clinicians and support staff struggled with the need to carefully track the clinical information flowing through the practice in a paper-based system, while at the same time providing the best possible patient care. SOLUTION: A browser-based software application automated the practice's complete workflow system--from scheduling and referrals management to lab and radiology results. RESULTS: Consolidated information and workflow management means everyone spends less time chasing paper and more time caring for patients. KEYS TO SUCCESS: Because today's information technology moves in a rapid sequence of incremental innovations, you can't wait for a "final" solution before you begin to automate.

Ambulatory Care Information Systems↗