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Information processing in the primate visual system: an integrated systems perspective.

The primate visual system contains dozens of distinct areas in the cerebral cortex and several major subcortical structures. These subdivisions are extensively interconnected in a distributed hierarchical network that contains several intertwined processing streams. A number of strategies are used for efficient information processing within this hierarchy. These include linear and nonlinear filtering, passage through information bottlenecks, and coordinated use of multiple types of information. In addition, dynamic regulation of information flow within and between visual areas may provide the computational flexibility needed for the visual system to perform a broad spectrum of tasks accurately and at high resolution.

Animals

Expert systems integrated with information systems.

Amongst the users of the AIDA applications there is a rapidly growing interest in the use of expert systems, not as independent systems, but as logical extensions of their already existing information systems. In this paper a prototype system (IDEA) will be described that consists of a set of utilities for the construction of an expert system within the context of an AIDA application. Although IDEA does not excel in sophisticated knowledge representations nor in search strategies (the development of which was not our primary concern) it is able to demonstrate that the facilities provided by AIDA together with the IDEA facilities result in an expert system which is characterized by a high degree of integration with the already operational information system.

Artificial Intelligence

The difference between interfaced and integrated systems.

The definitions of an "integrated system" and an "interfaced system" are unclear. Consequently, purchasers and developers of systems are often unable to judge the degree to which a system is integrated. This paper presents definitions of integrated systems and interfaced systems, describes the differences between the two, and reviews resulting conclusions.

Computer Systems

Enhanced secretion of human nerve growth factor from Saccharomyces cerevisiae using an advanced delta-integration system.

We have designed an advanced delta-integration system (integration of genes into the delta-sequence of yeast retrotransposon Ty) and used it for secretion of human nerve growth factor (hNGF) from Saccharomyces cerevisiae. The expression and secretion of hNGF was directed by the PGK promoter and MF alpha 1 prepro-signal. Using two selectable markers (URA3 and leu2-d), haploid yeast strains were constructed with approximately 20 copies of a delta-integrated hNGF expression cassette on four chromosomes. The strain secreted hNGF at levels 3-4 fold higher than a 2 micron-based plasmid. Northern and Western analyses revealed that the oversecretion was caused by an increased amount of mRNA. We also detected an unusual processing of the MF alpha 1 prepro-hNGF fusion protein that required the pep4 mutation. Application of this system for industrial purposes is discussed.

Biotechnology

The benefits and perils of system integration.

The current health care environment is complex, with no single systems solution dominating the marketplace. A new approach utilizes Networked Systems Integration to link disparate systems together. This paper discusses the Systems Integration approach and suggests that it encourages user commitment, provides greater modularity, is cost effective, and supports solutions that offer greater functionality. However, it is noted that this approach is not without problems that can dramatically effect the realization of benefits.

Competitive Bidding

An integrated system for large scale cell culture.

The potential of tissue culture as a means of production of various viruses for use in vaccines, or various biomolecules such as the interferons, interleukins, various enzymes and growth factors, has been steadily increasing over the last few years. If the full potential for the production of these products is to be realized, significant technological advances in the area of large scale cell culture are required. Most cells producing the above mentioned molecules and products grow only when attached to a surface. Therefore, the ability to harness cell culture as a tool for large scale production of products is dependent on the availability of large surface areas that are biocompatible with cell attachment and growth and are presented in such a form that proper nutrient solutions are continually being offered to the cells. This presentation will describe a closed loop circumfusion system with an available surface area scaleble to 72 m2. This system is integrated with a computer based controller providing programmable monitoring, control, and documentation of the culture. The system has been extensively tested in both in-house and field trials. This testing has shown the system to be compatible with the typical production environment rigors while highlighting the economic potentials of production using this unique system.

Animals

An integrated system for interstitial 192Ir implants.

An efficient system for preparing, afterloading, and removing interstitial 192Ir strands has been developed. Use of the system reduces the risk of personnel exposure and eliminates some patient discomfort. The system is "integrated" in that all aspects of the implantation process are considered, from source preparation to source removal. Strand preparation is facilitated by an "assembly line" process using shielded equipment. Components include a handling block for measuring and cutting active strands, a mirror, and a transport container. Afterloading and removal techniques use quick release devices and several forms of afterloading tubing and catheters, each terminated by a Luer lock adapter. Both blind-end and through-and-through implants are possible. Each 192Ir strand, threaded through an injection cap that mates with the Luer lock adapter, is quickly inserted into its tubing or catheter and locked into place. No crimping is required and no additional positioning of the sources is needed. Strand removal is easily accomplished by unlocking and removing the injection cap. The strands receive no mechanical damage and can be reused after appropriate cleaning. More than 100 cases have been performed without incident. Applications include head/neck, breast, and template and non-template vaginal wall treatments.

Brachytherapy

Systems integration: requirements for a fully functioning electronic radiology department.

Disparate computer-based information systems such as hospital information systems (HIS), radiology information systems (RIS), and picture archiving and communication systems (PACS) have been introduced into radiology departments at various times to meet specific operational objectives. Typically, these systems are implemented without an integration strategy. Systems integration, which optimizes integrity of data and labor savings, can be achieved by two general approaches. The first links the HIS to the PACS; the second involves interlinking of the HIS, RIS, and PACS, with the RIS as the central controlling system. Standardization in hardware, operating systems, and data base formats--which will allow true integration--is being addressed nationally and worldwide. Operational issues to resolve include ways to increase network capacity, control of data flow, and strategies for dealing with downtime. In the future, systems integration will enable prefetching, two-way interfaces, interfaces with digital dictation systems, and improved linkages with external digital input devices.

Computer Communication Networks

An interview with Sr. Monica Heeran. Enhancing quality through an integrated system. Interview by Sally D. McCulloch.

As President and Chief Executive Officer of PeaceHealth since July 1988, Sr. Monica F. Heeran, CSJP, presides over the management of seven health care facilities in Washington State, Oregon State, and Alaska. Additionally, she is the President and Chief Executive Officer of Sacred Heart Health System, a regional integrated health care system recently established to provide services for the underserved in Lane County, OR. 1993 marked the first full year of operation for the Sacred Heart Health Care System. The system, which unites several existing health care organizations into one cohesive group, was formed expressly to accomplish the goals of increasing access, enhancing quality, and lowering costs, and is a model health care provider for other areas of the country. Prior to assuming her current positions, Sr. Monica was the Administrator at Sacred Heart General Hospital, Oregon, for 15 years, preceded by terms as Administrator of Ketchikan General Hospital and St. Joseph Hospital, Bellingham. She received her Bachelor of Science Degree in Nursing from Seattle University and her Master's Degree in Hospital Administration from St. Louis University. Sr. Monica F. Heeran has served in the health care ministries of the Sisters of St. Joseph of Peace since 1950.

Chief Executive Officers, Hospital

System integration--the need in future anesthesia delivery systems.

Although current anesthesia delivery systems possess the virtues of familiarity, ruggedness, reliability, and longevity, problems inherent in their design require remedy. These systems consist of discrete subsystems that are unrelated physically, functionally, or by communications. Production of derived values, as opposed to raw data, is almost unheard of, although transformed data may be much more useful in the clinical environment. Future anesthesia delivery systems will use microprocessors to integrate data from multiple sensors with calculation, display, and control functions--without removing the anesthesiologist from the control loop. New ergonomic data will promote design of equipment that can be optimally manufactured, marketed, and used in clinical care. The proliferation of new equipment with advanced design and application features creates challenges for a society conscious of rising health-care costs. Creative alternatives to conventional financing, ownership, and early obsolescence of anesthesia systems must be sought in order to ensure that the quality of and capability for anesthetic care will continue to advance.

Anesthesia

[Development of an integrated system of family medicine--pathologic anatomy service to start epidemiologic studies on tumors occurring in an area of southern Italy. First results].

In Italy there are eight tumor Population-Based Registries (PBRs) that publish incidence data, and only one of them (Ragusa) provides data for Southern Italy. Usually, PBRs are based on data collection from Pathologists and medical records. Our integrated system differentiates from traditional PBRs because the information comes from the General Practitioners (GPs) and is completed with the diagnosis provided by the Pathologists (Ps). During two years we have registered 1,057 new cancers on a middle period population of 212,644. GPs and Ps signed 395 and 879 incident cases, respectively. GPs alone provided 16.8%, Ps alone 62.6%, and either source 20.6% of total cases. After excluding non melanotic skin cancers and bladder carcinoma, the GPs-Ps integrated system counted 828 new cases in two years. These incidence data are the first in our region (Puglia). The 178 cases signed by GPs alone should have been lost if the informations of our PBR had been based only on local Ps' records. Moreover, 94 of GPs cases (11% of total cancers registered) were subjects who moved outside the area for diagnosis and treatment. Even if this article evaluates the effect of under-registration attributable to Ps or GPs, the cancer incidence data and the active involvement of GPs indicate that they could be usefully involved in the registration of cancer data.

Epidemiologic Methods

Genomic integration system based on pBR322 sequences for the cyanobacterium Synechococcus sp. PCC7942: transfer of genes encoding plastocyanin and ferredoxin.

Synechococcus sp. PCC7942 recipient strains were constructed for the chromosomal integration of DNA fragments cloned in any pBR322-derived vector, which carries the ampicillin resistance (ApR) marker. The construction was based on the incorporation of specific recombination targets, the so-called 'integration platforms', into the chromosomal metF gene. These platforms consist of an incomplete bla gene (ApS) and the pBR322 ori separated from each other by a gene encoding an antibiotic (streptomycin or kanamycin) resistance (SmR or KmR). Recombination between a pBR322-derived donor plasmid and such a chromosomal platform results with high frequency in restoration of the bla gene and replacement of the chromosomal marker (SmR or KmR) by the insert of the donor plasmid. The integration into the platform depends on recombination between pBR322 ori and bla sequences only and is therefore independent of the DNA insert to be transferred. The desired recombinants are found by selection for a functional bla gene (ApR) and subsequent screening for absence of the chromosomal antibiotic marker. Gene transfer with this integration system was found to occur efficiently and reliably. Furthermore, the presence of the pBR322 ori in the platform allowed for 'plasmid rescue' of integrated sequences. The system was applied successfully for the transfer of the gene encoding plastocyanin (petE1) from Anabaena sp. PCC7937 and for the integration of an extra copy of the gene encoding ferredoxin I (petF1) from Synechococcus sp. PCC7942 itself.

Blotting, Northern

An integrated system for the automation of the clinical chemistry laboratory.

A user programmable microcomputer-based integrated system for automatic analysis in the clinical chemistry laboratory is presented. Friendly user-instrument interaction helps the operator when defining tests and analytical conditions or entering sample data and test requests. Quality control data are retained for the automatic production of various statistical lists and graphs. Routine operator intervention is limited to reagent preparation, sample loading onto the autosampler plate, definition of the tests to be performed on each of the samples and data validation before the generation of reports. Finally, connection with an existing laboratory management system is provided by means of a standard serial interface.

Automation

An integrated system for multidisciplinary assessments in stroke rehabilitation.

BACKGROUND AND PURPOSE: There is increasing emphasis on the use of integrated systems for timely, accurate, and efficient data collection for a range of service, audit, quality, and research applications. The present study evaluates the acceptability and the quality of data collected on a ward-based system over a 6-month period. METHODS: A multidisciplinary system specific for stroke rehabilitation was used. Members of each discipline were required to enter demographic, medical, nursing, therapy, and psychosocial data as appropriate to their specialty. A users' survey was undertaken at the beginning and at the end of the study. The quality and completeness of data entry were assessed by a "snapshot" of the database at the end of the study period. Primary users (n = 13) included physicians, nurses, and therapists. RESULTS: The user survey at the end of the evaluation showed a significant increase in confidence in using the system. Although the frequency of use had increased, the time spent in data entry had decreased significantly. The increase in work load, estimated at 15 to 60 minutes per week, was considered to be balanced by the benefits in patient care, audit, and research. There were 67 medical and 1046 other assessments on 67 patients entered into the system. Seven patients (11%) had incomplete medical records. Nursing and therapy assessments had been entered for all patients at admission and on discharge, with more than 95% of all possible assessments monitoring recovery being recorded accurately compared with conventional records. CONCLUSIONS: The study showed that it was possible to introduce a computerized multidisciplinary assessment system on rehabilitation wards as a part of day-to-day work without the need for significant extra resources.

Cerebrovascular Disorders

Integrated systems: from library to campus and beyond.

Integrated library systems have not yet been created, although they have been emphasized for nearly two decades. Now and in the future, the task is even more complex because the principal issue is access to information itself, wherever it is located and in whatever form it may exist. The goal becomes more feasible because of changes in library practices achieved with technological innovation. Although individual elements of a campus-wide information system may already exist, the details for implementation are yet to be articulated.

Information Systems