Achieving COVID-19 and Routine Immunization Data Systems Integration on the Electronic Management of Immunization Data System in Nigeria.

BACKGROUND: In 2021, Nigeria developed a novel Electronic Management of Immunization Data (EMID) system to address COVID-19 data management challenges and ensure the successful implementation of its COVID-19 vaccine deployment plan. The EMID system was envisioned to be interoperable with the DHIS2 national data management system and serve as a gateway into the integration of other primary health care (PHC) service data management. However, the EMID system faced challenges, including inability to filter reports, missing or loss of data, and difficulties with data synchronization, which curtailed its potential to meet the country's needs for COVID-19 data management and negatively impacted system scalability to enable integration with other PHC data systems. METHODS: Multilayered stakeholder interviews were conducted to determine the optimal functionality requirements for the EMID system. Based on these findings, an optimization plan was designed and implemented to address identified gaps and create a more stable and scalable system to enable further system integrations. Following optimization, a routine immunization module was developed and integrated with the EMID system as a first step to achieving an integrated data management system for PHC services in Nigeria. RESULTS: The integrated system currently provides an opportunity to address data fragmentation and strengthen PHC service delivery in Nigeria. By allowing 1 health care worker to deliver both vaccinations, there is also potential for reduction in cost and redundancies, informing redistribution of the health workforce and overall system strengthening. CONCLUSION: The journey from the initial challenges faced by the EMID system to the development of an integrated system for PHC services in Nigeria has been a transformative one. Through a thorough optimization process, training and capacity-building, stakeholder-driven improvements, and an elicitation exercise, the EMID system has evolved into a powerful tool for addressing data fragmentation and enhancing public health service delivery in the country.

Modeling the Application of IHE QRPH Profiles in Data Integration Centers: A Practical Approach with 3LGM2.

The Data Integration Centers (DICs), all part of the German Medical Informatics Initiative (MII), prepare routine care data captured in university hospitals to enable its reuse in clinical research. Tackling this challenging task requires them to maintain multiple data stores, implement the necessary transformation processes, and provide the required terminology services, all while also addressing the use case specific needs researchers might have. An MII wide application of the standardized profiles defined in the IHE QRPH domain might therefore be able to drastically reduce the overhead at any one DIC. The MII DIC reference model built in 3LGM2, a method to describe complex information system architectures, serves as a starting point to evaluate whether such an application is possible. We first extend the IHE modeling capabilities of 3LGM2 to also support the five profiles from the QRPH domain that our experts evaluated as relevant in the MII DIC context. We then expand the DIC reference model by some IHE QRPH actors and transactions, showing that their application could be beneficial in the MII DIC context, provided they surpass their trial status.

Reflections on the history of interoperability in hospitals.

OBJECTIVE: To discuss the origins of HL7 and its subsequent impact on interoperability in hospitals. PROCESS: Reconstruction of historical events from review of personal notes, interviews with key participants and review of relevant publications. CONCLUSIONS: The first versions of HL7 were based on the StatLAN protocol developed at the University of California, San Francisco and later commercialized by Simborg Systems Corporation. With the emergence of specialty clinical and departmental systems in the 1990s, a debate ensued between proponents of "open architecture" vs. "single vendor" systems. Although HL7 became the most widely used data-interchange protocol worldwide in healthcare, open architecture did not prevail in healthcare as it did in other industries. This is due to the unique market characteristics of the healthcare provider industry. The result today is the dominance of the healthcare IT marketplace by a small number of large vendors with relatively few options for in-depth specialty clinical systems.

Initial Experience of 10 Imaging Vendors with the IHE SHARAZONE: a New Multivendor Peer-to-Peer Test Service for DICOM Objects.

Alignment of DICOM (Digital Imaging and Communications in Medicine) capabilities among vendors is crucial to improve interoperability in the healthcare industry and advance medical imaging 2. However, a sustainable model for sharing DICOM samples is not available. To address this issue, Integrating the Healthcare Enterprise (IHE) has introduced the IHE SHARAZONE, a continuous cross-vendor DICOM data sharing test service. IHE is a highly regarded organization known for profiling standards such as DICOM, HL7 v2 (Health Level Seven, version 2), HL7 CDA (Clinical Document Architecture), and HL7 FHIR (Fast Healthcare Interoperability Resources) into practical solutions for clinical practice. The primary goal of the IHE SHARAZONE is to provide a reliable and consistent cross-vendor DICOM data sharing system. To evaluate its effectiveness, a 5-month pilot was conducted with ten imaging vendors. The pilot concluded with a participant survey, which yielded valuable insights into the initial experience with the IHE SHARAZONE. These findings can inform future improvements and developments to this important service.

Integrating Cross-Departmental Data.

Developing smart clinical decision support systems requires integrating data from several medical departments. This short paper outlines the challenges we faced in cross-departmental data integration for an oncological use case. Most severely, they have led to a significant reduction in case numbers. Only 2,77% of cases meeting the initial inclusion criteria of the use case were present in all accessed data sources.

Informe de gestión 2020 / Management Report 2020

El informe contiene el desarrollo de los siguientes puntos: 1. RESUMEN; 2. JUNTOS SOMOS MÁS FUERTES: RESPUESTA A LA PANDEMIA COVID-19; 3. INTEGRACIÓN REGIONAL EN SALUD: PROMOCIÓN DEL DERECHO A LA SALUD; 4. AGENDA SANITARIA: INICIATIVAS INTERNACIONALES MEDIANTE LA ARTICULACIÓN DE LAS AGENDAS DE ORGANISMOS INTERNACIONALES; FORTALECIMIENTO INSTITUCIONAL DE SALUD DE LOS PAÍSES MEDIANTE EL INTERCAMBIO DE EXPERIENCIAS Y ORIENTACIÓN DE POLÍTICAS NACIONALES; 6. PRIORIDADES ANDINAS: ESTRATEGIAS Y MECANISMOS DE ARTICULACIÓN CON ENFOQUE DE DERECHOS, PROMOCIÓN, PREVENCIÓN, DETERMINANTES SOCIALES E INTERCULTURALIDAD; 7. DERECHOS DE NIÑAS, NIÑOS Y ADOLESCENTES; 8. PROGRAMA "FORTALECIMIENTO DEL DIAGNÓSTICO DE LABORATORIO DE TUBERCULOSIS EN LAS AMÉRICAS" ; 9. COMUNICACIÓN E IMAGEN INSTITUCIONAL

Anaerobic-aerobic treatment of wastewater and leachate: A review of process integration, system design, performance and associated energy revenue.

Hybrid anaerobic-aerobic biological systems are an environmentally sustainable way of recovering bioenergy during the treatment of high-strength wastewaters and landfill leachate. This study provides a critical review of three major categories of anaerobic-aerobic processes such as conventional wetland, high-rate and integrated bioreactor systems applied for treatment of wastewaters and leachate. A comparative assessment of treatment mechanisms, critical operating parameters, bioreactor configurations, process control strategies, efficacies, and microbial dynamics of anaerobic-aerobic systems is provided. The review also explores the influence of wastewater composition on treatment performance, ammonium nitrogen removal efficacy, impact of mixing leachate, energy consumption, coupled bioenergy production and economic aspects of anaerobic-aerobic systems. Furthermore, the operational challenges, prospective modifications, and key future research directions are discussed. This review will provide in-depth understanding to develop sustainable engineering applications of anaerobic-aerobic processes for effective co-treatment of wastewaters and leachate.

Integrating System Dynamics Into Action Research: Drivers and Challenges in a Synergetic Complementarity Comment on "Insights Gained From a Re-analysis of Five Improvement Cases in Healthcare Integrating System Dynamics Into Action Research".

This commentary discusses the paper by Holmström et al that explored how system dynamics (SD) may contribute effectively to an action research (AR) process to improve five health case studies. Accordingly, we reviewed some of the methodological aspects of the proposed integration of SD into AR using ongoing debates on multi-methodology and mixed methods research. In a systemic evaluation of the proposed design, we concentrated on some of the common distinct features of SD and AR, and the challenges as well as the expected outcomes of this integration. Finally, we tried to position the suggested framework within the multi-methodology efforts and to pave the way for developing it in future research and practice.

Heterogeneous Autonomous Robotic System in Viticulture and Mariculture: Vehicles Development and Systems Integration.

There are activities in viticulture and mariculture that require extreme physical endurance from human workers, making them prime candidates for automation and robotization. This paper presents a novel, practical, heterogeneous, autonomous robotic system divided into two main parts, each dealing with respective scenarios in viticulture and mariculture. The robotic components and the subsystems that enable collaboration were developed as part of the ongoing HEKTOR project, and each specific scenario is presented. In viticulture, this includes vineyard surveillance, spraying and suckering with an all-terrain mobile manipulator (ATMM) and a lightweight autonomous aerial robot (LAAR) that can be used in very steep vineyards where other mechanization fails. In mariculture, scenarios include coordinated aerial and subsurface monitoring of fish net pens using the LAAR, an autonomous surface vehicle (ASV), and a remotely operated underwater vehicle (ROV). All robotic components communicate and coordinate their actions through the Robot Operating System (ROS). Field tests demonstrate the great capabilities of the HEKTOR system for the fully autonomous execution of very strenuous and hazardous work in viticulture and mariculture, while meeting the necessary conditions for the required quality and quantity of the work performed.

MEMORIA DEL ORGANISMO ANDINO DE SALUD CONVENIO HIPÓLITO UNANUE 1971­2021: ORAS-CONHU 2022 / 5 0 a ñ o s t r a b a ja n d o p o r la s a lu d, e l b ie n e s t a r y la in t e g r a c ió n a n d in a / ANNUAL REPORT OF THE ANDEAN HEALTH AGENCY HIPÓLITO UNANUE AGREEMENT 1971 ­ 2021 ORAS-CONHU; 2022

La presente publicación da cuenta de los principales hitos y logros obtenidos a través de las diferentes gestiones institucionales en los últimos cincuenta años. Estos sintetizan las apuestas y retos en la búsqueda de salud para todos, con sistemas nacionales de salud más accesibles y con el fortalecimiento de la ciudadanía en este terreno, coadyuvando a superar las brechas para alcanzar mayores niveles de equidad y bienestar para cada una de las personas. Ello permitirá enfrentar la actual pandemia con mayor eficacia, en estos tiempos, marcados por la emergencia, la experiencia y el compromiso de servicio, el ORAS-CONHU seguirá contribuyendo en responder los nuevos retos de los países andinos

New horizons in the stormy sea of multimodal single-cell data integration.

While measurements of RNA expression have dominated the world of single-cell analyses, new single-cell techniques increasingly allow collection of different data modalities, measuring different molecules, structural connections, and intermolecular interactions. Integrating the resulting multimodal single-cell datasets is a new bioinformatics challenge. Equally important, it is a new experimental design challenge for the bench scientist, who is not only choosing from a myriad of techniques for each data modality but also faces new challenges in experimental design. The ultimate goal is to design, execute, and analyze multimodal single-cell experiments that are more than just descriptive but enable the learning of new causal and mechanistic biology. This objective requires strict consideration of the goals behind the analysis, which might range from mapping the heterogeneity of a cellular population to assembling system-wide causal networks that can further our understanding of cellular functions and eventually lead to models of tissues and organs. We review steps and challenges toward this goal. Single-cell transcriptomics is now a mature technology, and methods to measure proteins, lipids, small-molecule metabolites, and other molecular phenotypes at the single-cell level are rapidly developing. Integrating these single-cell readouts so that each cell has measurements of multiple types of data, e.g., transcriptomes, proteomes, and metabolomes, is expected to allow identification of highly specific cellular subpopulations and to provide the basis for inferring causal biological mechanisms.

Integrated bioinformatics and network pharmacology to identify the therapeutic target and molecular mechanisms of Huangqin decoction on ulcerative Colitis.

Huangqin decoction (HQD) is a Traditional Chinese Medicine formula for ulcerative colitis. However, the pharmacology and molecular mechanism of HQD on ulcerative colitis is still unclear. Combined microarray analysis, network pharmacology, and molecular docking for revealing the therapeutic targets and molecular mechanism of HQD against ulcerative colitis. TCMSP, DrugBank, Swiss Target Prediction were utilized to search the active components and effective targets of HQD. Ulcerative colitis effective targets were obtained by microarray data from the GEO database (GSE107499). Co-targets between HQD and ulcerative colitis are obtained by Draw Venn Diagram. PPI (Protein-protein interaction) network was constructed by the STRING database. To obtain the core target, topological analysis is exploited by Cytoscape 3.7.2. GO and KEGG enrichment pathway analysis was performed to Metascape platform, and molecular docking through Autodock Vina 1.1.2 finished. 161 active components with 486 effective targets of HQD were screened. 1542 ulcerative colitis effective targets were obtained with |Log2FC|> 1 and adjusted P-value < 0.05. The Venn analysis was contained 79 co-targets. Enrichment analysis showed that HQD played a role in TNF signaling pathway, IL-17 signaling pathway, Th17 cell differentiation, etc. IL6, TNF, IL1B, PTGS2, ESR1, and PPARG with the highest degree from PPI network were successfully docked with 19 core components of HQD, respectively. According to ZINC15 database, quercetin (ZINC4175638), baicalein (ZINC3871633), and wogonin (ZINC899093) recognized as key compounds of HQD on ulcerative colitis. PTGS2, ESR1, and PPARG are potential therapeutic targets of HQD. HQD can act on multiple targets through multi-pathway, to carry out its therapeutic role in ulcerative colitis.

A Unifying Framework for Human-Agent Collaborative Systems-Part I: Element and Relation Analysis.

The human-agent collaboration (HAC) is a prospective research topic whose great applications and future scenarios have attracted vast attention. In a broad sense, the HAC system (HACS) can be broken down into six elements: "Man," "Agents," "Goal," "Network," "Environment," and "Tasks." By merging these elements and building a relation graph, this article proposes a systematic analysis framework for HACS, and attempts to make a comprehensive analysis of these elements and their relationships. We coin the abbreviation "MAGNET" to name the framework by stringing together the initials of the above six terms. The framework provides novel insights into analyzing various HAC patterns and integrates different types of HACSs in a unifying way. The presentation of the HACS framework is divided into two parts. This article, part I, presents the systematic analysis framework. Part II proposes a normalized two-stage top-level design procedure for designing an HACS from the perspective of MAGNET.

Hierarchical systems integration for coordinated urban-rural water quality management at a catchment scale.

Managing river quality is important for sustainable catchment development. In this study, we present how catchment management strategies benefit from a coordinated implementation of measures that are based on understanding key drivers of pollution. We develop a modelling approach that integrates environmental impacts, human activities, and management measures as three hierarchical levels. We present a catchment water management model (CatchWat) that achieves all three hierarchical levels and is applied to the Cherwell Catchment, UK. CatchWat simulations are evaluated against observed river flow and pollutant data including suspended solids, total nitrogen, and total phosphorus. We compare three competing hypotheses, or framings, of the catchment representation (integrated, urban-only, and rural-only framings) to test the impacts of model boundaries on river water quality modelling. Scenarios are formulated to simulate separate, combined and coordinated implementation of fertiliser application reduction and enhanced wastewater treatment. Results show that models must represent both urban and rural pollution emissions to accurately estimate river quality. Agricultural activities are found to drive river quality in wet periods because runoff is the main pathway for rural pollutants. Meanwhile, urban activities are the key source of pollution in dry periods because effluent constitutes a larger percentage of river flow during this time. Based on this understanding, we identify a coordinated management strategy that implements fertiliser reduction measures to improve river quality during wet periods and enhanced wastewater treatment to improve river quality during dry periods. The coordinated strategy performs comparably to the combined strategy but with higher overall efficiency. This study emphasises the importance of systems boundaries in integrated water quality modelling and simulating the mechanisms of seasonal water quality behaviour. Our key recommendation is that incorporating these mechanisms is required to develop coordinated strategies for river water quality management, that can ultimately lead to more efficient and sustainable catchment management.

Privacy-preserving harmonization via distributed ComBat.

Challenges in clinical data sharing and the need to protect data privacy have led to the development and popularization of methods that do not require directly transferring patient data. In neuroimaging, integration of data across multiple institutions also introduces unwanted biases driven by scanner differences. These scanner effects have been shown by several research groups to severely affect downstream analyses. To facilitate the need of removing scanner effects in a distributed data setting, we introduce distributed ComBat, an adaptation of a popular harmonization method for multivariate data that borrows information across features. We present our fast and simple distributed algorithm and show that it yields equivalent results using data from the Alzheimer's Disease Neuroimaging Initiative. Our method enables harmonization while ensuring maximal privacy protection, thus facilitating a broad range of downstream analyses in functional and structural imaging studies.