informatics

信息学
  • 文章类型: Journal Article
    背景:高流量鼻插管(HFNC)装置通常用于治疗小儿重症急性哮喘。然而,几乎没有证据表明它在现实世界中的有效性。
    目的:我们试图比较HFNC治疗重度急性哮喘患儿与对照组患儿的生理效应和临床结局。
    方法:这是一项在一家四级保健儿童医院进行的单中心回顾性配对队列研究。包括2015年至2022年因严重急性哮喘住院的2-18岁儿童。病例包括在住院的前24小时内接受HFNC治疗的患者。对照主要用氧气面罩处理。使用人口统计进行Logistic回归1:1倾向评分匹配,初始生命体征,和药物。主要结果是在住院的最初24小时内临床哮喘症状的改善,以相对于最初的百分比变化来衡量。
    结果:在693个符合条件的案例中,443与合格的对照匹配。倾向得分在队列之间紧密对齐,临床特征的唯一显着差异是对照组中黑人种族患者的百分比更高(54.3%vs.46.6%;p=0.02)。与匹配的对照相比,HFNC队列的心率改善较小(-11.5%[-20.9;-0.9]vs.-14.7%[-22.6;-5.7];p<0.01),呼吸频率(-14.3%[-27.9;5.4]vs.-16.7%[-31.5;0.0];p=0.03),和小儿哮喘严重程度评分(-14.3%[-28.6;0.0]vs.住院24小时后-20.0%[-33.3;0.0];p<0.01)。HFNC队列也有更长的儿科重症监护病房(PICU)住院时间(LOS)(1.5天[1.1;2.1]vs.1.2天[0.9;1.8];p<0.01)和医院LOS(2.8天[2.1;3.8]vs.2.5天[1.9;3.4];p<0.01)。当分组到年轻患者(2-3岁)时,或严重程度得分最高的人(通过>9),接受HFNC治疗的患者在临床症状改善方面无差异,但维持了较长的PICULOS.
    结论:与对照组相比,使用HFNC治疗严重急性小儿哮喘的患者在住院24小时内的临床改善程度降低,LOS增加。年轻患者和严重程度评分最高的患者的特定亚组在临床症状改善方面没有差异,表明在特定患者人群中存在差异。
    BACKGROUND: The high-flow nasal cannula (HFNC) device is commonly used to treat pediatric severe acute asthma. However, there is little evidence regarding its effectiveness in real-world practice.
    OBJECTIVE: We sought to compare the physiologic effects and clinical outcomes for children treated for severe acute asthma with HFNC versus matched controls.
    METHODS: This was a single-center retrospective matched cohort study at a quaternary care children\'s hospital. Children ages 2-18 hospitalized for severe acute asthma from 2015 to 2022 were included. Encounters receiving treatment with HFNC within the first 24 h of hospitalization were included as cases. Controls were primarily treated with oxygen facemask. Logistic regression 1:1 propensity score matching was done using demographics, initial vital signs, and medications. The primary outcome was an improvement in clinical asthma symptoms in the first 24 h of hospitalization measured as percent change from initial.
    RESULTS: Of 693 eligible cases, 443 were matched to eligible controls. Propensity scores were closely aligned between the cohorts, with the only significant difference in clinical characteristics being a higher percentage of patients of Black race in the control group (54.3% vs. 46.6%; p = 0.02). Compared to the matched controls, the HFNC cohort had smaller improvements in heart rate (-11.5% [-20.9; -0.9] vs. -14.7% [-22.6;-5.7]; p < 0.01), respiratory rate (-14.3% [-27.9;5.4] vs. -16.7% [-31.5;0.0]; p = 0.03), and pediatric asthma severity score (-14.3% [-28.6;0.0] vs. -20.0% [-33.3;0.0]; p < 0.01) after 24 h of hospitalization. The HFNC cohort also had longer pediatric intensive care unit (PICU) length of stay (LOS) (1.5 days [1.1;2.1] vs. 1.2 days [0.9;1.8]; p < 0.01) and hospital LOS (2.8 days [2.1;3.8] vs. 2.5 days [1.9;3.4]; p < 0.01). When subgrouping to younger patients (2-3 years old), or those with the highest severity scores (PASS > 9), those treated with HFNC had no difference in clinical symptom improvements but maintained a longer PICU LOS.
    CONCLUSIONS: Encounters using HFNC for severe acute pediatric asthma had decreased clinical improvement in 24 h of hospitalization compared to matched controls and increased LOS. Specific subgroups of younger patients and those with the highest severity scores showed no differences in clinical symptom improvement suggesting differential effects in specific patient populations.
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  • 文章类型: Case Reports
    为了应对通过实施基于云的虚拟桌面共享临床研究数据的挑战,加强研究人员之间的协作,同时维护数据安全。
    本案例研究详细介绍了麻省大学陈医学院(麻省大学陈分校)虚拟桌面的部署。该过程涉及组建研究信息学指导执行工作组,确定关键要求,实施AmazonWorkSpaces,并建立可配置的数据管理以支持研究。
    主要课程包括协作的重要性,平衡用户友好性和功能,数据管理的灵活性,在预算限制范围内最大限度地提高虚拟桌面效率,和持续的用户反馈。虚拟桌面的实现支持安全协同研究,推进医学知识和改善医疗保健结果。
    实现虚拟桌面的结构化方法解决了数据安全性,法规遵从性,和实时协作挑战。持续的反馈和迭代改进增强了系统的有效性。
    UMassChan成功实施虚拟桌面证明了此类系统支持安全、合作研究,为其他学术健康中心的类似举措提供见解。
    UNASSIGNED: To address the challenges of sharing clinical research data through the implementation of cloud-based virtual desktops, enhancing collaboration among researchers while maintaining data security.
    UNASSIGNED: This case study details the deployment of virtual desktops at UMass Chan Medical School (UMass Chan). The process involved forming a Research Informatics Steering Executive workgroup, identifying key requirements, implementing Amazon WorkSpaces, and establishing configurable data management for research support.
    UNASSIGNED: Key lessons include the significance of collaboration, balancing user-friendliness and functionality, flexibility in data management, maximizing virtual desktop efficiency within budget constraints, and continuous user feedback. The implementation of virtual desktops supports secure collaborative research, advancing medical knowledge and improving healthcare outcomes.
    UNASSIGNED: The structured approach to implementing virtual desktops addresses data security, regulatory compliance, and real-time collaboration challenges. Continuous feedback and iterative improvements have enhanced the system\'s effectiveness.
    UNASSIGNED: The successful implementation of virtual desktops at UMass Chan demonstrates the potential for such systems to support secure, collaborative research, offering insights for similar initiatives in other academic health centers.
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  • 文章类型: Journal Article
    人工智能(AI)的前景引起了患者的热情,医疗保健专业人员,以及寻求利用其潜力来增强越来越多的慢性和急性疾病的诊断和管理的技术开发人员。现场护理测试(POCT)增加了获得护理的机会,因为它使传统医疗环境之外的护理成为可能。开发人员之间的合作,临床医生,和最终用户是解决临床问题的有效最佳实践。一组通用的明确定义的术语很容易被研究团队理解,是促进这些合作的有价值的工具。我们提出简短的,准确,以及用于开发新设备和决策支持技术的术语和技术的明确描述,这些技术与POCT最常见的应用相关。这个用于描述AI和机器学习技术的术语词典是医疗保健专业人员的快速参考。研究人员,开发者,和病人。常用的方法和技术被制成表格,并带有文本,提供其常用用法和所需数据特征的上下文。最后,我们总结了模型有效性测量和组件特征贡献的评估。人工智能(AI)是指从数据集推断意义的非人类技术。它可以产生概括,分类,预测,并且可以使用自动学习方法识别关联。本指南概述了这些方法及其在即时测试中的应用。
    The promise of artificial intelligence (AI) has generated enthusiasm among patients, healthcare professionals, and technology developers who seek to leverage its potential to enhance the diagnosis and management of an increasing number of chronic and acute conditions. Point-of-care testing (POCT) increases access to care because it enables care outside of traditional medical settings. Collaboration among developers, clinicians, and end users is an effective best practice for solving clinical problems. A common set of clearly defined terms that are easily understood by research teams is a valuable tool that fosters these collaborations. We present brief, accurate, and clear descriptions of terms and techniques used to develop new device and decision support technologies in association with their most common applications to POCT. This lexicon of terms used to describe AI and machine learning techniques is quick reference for healthcare professionals, researchers, developers, and patients. Commonly used methods and techniques are tabulated and presented with text providing the context of their common usage and required data characteristics. Finally, we summarize model effectiveness measurement and the assessment of component features contributions. Artificial intelligence (AI) refers to non-human techniques that infer meaning from sets of data. It can produce generalizations, classifications, predictions, and can identify associations using automated learning methods. This guide provides an overview of these methods and their application to point-of-care testing.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    骨和软骨组织是由机械输入系统地调节的生理动态器官。在细胞水平,机械刺激参与一个复杂的网络,其中机械传感器和发射器合作来操纵下游信号。尽管证据越来越多,对现有信息的利用明显不足,由于有限的整合和分析。在这种情况下,我们构想了一种名为MechanoBone的交互式网络工具,以引入基于文献的发现的新途径。最初,我们通过从Pubmed中获取内容并通过自然语言工具包项目进行处理来编译一个文献数据库,发布者,和自定义库。我们根据现有证据确定了实体之间的直接共现,通过SQLite在关系数据库中存档。然后通过利用链路预测算法对潜在连接进行量化。其次,生成了机械生物学途径图,并在我们的数据库基础上,通过加权算法建立了实体-路径相关性评分系统,字符串,和KEGG,预测特定实体的潜在功能。此外,我们建立了基于机械环境的探索,根据大数据根据基因的相关性对基因进行排序,揭示了骨研究中潜在的机械敏感因素和未来的临床应用。总之,MechanoBone能够:1)解释机械生物学过程;2)在特定机械条件下识别分子和途径之间的相关性和串扰;3)将临床应用与骨骼研究中的机械生物学过程联系起来。它提供了一个具有可视化和交互性的文献挖掘工具,在骨相关细胞的机械生物学框架内促进靶向分子导航和预测,从而加强生物医学领域的知识共享和大数据分析。
    Bone and cartilage tissues are physiologically dynamic organs that are systematically regulated by mechanical inputs. At cellular level, mechanical stimulation engages an intricate network where mechano-sensors and transmitters cooperate to manipulate downstream signaling. Despite accumulating evidence, there is a notable underutilization of available information, due to limited integration and analysis. In this context, we conceived an interactive web tool named MechanoBone to introduce a new avenue of literature-based discovery. Initially, we compiled a literature database by sourcing content from Pubmed and processing it through the Natural Language Toolkit project, Pubtator, and a custom library. We identified direct co-occurrence among entities based on existing evidence, archiving in a relational database via SQLite. Latent connections were then quantified by leveraging the Link Prediction algorithm. Secondly, mechanobiological pathway maps were generated, and an entity-pathway correlation scoring system was established through weighted algorithm based on our database, String, and KEGG, predicting potential functions of specific entities. Additionally, we established a mechanical circumstance-based exploration to sort genes by their relevance based on big data, revealing the potential mechanically sensitive factors in bone research and future clinical applications. In conclusion, MechanoBone enables: 1) interpreting mechanobiological processes; 2) identifying correlations and crosstalk among molecules and pathways under specific mechanical conditions; 3) connecting clinical applications with mechanobiological processes in bone research. It offers a literature mining tool with visualization and interactivity, facilitating targeted molecule navigation and prediction within the mechanobiological framework of bone-related cells, thereby enhancing knowledge sharing and big data analysis in the biomedical realm.
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  • 文章类型: Journal Article
    背景:临床实践设置越来越依赖于数字或电子健康技术的使用,如电子健康记录。支持护士适应数字化医疗保健系统至关重要;然而,对护理毕业生过渡到工作场所的经历知之甚少。
    目的:本研究旨在(1)描述新合格护士在工作场所的数字健康体验,和(2)确定战略,可以帮助支持新毕业生的过渡和实践与数字健康。
    方法:采用探索性描述性定性设计。来自加拿大东部和西部的14名护士参加了半结构化访谈,并使用归纳内容分析对数据进行了分析。
    结果:确定了三个主题:(1)成为注册护士之前的经历,(2)加入工作场所的经验,(3)弥合数字卫生实践转型差距的建议。研究结果表明,参与者在数字健康教育方面的差距比差异更多。与技术相关的挑战,以及它们对护理实践的影响。
    结论:数字健康是当代医疗保健的基础;因此,在护理学校和整个专业护理实践期间的全面教育,以及组织支持和政策,是关键的支柱。投资于数字健康技术的卫生系统必须为护士创造支持性的工作环境,使他们能够在技术丰富的环境中茁壮成长,并提高他们提供数字健康未来的能力。
    BACKGROUND: Clinical practice settings have increasingly become dependent on the use of digital or eHealth technologies such as electronic health records. It is vitally important to support nurses in adapting to digitalized health care systems; however, little is known about nursing graduates\' experiences as they transition to the workplace.
    OBJECTIVE: This study aims to (1) describe newly qualified nurses\' experiences with digital health in the workplace, and (2) identify strategies that could help support new graduates\' transition and practice with digital health.
    METHODS: An exploratory descriptive qualitative design was used. A total of 14 nurses from Eastern and Western Canada participated in semistructured interviews and data were analyzed using inductive content analysis.
    RESULTS: Three themes were identified: (1) experiences before becoming a registered nurse, (2) experiences upon joining the workplace, and (3) suggestions for bridging the gap in transition to digital health practice. Findings revealed more similarities than differences between participants with respect to gaps in digital health education, technology-related challenges, and their influence on nursing practice.
    CONCLUSIONS: Digital health is the foundation of contemporary health care; therefore, comprehensive education during nursing school and throughout professional nursing practice, as well as organizational support and policy, are critical pillars. Health systems investing in digital health technologies must create supportive work environments for nurses to thrive in technologically rich environments and increase their capacity to deliver the digital health future.
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  • 文章类型: Journal Article
    将个人与现有社区资源联系起来对于满足社会需求和改善人口健康至关重要。虽然有许多正在进行的信息学工作将社会需求筛查和转介嵌入医疗保健系统及其电子健康记录中,对数字生态系统和社区组织(CBO)提供或连接个人到这些资源的需求的关注较少。
    我们使用以人为本的设计为CBO开发了数字平台,专注于识别健康和社会资源以及与客户的沟通。
    以设计过程的开发阶段为中心,我们分两个阶段与社区组织领导和员工进行了深度访谈,以创建和迭代平台。我们从技术接受模型中引出并将参与者反馈映射到理论知情领域,如有用性和易用性,构建最终产品,并随着平台开发的进行总结所有主要设计决策。
    总的来说,我们在连续2个发展阶段完成了对18位社区组织领导和员工的22次访谈。面试记录编码后,有四个与可用性相关的主要主题,相关性,以及影响使用的外部因素。具体来说,CBO表示有兴趣使用客户关系管理软件来管理他们的客户互动和沟通,他们需要特定的额外功能来解决他们日常工作的范围,即(1)与客户的数字和SMS文本消息通信,以及(2)根据不同的客户需求和各种计划资格标准识别相关社区资源的简单方法。最后,出现了明确的执行需求,例如对使用新平台的员工的数字培训和支持。最后的平台,标题为“映射以增强参与社区的活力(MAVEN),“于2022年在Salesforce环境中完成,它包括直接映射到设计过程的特性和功能。
    让社区组织参与以用户为中心的健康和社会资源平台的设计,对于挖掘他们在服务当地社区和社区方面的深厚专业知识至关重要。由行为理论提供的设计方法可以类似地用于其他信息学研究。往前走,需要更多的工作来支持特定于CBO需求的平台的实施,特别是考虑到资源,培训,和自定义需要在这些设置。
    UNASSIGNED: Connecting individuals to existing community resources is critical to addressing social needs and improving population health. While there is much ongoing informatics work embedding social needs screening and referrals into health care systems and their electronic health records, there has been less focus on the digital ecosystem and needs of community-based organizations (CBOs) providing or connecting individuals to these resources.
    UNASSIGNED: We used human-centered design to develop a digital platform for CBOs, focused on identification of health and social resources and communication with their clients.
    UNASSIGNED: Centered in the Develop phase of the design process, we conducted in-depth interviews in 2 phases with community-based organizational leadership and staff to create and iterate on the platform. We elicited and mapped participant feedback to theory-informed domains from the Technology Acceptance Model, such as Usefulness and Ease of Use, to build the final product and summarized all major design decisions as the platform development proceeded.
    UNASSIGNED: Overall, we completed 22 interviews with 18 community-based organizational leadership and staff in 2 consecutive Develop phases. After coding of the interview transcripts, there were 4 major themes related to usability, relevance, and external factors impacting use. Specifically, CBOs expressed an interest in a customer relationship management software to manage their client interactions and communications, and they needed specific additional features to address the scope of their everyday work, namely (1) digital and SMS text messaging communication with clients and (2) easy ways to identify relevant community resources based on diverse client needs and various program eligibility criteria. Finally, clear implementation needs emerged, such as digital training and support for staff using new platforms. The final platform, titled \"Mapping to Enhance the Vitality of Engaged Neighborhoods (MAVEN),\" was completed in the Salesforce environment in 2022, and it included features and functions directly mapped to the design process.
    UNASSIGNED: Engaging community organizations in user-centered design of a health and social resource platform was essential to tapping into their deep expertise in serving local communities and neighborhoods. Design methods informed by behavioral theory can be similarly employed in other informatics research. Moving forward, much more work will be necessary to support the implementation of platforms specific to CBOs\' needs, especially given the resources, training, and customization needed in these settings.
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  • 文章类型: Journal Article
    目的:本研究的目的是确定为儿科患者提供护理的医院中与β-内酰胺/β-内酰胺酶抑制剂(BL/BLI)剂量描述相关的现行做法,并确定标准化BL/BLI剂量交流和订购基于药物的整体策略的感知含义。
    方法:通过4个儿科药房和感染性疾病列表服务器分发了27项电子调查。调查问题与医院人口统计有关,给药沟通实践,BL/BLI订购和标签实践,安全使用BL/BLI的障碍,以及潜在的标准化对整体药物传播战略的影响。采用SPSS进行定量分析,采用MAXQDA进行定性分析。
    结果:在排除不完整的响应并对同一机构的多个响应进行协调后,对总共140个独特的调查响应进行了分析。总的来说,56.2%的机构为儿科患者按BL部分订购BL/BLIs,22%的机构按BL部分订购成人患者。大约一半(51.8%)的受访者认为,将药物标准化至总药物会对他们的机构产生负面影响;对潜在影响的看法因机构的订购策略而异。
    结论:BL/BLIs的沟通和订购在机构之间以及儿科和成人患者之间不一致。在短期内,人们认为标准化会加剧体制挑战。
    OBJECTIVE: The purpose of this study was to define current practices related to beta-lactam/beta-lactamase inhibitor (BL/BLI) dose descriptions in hospitals that provide care for pediatric patients and to identify perceived implications of standardizing BL/BLI dose communication and ordering to a total drug-based strategy.
    METHODS: A 27-item electronic survey was distributed via 4 pediatric pharmacy and infectious diseases listservs. Survey questions pertained to hospital demographics, dosing communication practices, BL/BLI ordering and labeling practices, obstacles to safe BL/BLI use, and the effects of potential standardization to a total drug communication strategy. SPSS was used for quantitative analysis and MAXQDA was used for qualitative analysis.
    RESULTS: A total of 140 unique survey responses were analyzed after exclusion of incomplete responses and reconciliation of multiple responses from the same institution. Overall, 56.2% of institutions order BL/BLIs by BL component for pediatric patients, and 22% of institutions order by BL component for adult patients. Approximately half (51.8%) of respondents felt that standardizing to total drug would have a negative effect at their institution; perception of potential effect varied based on the institution\'s ordering strategy.
    CONCLUSIONS: Communication and ordering of BL/BLIs is inconsistent across institutions and between pediatric and adult patients. In the short term, the perception is that standardization would compound institutional challenges.
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  • 文章类型: Journal Article
    通过微藻和绿色技术生产可再生生物燃料是一种有前途的解决方案,可以满足未来的能源需求,同时减少温室气体(GHG)排放并回收能源,实现碳中和生物经济和环境可持续性。最近,能源信息学(EI)技术的集成作为一种新兴方法,确保了微藻生物技术和生物能源应用的可行性和增强。集成人工智能(AI)等EI技术,微藻领域应用中的预测建模系统和生命周期分析(LCA)可以降低成本,效率,生产力和可持续性。随着EI技术的发展,数据驱动的见解和决策,可以实现资源优化和更好地了解微藻培养对环境的影响,使其成为推进这一领域及其应用的关键一步。本文介绍了基于微藻的废水处理和生物能源生产系统中的常规技术。此外,已经讨论了EI在微藻技术中的最新集成,从AI应用到使用预测控制系统的建模和优化。还介绍了环境可持续性和经济角度的LCA和技术经济评估(TEA)。与EI方法相结合的基于微藻的废水处理对生物能源生产的未来挑战和前景,还讨论了与微藻作为未来能源的发展有关的问题。
    The production of renewable biofuel through microalgae and green technology can be a promising solution to meet future energy demands whilst reducing greenhouse gases (GHG) emissions and recovering energy for a carbon-neutral bio-economy and environmental sustainability. Recently, the integration of Energy Informatics (EI) technology as an emerging approach has ensured the feasibility and enhancement of microalgal biotechnology and bioenergy applications. Integrating EI technology such as artificial intelligence (AI), predictive modelling systems and life cycle analysis (LCA) in microalgae field applications can improve cost, efficiency, productivity and sustainability. With the approach of EI technology, data-driven insights and decision-making, resource optimization and a better understanding of the environmental impact of microalgae cultivation could be achieved, making it a crucial step in advancing this field and its applications. This review presents the conventional technologies in the microalgae-based system for wastewater treatment and bioenergy production. Furthermore, the recent integration of EI in microalgal technology from the AI application to the modelling and optimization using predictive control systems has been discussed. The LCA and techno-economic assessment (TEA) in the environmental sustainability and economic point of view are also presented. Future challenges and perspectives in the microalgae-based wastewater treatment to bioenergy production integrated with the EI approach, are also discussed in relation to the development of microalgae as the future energy source.
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  • 文章类型: Journal Article
    阿尔茨海默病神经影像学倡议(ADNI)通过其信息学核心彻底改变了阿尔茨海默病研究的景观,这促进了前所未有的数据标准化和共享。20多年来,ADNI建立了一个强大的信息学框架,能够验证生物标志物并支持全球研究工作。信息学的核心,以神经成像实验室(LONI)为中心,提供全面的数据中心,确保数据质量,可访问性,和安全,培育超过5600种出版物和重大的科学进步。通过接受开放的数据共享原则,ADNI在数据透明度方面设定了黄金标准,允许来自169个国家的26,000多名调查人员访问和下载丰富的多模式数据。这种合作方法不仅加速了生物标志物的发现和药物开发,提高了我们对阿尔茨海默病的理解,而且还成为其他研究计划的典范。展示了精心设计的信息学模型和共享数据在推动全球科学进步方面的变革潜力。重点:加速阿尔茨海默病的生物标志物发现和药物开发。阿尔茨海默病神经成像倡议(ADNI)的开放数据共享推动科学进步。数据探索和对数据档案的耦合分析。
    The Alzheimer\'s Disease Neuroimaging Initiative (ADNI) has revolutionized the landscape of Alzheimer\'s research through its Informatics Core, which has facilitated unprecedented data standardization and sharing. Over 20 years, ADNI established a robust informatics framework, enabling the validation of biomarkers and supporting global research efforts. The Informatics Core, centered at the Laboratory of Neuro Imaging (LONI), provides a comprehensive data hub that ensures data quality, accessibility, and security, fostering over 5600 publications and significant scientific advancements. By embracing open data sharing principles, ADNI set a gold standard in data transparency, allowing over 26,000 investigators from 169 countries to access and download a wealth of multimodal data. This collaborative approach not only accelerated biomarker discovery and drug development and advanced our understanding of Alzheimer\'s disease but also has served as a model for other research initiatives, demonstrating the transformative potential of carefully designed informatics models and shared data in driving global scientific progress. HIGHLIGHTS: Accelerating biomarker discovery and drug development for Alzheimer\'s disease. Alzheimer\'s Disease Neuroimaging Initiative\'s (ADNI\'s) open data sharing drives scientific progress. Data exploration and coupled analytics to data archives.
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