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Enhanced real-time cursor control algorithm, based on the spectral analysis of electromyograms.

This paper presents a new version of an EMG-based, hands-free, cursor control system, and compares its performance to that of a previous version. Both systems use classification algorithms that rely on the periodogram estimation of the power spectral density (PSD) of electromyogram (EMG) signals from muscles in the face. The older system requires three electrodes for EMG input, and utilizes an algorithm that calculates partial power accumulations over the frequency ranges of 0Hz - 145Hz and 145Hz - 600Hz in the PSDs of the EMG signals. The new system requires four electrodes for EMG input, and utilizes an algorithm that calculates mean power frequency (MPF) values to assist in distinguishing the cranial muscle that contracted. An experiment was devised to gauge the point-and-click capabilities of both systems. The experimental results were evaluated using Fitts' Law analysis. The results show that the new algorithm provides improved point-and-click performance over the old algorithm.

Algorithms↗

Three-dimensional tissue constructs built by bioprinting.

Bioprinting is an evolving tissue engineering technology. It utilizes computer controlled three-dimensional printers for rapid and high-precision construction of three-dimensional biological structures. We employed discrete and continuous bioprinting to build three-dimensional tissue constructs. In the former case bioink particles - spherical cell aggregates composed of many thousands of cells - are delivered one by one into biocompatible scaffolds, the biopaper. Structure formation takes place by the subsequent fusion of the bioink particles due to their liquid-like and self-assembly properties. In the latter case a mixture of cells and scaffold material is extruded from the biocartridge akin to toothpaste to arrive at the desired construct. Specifically, we built rectangular tissue blocks of several hundred microns in thickness as well as tubular structures of several millimeters in height. The physical basis of structure formation was studied by computer simulations.

Animals↗

[Digital picture archiving, processing and communication in diagnostic imaging with a Siemens Network (SIENET): initial results].

The concept of Picture Archiving and Communication System (PACS) in digital imaging offers substantial advantages: better data security, faster access to archived images, simultaneous availability of images at different sites, minimal space demand for archive medium, retrospective image post-processing opportunities and lower costs resulting from reduced film consumption and length of stay. However, practical experiences concerning reliability and efficiency of real PAC networks in radiological departments have to be made yet in order to improve network structure, software design and hardware performance. The ongoing stepwise installation and test of a Siemens PACS (SIENET) at the Department of Radiology at the Medical University of Lübeck will support the introduction of PACS concept into radiological practice.

Computer Communication Networks↗

Medical data capture and display: the importance of clinicians' workstation design.

The Department of Veterans Affairs is developing, testing and evaluating the benefits of physicians' workstations as an aid to medical data capture in an outpatient clinic setting. The physician's workstation uses a graphical user interface to aid the clinician in recording encounter data. Various input devices including keyboard, mouse, pen, voice, barcode reader, and tablet are available on the workstations, and user preferences will be examined. Access to general services such as electronic mail and reference databases is also available. The workstation provides a wide variety of patient specific data from the hospital information system, including image data. The single data collection process by the clinician will also provide data for the cost recovery process.

Computer Peripherals↗

[Computer systems in gastroenterologic endoscopy. An analysis of current availability on the Austrian market].

Five systems for computerized documentation (ADAM-Fujinon, ENDOBASE-Olympus, MEDASYS-Pentax, MEPAS-Fritsch & Jirak, OPTAMED-Krötlinger) are compared in their different functions: configuration of system, software, communication, structure of program, user guidance, data-protection, data back-up, patient registration, preparation for examination, terminology setup, report generation, image filing, statistic, system adjustments, costs. This paper should be a help in buying a computer-aided system. All systems fulfil the three basic requirements for a computer-aided documentation in gastrointestinal endoscopy: database, image filing, report generation. Actually none of the programs can be favoured. Peculiarities, weakness and strength of the different programs are discussed. The principle of the scoring-method in choosing a system is explained.

Austria↗

User interface design and evaluation for electronic medical record system.

A user interface for an electronic medical record system (EMRS) is proposed. A pen-based device adopted for data input and the GUI windows layout simulate conventional paper forms, so that doctors can quickly grow accustomed to the EMRS. A comparison study shows the proposed interface does not significantly delay the examination, even when used in hospitals with many outpatients.

Ambulatory Care↗

Problems of knowledge acquisition automation in medical expert systems.

Certain problems exist in the automation of knowledge acquisition (identification of phenomena, their description, formalization and coding), for medical diagnosis, therapy and scientific investigations. Issues concern the comparison of various approaches and their ability to be implemented and utilized.

Artificial Intelligence↗

Ergonomics and body mechanics in the work place.

Ergonomics in the work place has become more critical in recent years, both from a sedentary and a dynamic perspective. As mentioned, overall work-place injuries have decreased, but carpal tunnel disease has risen steadily. It is essential that health care providers understand the basis of ergonomics to ensure quality of care to the injured worker as well as to promote safe work practices. The field of ergonomics has had more concrete scientific evidence from which to draw conclusions than body mechanics. Health care providers are able to make an assessment of a work station and have clear scientific evidence to support their rationale to change that work station. The controversy still goes on regarding the correct position the spine should assume when one attempts to lift. Only with continued basic scientific research will we solve that dilemma.

Biomechanical Phenomena↗

Optimizing physician access to surgical intensive care unit laboratory information through mobile computing.

Approximately 30 minutes of computer access time are required by surgical residents at Stanford University Medical Center (SUMC) to examine the lab values of all patients on a surgical intensive care unit (ICU) service, a task that must be performed several times a day. To reduce the time accessing this information and simultaneously increase the readability and currency of the data, we have created a mobile, pen-based user interface and software system that delivers lab results to surgeons in the ICU. The ScroungeMaster system, loaded on a portable tablet computer, retrieves lab results for a subset of patients from the central laboratory computer and stores them in a local database cache. The cache can be updated on command; this update takes approximately 2.7 minutes for all ICU patients being followed by the surgeon, and can be performed as a background task while the user continues to access selected lab results. The user interface presents lab results according to physiologic system. Which labs are displayed first is governed by a layout selection algorithm based on previous accesses to the patient's lab information, physician preferences, and the nature of the patient's medical condition. Initial evaluation of the system has shown that physicians prefer the ScroungeMaster interface to that of existing systems at SUMC and are satisfied with the system's performance. We discuss the evolution of ScroungeMaster and make observations on changes to physician work flow with the presence of mobile, pen-based computing in the ICU.

Algorithms↗

Lightweight, mobile E-mail for intra-clinic communication.

We have developed a mobile messaging system designed for use in the clinic setting. The system is designed to facilitate quick, informal, interactions that occur in a clinical setting, e.g., requests for assistance or information. The system includes safeguards to make sure that the sender of a message is aware if a message is not read in a timely fashion. Evaluation of the system shows message delivery was about 50% slower than our target of 30 seconds. Although the mobile device used is fairly small when combined with a radio unit, it is too bulky and users did not necessarily carry the system with them. This led to delays (over eleven minutes on average) before messages were seen. We expect that improvements in hardware and clinical software will lead to more common use of such adjunct software systems.

Communication↗

Differential presentation of cortical and trabecular peripheral bone mineral density in acromegaly.

Growth hormone (GH) has been suggested as a therapeutic tool for the treatment of osteopenia. To assess the differential influence of growth hormone on cortical and trabecular bone, bone mineral densities (BMD) of the ultradistal radius were determined in 18 men and 19 women with clinically and biochemically confirmed acromegaly using peripheral computed tomography and a specialized scanner (Stratec XCT 900). The results were expressed in equivalents to hydroxyl-apatite (mg/ccm) and compared with the BMD of healthy controls (17 men, 34 women). Cortical bone mineral density was significantly higher in acromegalic women (295.2 +/- 18.4, X +/- SEM) and men (339.4 +/- 21.2) compared to healthy women (243.0 +/- 12.8) and men (272.2 +/- 15.9). In contrast, trabecular BMD did not differ between acromegalic patients (men: 161.0 +/- 16.1; women: 116.5 +/- 10.5) and controls (men: 158.0 +/- 12.2; women: 134.1 +/- 6.3). Acromegalic women showed a significant correlation between insulin-like growth factor (IGF-I) expression and cortical BMD, whereas in acromegalic men GH levels correlated significantly with cortical BMD. Greatly increased serum osteocalcin levels in both, acromegalic men (15.5 +/- 3.3 ng/ml) and women (12.9 +/- 1.8) compared to controls (men: 6.7 +/- 1.7; women: 7.7 +/- 1.0) indicates the activation of osteoblastic bone formation. This study revealed an increase in cortical BMD at the forearm; in acromegalic patients; though trabecular BMD did not differ from controls. The differential mineralization of cortical and trabecular bone in acromegaly may be indicative of the detrimental effect accompanying pituitary insufficiency can have on trabecular bone, despite substitution therapy, but could also be due to different reactivity of cortical and trabecular bone to GH and/or IGF I. The observable increase of bone mineral density in acromegaly suggests a potential use for GH in treating osteoporosis.

Acromegaly↗