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At least 37 records · Page 2Linked to original sources

Automation in clinical microbiology: a new approach to identifying micro-organisms by automated pattern matching of proteins labelled with 35S-methionine.

A new rapid automated method for the identification and classification of microorganisms is described. It is based on the incorporation of 35S-methionine into cellular proteins and subsequent separation of the radiolabelled proteins by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). The protein patterns produced were species specific and reproducible, permitting discrimination between the species. A large number of Gram negative and Gram positive aerobic and anaerobic organisms were successfully tested. Furthermore, there were sufficient differences within species between the protein profiles to permit subdivision of the species. New typing schemes for Clostridium difficile, coagulase negative staphylococci, and Staphylococcus aureus, including the methicillin resistant strains, could thus be introduced; this has provided the basis for useful epidemiological studies. To standardise and automate the procedure an automated electrophoresis system and a two dimensional scanner were developed to scan the dried gels directly. The scanner is operated by a computer which also stores and analyses the scan data. Specific histograms are produced for each bacterial species. Pattern recognition software is used to construct databases and to compare data obtained from different gels: in this way duplicate "unknowns" can be identified. Specific small areas showing differences between various histograms can also be isolated and expanded to maximise the differences, thus providing differentiation between closely related bacterial species and the identification of differences within the species to provide new typing schemes. This system should be widely applied in clinical microbiology laboratories in the near future.

Automation↗

Automation reliability in unmanned aerial vehicle control: a reliance-compliance model of automation dependence in high workload.

OBJECTIVE: Two experiments were conducted in which participants navigated a simulated unmanned aerial vehicle (UAV) through a series of mission legs while searching for targets and monitoring system parameters. The goal of the study was to highlight the qualitatively different effects of automation false alarms and misses as they relate to operator compliance and reliance, respectively. BACKGROUND: Background data suggest that automation false alarms cause reduced compliance, whereas misses cause reduced reliance. METHOD: In two studies, 32 and 24 participants, including some licensed pilots, performed in-lab UAV simulations that presented the visual world and collected dependent measures. RESULTS: Results indicated that with the low-reliability aids, false alarms correlated with poorer performance in the system failure task, whereas misses correlated with poorer performance in the concurrent tasks. CONCLUSION: Compliance and reliance do appear to be affected by false alarms and misses, respectively, and are relatively independent of each other. APPLICATION: Practical implications are that automated aids must be fairly reliable to provide global benefits and that false alarms and misses have qualitatively different effects on performance.

Aircraft↗

Automated percutaneous lumbar discectomy with and without chymopapain pretreatment versus non-automated discoscopy-monitored percutaneous lumbar discectomy. An experimental study in human cadaver spines.

Percutaneous lumbar discectomy has gained growing interest during recent years as an alternative to open surgery for protrusions and non-sequestrated subligamentous intervertebral disc herniations. As a less invasive method it competes with chemonucleolysis. At least two modifications are known to date: automated percutaneous lumbar discectomy (APLD) with a 2-mm suction probe and non-automated, discoscopy-monitored percutaneous lumbar discectomy with a suction rongeur and a motor-driven shaver (NAPLD). In this study these two methods are compared for the amount of material extracted, dependence upon the degree of degeneration of the disc and intrinsic technical problems, using 20 human cadaver lumbar specimens for experimental testing. Total nucleotomy was not possible with either method. APLD yielded significantly less material and proved to be less effective in severely degenerated intervertebral discs than the NAPLD procedure, as preexisting gaps within the degenerated nucleus pulposus allowed the tissue to shift away from the tip of the 2-mm probe and facilitated displacement of the probe within the anulus fibrosus. By contrast, the rongeur, which first cuts the material to be removed and then carries it away by suction, was much more effective. Further data to support the advantages of non-automated percutaneous nucleotomy are discussed. Pretreatment of the disc with chymopapain did not result in a higher yield of nucleus material when combined with APLD.

Chymopapain↗

Will we see automated record keeping systems in common use in anesthesia during our lifetime? The automated anesthetic record will not automatically solve problems in record keeping.

The proponents of automated anesthetic records list the ostensibly logical reasons for them and then claim that automated records will make everything better. The logic goes as follows: (1) It is good to have accurate records because accurate records (a) make clinical decision making more effective and improve patient safety, (b) provide better defense against frivolous lawsuits, and (c) enable more astute medical policy decisions based on improved retrospective case reviews; (2) automatic record-keeping systems will give more nearly accurate records; (3) therefore, quality of care will improve if we acquire automatic record-keeping systems. This logic fails on several counts, which are detailed in this essay. Having said all this, however, I do believe that automated record systems will be implemented and they will be extremely useful, both for the patient and for those who care for the patient. However, we must exercise great care in their design and implementation, lest they wind up doing more harm than good.

Anesthesia↗

Adjusted-dose intravenous heparin treatment evaluation of an automated and a non automated schedule.

An automated schedule for adjusted continuous intravenous heparin treatment was tested under physician supervision in 19 patients and the results were compared to those obtained in 27 patients treated prior to automation. Both schedules used plasma activated partial thrombo-plastin time (P-APTT) for adjustment of heparin infusion and aimed at the same therapeutic interval for P-APTT (1.5-2 times the value in normal pooled plasma). The quality of treatment was assessed on the basis of clinical information and its ability to keep the P-APTT within or close to the therapeutic interval. The automated schedule reduced the involvement of the physician by 73% without changing the quality of treatment or increasing the consumption of other resources such as the number of P-APTT analyses. Both schedules were able to keep the P-APTT of the patients within the therapeutic interval for about 40% of the treatment time.

Adolescent↗

Comparison of an ELISA system for the quantification of hepatitis B antibody with an automated and a semi-automated system.

In order to manage the increased workload resulting from post vaccination hepatitis antibody testing of health care workers, the anti-hepatitis B ELISA assay ETI-AB-AUK (Sorin Biomedica), adapted for quantification using standards available as an addition to the qualitative kit assay (ABAU-STD-SET, (Sorin Biomedica)) and a sample pre-dilution step, was compared with a fully automated microparticle enzyme immunoassay IMX AUSAB (Abbott Laboratories), and a semi-automated enhanced luminescence system (Amerlite Amersham, now Kodak). Seventy-eight samples were concurrently tested and analysed statistically using a Regression Coefficient computer package (Apple Mackintosh Cricket). Good quantitative agreement was observed with ELISA vs IMX giving a linear correlation coefficient (r = 0.96). The linear correlation coefficient for ELISA vs Amerlite was r = 0.77. This study validates the use of the automated IMX system and allows the comparison of IMX results with previous 'semi-quantitative' ELISA results when longitudinally assessing patients response to a recombinant hepatitis B vaccine.

Autoanalysis↗

Quantitative determination of expression of the prostate cancer protein alpha-methylacyl-CoA racemase using automated quantitative analysis (AQUA): a novel paradigm for automated and continuous biomarker measurements.

Despite years of discovery and attempts at validation, few molecular biomarkers achieve acceptance in the clinical setting. Tissue-based markers evaluated by immunohistochemistry suffer from a high degree of inter- and intraobserver variability. One recent advance in this field that promises to automate this process is the development of AQUA, a molecular-based method of quantitative assessment of protein expression. This system integrates a set of algorithms that allows for the rapid, automated, continuous, and quantitative analysis of tissue samples, including the separation of tumor from stromal elements and the subcellular localization of signals. This study uses the AQUA system to assess a recently described prostate cancer biomarker, alpha-methylacyl-CoA-racemase (AMACR), and to determine the effectiveness of the quantitative measurement of this marker as a means for making the diagnosis of prostate cancer. Using a prostate cancer progression tissue microarray containing a wide range of prostate tissues, AQUA was directly compared to standard immunohistochemical evaluation for AMACR protein expression using the p504s monoclonal antibody. Both methods produced similar results showing AMACR protein expression to be strongest in the clinically localized prostate cancer, followed by the metastatic tumor samples. Benign prostate tissue was categorized as negative for most tissue samples by immunohistochemistry. However, AMACR was detectable using the AQUA system at low levels using the standard 1:25 dilution but also at 1:250 dilution, which is not detectable by light microscopy. The AQUA system was also able to discriminate foamy gland prostate cancers, which are known to have a lower AMACR expression than typical acinar prostate cancers, from benign prostate tissue samples. Finally, a receiver-operating-characteristic curve was plotted to determine the specificity of the AMACR AQUA Z-score (normalized AQUA score) to predict that a given tissue microarray sample contains cancer. The area under the curve was calculated at 0.90 (P < 0.00001; 95% CI, 0.84 to 0.95). At an AMACR AQUA Z-score score of -0.3, 91% of the 70 samples classified as prostate cancer were correctly categorized without the intervention of a pathologist reviewing the tissue microarray slide. In conclusion, the AQUA system provides a continuous measurement of AMACR on a wide range of prostate tissue samples. In the future, the AMACR AQUA Z-score may be useful in the automated screening and evaluation of prostate tissue biomarkers.

Biomarkers, Tumor↗

Automated quantification of left ventricular function by the automated contour tracking method.

The automated contour tracking (ACT) method has been developed for the automated measurement of area volume using the energy minimization method without tracing a region of interest. The purpose of this study was to compare the ACT method and left ventriculography (LVG) for the measurement of left ventricular (LV) function in the clinical setting. An apical four-chamber view was visualized by two-dimensional echocardiography and recorded for off-line analysis in 14 patients with high-quality images who underwent LVG. The ACT method automatically traces the endocardial border from the recorded images and calculates LV volumes (end-diastole and end-systole) and ejection fraction (EF). Both ACT and LVG were compared by linear regression analysis for the measurement of EF. EF determined by the ACT method agreed well with that by LVG (r = 0.96, y = 0.94x + 4.6, standard error of the estimate = 3.9%). The mean difference between the ACT and LVG was -1.4%+/- 7.3%. In conclusion, the ACT method is reliable for noninvasive estimation of EF in high-quality images. This suggests that this new technique may be useful in the automated quantification of LV function.

Adult↗

The added diagnostic value of automated QT-dispersion measurements and automated ST-segment deviations in the electrocardiographic diagnosis of acute cardiac ischemia.

The purpose of this study was to determine the added value of automated QT dispersion and ST-segment measurements to physician interpretation of 12-lead electrocardiograms (ECGs) in patients with chest pain. To date, poor reproducibility of manual measurements and lack of shown added value have limited the clinical use of QT dispersion. Twelve-lead ECGs (n = 1,161) from the Milwaukee Prehospital Chest Pain Database were independently classified by 2 physicians into 3 groups (acute myocardial infarction (AMI), acute cardiac ischemia (ACI), or nonischemic), and their consensus was obtained. QT-end and QT-peak dispersions were measured by a computerized system. The computer also identified ST-segment deviations. Sensitivity, specificity, and positive predictive values (PPVs) and negative predictive values (NPV) for AMI and ACI were evaluated independently and in combinations. For AMI, physicians' consensus classification was remarkably good (sensitivity, 48%, specificity, 99%). Independent classification by QT-end and QT-peak dispersions or ST deviations was not superior to the physicians' consensus. Optimal classification occurred by combining automated QT-end dispersion and ST deviations with physicians' consensus. This combination increased sensitivity for the diagnoses of AMI by 35% (65% vs 48%, P < .001) and ACI by 55% (62% vs 40%, P < .001) compared with physicians' consensus, while maintaining comparable specificity. This study supports a potential clinical role for automated QT dispersion when combined with other diagnostic methods for detecting AMI and ACI.

Adolescent↗

Modeling and deadlock avoidance of automated manufacturing systems with multiple automated guided vehicles.

An automated manufacturing system (AMS) contains a number of versatile machines (or workstations), buffers, an automated material handling system (MHS), and is computer-controlled. An effective and flexible alternative for implementing MHS is to use automated guided vehicle (AGV) system. The deadlock issue in AMS is very important in its operation and has extensively been studied. The deadlock problems were separately treated for parts in production and transportation and many techniques were developed for each problem. However, such treatment does not take the advantage of the flexibility offered by multiple AGVs. In general, it is intractable to obtain maximally permissive control policy for either problem. Instead, this paper investigates these two problems in an integrated way. First we model an AGV system and part processing processes by resource-oriented Petri nets, respectively. Then the two models are integrated by using macro transitions. Based on the combined model, a novel control policy for deadlock avoidance is proposed. It is shown to be maximally permissive with computational complexity of O (n2) where n is the number of machines in AMS if the complexity for controlling the part transportation by AGVs is not considered. Thus, the complexity of deadlock avoidance for the whole system is bounded by the complexity in controlling the AGV system. An illustrative example shows its application and power.

Artifacts↗

Automated three-dimensional analysis of mitral annular dynamics in patients with myocardial infarction using automated mitral annular tracking method.

BACKGROUND: A newly developed automated mitral annular tracking method (AMAT) has recently become available and enables us to perform automated analysis of mitral annular dynamics. PURPOSE: To evaluate mitral annular dynamics using AMAT. METHODS: AMAT was performed using a Toshiba Aplio SSA-770 ultrasound system in 15 normal healthy volunteers (group N), 16 patients with anterior MI (group A), and 12 inferior MI (group B). The distance between an annular point at end-diastole and at end-systole (distance D) was automatically measured using AMAT at the basal portion of the anterior, lateral, posterior, inferior, and inferoseptal wall. The angle between the mitral annular plane at end-diastole and the direction of movement of each mitral annular point from end-diastole to end-systole (angle A) was also automatically measured at all five mitral annular points. The coefficients of variation (CV) of both distance D and of angle A were calculated as indices of asynchrony of mitral annular dynamics. RESULTS: CV of distance D in group A (22 +/- 9% (P < 0.01 vs group N)) and group B (22 +/- 10% (P < 0.01 vs group N)) were both significantly larger than in group N (13 +/- 4%). CV of angle A in group A (15 +/- 10% (P < 0.05 vs group N)) and group B (15 +/- 10% (P < 0.05 vs group N)) were also significantly larger than that in group N (8 +/- 3%). CONCLUSION: Automated analysis using AMAT showed that mitral annular dynamics of patients with MI were less symmetrical than in normal healthy volunteers.

Adult↗

Can semi-automated image cytometry on induced sputum become a screening tool for lung cancer? Evaluation of quantitative semi-automated sputum cytometry on radon- and uranium-exposed workers.

The correlations between semi-automated sputum cytometry (ASC), conventional cytology and the final diagnosis was investigated in industrially-exposed workers. Slides of sputum samples from 201 former uranium miners with silicosis, 100 patients with asbestosis, 103 workers resected for lung cancer, and 200 controls (50% smokers), were stained using the Papanicolaou (Pap) method and the Feulgen reaction with thionin. Cytometry was performed using the Cyto-Savant automated system. Atypical nuclei were found in 72 of 404 patient samples, 327 samples were normal and five were inadequate for ASC analysis. Thirteen tumours (Pap IV, Pap V) and 11 cases of severe dysplasia were identified by cytology. Lung cancer was confirmed in 20 patients. Compared to the final diagnosis of lung cancer, the sensitivity of ASC was 75% (15 out of 20) and specificity 89.8% (520 out of 579). The results represent a diagnostic efficiency of 89.3%. The combination of ASC with cytology increased sensitivity to 80% (16 out of 20) without significant loss of specificity (89.7% or 523 out of 581). In this investigation of a limited number of patients with occupational radon or asbestos exposure, semi-automated sputum cytometry appears to be sensitive and reliable for the detection of malignant changes in the tracheobronchial mucosa. Together with conventional cytology, it would be reasonable to test the validity of the combined methods in a large-scale feasibility study of early lung cancer detection.

Adult↗

Comparison of standard white-on-white automated perimetry and short-wavelength automated perimetry in early glaucoma patients.

BACKGROUND: To evaluate the relationship between short-wavelength automated perimetry (SWAP) and the standard white-on-white automated perimetry (W-W) in detection of early glaucomatous visual field deficits. METHODS: Twenty-four patients suspected of having glaucoma and who had experience with automated visual field tests were evaluated by SWAP and standard W-W perimetry. Results of the mean deviation (MD), pattern standard deviation (PSD), pattern deviation probability plot, test reliability, and test time were compared. RESULTS: The average MD in the SWAP group was significantly higher than that in the W-W group (SWAP: -6.55 db, W-W: -2.69 db, p<0.001). A significant difference also existed in PSD between the 2 groups (SWAP: 3.49 db, W-W: 2.40 db, p<0.001). The test time was longer in the SWAP group than in the W-W group (SWAP: 15 min, 6 s; W-W: 13 min, 8 s, p<0.001). There was no significant difference between the 2 groups in test reliability or in the number of points that were depressed below the 1% and 5% sensitivity levels on the pattern deviation probability plot. CONCLUSIONS: This study showed that greater MD and PSD were demonstrated with SWAP. The test time was longer for SWAP. However, in order to conclude that SWAP is an early indicator of glaucomatous damage, longer follow-up and further analyses are required.

Adolescent↗

Automated synthesis of a C-terminal photoprobe using combined Fmoc and t-Boc synthesis strategies on a single automated peptide synthesizer.

Peptide photoprobes can be utilized to identify peptide binding sites of various proteins. The photoprobe p-benzoylbenzoic acid (BBA) possesses several unique chemical characteristics which make it ideal for the construction of a peptide photoprobe: It can be directly coupled to the peptide during synthesis, it is stable to HF treatment, it is inert until photolysis, and the photo-activated probe is non-specific in its binding to proteins. The construction of an N-terminal p-benzoylbenzoyl-peptide photoprobe utilizing an automated peptide synthesizer is straight-forward because p-benzoylbenzoic acid can be incorporated during routine peptide synthesis as if it were the N-terminal amino acid. In contrast, the construction of a C-terminal photoprobe peptide is more complex and requires the presence of a C-terminal lysine to incorporate the photoprobe into the peptide. We have devised a suitable pathway to attach BBA to the C-terminal of a synthetic peptide in an automated fashion. The method described in this report utilizes Fmoc chemistry for the automated loading of Boc-Lysine-epsilon-Fmoc to hydroxymethyl resin. After loading, the epsilon-amine of the resin-bound lysine is deprotected with piperidine and the addition of BBA to the epsilon-amine then occurs via a peptide bond. The peptide synthesizer is then converted over to t-Boc chemistry, and the remainder of the synthesis is carried out using standard protocols.

Amino Acid Sequence↗

PREPmate automated processor: comparison of automated and manual methods of liquid-based gynecologic sample preparation.

The development of procedures for fully automated processing of liquid-based gynecologic samples has been the focus of considerable interest to the cytology laboratory. Liquid-based collection and processing technology has been shown to improve sample adequacy, resulting in an overall improvement in quality of sample preparations. PREPmate, an accessory to the PrepStain slide processor, automates the initial enrichment process of mixing and dispensing the specimen over a density gradient. This report describes a study evaluating cellularity and diagnostic reproducibility in SurePath samples processed using the PREPmate accessory compared to samples processed using a manual technique. Samples processed using the PREPmate accessory contained 8.3% more squamous cells. Exact diagnostic reproducibility between preparation types was 83.3%; when considering negative vs. abnormal (ASCUS+), in adequate samples, reproducibility was 100%.

Automation↗

An automated interrupted suturing device for coronary artery bypass grafting: automated coronary anastomosis.

BACKGROUND: The purpose of this study was to have a preliminary assessment of the safety and efficacy of an automated vascular suturing device. METHODS: The device (Heartflo, Perclose/Abbott Labs, Redwood City, CA), which delivers 10 interrupted 7-0 polypropylene sutures between side-to-side arteriotomies, was evaluated in animals (8 Yorkshire pigs). RESULTS: Tissue edge capture and quality of anastomosis were highly rated. Time of anastomoses averaged 22 minutes. This time was prolonged primarily due to suture management, tying of interrupted sutures, and learning curve effects. Six of the anastomoses were hemostatic and two required an additional stitch each. Angiography and histology of the anastomosis confirmed patency and quality of the anastomosis. CONCLUSIONS: Our preliminary results indicate that the Heartflo automated anastomotic device is safe and effective. Preclinical and clinical studies to validate its acute and long-term effectiveness will commence shortly.

Anastomosis, Surgical↗

Comparison of plasma sample purification by manual liquid-liquid extraction, automated 96-well liquid-liquid extraction and automated 96-well solid-phase extraction for analysis by high-performance liquid chromatography with tandem mass spectrometry.

Three extraction procedures were developed for the quantitative determination of a carboxylic acid containing analyte (I) in human plasma by high-performance liquid chromatography (HPLC) with negative ion electrospray tandem mass spectrometry (MS-MS). The first procedure was based on the manual liquid-liquid extraction (LLE) of the acidified plasma samples with methyl tert.-butyl ether. The second procedure was based on the automation of the manual LLE procedure using 96-well collection plates and a robotic liquid handling system. The third approach was based on automated solid-phase extraction (SPE) using 96-well SPE plates and a robotic liquid handling system. A lower limit of quantitation of 50 pg/ml was achieved using all three extraction procedures. The total time required to prepare calibration curve standards, aliquot the standards and plasma samples, and process a total of 96 standards and samples by manual LLE was three-times longer than the time required for 96-well SPE or 96-well LLE (4 h, 50 min vs. 1 h, 43 min). Even more importantly, the time the bioanalyst physically spent on the 96-well LLE or 96-well SPE procedure was only a small fraction of the time spent on the manual LLE procedure (<10 min vs. 4 h, 10 min). It should be noted that the 96-well SPE procedure incorporated the two steps of evaporation of the eluates to dryness and subsequent reconstitution of the dried extract. The total time required for the 96-well SPE could be reduced by 50% if the eluates were injected directly, eliminating the drying and reconstitution steps, which is achievable when sensitivity is less of an issue.

Automation↗

Automated detection of red cell antibodies in donor sera using an automated technology.

The evaluation of two automated (AutoGrouper-16C) antibody detection techniques, designed for routine use is reported. Three channels on the instrument were modified for low-ionic-strength or enzyme methods. The incidence of antibody detection was 90.5 percent, and all antibodies that were not detected had titers of 4 or less and would be unlikely to cause adverse clinical reactions if transfused. The adaptation of this automated instrument for donor antibody screening resulted in substantial time and cost savings.

Automation↗