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PubMed1992

The medical libraries of Vietnam--a service in transition.

The medical libraries of Vietnam maintain high profiles within their institutions and are recognized by health care professionals and administrators as an important part of the health care system. Despite the multitude of problems in providing even a minimal level of medical library services, librarians, clinicians, and researchers nevertheless are determined that enhanced services be made available. Currently, services can be described as basic and unsophisticated, yet viable and surprisingly well organized. The lack of hard western currency required to buy materials and the lack of library technology will be major obstacles to improving information services. Vietnam, like many developing nations, is about to enter a period of technological upheaval, which ultimately will result in a transition from the traditional library limited by walls to a national resource that will rely increasingly on electronic access to international knowledge networks. Technology such as CD-ROM, Integrated Services Digital Network (ISDN), and satellite telecommunication networks such as Internet can provide the technical backbone to provide access to remote and widely distributed electronic databases to support the information needs of the health care community. Over the long term, access to such databases likely will be cost-effective, in contrast to the assuredly astronomical cost of building a comparable domestic print collection. The advent of new, low-cost electronic technologies probably will revolutionize health care information services in developing nations. However, for the immediate future, the medical libraries of Vietnam will require ongoing sustained support from the international community, so that minimal levels of resources will be available to support the information needs of the health care community. It is remarkable, and a credit to the determination of Vietnam's librarians that, in a country with a legacy of war, economic deprivation, and international isolation, they have somehow managed to provide a sound basic level of information services for health care professionals.

Communism↗
PubMed2000

Selection of peptidic mimics of digoxin from phage-displayed peptide libraries by anti-digoxin antibodies.

Since the initial report of the development of methodology to generate high-affinity digitalis-specific (digoxin) antibodies, these antibodies have proven extremely useful tools to monitor digoxin levels in digitalized patients and, as Fab fragments, to reverse toxic digoxin effects in life-threatening digoxin overdoses. These antibodies (both digoxin-specific and ouabain-specific) have been used extensively by investigators for the identification and characterization of putative endogenous digitalis-like factors. In this study, we used two well-characterized mouse anti-digoxin monoclonal antibodies (mAbs), designated 26-10 and 45-20, as binding templates with which to select short bacteriophage-displayed (pIII protein inserted) peptides that are capable of binding to these mAbs and mimicking the conformational structure of digoxin. Selective enrichment from two phage-displayed random peptide libraries enabled us to isolate and identify distinct 15 and 26 amino acid residue peptide inserts that bind with high avidity and idiotypic specificity to the selecting mAbs. Among these displayed inserts a subset was identified whose mAb binding is inhibited by digoxin and whose corresponding synthetic peptides inhibit phage binding. They, therefore, appear to bind at the mAbs digoxin-binding sites. These data provide the first clear evidence that short polypeptides can serve as surrogates for the low molecular mass hapten digoxin.

Amino Acid Sequence↗
PubMed2003

Differential receptors create patterns diagnostic for ATP and GTP.

Herein we report the combination of a library of resin-bound sensors along with a multicomponent sensor array. This novel combinatorial array sensor system shows selectivity for nucleotide phosphates in solution. The design of the anchored receptor includes a 1,3,5-trisubstituted-2,4,6-triethylbenzene scaffold coupled with peptide libraries. Each chemosensor is placed into a micromachined cavity within a silicon wafer, and the optical changes observed by a charged-coupled device result in near-real-time digital analysis of solutions. A colorimetric displacement assay was performed, and time-dependent imaging studies of the selected sensing ensembles result in a differential responses upon addition of adenosine 5'-triphosphate (ATP), adenosine 5'-monophosphate (AMP), or guanosine 5'-triphosphate (GTP). An advantage to this approach is that it creates an array of sensors that gives a fingerprint response for each analyte. Principal component analysis indicates that the library of chemosensors can differentiate between ATP, GTP, and AMP. On the basis of factor loading values, individual sensors from the library were sequenced to elucidate their chemical composition.

Adenosine Triphosphate↗
PubMed1995

LabVIEW: a software system for data acquisition, data analysis, and instrument control.

Computer-based data acquisition systems play an important role in clinical monitoring and in the development of new monitoring tools. LabVIEW (National Instruments, Austin, TX) is a data acquisition and programming environment that allows flexible acquisition and processing of analog and digital data. The main feature that distinguishes LabVIEW from other data acquisition programs is its highly modular graphical programming language, "G," and a large library of mathematical and statistical functions. The advantage of graphical programming is that the code is flexible, reusable, and self-documenting. Subroutines can be saved in a library and reused without modification in other programs. This dramatically reduces development time and enables researchers to develop or modify their own programs. LabVIEW uses a large amount of processing power and computer memory, thus requiring a powerful computer. A large-screen monitor is desirable when developing larger applications. LabVIEW is excellently suited for testing new monitoring paradigms, analysis algorithms, or user interfaces. The typical LabVIEW user is the researcher who wants to develop a new monitoring technique, a set of new (derived) variables by integrating signals from several existing patient monitors, closed-loop control of a physiological variable, or a physiological simulator.

Analog-Digital Conversion↗
PubMedDate not supplied

ANCA-Tutor: a program that teaches interpretation of an immunofluorescence assay.

The microscope-based immunofluorescence assay for anti-neutrophil cytoplasmic antibodies (ANCAs) is used in the evaluation of patients with Wegener's granulomatosis and related forms of vasculitis. We developed an interactive personal computer program, ANCA-Tutor, that introduces users to the assay and examines their understanding of the test. The program runs under Microsoft Windows and is based on processed digital images of human neutrophils stained in a standard immunofluorescence test. The images contain descriptive text overlays. The program contains a library of reference images and strategies for distinguishing between staining patterns.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed2001

[Application of a computer-aided detection (CAD) system to digitalized mammograms for identifying microcalcifications].

PURPOSE: It is estimated that during mammographic screening programs radiologists fail to detect approximately 25% of breast cancers visible on retrospective review; this percentage rises to 50% if minimal signs are considered. Independent double reading is now strongly recommended as it allows to reduce the rate of false negative examinations by 5-15%. Recent technological progress has allowed to develop a number of computer-aided detection (CAD) systems. The aim of CAD is to help radiologists interpret lesions by serving as a second reader. In this study the authors developed and applied a CAD system to measure its ability to microcalcifications detect and compare its performance with that of a human observer. MATERIAL AND METHODS: The study was performed as part of the CALMA (computer-aided library for mammography) project of the Pisa section of the National Institute of Nuclear Physics. The aim of this project is to set up a large database of digital mammograms and to develop a CAD system. Our study series consisted of 802 mammograms - corresponding to 213 patients - digitalized between March and June 2000. We performed traditional mammography and then digitalized the mammograms using a CCD linear scanner (pixel size of 85 x 85 microm2, 12 bits). The images were evaluated by two radiologists with similar experience and then by the CAD system. This CAD system searches for microcalcifications by using ad hoc algorithms and an artificial neural network (Sanger type). RESULTS: The number of clusters in our database was 141 corresponding to 140 images; 692 images were non pathological. The CAD system identified a variable number of clusters depending on the threshold values. The threshold value is a number over which the probability of finding a lesion is highest. With thresholds of 0.13 and 0.14 the CAD system identified 140/141 clusters (99.3%); with a threshold of 0.15 it identified 139/141 clusters (98.6%); with a threshold of 0.16, 137/141 (97.2%); with a threshold of 0.18, 133/141 (94.3%); with thresholds of 0.18 and 0.20, 130/141 (92.2%). With threshold values of 0.13, 0.14, 0.15, 0.16 and 0.17 the system's sensitivity was greater than 82%, whereas with values of 0.18 and 0.20 it was greater than 80%. The number of false positive region of interest (ROI) / image was greater with low threshold values: in particular, thresholds of 0.13 and 0.14 yielded 16 false positives /image, thresholds of 0.15 and 0.16 yielded 9 and 7 false positives/image, and both 0.18 and 0.20 only 5/image. DISCUSSION: ROC curve shows how the use of high threshold values determined a very high specificity despite very low sensitivity rates. Conversely, low threshold values allowed to have a high sensitivity and a very low specificity. The best performance of our CAD system was obtained with threshold values at 0.15 and 0.16. In fact these thresholds resulted in a high sensitivity (greater than 82%) with an acceptable number of false positives/image, 9 and 7/image, respectively. It is not yet known how radiologists can deal with large numbers of false positives in screening programmes but in our opinion the most important feature of a good CAD system is a high sensitivity. CONCLUSIONS: In the near future the use of CAD systems will be widespread and easier to apply to everyday practice above all in centers where digital mammography is performed. Mammograms could be directly shown to radiologists after the CAD system has selected the ROI and analysed the images. Thanks to its high sensitivity and despite its low specificity CAD represents a concrete aid for radiologists.

Breast Diseases↗
PubMed2001

Automatic generation of glomerular capillary topological organization.

Glomerular structural changes are conventionally investigated by optical or electron microscopy on two-dimensional (2D) sections. To understand the relationship between functional and structural changes of glomerular capillary networks in more detail, three-dimensional (3D) investigation of the capillary tufts is required. Since confocal microscopy and scanning electron microscopy cannot completely show the 3D topological organization of the capillary tuft, we have developed an automatic method to obtain a 3D model of the glomerular capillary lumen structure and to derive its topological organization. Serial semithin sections of a glomerular tuft, from rat kidney tissue, were digitized at high resolution. Capillary lumens were digitally outlined and segmented images were automatically aligned. A 3D model of the capillary tuft was automatically generated using the Visualization Toolkit library and the Marching Cubes algorithm. We then developed an original algorithm for automatic 3D skeletonization of capillary lumen volume to identify capillary segments and bifurcations and to obtain the topological organization of the network and geometric parameters of capillary segments (length, radius, and spatial configuration). Capillary segment connectivity was graphically presented in a 2D layout with an automatic procedure, revealing the lobular organization of the network. This technique, successfully applied to serial sections of a glomerular capillary, can be used to study a population of glomerular capillaries to disclose the structural effects of pathological conditions. The methodology can be extended to other vascular structures, such as the microcirculation of neoplastic tissues.

Algorithms↗
PubMed1991

State-of-the-art digital radiography.

Technologic advances in digital radiography have improved the ways in which radiographic images are acquired, displayed, transmitted, recorded, and archived. With computed radiography, performed with storage phosphor plates and interactive high-resolution workstations, radiation dose is reduced and repeat exposures necessitated due to technical errors are eliminated. Digital fluorography allows reductions in dose, procedure time, and film costs. These digital imaging modalities have been well accepted clinically and are equal in diagnostic accuracy to conventional methods. Teleradiology has advanced with the development of laser film digitization, fiberoptic networks, and dial-up circuit switching technology. Laser film printers yield improved hard copies of transmitted images, but further work is needed to faithfully reproduce the images displayed on high-resolution work-stations. Although the capacity for archiving digital image data has increased (260,000 examinations or 23,500 Gbytes can be stored in a six-unit optical disc library), higher capacity storage media are needed. Further technologic advances in the speed of image transmission and storage capacity are anticipated.

Humans↗
PubMed2005

A study of personal digital assistants to enhance undergraduate clinical nursing education.

This study reports on personal digital assistants (PDAs) as a means to prepare nurse professionals who value and seek current information. An interdisciplinary team of nursing and library faculty, information technology and bookstore staff, students, and educational consultants developed this project. A pre-post and comparative group design of second-degree students in the accelerated and traditional baccalaureate nursing degree (BSN) options was used to examine students' information-seeking behaviors, and the effectiveness and cost of innovation strategies associated with incorporation of PDAs into students' clinical practice. Results of this study support PDAs as an effective student learning resource, especially for reference materials. The student group with PDAs had increasing numbers of questions associated with clinical situations and a greater recognition of the need to use current resources. Students made substantial use of their PDAs and health team members, while decreasing reliance on textbooks and clinical faculty. Students' use of and satisfaction with this technology is linked to access speed and readability. Providing faculty with PDAs is recommended to enhance their comfort with and incorporation of PDAs into clinical teaching.

Attitude of Health Personnel↗
PubMed1995

Building a medical multimedia database system to integrate clinical information: an application of high-performance computing and communications technology.

The rapid growth of diagnostic-imaging technologies over the past two decades has dramatically increased the amount of nontextual data generated in clinical medicine. The architecture of traditional, text-oriented, clinical information systems has made the integration of digitized clinical images with the patient record problematic. Systems for the classification, retrieval, and integration of clinical images are in their infancy. Recent advances in high-performance computing, imaging, and networking technology now make it technologically and economically feasible to develop an integrated, multimedia, electronic patient record. As part of The National Library of Medicine's Biomedical Applications of High-Performance Computing and Communications program, we plan to develop Image Engine, a prototype microcomputer-based system for the storage, retrieval, integration, and sharing of a wide range of clinically important digital images. Images stored in the Image Engine database will be indexed and organized using the Unified Medical Language System Metathesaurus and will be dynamically linked to data in a text-based, clinical information system. We will evaluate Image Engine by initially implementing it in three clinical domains (oncology, gastroenterology, and clinical pathology) at the University of Pittsburgh Medical Center.

Abstracting and Indexing↗
PubMed1996

FISH digital imaging microscopy in mosquito genomics.

The yellow fever mosquito, Aedes aegypti, transmits pathogens that affect both humans and livestock, and has been the focus of extensive research to identify genetic loci that may be useful in control strategies. Fluorescence in situ hybridization (FISH) and digital imaging microscopy have provided a rapid mechanism to populate the physical map with probes derived from genetic markers, cDNAs and recombinant genomic libraries. When the physical and genetic linkage maps are aligned, map-based cloning will allow the rapid isolation of target genomic sequences. The strategy of FISH mapping and the results of initial hybridization studies are reviewed here by Martin Ferguson, Susan Brown and Dennis Knudson. An Ae. aegypti-specific genomic database, which collates data from mapping studies, sequences, references and other relevant information, is also discussed.

Journal Article↗
PubMed2004

Online annotation tool for digital mammography.

RATIONALE AND OBJECTIVES: To develop a software tool for radiologists to annotate mammograms online. MATERIALS AND METHODS: The tool is web-based with a Java development environment and composed of a Digital Image and Communication in Medicine (DICOM) image viewer, a clinical information collector, and a database. The use of the tool with a sample case is demonstrated in this article. RESULTS: An online tool for the annotation of digital mammograms for teaching and research purposes has been developed. CONCLUSION: This annotation tool can be used to provide an annotated-case library on mammography education for residents and fellows.

Education, Medical, Continuing↗
PubMed2004

A meta-analysis of superior thyroid artery variations in different human groups and their clinical implications.

We have investigated whether the presence, numerical variations and site of origin of the superior thyroid artery (STA) are influenced by the ethnic group and gender, whether the origin and caliber of this vessel are symmetrical, to what extent a non-selective thyroid angiography, either conventional or by digital subtraction, is effective in visualizing it, and whether this information may be useful in selected clinical conditions. A meta-analysis has been performed, including 24 library- and Medline-selected publications on Caucasoids (European and non-European) and East Asians and a set of original data on European Caucasoids. A total of 3453 Caucasoid and 931 East Asian items, including entire bodies, half bodies and arteries, were used. After testing the homogeneity of the available data sources in relation to the anatomical variables under study we calculated a cumulative value for each selected anatomical parameter and evaluated differences by non parametric statistics. Effectiveness of non-selective thyroid angiography was determined using sensitivity, specificity, positive and negative predictive values. A higher frequency of origin from the external carotid artery was present in Caucasoids than in East Asians. In contrast, a higher frequency of origin from common carotid artery was observed in East Asians versus Caucasoids. No gender differences were found for any of the parameters analyzed in East Asians. In addition, an equal probability of either asymmetrical or symmetrical origin on the two sides of the neck for STA was found in East Asians. In contrast, a symmetry of caliber for STA was found in European Caucasoids. Finally, only a moderate effectiveness of non-selective thyroid angiography, either conventional or by digital subtraction, was determined for visualization of STA in European Caucasoids. Statistically significant variations in some STA anatomical parameters occur between Caucasoids and East Asians. These differences, together with the high frequency of asymmetry for STA origin in East Asians and low effectiveness of STA visualization by non-selective angiography in European Caucasoids, may result in useful information for clinical reasoning in selected conditions of the thyroid region.

Arteries↗
PubMed2006

The ARES test system for palm OS handheld computers.

The ARES (ANAM Readiness Evaluation System) is a cognitive testing system designed for operation on palm OS handheld computers i.e., Personal Digital Assistants (PDA). It provides an inexpensive and portable testing platform for field and clinical applications. ARES test batteries can be configured from a library of tests derived from the ANAM test system. ARES features include support of multiple users on a single PDA, a Microsoft Windows test battery authoring program, and a program for downloading, viewing, graphing, and archiving data. In validity tests, the same subjects were tested on identical ARES and conventional ANAM NeuroCog test batteries. Scores from the two platforms correlated highly, but absolute scores differed slightly. In reliability testing with the ARES Warrior battery, ARES scores were highly correlated in daily tests.

Cognition Disorders↗
PubMed1965

A COMPUTER SYSTEM FOR A UNION CATALOG: THEME AND VARIATIONS.

This article describes a computer system for the generation and maintenance of a union catalog of periodicals and for printouts of both the entire file and selected portions. Although the system was designed to meet the specifications of the Union Catalog of Medical Periodicals of New York, its use is not limited. Only the basic file maintenance program is indispensable; the subsidiary programs may be used as needed. The scope and content of the catalog are determined by the input. The preparation of the input is described in detail, with comment on the keypunching of library records. Applications to other kinds of catalogs are suggested.

Catalogs, Union as Topic↗
PubMedDate not supplied

A tool for designing digital test objects for module performance evaluation in medical digital imaging.

Currently, medical digital imaging systems are characterized by the introduction of additional modules such as digital display, image compression and image processing, as well as film printing and digitization. These additional modules require performance evaluation to ensure high image quality. A tool for designing computer-generated test objects applicable to performance evaluation of these modules is presented. The test objects can be directly used as digital images in the case of film printing, display, compression and image processing, or indirectly as images on film in the case of digitization. The performance evaluation approach is quality control protocol based. Digital test object design is user-driven according to specifications related to the requirements of the modules being tested. The available quality control parameters include input/output response curve, high contrast resolution, low contrast discrimination, noise, geometric distortion and field uniformity. The tool has been designed and implemented according to an object oriented approach in Visual C++ 5.0, and its user interface is based on the Microsoft Foundation Class Library version 4.2, which provides interface items such as windows, dialog boxes, lists, buttons, etc. The compatibility with DICOM 3.0 part 10 image formats specifications allows the integration of the tool in the existing software framework for medical digital imaging systems. The capability of the tool is demonstrated by direct use of the test objects in case of image processing, and indirect use of the test objects in case of film digitization.

Algorithms↗