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PubMed1994

Realistic modeling of clinical laboratory operation by computer simulation.

An important objective of laboratory management is to adjust the laboratory's capability to the needs of patients' care as well as economy. The consequences of management may be changes in laboratory organization, equipment, or personnel planning. At present only one's individual experience can be used for making such decisions. We have investigated whether the techniques of operations research could be transferred to a clinical laboratory and whether an adequate simulation model of the laboratory could be realized. First we listed and documented the system design and the process flow for each single laboratory request. These input data were linked by the simulation model (programming language SIMSCRIPT II.5). The output data (turnaround times, utilization rates, and analysis of queue length) were validated by comparison with the current performance data obtained by tracking specimen flow. Congruence of the data was excellent (within +/- 4%). In planning experiments we could study the consequences of changes in order entry, staffing, and equipment on turnaround times, utilization, and queue lengths. We conclude that simulation can be a valuable tool for better management decisions.

Chemistry, Clinical↗

PubMed1976

The comparison of parameters estimated from several different samples by maximum likelihood.

A system of computer programs has been developed to compare the parameters of several samples taken from populations with arbitrary but known distribution functions. The user indicates which of the parameters are assumed to be equal in all populations under the null hypothesis alone or under both the null and the alternative hypotheses. The programs perform maximum likelihood estimation under the general and the restricted model and also calculate the values needed for a likelihood ratio test. The programming language used was PL/I-FORM AC. An illustrative numerical example is given.

Animals↗

PubMed1993

[Computer controlled brain death documentation in the intensive care unit].

An interactive, knowledge-based computer system for brain death documentation is presented. The specific exponents BRAINDEX R and G were realised by the software tool Personal Consultant Plus and the programming language Clipper, respectively. The strategies of conclusion were forward chaining for approximate evaluation of coma stages and backward chaining for analysing the brain death syndrome. BRAINDEX was developed for use with an IBM personal computer or compatible equipment. Systemic analyses were compared retrospectively with the data from clinical brain death protocols (n = 132) of 128 comatose patients (mean age 35.1 +/- 15.8 years) with a Glasgow Coma Score of 3. Identical classifications (system vs physician) were found in all patients without diagnosis of brain death (n = 35). Differences related to the findings of the physician were evaluated in lower numbers of the systemic positive diagnosis of brain death (82 vs 89) and higher numbers of impossibility of systemic evaluation (11 vs 2). These results were obtained by conclusions of the computer system drawn by restrictive systemic mechanisms to avoid false-negative diagnoses. The system therefore seems to be useful for documentation, consultation, and as a teaching instrument and data bank in brain death.

Adult↗

PubMed1993

[SN-FORTH/MSX: a state notation system for controlling behavioral experiments with a low-priced computer].

A software system, SN-FORTH/MSX, has been developed to control behavioral experiments with a low-priced personal computer, MSX. Designed on the model of state notation, SN-FORTH/MSX enables researchers to program easily a wide variety of behavioral procedures including complex processes that are hard to describe with conventional programming languages such as BASIC and C. Since the real-time monitor of this system has a capability of parallel processing of multiple state-sets, several independent experiments can be simultaneously conducted with a single computer. Users can observe and modify the working of real-time monitor in each instant with a set of run-time commands supplied in the system.

Behavior↗

PubMed1996

Design of a high resolution image cytometer with open software architecture.

A relatively inexpensive, non-proprietary high resolution color pathology workstation is described. Hardware consists of a JVC frame capture camera with adjustable resolution up to 4416 x 3456, matching frame grabber and a Unix workstation. Analytic software was developed using Khoros 1.0.5, a powerful and flexible system for the development of image analysis applications that is based on a visual programming language. Applications have been developed for DNA ploidy, quantitative immunohistochemistry and texture and shape analysis. The instrument's software is uniquely extensible and transparent, and has been made publicly available over the Internet.

Cell Physiological Phenomena↗

PubMed1995

Physicians and immigrant patients. Cross-cultural communication.

OBJECTIVE: To formulate recommendations for facilitating communication and helping prevent misunderstandings during cross-cultural patient-physician interactions. DESIGN: Qualitative study using content and semantic analyses of information supplied in focus groups. SETTING: All family physician respondents were associated with departments of family medicine at two urban hospitals and had expressed interest in this study; all immigrant patients were recruited from the English-as-a-Second-Language program at a community agency. PARTICIPANTS: Thirteen immigrant patients, distributed in two groups (one of seven women and one man and one of three men and two women), and five family physicians (two women and three men). MAIN OUTCOME MEASURES: Responses to prepared questions asked in focus groups. RESULTS: Family physicians thought that understanding patients' cultures better would improve quality of care. Patients did not always understand why their physicians asked questions about their culture, sometimes finding these questions irrelevant or intrusive. Comments were used to formulate recommendations for patient-physician interactions. CONCLUSIONS: Physicians and patients are aware of culture as a factor in their relationships but differ on its importance to quality of care.

Adult↗

PubMed1996

WebReport: a World Wide Web based clinical multimedia reporting system.

This paper describes WebReport, a World Wide Web (WWW) client for the Image Engine multimedia clinical information system under development at the University of Pittsburgh. WebReport uses advanced HTML features such as frames, forms, tables and inline JPEG image display to provide an easy to use system for retrieving and viewing diagnostic images and reports generated by clinical procedures such as gastrointestinal endoscopy, radiology and surgical pathology. WebReport implements a number of WWW client-side features, such as HTML forms data entry verification and makes extensive use of the JavaScript programming language. The WebReport system uses a number of approaches for ensuring the confidentiality and security of patient data transmitted over the InterNet.

Computer Communication Networks↗

PubMed1977

Behavioral training for parents of retarded children: alternative formats based on instructional manuals.

A series of instructional manuals in behavior modification with retarded children was tested as a self-contained resource and as part of three larger training programs involving different amounts of professional assistance to parents: telephone consultations, training groups, training groups plus home visits. One hundred and sixty families were randomly assigned to the four training conditions or to a delayed-treatment control group. The 20-week treatment period emphasized the programming of self-help skills, but also provided an introduction to programming language skills and managing behavior problems. The manuals-alone format was as effective as the more expensive training formats in producing gains in children's self-help skills and fostering knowledge of behavioral principles in mothers. The two group-training formats produced more efforts at behavior-problem management, greater gains in knowledge of principles by fathers, and higher self-confidence as teachers. Telephone consultation was generally the least effective training format; the manuals-alone condition was surprisingly effective. Some implications of the results for future strategies of family intervention were discussed.

Activities of Daily Living↗

PubMed1997

Object-oriented developmental environment for image-analysis applications: implementation for 2D gel electrophoretogram analysis.

MOTIVATION: The principal motivation was to design an environment for the development of image-analysis applications which would allow the integration of independent modules into one frame and make available tools for their build-up, running, management and mutual communication. RESULTS: The system was designed as modular, consisting of the core and work modules. The system core focuses on overall management and provides a library of classes for build-up of the work modules, their user interface and data communication. The work modules carry practical implementation of algorithms and data structures for the solution of a particular problem, and were implemented as dynamic-link libraries. They are mutually independent and run as individual threads, communicating with each other via a unified mechanism. The environment was designed to simplify the development and testing of new algorithms or applications. An example of implementation for the particular problem of the analysis of two-dimensional (2D) gel electrophoretograms is presented. The environment was designed for the Windows NT operating system with the use of Microsoft Foundation Class Library employing the possibilities of C++ programming language. AVAILABILITY: Available on request from the authors.

Computer Graphics↗

PubMed1997

Knowledge representation for computer-aided planning of controlled clinical trials: the PATriCIa project.

The main thesis of the PATriCIa project is that a knowledge-based system can provide efficient and reliable support for biometricians as well as physicians involved in planning of controlled clinical trials, resulting in a higher quality of medical research. Structure and contents of study protocols are analyzed, and an object-oriented method for formally representing biometric knowledge is proposed. A study protocol can be generated from this formal representation. The programming language Prolog is used to realize the system based on a blackboard architecture. It is concluded that the knowledge representation method developed in the PATriCIa project is well suited for the purpose of generating study protocols for controlled clinical trials.

Biometry↗

PubMed1997

Novel techniques for visualising biological information.

The major challenge facing the bioinformatics community is the continuing increase in the number, size and complexity of biological databases with which it must contend. The goal of the research discussed herein is the development and utilisation of techniques that allow researchers to extract new and useful information from these burgeoning information resources using advanced visualisation methods and paradigms, coupled with distributed object technologies that allow communications between applications and remote databases. Visualisation has roles not only in analysis, but also in building more user-friendly interfaces, implementing methods to navigate large information spaces intuitively and powerful techniques to browse and query data. By using platform-independent object-oriented programming languages, these resources may be developed as reusable pieces of software componentry with their methods and interfaces defined fully, and then distributed through organisations such as the bioWidget Consortium. The widget and object-oriented approach is a powerful paradigm in developing new applications from existing components. Development time is reduced and greater time is spent on analysing these data, rather than in the writing of monolithic applications. More powerful applications can be constructed from components interacting in concert and offers the opportunity of a new generation of bioinformatics tools.

Base Composition↗

PubMed1998

JADE: An approach for interconnecting bioinformatics databases

To achieve the integration of biological data available on the World Wide Web and maintained in diverse sources such as GDB, Genbank or Acedb, we have developed a software called Jade. Jade allows programmers to create analytic tools and graphical user interfaces for one or more existing bioinformatics data sources. These tools can then be interchanged, compared and reused without making modifications in the data sources themselves. The system is implemented in the Java programming language and will run equally well on Macintosh, Windows or Unix workstations. Jade is free and can be used immediately by all interested parties.

Journal Article↗

PubMed1998

JADE: an approach for interconnecting bioinformatics databases.

Computational Biology↗

PubMed1998

Toward a general model for the description of multimedia clinical data.

The patient folder integrates information originating from heterogeneous sources. For this reason computerized tools for patient data management should exploit the advantages of multimediality and offer an integrated environment for data presentation, and image and biosignal visualization. Object-oriented modeling is the best approach for designing systems for multimedia patient folder management. We propose an object-oriented model, able to define the entities constituting the patient folder and their logical organization. This model has sufficient flexibility to adapt to the most varied clinical environments. It allows the physician to structure the information needed for his/her patient folder without employing a programming language.

Computer Simulation↗

PubMed1998

Platform independent implementation of DICOM-based miniPACS.

Platform independence is an important issue for a software designed to run across a hospital environment which is practically always heterogeneous one. This paper presents a simple miniPACS solution designed over an existing Intranet (Internet limited to a local area network). Platform independence is achieved with Java programming language which allows resulting code to be executed on virtually all machines. System consists of a server application providing DICOM (Digital Imaging and Communications in Medicine) services and clients that can use these services over a TCP/IP connection. The server application is capable of an image storage and supports a query mechanism to allow access to stored data, thus the clients may perform two major functions: providing image data for archiving or image retrieval for viewing. Presented client application provides both these functions. It retrieves stored images for further processing and returns calculated results to the archive. The parts of the system are connected through a DICOM interface. Consequently the system architecture is open and any devices like scanners or viewing stations supporting specific DICOM services may be attached.

Humans↗

PubMed1991

A method of assessing the efficacy of memory rehabilitation techniques using a "real-world" memory task: learning a computer language.

A software program developed to assess the effectiveness of memory rehabilitation techniques is described. This project addresses current weaknesses in the research literature on memory rehabilitation: 1) remediation strategies are evaluated in terms of performance on a practical, real-world memory task, rather than a laboratory learning task; 2) the program allows maximum flexibility in assessing a wide variety of remediation strategies and training schedules; and, 3) the software, which provides sensitive outcome measures and detailed feedback about performance, is adaptable to the needs of patients with widely varying degrees of memory impairment. The results of a demonstration project are included to illustrate the use of this technology in determining the usefulness of different mnemonic strategies for patients with specific patterns of memory deficit. The importance of assessing maintenance of rehabilitation training over time is stressed.

Computer Graphics↗

PubMed1997

Dynamite: a flexible code generating language for dynamic programming methods used in sequence comparison.

We have developed a code generating language, called Dynamite, specialised for the production and subsequent manipulation of complex dynamic programming methods for biological sequence comparison. From a relatively simple text definition file Dynamite will produce a variety of implementations of a dynamic programming method, including database searches and linear space alignments. The speed of the generated code is comparable to hand written code, and the additional flexibility has proved invaluable in designing and testing new algorithms. An innovation is a flexible labelling system, which can be used to annotate the original sequences with biological information. We illustrate the Dynamite syntax and flexibility by showing definitions for dynamic programming routines (i) to align two protein sequences under the assumption that they are both poly-topic transmembrane proteins, with the simultaneous assignment of transmembrane helices and (ii) to align protein information to genomic DNA, allowing for introns and sequencing error.

Algorithms↗

PubMed1995

General purpose model and a computer program for combined segregation and path analysis (SEGPATH): automatically creating computer programs from symbolic language model specifications.

A general purpose model and a flexible computer program, called SEGPATH, have been developed to assist in the creation and implementation of a variety of genetic epidemiological models. SEGPATH is a computer program which can be used to generate programs to implement linear models for pedigree data, based upon a flexible, model-specification syntax. SEGPATH models can perform segregation analysis, path analysis, or combined segregation and path analysis using any user-specified path model and can be structured to analyze any number of multivariate phenotypes, environmental indices, and/or measured covariate fixed effects (including measured genotypes). Population heterogeneity models, repeated-measures models, longitudinal models, auto-regressive models, developmental models, and gene-by-environment interaction models can all be created under SEGPATH. Pedigree structures can be defined to be arbitrarily complex, and the data analyzed with programs generated by SEGPATH can have any missing value structure, with entire individuals missing, or missing on one or more measurements. Corrections for ascertainment can be done on a vector of phenotypes and/or other measures. Because the model specification syntax is general, SEGPATH can also be used in non-genetic applications where there is a hierarchical structure, such as longitudinal, repeated-measures, time series, or nested models. A variety of applications are demonstrated.

Genetics, Population↗