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PubMed1996

Computed tomography correlation in atypical (peripheral) right upper lobe collapse: the minor fissure as an explanation for the pleural-based density.

Peripheral right upper lobe collapse describes the unusual plain film finding in which the collapsed lobe simulates a peripheral, pleural-based mass. Most investigators have postulated that the peripheral opacity is explained by the interface between the superior segment of the lower lobe and the posterior aspect of the collapsed upper lobe, which does not swing as far medial as in the normal pattern of collapse. In our patient, using computed tomography (CT) correlation, we demonstrated that the finding is explained by the interface between the middle lobe and the anterior aspect of the collapsed upper lobe.

Humans↗
PubMed2004

Conversion of EEG activity into cursor movement by a brain-computer interface (BCI).

The Wadsworth electroencephalogram (EEG)-based brain-computer interface (BCI) uses amplitude in mu or beta frequency bands over sensorimotor cortex to control cursor movement. Trained users can move the cursor in one or two dimensions. The primary goal of this research is to provide a new communication and control option for people with severe motor disabilities. Currently, cursor movements in each dimension are determined 10 times/s by an empirically derived linear function of one or two EEG features (i.e., spectral bands from different electrode locations). This study used offline analysis of data collected during system operation to explore methods for improving the accuracy of cursor movement. The data were gathered while users selected among three possible targets by controlling vertical [i.e., one-dimensional (1-D)] cursor movement. The three methods analyzed differ in the dimensionality of the cursor movement [1-D versus two-dimensional (2-D)] and in the type of the underlying function (linear versus nonlinear). We addressed two questions: Which method is best for classification (i.e., to determine from the EEG which target the user wants to hit)? How does the number of EEG features affect the performance of each method? All methods reached their optimal performance with 10-20 features. In offline simulation, the 2-D linear method and the 1-D nonlinear method improved performance significantly over the 1-D linear method. The 1-D linear method did not do so. These offline results suggest that the 1-D nonlinear or the 2-D linear cursor function will improve online operation of the BCI system.

Adult↗
PubMed2001

Assistance in the palm of your hand. Portable technology can free physicians from billing and coding chains.

PROBLEM: Paper-based billing system required unmanageable amount of paper, time and work. SOLUTION: Integration of handheld devices with ASP-based charge capture service. RESULTS: Increased accuracy in billing information, reduced incidence of denied claims, faster reimbursement, more accurate view of financial status. KEYS TO SUCCESS: The technology's ease of use, varied capabilities and early benefits.

Accounts Payable and Receivable↗
PubMed2004

Effects of blackcurrant anthocyanin intake on peripheral muscle circulation during typing work in humans.

This double-blind, placebo-controlled, crossover study investigated the effect of blackcurrant anthocyanin (BCA) intake on peripheral circulation during rest and during typing work by using near-infrared spectroscopy (NIRS), and it also assessed improvement in shoulder stiffness caused by poor local circulation. In a resting circulation study, nine healthy male subjects took capsules of BCA at a dosage of 17 mg kg(-1) or placebo (isoenergetic sugar). NIRS was used to measure left forearm blood flow (FBF) following venous occlusion and muscle oxygen consumption following arterial occlusion prior to and hourly for 4 h after ingestion of BCA. Plasma anthocyanin concentration was measured prior to ingestion and 1, 2, and 4 h later. FBF increased significantly 2 h after BCA ingestion [BCA 1.22 (0.13)-fold increase relative to pre-values vs placebo 0.83 (0.06) of pre-values; P < 0.05] and then tended to increase for a further 3 h after ingestion [BCA 1.26 (0.15)-fold increase relative to pre-values vs placebo 0.82 (0.07) of pre-values; P = 0.078]. There was, however, no significant difference in muscle oxygen consumption between BCA and placebo intake at any time point. In a typing work study, 11 healthy subjects took capsules of BCA (7.7 mg kg(-1)) or placebo (isoenergetic sugar) daily for 2 weeks. The subjects then performed intermittent typing workload for 30 min in order to induce acute shoulder stiffness. During the workload, total hemoglobin and oxygenated hemoglobin (oxy-Hb) were determined using NIRS and myoelectric signals measured in the right trapezius muscle using electromyography (EMG). The viscoelasticity of the trapezius muscle was also evaluated using a muscle stiffness meter before and after the typing workload. BCA intake prevented the decrease in oxy-Hb significantly (P < 0.05), and also tended to alleviate the increase in root mean square (RMS) of the EMG during the typing workload, and also muscle stiffness after the workload. There was no improvement in typing performance with BCA intake. The results of this study suggest that intake of BCA may improve shoulder stiffness caused by typing work by increasing peripheral blood flow and reducing muscle fatigue.

Administration, Oral↗
PubMed2005

Multimodal feedback for the acquisition of small targets.

This paper examines how multimodal feedback assists small-target acquisition in graphical user interfaces. All combinations of three feedback modes are analysed: non-speech audio; tactile; and pseudo-haptic "sticky" feedback. The tactile conditions used stimulation through vibration (rather than force-feedback), and the sticky conditions were implemented by dynamically reconfiguring mouse control-display gain as the cursor entered the target. Results show that for small, discretely located targets all feedback modes reduce targeting times, with stickiness providing substantial improvements. Furthermore, stickiness and tactile appear to combine well. However, the results of a more ecologically oriented menu-selection task show the need for caution, revealing that excessive feedback can damage interaction though "noise" that interferes with the acquisition of neighbouring targets.

Adult↗
PubMed2005

Touch-screen computer systems in the rheumatology clinic offer a reliable and user-friendly means of collecting quality-of-life and outcome data from patients with rheumatoid arthritis.

OBJECTIVES: To investigate the feasibility of collecting rheumatoid arthritis (RA) patient self-administered outcome data using touch-screen computers in a routine out-patient clinic. METHODS: Forty patients with RA completed the touch-screen and paper Rheumatoid Arthritis Quality of Life Questionnaire (RAQol) in the clinic and rated ease of use and preference. Forty-five others completed the Stanford Health Assessment Questionnaire (HAQ) and visual analogue scales (VASs) for pain, fatigue and global arthritis activity on touch screen and paper and a joint assessment on touch screen. They rated ease of use and willingness to complete the assessment again. Joints were independently assessed, and completion times and technical problems recorded. RESULTS: No technical problems were encountered. The touch-screen RAQol took no longer to complete, was preferred by 64% (33% had no preference) and was rated significantly higher for ease of use (two-tailed P=0.003, n=40) even by computer naïve patients (two-tailed P=0.031, n=24). Intraclass correlation coefficients between methods were high for RAQol (0.986) and tender joint counts (0.918), and as high for the pain, fatigue and global activity (0.855, 0.741, 0.881) as for test-retest of the paper versions (0.865, 0.746, 0.863). Ninety-eight per cent rated the touch screen very/quite easy for HAQ and VAS, and 90% for joint assessment. Ninety-six per cent stated a willingness to complete the touch-screen assessment in clinic again. CONCLUSIONS: Touch-screen questionnaires in the clinic can produce comparable results to paper, eliminate the need for data entry and afford immediate access to results. It is an acceptable, and in many cases a preferable, option to paper, regardless of age and previous experience of computers.

Adult↗
PubMed1996

[Selection criteria for dental software].

Dentists who wish to introduce a computer based patient record system in their office are confronted with a lack of information concerning the selection of dental software. As wishes and demands concerning the content and options given by a dental computer program can vary widely from dentist to dentist and as dental software is changing rapidly a global objective evaluation is of no practical validity. Therefore a list of general and specific selection criteria was developed, enabling the practitioner to make a personal, objective comparison of quality of content versus wishes, price and service of different dental software programs. The criteria are discussed in this article.

Computer Peripherals↗
PubMed2004

Computer control using human intracortical local field potentials.

We describe the use of human cortical control signals to operate two assistive technology tools--a virtual keyboard speller and a computer-simulated digit. The cortical signals used for control are local field potentials recorded through an implanted neurotrophic electrode. In this system, the patients' cortical signals are transmitted wirelessly to a receiver and translated by computer software into either a computer cursor movement (for the virtual keyboard) or flexion of a cyber digit on a virtual hand. This report focuses on the progress of two subjects toward effective use of their "virtual" neuro-prosthetic devices to meet their assistive technology needs.

Communication Devices for People with Disabilities↗
PubMed1999

Examining the symptom experience of hospitalized patients using a pen-based computer.

The purposes of this study were to test the feasibility of using a pen-based computer to capture self-reported symptom data, to evaluate the system, and to evaluate the importance of obtaining symptom data. The sample included 72 patients who were hospitalized for a variety of medical conditions. Self-reported symptom data was obtained with the automated Sign and Symptom Checklist. The feasibility of using an automated symptom checklist to capture self-reported symptom data was demonstrated. Patients' evaluations of the ease of use and the format of the system were primarily positive; mean ratings ranged from 4.58 to 4.70 on a 5-point scale. Patients indicated the importance of documenting symptoms, with a few suggesting that the use of an automated symptom checklist may increase communication between providers and patients. Study findings support the inclusion of self-reported symptom data in electronic health records and national health care databases.

Attitude to Computers↗
PubMed1995

Accessing oncology information at the point of care: experience using speech, pen, and 3-D interfaces with a knowledge server.

Oncologists' information needs arise at diverse times and settings. For example: "Is superior vena cava syndrome a medical emergency?" Our collaborative group is developing a system that supports an interface with combinations of spoken, gestural, and simulated three-dimensional manipulation to help an oncologist focus on the information need, not the system. The system requires a small amount of input from the oncologist, and then anticipates what information is pertinent to the patient at hand, based on the sources it has available. The system makes use of a "Knowledge Server" to find relevant information. The Knowledge Server uses selected data for the particular patient from a Computer-based Patient Record (CPR) to provide context for the information needs. The Knowledge Server leverages the Unified Medical Language System (UMLS) resources as well as relevant communications standards. A layered, interaction protocol is used to help manage the fulfillment of information needs. Each of the oncology knowledge sources is transformed into a uniform representation that utilizes both its formal schema (e.g., its table of contents) and its concepts and words indexed through the UMLS Metathesaurus. Our focus on the appropriate use of information from a CPR, and on anticipating oncologists' information needs, resulted from our study of several longitudinal patient scenarios. We believe that our use of scenario-based design techniques will help to ensure the system's success.

California↗
PubMed1991

Bone loss in patients with rheumatoid arthritis--effect of steroids measured by low dose quantitative computed tomography.

For 2 years bone density changes in patients with rheumatoid arthritis were monitored to determine the effect of low dose corticosteroid treatment. Sixteen perimenopausal females were studied. Of these nine were treated with 5 to 20 mg prednisone per day and seven had no steroids. The differential effects on trabecular bone density and on cortical bone in the radius and the tibia were examined with high precision peripheral quantitative computed tomography (QCT). Steroid therapy did not influence cortical bone loss and had only a minor influence on trabecular bone density. Of greater importance was the influence of estrogen depletion. Corticosteroids and estrogen depletion, however, cannot explain fully the yearly loss of 5.7% in the trabecular and 4% in the cortical bone of the radius.

Adult↗
PubMed2004

BCI Competition 2003--Data set IIb: enhancing P300 wave detection using ICA-based subspace projections for BCI applications.

An algorithm based on independent component analysis (ICA) is introduced for P300 detection. After ICA decomposition, P300-related independent components are selected according to the a priori knowledge of P300 spatio-temporal pattern, and clear P300 peak is reconstructed by back projection of ICA. Applied to the dataset IIb of BCI Competition 2003, the algorithm achieved an accuracy of 100% in P300 detection within five repetitions.

Algorithms↗
PubMed2003

Predicting the failure load of the distal radius.

The distal radius is an important site for the early detection of patients at risk for fracture. Since measuring bone strength in vivo is not possible, we evaluated which bone assessment method of the forearm would best predict failure load of the distal radius and computed a factor of risk for wrist fracture (Phi wrist). Thirty-eight cadaveric forearm specimens were measured by five different techniques to assess bone density, bone mineral content, geometry and trabecular structure at the distal forearm. The bone assessment techniques included dual-energy X-ray absorptiometry (DXA) of the radius, peripheral quantitative computed tomography (pQCT) of the 4% and 20% distal sites of the radius, DXA of the phalanges, digital X-ray radiogrammetry of the forearm (DXR-BMD), and quantitative ultrasound of the radius. The failure load of each excised radius was determined by simulating a fall on an outstretched hand. The pQCT measurements of polar stress-strain index and cortical content explained the greatest portion of variance in failure load (r2=0.82-0.85). Bone mineral content measures were generally better predictors of failure load (r2=0.53-0.85) than the corresponding volumetric or areal bone mineral density values (r2=0.22-0.69) measured by either pQCT or DXA. Multiple regression analysis showed that the addition of a bone geometry measure improved the ability of a bone density measure alone to predict failure load. There was high variability in the ability of different techniques and different variables within a given technique to predict failure load. Estimates of the factor of risk for wrist fracture (Phi wrist) revealed that the women in this study would have been likely to fracture their distal radius upon falling from a standing height (Phi wrist= 1.04), whereas the men would have likely withstood the impact without fracturing their wrist (Phi wrist= 0.79).

Absorptiometry, Photon↗
PubMed1980

Differentiating empyemas and peripheral pulmonary abscesses: the value of computed tomography.

In 13 patients, conventional radiographic techniques and clinical histories were not sufficient to determine whether a peripheral cavitary lesion was an abscess or an empyema. However, after computed tomography (CT), eight patients were diagnosed as having abscesses and five as having empyemas. Abscesses had an irregular shape and a relatively thick wall which was not uniformly wide and did not have a discrete boundary between the lesion and lung parenchyma. In contrast, empyemas had a regularly shaped lumen, a smooth inner surface, and a sharply defined border between the lesion and lung. CT studies can help to distinguish between empyemas and abscesses, and treatment can be started sooner in difficult cases.

Adult↗
PubMed1997

Multiple sclerosis lesion quantification using fuzzy-connectedness principles.

Multiple sclerosis (MS) is a disease of the white matter. Magnetic resonance imaging (MRI) is proven to be a sensitive method of monitoring the progression of this disease and of its changes due to treatment protocols. Quantification of the severity of the disease through estimation of MS lesion volume via MR imaging is vital for understanding and monitoring the disease and its treatment. This paper presents a novel methodology and a system that can be routinely used for segmenting and estimating the volume of MS lesions via dual-echo fast spin-echo MR imagery. A recently developed concept of fuzzy objects forms the basis of this methodology. An operator indicates a few points in the images by pointing to the white matter, the grey matter, and the cerebro-spinal fluid (CSF). Each of these objects is then detected as a fuzzy connected set. The holes in the union of these objects correspond to potential lesion sites which are utilized to detect each potential lesion as a three-dimensional (3-D) fuzzy connected object. These objects are presented to the operator who indicates acceptance/rejection through the click of a mouse button. The number and volume of accepted lesions is then computed and output. Based on several evaluation studies, we conclude that the methodology is highly reliable and consistent, with a coefficient of variation (due to subjective operator actions) of 0.9% (based on 20 patient studies, three operators, and two trials) for volume and a mean false-negative volume fraction of 1.3%, with a 95% confidence interval of 0%-2.8% (based on ten patient studies).

Algorithms↗
PubMed1985

A comprehensive interactive on-line computer system for research and clinical practice in orthodontics.

An interactive on-line computer system for the measurement of cephalometric radiographs, and facial and plaster cast photographs is described. The details of the hardware (computer and peripherals) and software are provided. Numerical and graphical analysis and presentation of the resultant data are discussed. Many research and clinical applications of the system are outlined.

Cephalometry↗