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PubMed1991

Health managers' attitudes toward robotics and artificial computer intelligence: an empirical investigation.

An empirical investigation of the perceived role of robotics and artificial computer intelligence in the future of health care reveals factors favoring a positive attitude by health administrators. The study employed a two-part survey administered in late 1989 and early 1990 to health care managers in hospitals and nursing homes. Part One of the survey asked about the participant, his or her work habits and work environment. Part Two obtained a psychological profile of rationality vs. intuition in problem solving. Through bivariate and multivariate post hoc statistical tests, we discovered the following variables which significantly determined attitudes toward robotics and artificial computer intelligence: sex; number of employees supervised; perceptions of waste and inefficiency in the workplace; perceptions of time-consuming personnel problems; perceived need to make more efficient use of time, money, and facilities; and perceived favorable climate for innovation. Among the factors which did not have an effect on attitudes toward advanced technology were three measures of rationality vs. intuition in problem solving.

Artificial Intelligence↗
PubMed1996

The value of life and the value of population.

"This paper first distinguishes structured and unstructured approaches to valuing life. The unstructured approach bases its valuations on people's raw preferences, whereas the structured approach imposes a theoretical framework about the structure of value. The paper recommends the structured approach. This opens the way to considering the value of adding people to the population. The paper examines a common intuition that adding people is not in itself valuable, and explains the difficulties this intuition encounters."

Behavior↗
PubMed2000

Quantitative evaluation of surgical task performance by remote-access endoscopic telemanipulation.

BACKGROUND: The performance limitations inherent in minimally invasive surgery may be overcome by using an interface that provides intuitive orientation for video display and tool manipulation. A prototype remote-access endoscopic telemanipulator was designed to fulfill these requirements and used for a surgical anastomosis task. METHODS: A remote-access telemanipulator system, employing remote center-of-motion geometry, was used to complete distant in vitro tubular anastomoses. The performance of four surgeons using this system was compared with that achieved in completing the same anastomosis task in an open environment using open surgical techniques and in a minimally invasive environment using standard laparoscopic methods. RESULTS: The average performance times for completion of the anastomosis task was 1448 +/- 130 s using the telemanipulator system compared with 2108 +/- 291 s with laparoscopic instruments and 296 +/- 25 s with conventional techniques. Leakage rates from the tubular anastomoses were 5.2 +/- 1.4 ml/s in the telemanipulator group, 6.9 +/- 2.0 ml/s in the laparoscopic group, and 3.2 +/- 0.9 ml/s in the conventional methods group. All experimental subjects were able to complete the assigned task in each experimental condition successfully without complications. CONCLUSIONS: Our results in this pilot study suggest that remote-access endoscopic telemanipulation can execute complex three-dimensional manipulations, and that the intuitive orientation of the surgeon's workstation may contribute to easier task completion.

Anastomosis, Surgical↗
PubMed2006

GRAMA: genetic mapping analysis of temperature gradient capillary electrophoresis data.

Temperature gradient capillary electrophoresis (TGCE) is a high-throughput method to detect segregating single nucleotide polymorphisms and InDel polymorphisms in genetic mapping populations. Existing software that analyzes TGCE data was, however, designed for mutation analysis rather than genetic mapping. Genetic recombinant analysis and mapping assistant (GRAMA) is a new tool that automates TGCE data analysis for the purpose of genetic mapping. Data from multiple TGCE runs are analyzed, integrated, and displayed in an intuitive visual format. GRAMA includes an algorithm to detect peaks in electropherograms and can automatically compare its peak calls with those produced by another software package. Consequently, GRAMA provides highly accurate results with a low false positive rate of 5.9% and an even lower false negative rate of 1.3%. Because of its accuracy and intuitive interface, GRAMA boosts user productivity more than twofold relative to previous manual methods of scoring TGCE data. GRAMA is written in Java and is freely available at http://www.complex.iastate.edu .

Algorithms↗
PubMed2000

[Computer-assisted planning of corrective osteotomies in cases of epiphysiolysis capitis femoris].

Slipped capital femoral epiphysis (SCFE) leads to an unphysiologic function in adolescent hips. Evaluation of the slippage as well planning of corrective osteotomies is a major three-dimensional (3D) problem. Therefore, the current clinical evaluation, which is based on biplanar plain radiographs, cannot be satisfying. More is needed than simply measuring the femoral geometry to evaluate the impact of a slippage onto the physiologic hip function. We have developed a computer-based system for planning and evaluation of reorienting osteotomies in severe cases of SCFE. In our system, CT-based 3D computer models of the hip are used to simulate the range of motion within physiologic cartilage-to-cartilage contact. This helps to visualize and quantify the early impingement due to the slippage. In addition, 3D techniques allow to simulate and plan the corrective osteotomy in an intuitive way on the computer screen. Using the same range of motion system mentioned above, the projected result can be evaluated quantitatively and compared to other approaches. The motion simulation is based on the surface geometry of the joint partners rather than on a predefined, fixed rotation center. The presented system allows a much more intuitive and appropriate system for indicating and planning corrective osteotomies than conventional methods.

Adolescent↗
PubMed1999

Model and analysis of chemotactic bacterial patterns in a liquid medium.

A variety of spatial patterns are formed chemotactically by the bacteria Escherichia coli and Salmonella typhimurium. We focus in this paper on patterns formed by E. coli and S. typhimurium in liquid medium experiments. The dynamics of the bacteria, nutrient and chemoattractant are modeled mathematically and give rise to a nonlinear partial differential equation system. We present a simple and intuitively revealing analysis of the patterns generated by our model. Patterns arise from disturbances to a spatially uniform solution state. A linear analysis gives rise to a second order ordinary differential equation for the amplitude of each mode present in the initial disturbance. An exact solution to this equation can be obtained, but a more intuitive understanding of the solutions can be obtained by considering the rate of growth of individual modes over small time intervals.

Bacterial Physiological Phenomena↗
PubMed2005

Ergonomics and human factors in endoscopic surgery: a comparison of manual vs telerobotic simulation systems.

BACKGROUND: Minimally invasive surgical techniques expose surgeons to a variety of occupational hazards that may promote musculoskeletal disorders. Telerobotic systems for minimally invasive surgery may help to reduce these stressors. The objective of this study was to compare manual and telerobotic endoscopic surgery in terms of postural and mental stress. METHODS: Thirteen participants with no experience as primary surgeons in endoscopic surgery performed a set of simulated surgical tasks using two different techniques--a telerobotic master--slave system and a manual endoscopic surgery system. The tasks consisted of passing a soft spherical object through a series of parallel rings, suturing along a line 5-cm long, running a 32-in ribbon, and cannulation. The Job Strain Index (JSI) and Rapid Upper Limb Assessment (RULA) were used to quantify upper extremity exposure to postural and force risk factors. Task duration was quantified in seconds. A questionnaire provided measures of the participants' intuitiveness and mental stress. RESULTS: The JSI and RULA scores for all four tasks were significantly lower for the telerobotic technique than for the manual one. Task duration was significantly longer for telerobotic than for manual tasks. Participants reported that the telerobotic technique was as intuitive as, and no more stressful than, the manual technique. CONCLUSIONS: Given identical tasks, the time to completion is longer using the telerobotic technique than its manual counterpart. For the given simulated tasks in the laboratory setting, the better scores for the upper extremity postural analysis indicate that telerobotic surgery provides a more comfortable environment for the surgeon without any additional mental stress.

Arm↗
PubMed2000

Experimental trial on solo surgery for minimally invasive therapy: comparison of different systems in a phantom model.

BACKGROUND: Robotic aid in minimally invasive surgery (MIS) is becoming more and more common. We designed an experimental trial in a phantom model to verify the feasibility of solo surgery for MIS. By performing laparoscopic cholecystectomy on a phantom model, we compared combinations of different systems available in terms of safety, comfort, and time requirements. METHODS: Two surgeons skilled in endoscopic procedures tested the following systems as endoscope holders: the robotic system (AESOP), foot-controlled (AESOP 1000), and voice-controlled (AESOP 2000); the remote controlled FIPS Endoarm, electrically driven and controlled by a finger-ring joystic; the passive system TISKA Endoarm, a mechanical arm moved by hand and fixed by electromagnetical brakes. All of these systems combined with a second TISKA Endoarm as an instrument holder. A combination of two mechanical Martin arms, c, also was tested. The results were compared with those from a control group involving an assistant surgeon. A total of 70 experiments were performed. RESULTS: The shortest dissection time was registered by the combination of two TISKA Endoarms, with a statistically significant difference as compared with the control group (p < 0.05) and experiments using AESOP 1000 (p < 0.05). The TISKA Endoarm also proved to be more comfortable when used as an instrument holder (p < 0.001 vs Martin arm), and rated second only to AESOP 2000 as an endoscope holder. The rating of AESOP 2000 as endoscope holder was significantly higher than that of all other groups (p < 0.001). The study proved the feasibility of solo surgery. The time needed for dissection was shortest when two TISKA Endoarms were used, demonstrating the possible advantages of solo surgery. The TISKA Endoarm received a subjective positive rating when used as both endoscope holder and instrument holder. The voice control of AESOP 2000 seemed to be a major improvement in the development of an optimal man-machine interface. Nevertheless, the system presents considerable space requirements and does not supply control of 30 degrees optics. The principle of the finger-ring joystick adopted by the FIPS Endoarm seemed very intuitive but lacking in ergonomy. CONCLUSION: Laparoscopic solo surgery can be considered a safe procedure, although further technologic developments should lead to improved ergonomy, intuitiveness of handling, and architecture of the systems, offering the surgeon better control, increased precision of action, and reduction in operation time.

Minimally Invasive Surgical Procedures↗
PubMed2005

The function debate in philosophy.

This paper reviews the debate on the notion of biological function and on functional explanation as this takes place in philosophy. It describes the different perspectives, issues, intuitions, theories and arguments that have emerged. The author shows that the debate has been too heavily influenced by the concerns of a naturalistic philosophy of mind and argues that in order to improve our understanding of biology the attention should be shifted from the study of intuitions to the study of the actual practice of biological inquiry.

Animals↗
PubMed2006

Genetic testing and private insurance--a case of "selling one's body"?

Arguments against the possible use of genetic test results in private health and life insurance predominantly refer to the problem of certain gene carriers failing to obtain affordable insurance cover. However, some moral intuitions speaking against this practice seem to be more fundamental than mere concerns about adverse distributional effects. In their perspective, the central ethical problem is not that some people might fail to get insurance cover because of their 'bad genes', but rather that some people would manage to get insurance cover because of their 'good genes'. This paper tries to highlight the ethical background of these intuitions. Their guiding idea appears to be that, by pointing to his favourable test results, a customer might make an attempt to 'sell his body'. The rationale of this concept is developed and its applicability to the case at issue is critically investigated. The aim is to clarify an essential objection against the use of genetic information in private insurance which has not yet been openly addressed in the academic debate of the topic.

Commerce↗
PubMed2006

Assessing the total effect of time-varying predictors in prevention research.

Observational data are often used to address prevention questions such as, "If alcohol initiation could be delayed, would that in turn cause a delay in marijuana initiation?" This question is concerned with the total causal effect of the timing of alcohol initiation on the timing of marijuana initiation. Unfortunately, when observational data are used to address a question such as the above, alternative explanations for the observed relationship between the predictor, here timing of alcohol initiation, and the response abound. These alternative explanations are due to the presence of confounders. Adjusting for confounders when using observational data is a particularly challenging problem when the predictor and confounders are time-varying. When time-varying confounders are present, the standard method of adjusting for confounders may fail to reduce bias and indeed can increase bias. In this paper, an intuitive and accessible graphical approach is used to illustrate how the standard method of controlling for confounders may result in biased total causal effect estimates. The graphical approach also provides an intuitive justification for an alternate method proposed by James Robins [Robins, J. M. (1998). 1997 Proceedings of the American Statistical Association, section on Bayesian statistical science (pp. 1-10). Retrieved from http://www.biostat.harvard.edu/robins/research.html; Robins, J. M., Hernán, M., & Brumback, B. (2000). Epidemiology, 11(5), 550-560]. The above two methods are illustrated by addressing the motivating question. Implications for prevention researchers who wish to estimate total causal effects using longitudinal observational data are discussed.

Adolescent↗
PubMed1993

Emotion and two kinds of meaning: cognitive therapy and applied cognitive science.

The clinical cognitive approach assumes that emotional reactions are mediated through the meanings given to events. Cognitive therapy aims to change emotion by changing meanings. It focuses on specific level meanings, evaluating the truth value of particular beliefs. Bower's science-driven associative network theory of cognition and emotion is also primarily concerned with specific meanings. This focus on meaning at a specific level causes problems, e.g. the contrasts between 'intellectual' and 'emotional' belief, between 'cold' and 'hot' cognition, and between explicit and intuitive knowledge. These problems are resolved in the Interacting Cognitive Subsystems (ICS) approach. ICS distinguishes between a specific and a more holistic, intuitive, level of meaning. In contrast to alternative approaches, ICS suggest that holistic level meanings are of primary importance in emotion production. Representations at this level consist of schematic mental models, encoding high-order inter-relationships and prototypical patterns extracted from life experience. The ICS approach to meaning is described and its implications for understanding and treating emotional disorders discussed, together with relevant empirical findings. ICS suggests a therapeutic focus on holistic rather than specific meanings, a role for 'non-evidential' interventions, such as guided imagery, and a rational basis for certain experiential therapies.

Adaptation, Psychological↗
PubMedDate not supplied

Extracting the coherent core of human probability judgement: a research program for cognitive psychology.

Human intuition is a rich and useful guide to uncertain events in the environment but suffers from probabilistic incoherence in the technical sense. Developing methods for extracting a coherent body of judgement that is maximally consistent with a person's intuition is a challenging task for cognitive psychology, and also relevant to the construction of artificial expert systems. The present article motivates this problem, and outlines one approach to it.

Artificial Intelligence↗
PubMed1992

Computer visualization of left ventricular geometry during the cardiac cycle.

Mathematical expressions regulating ventricular dimensions during the cardiac cycle have been defined. Classical, static images are limited in comparison with ventriculograms, are not intuitive for teaching, and do not effectively convey effects of hypertrophy or dilatation. Accordingly we developed Tachycardia, an interactive menu-driven graphics program. The program allows three-dimensional visualization of the kinetics of the thick-walled, ellipsoidal left ventricle (LV). The user may specify mass, ejection fraction, end-diastolic volume, major to minor axis ratio, and diastole to systole time ratio. Real-time animation of heart rates ranging from 50-150/min is achieved. A library contains animations representing the normal LV, including dilatation and concentric or eccentric hypertrophy. For comparison of differences in LV geometry among ventricles, multiple animations can be viewed simultaneously. We conclude that computerized animation provides an intuitive understanding of the dynamic geometry of the cardiac cycle. User definition of the visualization can provide clinical utility and teaching value.

Computer Graphics↗
PubMed1993

Optimal test strategy in the case of two tests and one disease.

Decision-making, especially about test performance, is very complex in nature. Clinical decision analysis can provide tools for doctors which can be used in improving the ordering of laboratory tests. This article describes an approach which is relevant for medical practice and easy to understand, with the goal of obtaining better decisions rather than optimal solutions. The methodology enables a clear understanding of the possibilities and restrictions of test use and needs very little calculation. The cornerstone of the methodology is a graphical representation, by which the benefits of test use are evaluated. Furthermore, a simple algorithm has been developed that can be used to find the optimal solution in the case of two tests. In each step decision rules can be used. In a graphical representation the effect of combining tests can be easily evaluated. If a test combination is chosen one has to decide which sequence is optimal. Finally one has to choose between parallel and series testing. The gain in time of the parallel procedure (and possible gain in effectiveness of treatment) should be compared with the efficiency gain of series testing. The authors conclude that the developed methodology is closer to the intuitive decision-making process than the traditional decision-making techniques and therefore can be used in order to improve the rather intuitive decisions of doctors.

Clinical Laboratory Techniques↗
PubMed1989

Automatic detection of gait events: a case study using inductive learning techniques.

One of the problems which occurs in the development of a control system for functional electrical stimulation of the lower limbs is to detect accurately specific events within the gait cycle. We present a method for the classification of phases of the gait cycle using the artificial intelligence technique of inductive learning. Both the terminology of inductive learning and the algorithm used for the analyses are fully explained. Given a set of examples of sensor data from the gait events that are to be detected, the inductive learning algorithm is able to produce a decision tree (or set of rules) which classify the data using a minimum number of sensors. The nature of the redundancy of the sensor set is examined by progressively removing combinations of sensors and noting the effect on both the size of the decision trees produced and their classification accuracy on 'unseen' testing data. Since the algorithm is able to calculate which sensors are more important (informative), comparisons with the intuitive appreciation of sensor importance of five researchers in the fields were made, revealing that those sensors which appear intuitively most informative may, in fact, provide the least information. Comparison results with the standard statistical classification technique of linear discriminant analysis are also presented, showing the relative simplicity of the inductively derived rules together with their good classification accuracy. In addition to the control of FES, such techniques are also applicable to automatic gait analysis and the construction of expert systems for diagnosis of gait pathologies.

Algorithms↗
PubMed1985

Adjusting for baseline measurements in the two-period crossover study: a cautionary note.

It is intuitively appealing in planning a two-period crossover study to have each patient measured on the response variable at the beginning as well as at the end of both periods, and to take the change from the value at the start of the period to the value at the end as the measure of the patient's response to the treatment given during that period. This apparently innocuous procedure may, contrary to one's intuition, produce bias in the analysis of the data for a difference between the residual effects and a difference between the direct treatment effects.

Epidemiologic Methods↗
PubMed1993

Assessment of competence in clinical practice--a review of the literature.

Continuous practical assessments for those programmes leading to registration began to be introduced in the UK in the late 1970s and were generally hailed, certainly by educationalists, as being a much more valid, reliable and realistic method of assessment (Quinn 1989). However, now, with the increasing pressures on the role of the ward manager, the introduction of supernumerary status for learner nurses and shorter clinical placements, it could be argued that continuous practical assessment is in great danger of becoming no assessment at all. The extent to which experienced nurses are able to supervise and give the continued feedback on learners' progress that was considered such a significant improvement on the previous systems of assessments is questioned. On examination of the literature, consideration will be given to how experienced nurses measure and help others measure performance. The tools practitioners use to assist them in forming their judgements need to be examined. Are practitioners concerned with students' successful completion of tasks or do they rely on intuitive judgements in the complexity of the 'real life' situation? If intuitive judgements are involved, do they have any foundations, or are they concerned with mere random form completion and personality measures? In particular examination will be made of the various measurement tools available and different approaches to the assessment of competency in the 'real world' of nursing practice. Since the United Kingdom Central Council (UKCC) formally introduced the Nurses' Rules (Nurses, Midwives and Health Visitors Act 1979) in 1983, all courses throughout the UK, leading to registration had to begin to formally prepare students to work towards the achievement of the identified competencies.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Competence↗