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PubMedDate not supplied

[Computerized prototype of a screening test for the assessment of psychomotor development in childhood].

The aim of Denver's screening test is to study the psychomotor development of normal or supposed normal children aged from 0 to 6 years and to suggest further investigation when an abnormal development is noticed. The test is divided into 4 sections: social behavior, fine motility, language, gross motility. The results are valid only if the test is done in a standardized manner. The aim of this paper is to describe the computerized prototype of the Denver test in use at the Divisional Pediatric Ambulatory of "A. Gemelli" University Policlinic in Rome. This test is used in the context of an automatized ambulatory management system called ARPIA, capable of interacting and guiding "non expert" user. The program performs the following functions: 1) General instructions for the execution and interpretation of the test. The original instructions of the test (1975 version) have been used. 2) Input, modification, exclusion of questions. The archive is organized in the following manner: questions are divided in the above four sections, according to the child, undergoing the test, age limit; the questions regarding information that can be asked directly to the parents or the display of a picture that better explains the test are marked. During the test the questions may be modified using a menu with a certain number of options to facilitate the use of the system. The questions to eliminate from the test may be appropriately marked and removed. The text is not physically deleted from the archive. The inverse operation of inclusion of a formerly removed question may be performed too.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1992

P50 suppression is not affected by attentional manipulations.

Auditory evoked potentials (EP) to high or moderate intensity, single or paired clicks were recorded from normal young adult subjects. A choice-reaction-time paradigm had two sets of instructions, for intensity discrimination and for number (single versus paired stimulus) discrimination. For intensity discrimination, the second click had no informative value and its N100 amplitude was markedly reduced relative to the first click. For number discrimination, the presence or absence of the second click provided the salient information, and N100 amplitude was actually slightly larger for the second compared to the first click. In contrast, the attentional manipulation had no effect on P50 amplitude, which showed over 50% suppression from the first to the second click for both tasks. Thus, suppression of P50 amplitude to the second of a pair of clicks is insensitive to attentional manipulations that have major effects on N100 amplitude. These findings suggest that abnormalities of schizophrenic P50 suppression reflect neuronal rather than psychological phenomena.

Adult↗
PubMed1991

Components of heart rate reactivity during mental arithmetic with and without speaking.

Reactivity to psychological stressors has been hypothesized to be related to the development of cardiovascular disease. Because mental arithmetic (MA) has been shown to produce significant increases in heart rate and blood pressure, it is one of the most commonly utilized laboratory psychological stressors. However, the use of MA to assess hemodynamic reactivity raises two issues: 1) increases in heart rate can be produced by vagal withdrawal, sympathetic activation, or a combination of the two, and these mechanisms may differ in their pathogenic implications; and 2) in most MA studies, subjects are instructed to perform the task aloud, thus raising the possibility that speaking may interfere with respiratory patterns which in turn can influence hemodynamic outcomes. To address these two issues, we studied heart rate responses of 10 subjects to 2 different versions of MA and a control condition in which vocalization of answers was manipulated. Heart rate (HR), heart rate variability (HRV) in the low frequency (LB) and respiratory frequency (RSA) bands, and respiratory rate were measured. Results indicate that, although the two task conditions produced similar heart rate increases, RSA decreased only in the nonspeaking condition. Overall, the findings suggest that HR changes during MA are attributable to vagal withdrawal but that vocalization of answers during the task interferes with analysis of HRV, thus obscuring the mechanisms responsible for these changes.

Adult↗
PubMed1991

[Application of fuzzy theory for optokinetic pattern test].

The optokinetic pattern test for optokinetic nystagmus is performed to diagnose equilibrium disorders on clinical examination. We constructed computer assisted instruction (CAI) algorithm based on knowledge of expert for optokinetic pattern (OKP) diagnosis theoretically based Fuzzy reasoning derived from Fuzzy theory to ascertain the possible application of CAI to OKP and to develop a useful diagnostic tool. The algorithm was constructed by rules of fuzzy reasoning using analysed data of diagnostic modes of one expert, consisting of six variables, and of 30 normal and 22 abnormal patterns of optokinetic nystagmus which were diagnosed by the expert. The results derived from the fuzzy reasoning and those obtained by expert agreed with 96% in this test battery. In addition, a consistency of 87.3% was obtained after comparison with another 251 OKP patterns which diagnosed by the same expert and estimated by this algorithm. This algorithm incorporating fuzzy theory is concluded to be useful in obtaining results of the same as those of an expert for diagnosing the equilibrium disorders. Furthermore, CAI using Fuzzy theory is confirmed to have good potential as a diagnostic tools.

Algorithms↗
PubMed1991

Ongoing pain as a mental workload indexed by P300 depression: discrimination of real and feigned pain conditions.

Two groups of subjects were formed. One, a real pain group, was subjected to aversive pressure on the fingernail surface during pain-only and pain-tracking conditions. The second group (feigned pain) was instructed to feign pain during corresponding runs in which fingernail pressure was applied at a just noticeable (not painful) level. Both groups also simultaneously performed an auditory oddball (.8/.2) task during their pain-only and pain-tracking conditions, as well as during an initial (baseline-1) and final (baseline-2) baseline condition in which only the oddball task was performed. Oddball-evoked P300 amplitudes were significantly different for the groups during the pain-tracking and baseline-2 conditions, with the amplitudes smaller in the real pain groups in both conditions. The pain-only and pain-tracking conditions in both groups caused significant P300 reductions in comparison with baseline-1 values. P300 latencies did not differ as a function of either groups or conditions. 100% of the real pain subjects and 67% of the feigned pain subjects could be correctly classified using P300 amplitude-derived indices.

Adult↗
PubMed1992

Masticatory muscle fatigue: endurance times and spectral changes in the electromyogram during the production of sustained bite forces.

The purpose of this experiment was to determine if the characteristics of fatigue observed in the limb muscle system are also evident in the muscles of mastication, specifically, the masseter and temporalis. Surface electrodes were placed bilaterally over the masseter and temporalis muscles of 10 adults. Each subject was instructed to maintain maximal and six levels of submaximal incisal bite forces for as long as possible. The power density spectrum of the electromyographic signals for each muscle was calculated at the onset and failure of the task. The decrease in endurance time with an increase in bite force followed a pattern similar to that in limb muscles, and each muscle was characterized by a consistent reduction in the mean power frequency of the power density spectrum and a variable change in r.m.s. power. The variability of changes in r.m.s. power (which is inconsistent with changes found in the limb muscles) was explained in terms of either changes in motor-unit firing rate or the muscle's relative contribution to the generation of bite force. The analyses also demonstrated a curvilinear relationship between bite force and r.m.s. power, but no relationship between bite force and the mean power frequency of the power density spectrum.

Adult↗
PubMed1990

Voluntary facial action generates emotion-specific autonomic nervous system activity.

Four experiments were conducted to determine whether voluntarily produced emotional facial configurations are associated with differentiated patterns of autonomic activity, and if so, how this might be mediated. Subjects received muscle-by-muscle instructions and coaching to produce facial configurations for anger, disgust, fear, happiness, sadness, and surprise while heart rate, skin conductance, finger temperature, and somatic activity were monitored. Results indicated that voluntary facial activity produced significant levels of subjective experience of the associated emotion, and that autonomic distinctions among emotions: (a) were found both between negative and positive emotions and among negative emotions, (b) were consistent between group and individual subjects' data, (c) were found in both male and female subjects, (d) were found in both specialized (actors, scientists) and nonspecialized populations, (e) were stronger when the voluntary facial configurations most closely resembled actual emotional expressions, and (f) were stronger when experience of the associated emotion was reported. The capacity of voluntary facial activity to generate emotion-specific autonomic activity: (a) did not require subjects to see facial expressions (either in a mirror or on an experimenter's face), and (b) could not be explained by differences in the difficulty of making the expressions or by differences in concomitant somatic activity.

Adult↗
PubMed1992

A successful computerized protocol for clinical management of pressure control inverse ratio ventilation in ARDS patients.

We have developed a computerized protocol that provides a systematic approach for management of pressure control-inverse ratio ventilation (PCIRV). The protocols were used for 1,466 h in ten around-the-clock PCIRV evaluations on seven patients with severe adult respiratory distress syndrome (ARDS). Patient therapy was controlled by protocol 95 percent of the time (1,396 of 1,466 h) and 90 percent of the protocol instructions (1,937 of 2,158) were followed by the clinical staff. Of the 221 protocol instructions, 88 (39 percent) not followed were due to invalid PEEPi measurements. Compared with preceding values during CPPV, the expired minute ventilation was reduced by 27 percent during PCIRV while maintaining a pH that was not clinically different (mean difference in pH = 0.02). There was no difference in the PaO2, PEEPi, or the FIO2 between PCIRV and CPPV. The PEEP setting was reduced by 33 percent from 9 +/- 0.05 to 6 +/- 0.6 and the I:E ratio increased from 0.64 +/- 0.04 to 2.3 +/- 0.10. Peak airway pressure was reduced by 24 percent (from 59 +/- 1.5 to 45 +/- 0.6) and mean airway pressure increased by 27 percent (from 22 +/- 0.8 to 28 +/- 0.6) in PCIRV. Right atrial and pulmonary artery pressures were higher and cardiac output lower in PCIRV but blood pressure was unchanged. The success of this protocol has demonstrated the feasibility of using PEEPi as a primary control variable for oxygenation. This computerized PCIRV protocol should make the future use of PCIRV less mystifying, simpler, and more systematic.

Adult↗
PubMed1991

Tempo, stress, and vowel reduction in American English.

Two processes that affect the acoustic characteristics of vowels, namely, phonological and phonetic vowel reduction are discussed. Phonological vowel reduction applies to unstressed vowels. Phonetic vowel reduction is supposed to apply to all vowels and be caused by fast speech rates, context, as well as lack of stress. In this experiment, the effects of changes in stress and in rate of speech (tempo) on the acoustic characteristics of American English monophthongal, nonretroflex vowels were examined. Four male and four female native speakers produced these vowels in two contexts, [h_d] and [b_d], in a carrier sentence, under four conditions of tempo stress (slow-stressed, slow-unstressed, fast-stressed, and fast-unstressed). Measurements of duration and fundamental frequency showed that the subjects did, in fact, vary tempo and stress as instructed. The effect of a change in stress on vowel duration was found to be slightly larger than that of a change in tempo. The putative vowel portion of each utterance was analyzed, formant tracks were obtained, and these were plotted in an auditory-perceptual space [J.D. Miller, J. Acoust. Soc. AM. 85, 2114-2134 (1989)]. These plots served to determine the part of the utterance that could, in most cases, be considered its steady state. For each utterance, an average of the coordinates of this steady-state portion was taken and was used to represent the utterance as a point in the auditory-perceptual space. The distance of these data points from the point representing the acoustic characteristics of a vowel produced by a neutral vocal tract was used to determine the magnitude of phonetic vowel reduction caused by faster tempo and less stress, relative to the slow-stressed condition. Although the results indicate that tempo and stress may not have a major influence on the distances of individual vowels from the neutral point, the size of the vowel space overall was affected. The vowel space was largest for the slow stressed condition and smallest for the fast unstressed condition. In addition, several vowel classifications schemes were tested using linear discriminant analysis, and the one proposed by Miller (1989) performed better than other combinations of fundamental frequency and the first three formants.

Adult↗
PubMed1991

Image data compression using a new floating-point digital signal processor.

A new dual-ported, floating-point, digital signal processor has been evaluated for compressing 512 and 1,024 digital radiographic images using a full-frame, two-dimensional, discrete cosine transform (2D-DCT). The floating point digital signal processor operates at 49.5 million floating point instructions per second (MFLOPS). The level of compression can be changed by varying four parameters in the lossy compression algorithm. Throughput times were measured for both 2D-DCT compression and decompression. For a 1,024 x 1,024 x 10-bit image with a compression ratio of 316:1, the throughput was 75.73 seconds (compression plus decompression throughput). For a digital fluorography 1,024 x 1,024 x 8-bit image and a compression ratio of 26:1, the total throughput time was 63.23 seconds. For a computed tomography image of 512 x 512 x 12 bits and a compression ratio of 10:1 the throughput time was 19.65 seconds.

Algorithms↗
PubMed1991

PNM: a program for parametric and nonparametric mapping of multidimensional data.

A program named PNM is presented for the mapping of multidimensional data within a two-class classification problem. A novel mapping method is used for the purpose. The computing procedure implemented in the program is described in detail. Definitions and examples of the control instructions of the program are given at length. An application of PNM for classifier design concerning differential diagnoses of the cerebrovascular accident is presented. It confirms the efficiency of the program in solving classification problems of relatively large size on a small computer.

Brain Ischemia↗
PubMed1991

Bayesian image reconstruction for emission tomography incorporating Good's roughness prior on massively parallel processors.

Since the introduction by Shepp and Vardi [Shepp, L. A. & Vardi, Y. (1982) IEEE Trans. Med. Imaging 1, 113-121] of the expectation-maximization algorithm for the generation of maximum-likelihood images in emission tomography, a number of investigators have applied the maximum-likelihood method to imaging problems. Though this approach is promising, it is now well known that the unconstrained maximum-likelihood approach has two major drawbacks: (i) the algorithm is computationally demanding, resulting in reconstruction times that are not acceptable for routine clinical application, and (ii) the unconstrained maximum-likelihood estimator has a fundamental noise artifact that worsens as the iterative algorithm climbs the likelihood hill. In this paper the computation issue is addressed by proposing an implementation on the class of massively parallel single-instruction, multiple-data architectures. By restructuring the superposition integrals required for the expectation-maximization algorithm as the solutions of partial differential equations, the local data passage required for efficient computation on this class of machines is satisfied. For dealing with the "noise artifact" a Markov random field prior determined by Good's rotationally invariant roughness penalty is incorporated. These methods are demonstrated on the single-instruction multiple-data class of parallel processors, with the computation times compared with those on conventional and hypercube architectures.

Algorithms↗
PubMed1977

Roentgen-tele-data: a radiodiagnostic recording system.

A radiodiagnostic data-handling system with telephones connected to the hospital exchange is described. Time, date, and location of examination are automatically recorded. The system can deliver spoken instructions from the computer and warns if data are not valid. Diagnosis, their degree of verification, and cases of special interest are added at display terminals. Codes, equipment, and output are described. Costs represent 1% of the department's expenditures. Future plans include a booking sytem, rapid access, and on-line connection to the main data system.

Computers↗
PubMed1992

Fulfilling the promise: implementing IAIMS at Georgetown University.

Predictions are that the integration of multiple information systems of a medical center will change the way doctors work and practice medicine in the future. Several major steps must be taken by an institution to make this a reality. The IAIMS program sponsored by the NLM is designed to achieve integration of resources in the medical center environment. The purpose of the IAIMS project at Georgetown is to develop a medical decision support system by bringing together multiple sources of information that reside on disparate computers and different database systems. This immense and complex task is described in this paper from an organizational, academic and technical perspective. Georgetown is developing a Biotechnology and Biomedical Knowledge Network which includes several informational and clinical databases, a variety of scholar workstations, instruction on use of computers, a campus-wide network with local area network nodes and a modular approach to systems integration. The IAIMS project is spearheaded by the medical library which has enabled a broad body of medical center users to benefit directly from new, dynamic services.

Academic Medical Centers↗
PubMed1992

Health status measurement. Implementation strategies.

The creation of valid instruments of health status measurement does not guarantee their use in the clinical setting. Traditional continuing medical education has not been shown to effect physician behavioral change. Examination of the literature on the dissemination of new technology underscores the need for the acceptance and use of new methods by local opinion leaders whose behavior serves as a model for their colleagues. Since health status measurement will require a new way of evaluating the patient visit and the creation of new provider behaviors, widespread implementation will require the recruitment of local clinical leaders to serve as spokesmen for reconsideration of office care procedures. Advocates of health status measurement should seize on a variety of opportunities to disseminate their work. Medical school curricula in courses such as physical diagnosis could expose different approaches to the patient encounter to a new generation of physicians in a fairly painless and seamless manner. Academic practice plans, by virtue of their increasing trend to centralization, could commit to patient-oriented data collection--if not for instructional purposes, then for the overall health of the delivery system. The instruction of nurses and paraprofessionals in the collection of these data could expand the measures and help drive the system when physicians are not embracing the technology. There is need to exploit the enhanced capacity of computer hardware and software in the service of efficient data collection and trend analysis of health status.(ABSTRACT TRUNCATED AT 250 WORDS)

Algorithms↗
PubMed1991

Medical Practice Support System. A medical practitioner's multimedia workstation.

The United States Navy has developed a computer based Medical Practice Support System (MEPSS) intended for use by medical practitioners working in isolated situations. The system, now being tested in operational settings, emphasizes inexpensive, easily obtained off-the-shelf hardware and specially developed, readily implemented software to provide users with: 1) medical record keeping, 2) an electronic medical library, 3) interactive video instruction programs suitable for continuing medical education, 4) computer based medical diagnosis and treatment assistance, and 5) electronic communications with other facilities. This demonstration emphasizes a user based developmental approach, integration of diverse systems under a single user interface, and portable hardware. The resulting system makes medical information needed by practitioners instantly available at the time of a patient encounter, whenever and wherever that encounter may occur. Making clinically valuable information immediately available, MEPSS demonstrates how practitioners can use computers to help their own efforts to improve patient care quality and efficiency.

Decision Making, Computer-Assisted↗
PubMedDate not supplied

A real-time analysis of a transplantation program with a personal computer.

This study concerns the use of commercial software (a spreadsheet combined with database and graphic functions) to analyze data on kidney transplantation. The program consists of a section containing (macro) instructions, a section for entering data, a database, a set of spreadsheets (one for each field) with which the statistical calculations and summary tables are executed, and a set of diagrams for the final visual output. Three kinds of data are made available: descriptive statistics, actuarial survival rates, and risk factor evaluation. The program can analyze the importance of the variables considered and estimate the effect of a therapeutic or diagnostic maneuver.

Computer Systems↗
PubMedDate not supplied

Quality videotapes with the help of a computer.

The last few years have seen a tremendous growth in videocassette usage, not only for entertainment, but also as a viable teaching method. Most homes in American now have at least one VCR. At Ozarka Vo Tech in Melbourne, AR, educators recognize the educational value of videotapes and have combined efforts to produce several quality computer-generated videotapes. With funding from projects, P189-01 A Competency-Based, Computer-Assisted, And Computer-Managed Model LPN Program, and the PI 2B061 Comprehensive Learning Lab, educators have been able to produce teacher-made videotapes to augment the different educational programs at our school. This article describes the method used, equipment needed, and general hints for improving the quality of teacher-made videotapes.

Humans↗