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A software standard has been designed that will facilitate the linking of all point-of-care testing (POCT) devices to information systems. This standard will replace the myriad of proprietary and incompatible solutions that currently exist. The standard is expected to be a feature of new POCT instruments by 2002.
We develop a procedure called RiPE (Retrieval-induced Phylogeny Environment) that automatically performs an evolutionary analysis of a protein (sub)family, (i) by retrieving the relevant sequences via a homology search, (ii) by using the search report to construct the alignment using only homologous subsequences (taking into account their neighborhood with a low chance of homology), (iii) by realigning, and (iv) by generating phylogenetic trees based on the alignment. In a first implementation of our scheme, we start with the available proteome data of model organisms, perform a PSI-BLAST search, use MView to convert hits into a multiple alignment, and perform realignment and tree building. As a test case, we have investigated the human ABC transporters of the subfamily G, starting with the five known human ABCG transporters. Our method retrieved homologous sequences not previously analyzed, generating a tree that is more plausible and better supported than previously published trees. The RiPE 0.1 prototype is available at the RiPE website, http://ifg-izkf.uni-muenster.de/fuellen/RiPE/ripe.html.
Health promotion and intervention projects at State and community levels need computerized data bases to assist in making policy decisions and in operating the projects. Computer data base systems are used in entering, storing, retrieving, and analyzing information about health project activities and their participants in a timely and cost-effective manner. Computer support is essential for such labor-intensive tasks as post-screening followup of participants, identifying subpopulations, and evaluating recruitment efforts and behavior change programs. The Pawtucket Heart Health Program developed a microcomputer software package, FPbase, for community health project data base management. FPbase is described and is available for use by other organizations. FPbase incorporates formative and process interactive data base activities and is suitable for use in operating intervention and screening programs at State and local levels. The system accommodates management of data for social marketing, evaluation, followup, and promotional activities.
The MOTRICO project plans the development of an advanced environment that will offer computer assistance for cardiac therapy and diagnosis, which would be useful in the hemodynamics units of those hospitals that have access to the instrumental techniques of Angiography and intravascular Ultrasounds. The initial work presented in this paper will describe modeling and finite element mesh generation of an idealized model of the human left coronary artery bifurcation. The computational geometric model has been developed on the basis of real anatomical information.
This report presents the impact of smoking habits on Italian mortality in 1998. Estimates of smoking-attributable fraction (FAF), smoking-attributable mortality (MAF), and years of potential life lost (YPLLf) were calculated using the SAMMEC software (CDC, USA), and the Peto method. During 1998, using the SAMMEC software, smoking caused approximately 83,650 premature deaths in Italy (67,600 in men, 16,000 in women, and 45 in infants), equal to 15.1% of mortality in adults above the age of 35 years (24.4% of mortality in men and 5.8% in women). YPLLf were about 900,000 in men, 221,000 in women, and 3,500 in infants. Using the Peto method, smoking-attributable deaths were about 70,200 (59,600 in men and 10,600 in women), equal to 12.7% of mortality in adults older than 35 years (21.5% of mortality in men and 3.9% in women). YPLLf were about 806,000 in men and 142,000 in women. Among adults, for both methods most smoking-related deaths were attributable to lung cancer, ischemic heart disease, chronic airways obstruction, and cerebrovascular disease. Differences between the estimates of the two methods underline the gap between a more conservative estimate (Peto method) and a less restrictive one (SAMMEC software). Given validity for both methods, it is likely smoking habits caused between 70,000 and 83,000 deaths in Italy during 1998.
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Large-scale microarray gene expression studies can provide insight into complex genetic networks and biological pathways. A comprehensive gene expression database was constructed using Affymetrix GeneChip microarrays and RNA isolated from more than 6,400 distinct normal and diseased human tissues. These individual patient samples were grouped into over 700 sample sets based on common tissue and disease morphologies, and each set contained averaged expression data for over 45,000 gene probe sets representing more than 33,000 known human genes. Sample sets were compared to each other in more than 750 normal vs. disease pairwise comparisons. Relative up or downregulation patterns of genes across these pairwise comparisons provided unique expression fingerprints that could be compared and matched to a gene of interest using the Match/X trade mark algorithm. This algorithm uses the kappa statistic to compute correlations between genes and calculate a distance score between a gene of interest and all other genes in the database. Using cdc2 as a query gene, we identified several hundred genes that had similar expression patterns and highly correlated distance scores. Most of these genes were known components of the cell cycle involved in G2/M progression, spindle function or chromosome arrangement. Some of the identified genes had unknown biological functions but may be related to cdc2 mediated mechanism based on their closely correlated distance scores. This algorithm may provide novel insights into unknown gene function based on correlation to expression profiles of known genes and can identify elements of cellular pathways and gene interactions in a high throughput fashion.
These programs represent the entry of the Mac into major statistical computing. We believe that for the physician researcher who is not a statistician, they make the Mac the platform for data analysis. We found that statistics, research design, and data analysis seemed different and much less intimidating to us and our trainees when approached through the Mac. We have reviewed the versions of these programs available at the time of this writing, in May 1992; potential buyers should contact the software publisher for information about more recent upgrades. At this point, our recommendations would be as follows: If you are wedded to SPSS or Minitab, try the Mac versions, and you will be impressed. Otherwise, the choice is between SYSTAT, which has been around long enough to demonstrate its richness and capacity to build on its strengths, and JMP, a brash newcomer, which demonstrates that you can teach an old dog (SAS) new tricks. StatView and SuperANOVA, while endowed with intuitive, easy-to-use interfaces, lack online help--a feature we consider important in a statistics package. We anticipate that the future will lead to simplification of the SYSTAT interface and the addition of more analytic capacities to JMP--and who knows what the next generation of competitors will bring?
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This article describes how the availability of applications programs on bedside and central station monitors increases nursing efficiency, enhances patient safety, and reduces hospital costs. Included are descriptions of some specific applications programs that comprise the Space-Labs Clinical Library: continuing education credit programs, drug therapy programs and a pacemaker information retrieval database. The benefits of these monitor-based programs--for both nurses and hospitals--are described.
UNLABELLED: Various automatic algorithms are now being developed to calculate left ventricular (LV) and right ventricular (RV) ejection fraction from tomographic radionuclide ventriculography. We tested the performance of 4 of these algorithms in estimating LV and RV volume and ejection fraction using a dynamic 4-chamber cardiac phantom. METHODS: We developed a realistic physical, dynamic 4-chamber cardiac phantom and acquired 25 tomographic radionuclide ventriculography images within a wide range of end-diastolic volumes, end-systolic volumes, and stroke volumes. We assessed the ability of 4 algorithms (QBS, QUBE, 4D-MSPECT, and BP-SPECT) to calculate LV and RV volume and ejection fraction. RESULTS: For the left ventricle, the correlations between reference and estimated volumes (0.93, 0.93, 0.96, and 0.93 for QBS, QUBE, 4D-MSPECT, and BP-SPECT, respectively; all with P < 0.001) and ejection fractions (0.90, 0.93, 0.88, and 0.92, respectively; all with P < 0.001) were good, although all algorithms underestimated the volumes (mean difference [+/-2 SDs] from Bland-Altman analysis: -39.83 +/- 43.12 mL, -33.39 +/- 38.12 mL, -33.29 +/- 40.70 mL, and -16.61 +/- 39.64 mL, respectively). The underestimation by QBS, QUBE, and 4D-MSPECT was greater for higher volumes. QBS, QUBE, and BP-SPECT could also be tested for the right ventricle. Correlations were good for the volumes (0.93, 0.95, and 0.97 for QBS, QUBE, and BP-SPECT, respectively; all with P < 0.001). In terms of absolute volume estimation, the mean differences (+/-2 SDs) from Bland-Altman analysis were -41.28 +/- 43.66 mL, 11.13 +/- 49.26 mL, and -13.11 +/- 28.20 mL, respectively. Calculation of RV ejection fraction correlated well with true values (0.84, 0.92, and 0.94, respectively; all with P < 0.001), although an overestimation was seen for higher ejection fractions. CONCLUSION: Calculation of LV and RV ejection fraction based on tomographic radionuclide ventriculography was accurate for all tested algorithms. All algorithms underestimated LV volume; estimation of RV volume seemed more difficult, with different results for each algorithm. The more irregular shape and inclusion of a relatively hypokinetic RV outflow tract in the right ventricle seemed to cause the greater difficulty with delineation of the right ventricle, compared with the left ventricle.
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Information and Communication Technology (ICT) assist healthcare professionals in the process of diagnosis, treatment, monitoring, medication prescription, referral, information retrieval and communication, documentation and transactions. This applies to intramural, transmural and extramural conditions. About 67% of patients involved in safety incidents believe that the incidents could have been prevented had an electronic health record been available. However, preliminary research also suggests that about 30% of patient safety incidents relate to software problems. ICT might improve quality of healthcare provided that ICT products, the ICT administration and use comply to essential requirements. This paper presents information about the state of the art of software quality, the measuring of software quality, quality management systems and a evaluation and certification method.
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