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Deep brain stimulation in movement disorders: stereotactic coregistration of two-dimensional electrical field modeling and magnetic resonance imaging.

OBJECT: Adjusting electrical parameters used in deep brain stimulation (DBS) for dystonia remains time consuming and is currently based on clinical observation alone. The goal of this study was to visualize electrical parameters around the electrode, to correlate these parameters with the anatomy of the globus pallidus internus (GPI), and to study the relationship between the volume of stimulated tissue and the electrical parameter settings. METHODS: The authors developed a computer-assisted methodological model for visualizing electrical parameters (the isopotential and the isoelectric field magnitude), with reference to the stereotactic target, for different stimulation settings (monopolar and bipolar) applied during DBS. Electrical field values were correlated with the anatomy of the GPI, which was determined by performing stereotactic magnetic resonance imaging in one reference patient. By using this method it is possible to compare potential and electrical field distributions for different stimulation modes. In monopolar and bipolar stimulation, the shape and distribution of the potential and electrical field are different and depend on the stimulation voltage. Distributions visualized for patient-specific parameters can be subsequently correlated with anatomical information. The application of this method to one patient demonstrated that the 0.2-V/ mm isofield line fits best with the lateral GPI borders at the level of the stimulated contacts. CONCLUSIONS: The electrical field is a crucial parameter because it is assumed to be responsible for triggering action potentials. Electrical field visualization allows the calculation of the stimulated volume for a given isoline. Its application to an entire series of patients may help determine a threshold for obtaining a therapeutic effect, which is currently unknown, and consequently may aid in optimizing parameter settings in individual patients.

Adolescent↗

Multi-response permutation procedure as an alternative to the analysis of variance: an SPSS implementation.

A permutation test typically requires fewer assumptions than does a comparable parametric counterpart. The multi-response permutation procedure (MRPP) is a class of multivariate permutation tests of group difference useful for the analysis of experimental data. However, psychologists seldom make use of the MRPP in data analysis, in part because the MRPP is not implemented in popular statistical packages that psychologists use. A set of SPSS macros implementing the MRPP test is provided in this article. The use of the macros is illustrated by analyzing example data sets.

Behavioral Research↗

Computer-aided method for calculating animal configurations during social interactions from two-dimensional coordinates of color-marked body parts.

In an experiment investigating the impact of preweaning social experience on later social behavior in pigs, we were interested in the mutual spatial positions of pigs during paired social interactions. To obtain these data, we applied a different colored mark to the head and back of each of 2 pigs per group and videotaped the pigs' interactions. We used the EthoVision tracking system to provide x,y coordinates of the four colored marks every 0.2 sec. This paper describes the structure and functioning of a FoxPro program designed to clean the raw data and use it to identify the mutual body positions of the 2 animals at 0.2-sec intervals. Cleaning the data was achieved by identifying invalid data points and replacing them by interpolations. An algorithm was then applied to extract three variables from the coordinates: (1) whether the two pigs were in body contact; (2) the mutual orientation (parallel, antiparallel, or perpendicular) of the two pigs; and (3) whether the pig in the "active" position made snout contact in front of, or behind, the ear base of the other pig. Using these variables, we were able to identify five interaction types: Pig A attacks, Pig B attacks, undecided head-to-head position, "clinch" resting position, or no contact. To assess the reliability of the automatic system, a randomly chosen 5-min videotaped interaction was scored for mutual positions both visually (by 2 independent observers) and automatically. Good agreement was found between the data from the 2 observers and between each observer's data and the data from the automated system, as assessed using Cohen's kappa coefficients.

Animals↗

Versatile computerized system for tracking and analysis of water maze tests.

A crucial step in the estimation of properties of compounds in behavioral experiments is the quantification and description of the different effects observed. The goal of the present work was the automation of the Morris water maze test, one of the most popular behavioral methods for the study of animal memory. An original system was developed that provides fast and accurate tracking of animals, storage of the results in the database and video archive and a means of analyzing the results. This computerized version of the Morris water maze test permits the quantification of such vague characteristics of cognitive function as the "directionality" of search of the hidden platform after a standard training series. The suggested parameters made it possible to discriminate cognitive properties of the novel compounds from other behavioral effects affecting escape latency. The effectiveness of this system was demonstrated in two experiments with neurochemically lesioned and drug-treated rats.

Analysis of Variance↗

Ground reaction force and spatiotemporal measurements of the gait of the mouse.

Measurement of ground reaction forces with force plates permits quantification of the subtle changes in movement associated with a variety of pathophysiological states. The apparatus used here permits simultaneous recording of other spatial and temporal characteristics of gait. Since the mouse is becoming increasingly important for modeling human disorders, we have recorded ground reaction forces (P) in this species. To date, we have measured the vertical component (Pz) and found it to be similar to that of other species, in that a greater Pz is exerted via the forelimb, although the areas under the force/time curves, are not different. Different points of discontinuity are seen in the forelimb and hindlimb curves, indicating differential deployment. Pz varies consistently with stance time and is consistent across the adult life of the mouse. It is suggested that the technique has potential for the study of a variety of mouse models of disease and of their therapies.

Animals↗

Using open-source solutions to teach computing skills for student research.

A course that relies on open-source software for teaching introductory computer programming and Web development to psychology graduate and advanced undergraduate students is described. The rationale, content, learning goals and outcomes of the course are described, along with the specific software used. The advantages of relying on open-source solutions rather than commercial software for implementing such a course are discussed.

Computer-Assisted Instruction↗

Tell me, what did you see? The stimulus on computers.

Most psychology experiments start with a stimulus, and, for an increasing number of studies, the stimulus is presented on a computer monitor. Usually, that monitor is a CRT, although other technologies are becoming available. The monitor is a sampling device; the sampling occurs in four dimensions: spatial, temporal, luminance, and chromatic. This paper reviews some of the important issues in each of these sampling dimensions and gives some recommendations for how to use the monitor effectively to present the stimulus. In general, the position is taken that to understand what the stimulus actually is requires a clear specification of the physical properties of the stimulus, since the actual experience of the stimulus is determined both by the physical variables and by the psychophysical variables of how the stimulus is handled by our sensory systems.

Behavioral Sciences↗

Concept-match medical data scrubbing. How pathology text can be used in research.

CONTEXT: In the normal course of activity, pathologists create and archive immense data sets of scientifically valuable information. Researchers need pathology-based data sets, annotated with clinical information and linked to archived tissues, to discover and validate new diagnostic tests and therapies. Pathology records can be used for research purposes (without obtaining informed patient consent for each use of each record), provided the data are rendered harmless. Large data sets can be made harmless through 3 computational steps: (1) deidentification, the removal or modification of data fields that can be used to identify a patient (name, social security number, etc); (2) rendering the data ambiguous, ensuring that every data record in a public data set has a nonunique set of characterizing data; and (3) data scrubbing, the removal or transformation of words in free text that can be used to identify persons or that contain information that is incriminating or otherwise private. This article addresses the problem of data scrubbing. OBJECTIVE: To design and implement a general algorithm that scrubs pathology free text, removing all identifying or private information. METHODS: The Concept-Match algorithm steps through confidential text. When a medical term matching a standard nomenclature term is encountered, the term is replaced by a nomenclature code and a synonym for the original term. When a high-frequency "stop" word, such as a, an, the, or for, is encountered, it is left in place. When any other word is encountered, it is blocked and replaced by asterisks. This produces a scrubbed text. An open-source implementation of the algorithm is freely available. RESULTS: The Concept-Match scrub method transformed pathology free text into scrubbed output that preserved the sense of the original sentences, while it blocked terms that did not match terms found in the Unified Medical Language System (UMLS). The scrubbed product is safe, in the restricted sense that the output retains only standard medical terms. The software implementation scrubbed more than half a million surgical pathology report phrases in less than an hour. CONCLUSIONS: Computerized scrubbing can render the textual portion of a pathology report harmless for research purposes. Scrubbing and deidentification methods allow pathologists to create and use large pathology databases to conduct medical research.

Computing Methodologies↗

What's hot and what's not anticipating trends in technology.

Technology tends to progress over time in a step fashion. Changes in productivity associated with technology, when followed over time, often plot out as an S curve. Long quiescent periods are interrupted by rapid rises in technology advance and productivity. Anticipating this is important since it often enables us to plan for new technology. The lag in response to change often leads to bad planning or bad decisions. For example, I recently brought a new 166 Mhz laptop just a month before the new 233s came out, with a corresponding drop in the price of the 166 models ... so it clear I am not omniscient on the subject. In this column we will discuss important trends and identify what is hot and what is not in order to help you anticipate change in technology. I'll explore eight areas in depth. I will also touch on what you need to do to take advantage of the new technology if you have invested in older legacy technology.

Computer Communication Networks↗

Being analog.

Explore the source record for details and available documents.

Computer Literacy↗

FOIN: a nominative information occultation function.

This article is intended to show that a great amount of work has to (and will) be done in terms of security for the healthcare information system community. Some very promising results have already been obtained in France, especially at CNAMTS, for providing the required security and privacy of nominative information in the context of future electronic exchanges between private/public hospital and CNAMTS, the french biggest mandatory healthcare insurance. FOIN, a robust anonymisation function, is just an example of such recent progress that traduces the french national engagement towards more flexible interconnection between various authorised healthcare information systems in close conjunction with more and more reliable and secure procedural and technical requirements. Firstly, the legal and medical needs for so strong anonymisation functions are described; secondly, the most important security requirements of these sensible functions are detailed and, lastly, the main security and implementation features of FOIN are globally indicated.

Algorithms↗

Medicare and Medicaid programs; schedule of limits on home health agency costs per visit for cost reporting periods beginning on or after July 1, 1984--HCFA. Proposed rule.

This rule sets forth a proposed schedule of limits on home health agency (HHA) costs that may be reimbursed under the Medicare program and a proposed revision of the regulations governing the limits. The schedule is an update of the limits to take into account more recent data and the effects of inflation on HHA operating costs and would apply to HHA costs for entire cost reporting periods beginning on or after July 1, 1984. The schedule would also explain the basic methodology for computing the cost limits, the change in terminology involving metropolitan statistical areas and a proposed change to the method of deriving the share of labor cost contained in the limits. The proposed revision to the regulations would clarify our policy concerning exceptions from the cost limits for newly established HHAs .

Centers for Medicare and Medicaid Services, U.S.↗

Medicare program; schedule of limits on home health agency costs per visit for cost reporting periods beginning on or after July 1, 1985--HCFA. Final notice.

This notice sets forth a schedule of limits on home health agency [HHA] costs that may be reimbursed under the Medicare program. The schedule is an update of the limits to take into account more recent data and the effects of inflation on HHA operating costs, and it applies to HHA costs for entire cost reporting periods beginning on or after July 1, 1985. The notice also explains the revised methodology for computing the cost limits for cost reporting periods beginning on or after July 1, 1985 and before July 1, 1988.

Centers for Medicare and Medicaid Services, U.S.↗