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PubMed2005

Toward semantic interoperability in home health care: formally representing OASIS items for integration into a concept-oriented terminology.

OBJECTIVE: The authors aimed to (1) formally represent OASIS-B1 concepts using the Logical Observation Identifiers, Names, and Codes (LOINC) semantic structure; (2) demonstrate integration of OASIS-B1 concepts into a concept-oriented terminology, the Medical Entities Dictionary (MED); (3) examine potential hierarchical structures within LOINC among OASIS-B1 and other nursing terms; and (4) illustrate a Web-based implementation for OASIS-B1 data entry using Dialogix, a software tool with a set of functions that supports complex data entry. DESIGN AND MEASUREMENTS: Two hundred nine OASIS-B1 items were dissected into the six elements of the LOINC semantic structure and then integrated into the MED hierarchy. Each OASIS-B1 term was matched to LOINC-coded nursing terms, Home Health Care Classification, the Omaha System, and the Sign and Symptom Check-List for Persons with HIV, and the extent of the match was judged based on a scale of 0 (no match) to 4 (exact match). OASIS-B1 terms were implemented as a Web-based survey using Dialogix. RESULTS: Of 209 terms, 204 were successfully dissected into the elements of the LOINC semantics structure and integrated into the MED with minor revisions of MED semantics. One hundred fifty-one OASIS-B1 terms were mapped to one or more of the LOINC-coded nursing terms. CONCLUSION: The LOINC semantic structure offers a standard way to add home health care data to a comprehensive patient record to facilitate data sharing for monitoring outcomes across sites and to further terminology management, decision support, and accurate information retrieval for evidence-based practice. The cross-mapping results support the possibility of a hierarchical structure of the OASIS-B1 concepts within nursing terminologies in the LOINC database.

Dictionaries, Medical as Topic↗
PubMed2005

Personal health records: definitions, benefits, and strategies for overcoming barriers to adoption.

Recently there has been a remarkable upsurge in activity surrounding the adoption of personal health record (PHR) systems for patients and consumers. The biomedical literature does not yet adequately describe the potential capabilities and utility of PHR systems. In addition, the lack of a proven business case for widespread deployment hinders PHR adoption. In a 2005 working symposium, the American Medical Informatics Association's College of Medical Informatics discussed the issues surrounding personal health record systems and developed recommendations for PHR-promoting activities. Personal health record systems are more than just static repositories for patient data; they combine data, knowledge, and software tools, which help patients to become active participants in their own care. When PHRs are integrated with electronic health record systems, they provide greater benefits than would stand-alone systems for consumers. This paper summarizes the College Symposium discussions on PHR systems and provides definitions, system characteristics, technical architectures, benefits, barriers to adoption, and strategies for increasing adoption.

Attitude to Computers↗
PubMed2006

Effect of acute aldosterone administration on gene expression profile in the heart.

Aldosterone is known to have a number of direct adverse effects on the heart, including fibrosis and myocardial inflammation. However, genetic mechanisms of aldosterone action on the heart remain unclear. This paper describes an investigation of temporal changes in gene expression profile of the whole heart induced by acute administration of a physiologic dose of aldosterone in the mouse. mRNA levels of 34,000 known mouse genes were measured at eight time points after aldosterone administration using oligonucleotide microarrays and compared with those of the control animals who underwent a sham injection. A novel software tool (CAGED) designed for analysis of temporal microarray experiments using a Bayesian approach was used to identify genes differentially expressed between the aldosterone-injected and control group. CAGED analysis identified 12 genes as having significant differences in their temporal profiles between aldosterone-injected and control groups. All of these genes exhibited a decrease in expression level 1-3 h after aldosterone injection followed by a brief rebound and a return to baseline. These findings were validated by quantitative RT-PCR. The differentially expressed genes included phosphatases, regulators of steroid biosynthesis, inactivators of reactive oxygen species, and structural proteins. Several of these genes are known to functionally mediate biochemical phenomena previously observed to be triggered by aldosterone administration, such as phosphorylation of ERK1/2. These results provide the first description of cardiac genetic response to aldosterone and identify several potential mediators of known biochemical sequelae of aldosterone administration in the heart.

Aldosterone↗
PubMed2002

The use of geographical information systems in examining variations in sociodemographic profiles of dental practice catchments: a case study of a Swansea practice.

AIM: The aim of this paper is to use a case study approach to illustrate the potential for using geographical information systems (GIS) to examine the provision of dental services in the UK. A major benefit of using GIS to examine sociodemographic profiles of patients on a dental register is to inform policy makers. METHOD: We illustrate the advantages of such an approach by using a postcoded list of registered patients for a dental practice in Swansea. To be of value in this context, the maintenance of up-to-date and fully postcoded information by practitioners is vital. We draw attention to the advantages (and current limitations) of using deprivation indices in conjunction with such lists. RESULT: GIS has significant potential in analysing patterns of registration, and utilisation, of such services but, to date, there has been a relative dearth of studies that have developed such systems. CONCLUSION: We conclude by drawing attention to wider benefits of such software tools in the dental profession and outline a research agenda to take these issues further.

Adult↗
PubMed2006

Optical broadband monitoring of conventional and ion processes.

This contribution is focused on applications of spectroscopic methods for the precise control of deposition processes. Besides a monochromator system with a moving grating for the deep ultraviolet/vacuum ultraviolet (DUV/VUV) spectral range, two approaches are presented for online spectrophotometers with CCD arrays. The conventional spectrophotometer is considered for the operator-assisted deposition of fluoride coatings applied in the DUV/VUV range. The concepts with CCD arrays are combined with an advanced software tool for an automatic production of optical coatings. An ion-assisted deposition process and ion-beam sputtering are considered for rapid manufacturing of complex layer systems in the visible and near-infrared spectral ranges. The present contribution summarizes and discusses the major aspects of the described combinations.

Journal Article↗
PubMed2006

[Analysis of the periprosthetic femoral bone reaction after uncemented total hip arthroplasty with computertomography assisted osteodensitometry in vivo: 6-year follow-up].

AIMS: We prospectively analyzed the cancellous and cortical periprosthetic femoral bone reaction after implantation of a cementless total hip arthroplasty with computertomography assisted osteodensitometry after a mean of 1 and 6 years. MATERIALS AND METHODS: Twenty-one patients (Ø age at implantation: 52 years) with osteoarthrits of the hip joint received 21 cementless hip prostheses with a three-dimensionally tapered design. All patients were analyzed clinically, with CT-osteodensitometry and plain radiography after a mean of 10 days, at 1 and 6 years postoperatively. Cancellous and cortical bone density was evaluated automatically using a special software tool. RESULTS: The proximal region of the stem showed progessive cortical (Ø -15% 1 year, -25% 6 years post-OP) and cancellous (Ø -26% 1 year, -49% 6 years post-OP) bone density loss. Cortical bone density loss was lower and non-progressive at the diaphysis (Ø -7% 1 year, -9% 6 years post-OP) and the distal region (Ø -6% 1 year, -4% 6 years post-OP) of the stem. All stems showed no signs of loosening on plain radiography and good clinical results according to the Harris hip score. CONCLUSION: Computertomography assisted osteodensitometry is the only method which allows discrimination between periprosthetic cortical and cancellous bone density changes in vivo. The analyzed uncemented stem fixates at the diaphysis and distal region. Due to the changed biomechanical loading after stem implantation, progressive proximal cancellous bone density loss was measured for the first time in vivo. Its role in the pathogenesis of implant loosening is still unknown and needs to be further elucidated.

Absorptiometry, Photon↗
PubMed2002

[Comparison of the accuracy of 3-dimensional fusion algorithms].

Recently many algorithms for matching three-dimensional medical data have been developed. Inter- and intramodal fusion of data adds valuable information for planning, controlling and evaluating therapies. This work presents a procedure to evaluate the accuracy of fusion algorithms by numerical means. In contrast to the usual way of visual inspection the developed software tools allow automatic numerical--and thus objective--evaluation of different algorithms using simulated realistic volume data. It is therefore possible to conduct reproducible comparisons of different matching methods. These tools also proved to be very valuable during the development and optimisation of an algorithm employing normalised mutual information.

Algorithms↗
PubMed2003

Effects of load and speed on lumbar vertebral kinematics during lifting motions.

This experimental study investigated the effects of load magnitude and movement speed on lumbar vertebral kinematics during lifting task performance. Ten participants performed sagittally symmetric lifting movements with systematically varied load using either a normal or a faster-than-normal speed. Skin-surface markers were strategically placed over the participants' spinous processes and other landmarks representing major body joints and were recorded during the movements by a motion capture system. The center of rotation (COR) locations and segmental movement profiles for lumbar vertebrae L2 to L5 were derived and analyzed. Results suggested that (a) the COR locations and vertebral angular displacement were not significantly affected by the speed or load variation; (b) a faster speed tended to shorten the time to complete the acceleration for all the lumbar vertebrae considered; and (c) the load increase incurred a tendency for the L5 to complete the primary displacement in a briefer time while enduring greater peak acceleration and velocity. The findings lead to a better understanding of the relation between lifting dynamics and spinal motion. Potential applications of this research include the development of more accurate biomechanical models and software tools for depicting spinal motions and quantifying low-back stress.

Adult↗
PubMed2005

Advances in cardiac magnetic resonance imaging and computed tomography.

Imaging evaluation of the heart encompasses structural evaluation of the chambers, valves and coronary arteries, and functional evaluation, including assessment of perfusion, wall motion and myocardial viability. Magnetic resonance imaging is well established for the structural and functional evaluation of the heart, and benefits from direct multiplanar image acquisition and a lack of ionizing radiation. Magnetic resonance imaging assessment of myocardial viability after myocardial infarction appears to be helpful in predicting benefit from revascularization procedures. Magnetic resonance imaging continues to hold promise as the least invasive method of coronary artery evaluation, and continuing developments are improving image quality and decreasing examination time. The development of cardiac-gating techniques for multidetector computed tomography has the potential to provide widespread availability of cardiac computed tomography. Short examination times and straightforward scanning procedures promise a convenient method for the examination of cardiac structure and function. However, this convenience must be balanced against radiation dose and contrast-media requirements when determining the appropriate use of cardiac computed tomography. Computed tomography coronary-calcium scoring can aid in the prediction of significant coronary events in all but the lowest-risk patients. The high negative-predictive value of computed tomography coronary angiography may allow some patients to avoid cardiac catheterization, but its role in the assessment of patients with moderate coronary atherosclerosis remains unclear. New software tools can assist in the complex and tedious analysis of the large volumes of data produced by these examinations.

Heart Diseases↗
PubMed2006

Studying multiple protein profiles over time to assess biomarker validity.

Protein profile analysis is increasingly used for identification of disease biomarkers. The approaches vary from surface-enhanced laser desorption/ionization to protein arrays. Newer platforms are constantly being developed. Almost all are based on matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and are often coupled with sophisticated software tools. Protein profiling has been applied to a variety of samples including plasma, urine, cerebrospinal fluid, saliva and solid tissue. This article focuses on those instances where it is possible to obtain sequential samples from the same individual. In the authors use of a profile method, many protein changes with highly significant correlations to disease have been found. The main challenge lies in the validation of the marker to demonstrate its adequacy for use in the clinical setting. The latter requires a methodology that is robust and amenable to high-throughput. One problem is that interindividual variability among the healthy population can mask major changes that occur on an intraindividual basis. Often, a large change for an individual may remain within the range of healthy individuals. Thus, one strategy to optimize biomarker discovery is to examine serial samples from a given individual, where a disease biomarker is established by comparison with the individual's own baseline sample. The focus of this review is to illustrate the principle and value of serial protein profiling using a rapid protein extraction method.

Adult↗
PubMed2005

Comparison of two cleansing pastes for the removal of biofilm from dentures and palatal lesions in patients with atrophic chronic candidiasis.

The efficacy of 2 oral hygiene products, an experimental toothpaste specific for complete denture cleansing and a regular standard toothpaste, was compared in terms of denture biofilm removal and cure of palatal lesions in patients with atrophic chronic candidiasis. The degree of correlation between presence of biofilm and mucosa erythema was also evaluated. Twenty-four complete denture wearers (45-80 years old) were divided into 2 groups: experimental paste and standard toothpaste (Sorriso-Kolynos, Brazil). Both groups received soft toothbrushes. The internal surfaces of upper dentures were stained using 1% sodium fluorescein and photographed at a 45 masculine angle at 0, 15, 30 and 60 days. The slides were scanned and the areas of interest (denture total area and biofilm area) were measured (Image Tool software). The degree of erythema was evaluated on slides according to the Prosthesis Tissue Index. There was a significant reduction (1%) in the degree of biofilm (ANOVA/Tukey) between the two initial visits (0 and 15 days) and the two final visits (30 and 60 days), and in the average erythema scores (Kruskal-Wallis) between 0 and 60 days, in both groups. The Mann-Whitney test showed a significant difference (1%) between pastes in terms of biofilm degree, but no difference was found for the erythema score. Correlation values between biofilm and erythema degree were 0.3801 (experimental paste) and (0.3678 (standard toothpaste). We may therefore conclude that the experimental product was efficient for the removal of denture plaque biofilm.

Aged↗
PubMed2006

Environmental factors associated with distribution and range limits of malaria vector Anopheles farauti in Australia.

Ecological factors associated with the narrow coastal distribution of Anopheles farauti Laveran s.s. were investigated using decision tree software and a recently developed software tool that permits analysis of environmental gradients across distributional boundaries. Significant variables identified by these procedures were then used to develop ecological niche models that permitted detailed--and improved--predictions of the species' overall distribution. These methods identified seven climatic factors (four of temperature factors and three atmospheric moisture factors) from among 40 environmental variables related to the range of this species. In addition, the gradient-analysis tool identified elevation as being particularly important. The distributional hypothesis predicted using ecological niche modeling of these factors included all of the record sites from which An. farauti s.s. was collected in northern Australia and successfully reconstructed its narrow limitation to coastal areas. Omission of elevation from analyses resulted in unrealistic predictions of potential distributional areas > 100 km inland, where the species has not been found.

Animals↗
PubMed2001

Recovering filter-based microarray data for pathways analysis using a multipoint alignment strategy.

The use of commercial microarrays is rapidly becoming the method of choice for profiling gene expression and assessing various disease states. Research Genetics has provided a series of biological and software tools to the research community for these analyses. The fidelity of data analysis using these tools is dependent on a series of well-defined reference control points in the array. During the course of our investigations, it became apparent that in some instances the reference control points that are required for analysis became lost in background noise. This effectively halted the analysis and the recovery of any information contained within that experiment. To recover this data and to increase analytical veracity, the simple strategy of superimposing a template of reference control points onto the experimental array was developed. The utility of this tool is established in this communication.

Filtration↗
PubMed2006

CT cystography with multiplanar reformation for suspected bladder rupture: experience in 234 cases.

OBJECTIVE: CT cystography has replaced conventional cystography in the evaluation of patients with suspected bladder rupture in most trauma centers. We performed this retrospective review to determine the accuracy of CT cystography and the role of multiplanar reformation in the diagnosis of bladder injury. MATERIALS AND METHODS: The patient cohort was composed of trauma patients with clinically or CT-suspected bladder ruptures who were evaluated with CT cystography using two different MDCT scanners at our level 1 trauma center. The patients were identified through Folio, a radiology research tool software system. The CT cystography results were compared with the findings at surgery, clinical follow-up, or both. RESULTS: Between January 1, 2000, and December 31, 2004, 234 patients were examined in our level 1 trauma center with CT cystography. From the total of 234 examinations, 216 (92.3%) were interpreted as negative and 18 examinations (7.7%) were interpreted as positive. On the 18 positive examinations, 11 were extraperitoneal bladder rupture, five were intraperitoneal bladder rupture, and two were combined intraperitoneal and extraperitoneal bladder rupture. Surgical bladder exploration and repair were performed in nine of the 18 cases. Seven (77.8%) of the nine cases had operative findings consistent with the CT cystogram findings. The overall sensitivity and specificity of CT cystography in diagnosing bladder rupture were each 100%. For extraperitoneal bladder rupture, the sensitivity and specificity were 92.8% and 100%, respectively. For intraperitoneal rupture, the sensitivity and specificity were 100% and 99%, respectively. CONCLUSION: CT cystography is accurate for diagnosing bladder rupture. Sagittal and coronal multiplanar reformations may be helpful in identifying most sites of bladder rupture.

Accidents, Traffic↗
PubMed1997

Navigational aids for real-time virtual bronchoscopy.

OBJECTIVE: Virtual bronchoscopy is a recently described technique for performing simulated bronchoscopy using data obtained from thin-section CT scans of the airways. Although the detail visible during virtual bronchoscopy can be striking, the lack of global context and physical cues can lead to disorientation for the radiologist, especially during real-time "fly-throughs." We investigated the use of seven software tools (coordinate axes, global maps, trail markers, cross-references to standard two-dimensional projections, rear-view windows, collision avoidance, and stereoscopic displays) that are navigational aids to overcome such disorientation. CONCLUSION: The navigational aids performed satisfactorily on virtual bronchoscopy studies from 21 patients. A frame rate of one to seven frames per second, depending on the complexity of the bronchial model, could be attained. Several of the aids worked best when used selectively or when updated frequently but not continuously. Navigational aids are potentially useful for guiding radiologists who do virtual bronchoscopy studies. Such aids are general tools that may be applicable to other types of virtual endoscopy.

Adult↗
PubMed2005

Application of the new ISO 2631-5 to health hazard assessment of repeated shocks in U.S. Army vehicles.

The U.S. Army Aeromedical Research Laboratory conducted a research program to develop a new methodology for health hazard assessment of tactical ground vehicle rides. This paper describes the new method and compares the health risk prediction using the new multiple shocks standard International Standards Organization (ISO 2631-5) to predictions by the current whole-body vibration (WBV) standard (ISO 2631-1). This article also describes the software tool developed to implement both parts of ISO 2631, as well as Army Regulation 40-10. The comparison shows the new standard to be more sensitive to cross-country terrain than other standards. Data analysis demonstrates the applicability of the new ISO 2631-5 standard to tactical ground vehicles, especially in the vertical axis.

Automobile Driving↗
PubMedDate not supplied

Short-term effect of auditory feedback on fundamental frequency after cochlear implantation.

The present study evaluates the short-term effect of cochlear implantation on the fundamental frequency (FO) of 13 deaf patients. All patients were provided with the Combi 40+ cochlear implant. Voice recording was made pre- and 3 months post-implantation. The FO was analysed using X-Tools software. The results showed that 38 per cent of our subjects had a statistically significant decrease of their mean F0 (p=0.001) at 3 months following implantation. It was also observed that the patients tended to have a lower F0 postoperatively approaching the normal range of F0. A large variability in F0 was noticed among the deaf subjects but no correlation with the duration of deafness was seen. There was also no correlation between speech recognition and speech production.

Adult↗
PubMedDate not supplied

Optical memory card applicability for implementing a portable medical record.

The implementation of portable record based on laser card technology is discussed in terms of data structures for quick access and software tools to reinforce security and confidentiality as required by medical data. Experimental results from a field test with a laser card technology are reviewed with regard to implementation in a large-scale and public information system. An efficient data structure is described for storage purposes, and some proposals are put forward to secure stored data.

Computer Security↗