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At least 991 records · Page 55Linked to original sources
PubMed2004

A methodology for verification of radiotherapy dose calculation.

OBJECT: A methodology for dosimetric verification of radiation therapy plans was developed and implemented. Dosimetric accuracy of clinically active intensity-modulated radiotherapy (IMRT) and intensity-modulated radiosurgery (IMRS) programs was assessed using this methodology. METHODS: The methodology included several dosimetric tasks that were performed to assess the dosimetric accuracy of a treatment plan. Absolute dosimetry of the composite plan was performed using an ionization chamber. Film dosimetry was performed for each individual field and for the multifield composite plan. Calculated dose distributions and film measurements were compared using software developed for the specific tasks. Two-dimensional maps of gamma index, dose difference, and distance-to-agreement were calculated and displayed. To date, good agreement between measurements and calculations has been observed in 160 clinical IMRT and IMRS plans. The largest observed absolute dose disagreement was -4.79%. The mean absolute dose difference was 0.26%, with a standard deviation of 1.75%. The authors specify a 3% dose difference and 3-mm distance as the scaling acceptability criteria for the gamma index calculations of the film measurement analysis. The planning and delivery system in clinical use has proven consistently to satisfy these criteria. CONCLUSIONS: The dosimetric verification methods and the software tools developed were both quantitative and clinically practical. The measurements and the analysis demonstrated that the IMRT and IMRS planning and delivery system in use was sufficiently accurate for highly conformal treatments.

Film Dosimetry↗
PubMedDate not supplied

The effect of lubricant eye drops on ocular wavefront aberrations.

PURPOSE: To study the effect of lubricant eye drop instillation on ocular wavefront aberrations. METHODS: The wavefront aberrations of the entire optical path of 30 eyes of 15 patients before and following instillation of lubricant eye drops (Bion Tears; Alcon Laboratories Inc, Ft Worth, Tex) were obtained over a 6-mm pupil using a Hartmann-Shack wavefront sensor (WaveScan; VISX Inc, Santa Clara, Calif). Additional computation of root-mean-square (RMS) errors of higher order aberrations from third to sixth order were done using Zernike Tool Software (VISX Inc). Main outcome measures include the mean changes of total higher order aberrations RMS, higher order aberrations, and point spread function (PSF) of the higher order aberrations. RESULTS: The mean changes of total higher order aberrations following instillation of lubricant eye drops on the right eyes were -0.07 microm (95% confidence interval [CI], -0.11 to -0.03) and -0.03 microm on the left eyes (95% CI, -0.07 to 0.01). Significant mean changes were noted for coma and trefoil aberrations with a magnitude of -0.08 microm (95% CI, -0.12 to -0.03) and -0.09 (95% CI, -0.13 to -0.05), respectively, as well as a mean change of the PSF of the higher order aberrations (-0.05 diopters, 95% CI, -0.08 to -0.02) on the right eyes. Although no significant changes in these parameters were demonstrated on the left eyes, a similar trend of changes was observed. CONCLUSIONS: Ocular wavefront aberrations may change following eye drop instillation as measured objectively by the WaveScan system. This effect should be taken into consideration in the assessment of patients for wavefront-guided laser vision correction procedures.

Adult↗
PubMed2004

A profound alteration of blood TCRB repertoire allows prediction of cerebral malaria.

Cerebral malaria (CM) is one of the severe complications of Plasmodium infection. In murine models of CM, Talphabeta cells have been implicated in the neuropathogenesis. To obtain insights into the TCRB repertoire during CM, we used high throughput CDR3 spectratyping and set up new methods and software tools to analyze data. We compared PBL and spleen repertoires of mice infected with Plasmodium berghei ANKA that developed CM (CM(+)) or not (CM(-)) to evidence modifications of the TCRB repertoire associated with neuropathology. Using distinct statistical multivariate methods, the PBL repertoires of CM(+) mice were found to be specifically altered. This alteration is partly due to recurrently expanded T cell clones. Strikingly, alteration of the PBL repertoire can be used to distinguish between CM(+) and CM(-). This study provides the first ex vivo demonstration of modifications of Talphabeta cell compartment during CM. Finally, our original approach for deciphering lymphocyte repertoires can be transposed to various pathological conditions.

Animals↗
PubMed1998

NCCN Internet-based data system for the conduct of outcomes research.

The National Comprehensive Cancer Network (NCCN), an alliance of 17 of the world's leading cancer centers, is currently conducting its first shared outcomes project in breast cancer. City of Hope National Medical Center serves as the data coordinating center for the project. A database system has been designed and deployed which allows project staff located all over the United States to submit data to the central repository at City of Hope via the Internet. The database application consists of a series of webenabled front-end screens linked to a Microsoft SQL Server database. The NCCN system incorporates high levels of data security, confidentiality, and integrity via data encryption, password and ID protection, submission of anonymous data, and quality-control processing on several levels. The application also provides the flexibility of entering the data via the web-based screens, or transferring electronic files of data from existing database systems. Recently released SAS statistical software tools have been integrated into the system to allow for a seamless interface for analysis and web-enabled output of reports. The goals and strategies in designing the NCCN system are described and sample screens are shown. Our experience to date indicates that this system is highly effective in providing the ability to perform nationwide retrieval and analysis of outcomes data.

Breast Neoplasms↗
PubMedDate not supplied

Hospital responses to a data-driven statewide quality improvement project.

BACKGROUND: The overall success of any continuous quality improvement (CQI) project lies in the ability to measure changes resulting from the project and to show that changes have resulted n improved care. METHOD: A software tool was developed to categorize hospital responses and activities implemented by hospitals as a result of the Cooperative Cardiovascular Project CCP). Information was captured regarding the hospital's acceptance of data and the educational/interventional strategies implemented. Hospital size, number of acute myocardial infarction patients treated, indicator performances, and type of presentation given (on-site versus regional visit) was entered to allow analysis of factors affecting the response. RESULT: sixty-one of 107 hospitals responded to the peer review organization. Of those, 49% planned further educational activities and 75% planned to implement some form of CQI activity. Comparison of responses in relation to the type of presentation received suggested that on-site presentations are associated with higher response rates and more intense quality improvement efforts. This also could be attributed to other factors such as hospital size, teaching environment, or number of acute myocardial infarction patients treated. CONCLUSION: The system developed allowed us to collate hospital improvement efforts as a result of CCP. The system is limited in its ability to identify those activities taking place before CCP. Further development and refinement of the tool is warranted to document quality improvement efforts and determine best strategies for peer review organization intervention.

Abstracting and Indexing↗
PubMed1998

A multifunctional system of the national genetic register.

The National (Federal) Russian Genetic Register operates as a multifunctional system. It is designed for finding solution to the following key problems: 1. Information provision to watch families having children with hereditary and congenital diseases. 2. Follow up of the diagnostic process (including that associated with molecular-cytogenetic studies) and making predictive decisions concerning a risk of hereditary disease in the family. 3. Monitoring of new cases of congenital/hereditary disease under the effect of genotoxic and general toxic environmental factors. 4. Rendering consulting services to those concerned and reference information on the organizational/methodological problems. The relational database is composed of textual and graphical data. This enables the doctors to enter and review the pedigree in the form they have got accustomed to. Numerous built-in classification schemes help simplify and speed up the completion of the medical records. An additional information can be entered in the textual form. When requested by the user, the information about the patient and his (her) family, stored in the database, can be displayed as a summary document (a statement). To do so, a special algorithm based on the results of the logical information analysis, as well as medical history of the patients themselves and their families' members has been put forward. The document thus compiled is open for being edited by the doctor. The local computer network is operated in the "user-server" mode. For information protection purposes, an authorized access system has been devised to protect various data categories. The software tools operate in the Windows environment for IBM-compatible personal computers. Also, use is made of Microsoft SQL-Server, Visual Fox-Pro 3.0, Visual C+2 2.1, and FORTRAN 5.1. The doctor decision modules are activated with mathematical models, an expert system, and a self-learning recognizing system. The Windows NT system is a choice for the existing Federal and Regional Genetic Centers. For territorial consulting purposes other alternatives might be Windows for Workgroup 3.11 or Windows 95. The local computer networks in individual organizations will be integrated to form a Corporate Medical Genetics Service of Russia. The system is to be completed before the year 2000 in a number of phases. Up to now, program packages for family database management and recurrent risk calculations have been worked out and tested.

Databases as Topic↗
PubMed1999

A 12-Mb complete coverage BAC contig map in human chromosome 16p13.1-p11.2.

We have constructed a complete coverage BAC contig map that spans a 12-Mb genomic segment in the human chromosome 16p13.1-p11.2 region. The map consists of 68 previously mapped STSs and 289 BAC clones, 51 of which-corresponding to a total of 7.721 Mb of genomic DNA-have been sequenced, and provides a high resolution physical map of the region. Contigs were initially built based mainly on the analysis of STS contents and restriction fingerprint patterns of the clones. To close the gaps, probes derived from BAC clone ends were used to screen deeper BAC libraries. Clone end sequence data obtained from chromosome 16-specific BACs, as well as from public databases, were used for the identification of BACs that overlap with fully sequenced BACs by means of sequence match. This approach allowed precise alignment of clone overlaps in addition to restriction fingerprint comparison. A freehand contig drawing software tool was developed and used to manage the map data graphically and generate a real scale physical map. The map we present here is approximately 3.5 x deep and provides a minimal tiling path that covers the region in an array of contigous, overlapping BACs.

Base Sequence↗
PubMed1999

Problem Knowledge Couplers: reengineering evidence-based medicine through interdisciplinary development, decision support, and research.

The rapid growth of medical knowledge is creating a demand for new ways of providing information in support of evidence-based medical practice. Problem Knowledge Couplers are a clinical decision support software tool that offer a new approach to this growing problem. Couplers are developed through a collaboration among clinicians, informaticians, and librarians. They recognize that functionality must be predicated upon combining unique patient information, gleaned through relevant structured question sets, with the appropriate knowledge found in the world's peer-reviewed medical literature. Two pilot studies indicate that couplers can meet the gold standards of decision making within both a primary care and a specialty practice. Issues remain about how to best integrate Problem Knowledge Couplers into clinical practice and whether large-scale outcomes research will support the findings of pilot studies. However, Problem Knowledge Couplers represent a promising approach that might portend a new model for health care delivery in the next millennium.

Adolescent↗
PubMed1999

Integration and visualization of multimodality brain data for language mapping.

A goal of the University of Washington Brain Project is to develop software tools for processing, integrating and visualizing multimodality language data obtained at the time of neurosurgery, both for surgical planning and for the study of language organization in the brain. Data from a single patient consist of four magnetic resonance-based image volumes, showing anatomy, veins, arteries and functional activation (fMRI). The data also include the location, on the exposed cortical surface, of sites that were electrically stimulated for the presence of language. These five sources are mapped to a common MR-based neuroanatomical model, then visualized to gain a qualitative appreciation of their relationships, prior to quantitative analysis. These procedures are described and illustrated, with emphasis on the visualization of fMRI activation, which may be deep in the brain, with respect to surface-based stimulation sites.

Anatomy, Cross-Sectional↗
PubMed2000

A tree-structured interactive system for representing medical knowledge.

In this paper we describe an integration and extension of the software tools in current use by the medical community to provide a sophisticated system for representing and acquiring medical knowledge. For the overall structure of the system that we describe, we propose that a web-based hyperlink system be implemented for representing almost all medical knowledge in a multi-rooted tree-structure form. The extension of the database involved to include patient records is discussed. The paper describes the role of contributors to the system as well as users, commentators, and organizers.

Databases as Topic↗
PubMed2000

[Cochlear implantation and auditory feedback].

The aim of the present study was to evaluate the short term effect of cochlear implantation on the fundamental frequency and the articulation of 13 patients. This investigation objectives for the first time the changes of fundamental frequency and articulation in cochlear implant patients. All postlingual deaf patients were provided with a Combi 40+ cochlear implant. Voice recording was performed pre- and three months post-implantation. The voice data was analyzed using the "X-Tool" software. The results show that 38% of the patients had a significant (p < 0.05) decrease of F0 mean three months after implantation. A postoperative decrease of F0 towards the normal range was observed generally in all patients. Spectographs pre- and post-implantation showed that the articulation improved already 3 months after partial restoration of auditory feedback. A large variability of F0 was noticed among the deaf subjects, but no correlation to the duration of deafness could be established.

Adolescent↗
PubMed2000

Prototypes and applications in neurotelemedicine.

The ENN project was able to develop internet based applications for sleep medicine and prototypes of multimedia tutorials for headache, epilepsy and headache. Telematic technologies were used throughout all workpackages of the European Neurological Network. This overview presents the conceptual links between expert systems, the multimedia database, CD-ROM based tutorials and software tools in order to support neurological diagnostic and therapeutic practice in sleep, headache and epilepsy.

Computer-Assisted Instruction↗
PubMed2002

Genome-scale evolution: reconstructing gene orders in the ancestral species.

Recent progress in genome-scale sequencing and comparative mapping raises new challenges in studies of genome rearrangements. Although the pairwise genome rearrangement problem is well-studied, algorithms for reconstructing rearrangement scenarios for multiple species are in great need. The previous approaches to multiple genome rearrangement problem were largely based on the breakpoint distance rather than on a more biologically accurate rearrangement (reversal) distance. Another shortcoming of the existing software tools is their inability to analyze rearrangements (inversions, translocations, fusions, and fissions) of multichromosomal genomes. This paper proposes a new multiple genome rearrangement algorithm that is based on the rearrangement (rather than breakpoint) distance and that is applicable to both unichromosomal and multichromosomal genomes. We further apply this algorithm for genome-scale phylogenetic tree reconstruction and deriving ancestral gene orders. In particular, our analysis suggests a new improved rearrangement scenario for a very difficult Campanulaceae cpDNA dataset and a putative rearrangement scenario for human, mouse and cat genomes.

Algorithms↗
PubMed2001

Production of the next-generation library virtual tour.

While many libraries offer overviews of their services through their Websites, only a small number of health sciences libraries provide Web-based virtual tours. These tours typically feature photographs of major service areas along with textual descriptions. This article describes the process for planning, producing, and implementing a next-generation virtual tour in which a variety of media elements are integrated: photographic images, 360-degree "virtual reality" views, textual descriptions, and contextual floor plans. Hardware and software tools used in the project are detailed, along with a production timeline and budget, tips for streamlining the process, and techniques for improving production. This paper is intended as a starting guide for other libraries considering an investment in such a project.

Computer Communication Networks↗
PubMed2002

Representation and processing of complex DNA spatial architecture and its annotated genomic content.

This paper presents a new general approach for the spatial representation and visualization of DNA molecule and its annotated information. This approach is based on a biological 3D model that predicts the complex spatial trajectory of huge naked DNA. With such modeling, a global vision of the sequence is possible, which is different and complementary to other representations as textual, linguistics or syntactic ones. The DNA is well known as a three-dimensional structure. Whereas, the spatial information plays a great part during its evolution and its interaction with the other biological elements This work will motivate investigations in order to launch new bioinformatics studies for the analysis of the spatial architecture of the genome. Besides, in order to obtain a friendly interactive visualization, a powerful graphic modeling is proposed including DNA complex trajectory management and its annotated-based content structuring. The paper describes spatial architecture modeling, with consideration of both biological and computational constraints. This work is implemented through a powerful graphic software tool, named ADN-Viewer. Several examples of visualization are shown for various organisms and biological elements.

DNA↗
PubMedDate not supplied

Histology teachware for the Web site of the University of Medicine and Pharmacy "Gr. T. Popa" Iaşi.

Design and implementation of Web educational materials for medical sciences are discussed starting from a brief presentation of the current trends in using Internet facilities and placing emphasis on the specific case of the www page constructed for the Department of Histology. The paper focuses on the development of teaching-aids for the morphological study of organs and systems, illustrated by the creation of Histology Album, including photographs and explanatory texts, which is accessible via this www departmental page. Relevant aspects for the construction of the Histology Album are detailed in terms of both logical structure and physical implementation, based on HTML techniques. Outcomes are expected in achieving a noticeable progress in students' instruction, as a result of diversifying the documentation possibilities and increasing the role of the individual work (by avoiding the permanent supervision of an instructor). Further improvements of this www page are commented in the light of the recently proposed frameworks for distance learning, relying on specialized software tools that allow student's interactive work.

Academic Medical Centers↗
PubMed2003

Revenue-cycle redesign: honing the details.

To minimize claim denials and ensure optimum payment for delivered services, many hospitals must fundamentally change their approach to managing the revenue cycle. The revenue cycle should be conceptualized as a continuum rather than as a set of isolated events, such as submitting bills or collecting payment. Cross-functional teams composed of representatives from clinical and financial areas should be created to systematically address recurrent breakdowns detected in the revenue cycle. PFS staff should be better compensated based on their value to revenue-cycle performance and receive adequate training on data collection and billing requirements to ensure the submission of clean claims. Medical-necessity screening software tools should be used at initial patient-access points to help identify scheduled services not covered by Medicare.

Accounts Payable and Receivable↗
PubMed2003

Evaluating image reconstruction methods for tumor detection in 3-dimensional whole-body PET oncology imaging.

UNLABELLED: We compare 3 image reconstruction algorithms for use in 3-dimensional (3D) whole-body PET oncology imaging. We have previously shown that combining Fourier rebinning (FORE) with 2-dimensional (2D) statistical image reconstruction via the ordered-subsets expectation-maximization (OSEM) and attenuation-weighted OSEM (AWOSEM) algorithms demonstrates improvements in image signal-to-noise ratios compared with the commonly used analytic 3D reprojection (3DRP) or FORE+FBP (2D filtered backprojection) reconstruction methods. To assess the impact of these reconstruction methods on detecting and localizing small lesions, we performed a human observer study comparing the different reconstruction methods. The observer study used the same volumetric visualization software tool that is used in clinical practice, instead of a planar viewing mode as is generally used with the standard receiver operating characteristic (ROC) methodology. This change in the human evaluation strategy disallowed the use of a ROC analysis, so instead we compared the fraction of actual targets found and reported (fraction-found) and also investigated the use of an alternative free-response operating characteristic (AFROC) analysis. METHODS: We used a non-Monte Carlo technique to generate 50 statistically accurate realizations of 3D whole-body PET data based on an extended mathematic cardiac torso (MCAT) phantom and with noise levels typical of clinical scans performed on a PET scanner. To each realization, we added 7 randomly located 1-cm-diameter lesions (targets) whose contrasts were varied to sample the range of detectability. These targets were inserted in 3 organs of interest: lungs, liver, and soft tissues. The images were reconstructed with 3 reconstruction strategies (FORE+OSEM, FORE+AWOSEM, and FORE+FBP). Five human observers reported (localized and rated) 7 targets within each volume image. An observer's performance accuracy with each algorithm was measured, as a function of the lesion contrast and organ type, by the fraction of those targets reported and by the area below the AFROC curve. This AFROC curve plots the fraction of reported targets at each rating threshold against the fraction of cases with (> or =1) similarly rated false reports. RESULTS: Images reconstructed with FORE+AWOSEM yielded the best overall target detection as compared with FORE+FBP and FORE+OSEM, although these differences in detectability were region specific. The FORE+FBP and FORE+AWOSEM algorithms had similar performances for liver targets. The FORE+OSEM algorithm performed significantly worse at target detection, especially in the liver. We speculate that this is the result of using an incorrect statistical model for OSEM and that the incorporation of attenuation weighting in AWOSEM largely compensates for this model inaccuracy. These results were consistent for both the fraction of actual targets found and the AFROC analysis. CONCLUSION: We demonstrated the efficacy of performing observer detection studies using the same visualization tools as those used in clinical PET oncology imaging. These studies demonstrated that the FORE+AWOSEM algorithm led to the best overall detection and localization performance for 1-cm-diameter targets compared with the FORE+OSEM and FORE+FBP algorithms.

Algorithms↗