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PubMed2003

Design and implementation of an automatic message-routing system for low-cost telemedicine.

Email has been used for some years as a low-cost telemedicine medium to provide support for developing countries. However, all operations have been relatively small scale and fairly labour intensive to administer. A scalable, automatic message-routing system was constructed which automates many of the tasks. During a four-month study period in 2002, 485 messages were processed automatically. There were 31 referrals from eight hospitals in three countries. These referrals were handled by 25 volunteer specialists from a panel of 42. Two system operators, located 10 time zones apart, managed the system. The median time from receipt of a new referral to its allocation to a specialist was 1.0 days (interquartile range 0.7-2.4). The median interval between allocation and first reply was 0.7 days (interquartile range 0.3-2.3). Automatic message handling solves many of the problems of manual email telemedicine systems and represents a potentially scalable way of doing low-cost telemedicine in the developing world.

Developing Countries↗

PubMed2003

A review of the first year's experience with an automatic message-routing system for low-cost telemedicine.

The Swinfen Charitable Trust has used email for some years as a low-cost telemedicine medium to provide consultant support for doctors in developing countries. A scalable, automatic message-routing system was constructed which automates many of the tasks involved in message handling. During the first 12 months of its use, 1510 messages were processed automatically. There were 128 referrals from 18 hospitals in nine countries. Of these 128 queries, 89 (70%) were replied to within 72 h; the median delay was 1.1 day. The 39 unanswered queries were sent to backup specialists for reply and 36 of them (92%) were replied to within 72 h. In the remaining three cases, a second-line (backup) specialist was required. The referrals were handled by 54 volunteer specialists from a panel of over 70. Two system operators, located 10 time zones apart, managed the system. The median time from receipt of a new referral to its allocation to a specialist was 0.2 days (interquartile range, IQR, 0.1-0.8). The median interval between receipt of a new referral and first reply was 2.6 days (IQR 0.8-5.9). Automatic message handling solves many of the problems of manual email telemedicine systems and represents a potentially scalable way of doing low-cost telemedicine in the developing world.

Charities↗

PubMed1991

Automatic analysis of radiographic images: II. Software implementation and testing on bitewing radiographs.

A prototype, completely automatic image-analysis system for dental bitewing radiographs was implemented in 'C' on a Unix workstation. A multiple layer hierarchical image model was created in software for each radiograph using production rule-based knowledge. The highest model layer formed an English-like description of anatomical structures including tooth type, interdental alveolar bone crest margins and spaces. A representation of spatial relationships between anatomical structures was formed, providing a method for comparing similar regions of a patient in serial, but not absolutely standardized, images. In 31 clinical radiographs, the system automatically identified 93% (193) of all available interdental spaces which are the key image regions for model creation. Each image required 2 minutes of processing time. The reproducibility of finding 34 interdental spaces in five films revealed one error. Further work is required to improve the recognition rate of the interdental regions towards 100% and to develop automatic comparisons between areas of change (disease?) in serial films.

Humans↗

PubMed1980

Automaticity of subsidiary pacemakers of patients with dysfunction of the sinus node.

Automaticity (postpacing impulse recovery time) of the sinus node or subsidiary pacemakers (or both) was determined by intracardiac recordings and atrial overdrive pacing in three patients with disease of the sinus node. Their electrocardiographic manifestations included sinus bradycardia, sinoatrial block, sinus arrest, atrioventricular junctional rhythm, and atrioventricular dissociation. One patient, who initially had syncope, demonstrated prolonged time for recovery of the sinus node (maximum corrected value, 3,485 msec) and impaired atrioventricular junctional automaticity (maximum corrected junctional recovery time, 1,460 msec). Of the remaining two patients without syncopal attacks, one had an adequate low atrial or junctional escape mechanism following cessation of pacing. The maximum low atrial escape interval was 1,660 msec, and the maximum junctional recovery time was 1,770 msec (corrected value, 140 msec). The third patient disclosed a prolonged maximum corrected recovery time for the sinus node (870 msec), while the maximum junctional recovery time was only 1,810 msec (corrected value, 160 msec). We conclude that automaticity of the subsidiary pacemakers in disease of the sinus node can be determined in the presence of atrioventricular dissociation or total sinus arrest, and that determination of the recovery time of the subsidiary pacemakers may be useful in identifying symptomatic patients with sinus nodal dysfunction.

Adult↗

PubMed2004

[Comparative analyses of the reliability of automatic external defibrillators].

Automatic external defibrillators are gaining increasing acceptance. Last year 6000 devices were installed in Germany. Since the average user has only limited medical knowledge, high demands have to be made on the automatic ECG diagnosis (fibrillation detection). Within the framework of this study a fully automatic test system that permits an objective comparison of the performance of the various devices available on the market was constructed. Older devices in particular do not always meet the requirements defined by international standards with regard to sensitivity and specificity. In addition, company philosophy appears to differ in terms of the preferential emphasis on sensitivity or specificity. Purchasers of such devices need take these findings into consideration.

Arrhythmias, Cardiac↗

PubMed1986

Automatic bioluminescent glucose determination using commercially available reagent kits coupled to the bacterial NAD(P)H-linked luciferase system.

A sensitive and specific automatic bioluminescent method is described for glucose determination in serum samples using commercially available reagent-kits. The Boehringer Gluco-quant kit, originally designed for spectrophotometric measurement, was successfully coupled to the bacterial luciferase NAD(P)H-linked system. The method's validity was proven by comparison with a spectrophotometric method. Correlation was excellent (r = 0.98, n = 50). Precision attained by 30 assays was good (CV 1.19%). The assay was verified by determining the glucose concentrations of more than 1000 serum samples. Using a microcomputer-controlled automatic luminescence analyser (Berthold LB 950 T) and reagent kits for luminometry (Boehringer Mannheim, LKB Wallac, Lumac/3M), the complete assay can be performed fully automatically with commercially available reagent kits. More than 200 samples can be assayed by one individual per day. The bioluminescence method is at least 100 times more sensitive than spectrophotometric measurements. Other reagent kits tested (Behring, Merck, Sigma) are also suitable for coupling to the NAD(P)H-linked luciferase system.

Blood Glucose↗

PubMed2006

Establishment of an indocyanine green test using an automatic chemistry analyzer.

The indocyanine green (ICG) clearance test has been used to assess the reserve of hepatic function. This method is based on the spectrometric measurement of its plasma concentration at maximum wavelength of 805 nm, which requires a spectrophotometer and associated maintenance. We established an ICG clearance test using a Toshiba 200FR automatic chemistry analyzer that can be tuned to a wavelength of approximately 805 nm. Five pooled sera spiked from 0 to 4.0 mg/dL were analyzed for linearity test and precision was determined at five levels in the range 0.1-2.0 mg/dL. The ICG retention rate at 15 min (R15) was determined for 38 patients using a conventional method and our method. The ICG clearance test using the automatic chemistry analyzer showed good linearity, and precision ranged from 0.3% to 1.0% for within-run CVs and from 0.6% to 4.7% for total CVs. The degree of agreement between the two methods was also acceptable (mean difference of 1.5%). It is expected that the ICG test using the automatic chemistry analyzer can replace the conventional ICG clearance test, considering the excellent agreement, good precision and linearity over a clinically relevant range.

Autoanalysis↗

PubMed1998

How automatic is manual gear shifting?

Manual gear shifting is often used as an example of an automated (vs. controlled) process in driving. The present study provided an empirical evaluation of this assumption by evaluating sign detection and recall performance of novice and experienced drivers driving manual shift and automatic transmission cars in a downtown area requiring frequent gear shifting. The results showed that manual gear shifting significantly impaired sign detection performance of novice drivers using manual gears compared with novice drivers using an automatic transmission, whereas no such differences existed between the two transmission types for experienced drivers. The results clearly demonstrate that manual gear shifting is a complex psychomotor skill that is not easily (or quickly) automated and that until it becomes automated, it is an attention-demanding task that may impair other monitoring aspects of driving performance. Actual or potential applications of this research include a reevaluation of the learning process in driving and the need for phased instruction in driving from automatic gears to manual gears.

Adolescent↗

PubMed2006

Cell orientation by a microgrooved substrate can be predicted by automatic control theory.

Cells have the ability to measure and respond to extracellular signals like chemical molecules and topographical surface features by changing their orientation. Here, we examined the orientation of cultured human melanocytes exposed to grooved topographies. To predict the cells' orientation response, we describe the cell behavior with an automatic controller model. The predicted dependence of the cell response to height and spatial frequency of the grooves is obtained by considering the symmetry of the system (cell + substrate). One basic result is that the automatic controller responds to the square of the product of groove height and spatial frequency or to the aspect ratio for symmetric grooves. This theoretical prediction was verified by the experiments, in which melanocytes were exposed to microfabricated poly(dimethylsiloxane) substrates having parallel rectangular grooves of heights (h) between 25 and 200 nm and spatial frequencies (L) between 100 and 500 mm(-1). In addition, the model of the cellular automatic controller is extended to include the case of different guiding signals acting simultaneously.

Biocompatible Materials↗

PubMed1982

Significance of the automaticity recovery phase following tachycardic overdrive.

The usefulness of automaticity recover time (ART) and automaticity recovery phase (ARP; the time requiring P-P cycles to return to the original P-P cycles following the termination of tachyarrhythmias) for evaluating the sinus node function was studied in 24 patients with tachyarrhythmias by recordings of 24-hour continuous electrocardiograms. Automaticity recovery time was not so valuable in evaluating sinus node function because the overlap of ART was observed between patients of normal sinus node function and patients with sick sinus syndrome. The pattern of ARP was classified into 4 types (I--IV). Type I showed qUick return to the original P-P after overdrive suppression, type II was characterized by first suppression and secondary acceleration, type III was the pattern characterized by repeated suppression after tachycardiac overdrive, and type IV was characterized by repetitive appearance of tachyarrhythmia and bradycardia. The period of each ARP was measured and the period of type II (42.2 +/- 16.6 sec) or III ARP (48.4 +/- 21.4 sec) was significantly longer than type I (22.1 +/- 11.1 sec). Type III ARP was considered to suggest sinus node dysfunction. In conclusion, it was suggested that not only the observation of ART but also ARP were valuable for evaluating more precise sinus node function. The observation of ARP is easily obtained from 24-hour continuous recordings of electrocardiograms.

Adolescent↗

PubMed2004

Evaluation of the Image-Pro Plus 4.5 software for automatic counting of labeled nuclei by PCNA immunohistochemistry.

The objective of this study was to create and evaluate a routine (macro) using Image-Pro Plus 4.5 software (Media Cybernetics, Silver Spring, USA) for automatic counting of labeled nuclei by proliferating cell nuclear antigen (PCNA) immunohistochemistry. A total of 154 digital color images were obtained from eleven sections of reticular oral lichen planus stained by PCNA immunohistochemistry. Mean density (gray-level), red density, green density, blue density, area, minor axis, perimeter rate and roundness were parameters used for PCNA labeled nuclei discrimination, followed by their outlined presentation and counting in each image by the macro. Mean density and area thresholds were automatically defined based, respectively, on mean density and mean area of PCNA labeled nuclei in the assessed image. The reference method consisted in visual counting of manually outlined labeled nuclei. Statistical analysis of macro results versus reference countings showed a very significant correlation (rs = 0.964, p < 0.001) for general results and a high level (89.8 +/- 3.8%) of correctly counted labeled nuclei. We conclude that the main parameters associated with a high correlation between macro and reference results were mean density (gray-level) and area thresholds based on image profiles; and that Image-Pro Plus 4.5 using a routine with automatic definition of mean density and area thresholds can be considered a valid alternative to visual counting of PCNA labeled nuclei.

Cell Count↗

PubMed2004

Study on shift schedule saving energy of automatic transmission of ground vehicles.

To improve ground vehicle efficiency, shift schedule energy saving was proposed for the ground vehicle automatic transmission by studying the function of the torque converter and transmission in the vehicular drivetrain. The shift schedule can keep the torque converter working in the high efficiency range under all the working conditions except in the low efficiency range on the left when the transmission worked at the lowest shift, and in the low efficiency range on the right when the transmission worked at the highest shift. The shift quality key factors were analysed. The automatic trans-mission's bench-test adopting this shift schedule was made on the automatic transmission's test-bed. The experimental results showed that the shift schedule was correct and that the shift quality was controllable.

Algorithms↗

PubMed1999

Automatic measurement of the red cell oxygen dissociation curve identical with the whole blood curve.

Automatic measurement of the entire oxygen dissociation curve (ODC) of blood and hemoglobin provides a useful means for evaluating their gas-transport function. The automatic oxygenation apparatus previously developed by Imai et al. (1970, 1981), which uses a polarographic determination of partial pressure of oxygen and a spectrophotometric determination of oxygen saturation of hemoglobin, has mostly been used for the measurement of accurate ODCs of hemoglobin solution. However, it was not suitable for red cell suspension because a significant noise was superimposed on the absorbance signal due to light-scattering by red cells. In the present study, we have overcome this problem by using an integrating sphere for the photometric system. Through extensive tests we found the optimal experimental conditions for obtaining the red cell oxygenation data that were identical with the whole blood data with respect to the position (oxygen affinity) and shape (sigmoid character) of the ODC and its pH-dependence (the Bohr effect). The accuracy was higher than that of commercially available automatic apparatuses such as the "Hemox-Analyzer" (Technical Consulting Service) and "Hem-O-Scan" (Aminco). Thus, our method provides an easy and convenient means for obtaining accurate ODCs mimicking the whole blood ODCs from one drop of whole blood. An application of our method to the effect of blood storage on ODC is presented, demonstrating the usefulness of our method.

Automation↗

PubMed1992

The influence of physical fitness on automatic and effortful memory changes in aging.

A cross-sectional study was carried out in order to determine the influence of cardiovascular fitness on age-related declines in cognitive performance. Forty-eight volunteers were divided into Young (n = 13, 18-27 years), Middle-Aged (n = 22, 60-65 years) and Old (n = 13, 65-88 years) groups and tested on a battery of cardiovascular, pulmonary, hemodynamic, and biochemical tests in order to assess physical fitness. Cognitive performance was evaluated by a variety of memory tasks distributed along an automatic-to-effortful processing continuum. Memory for location and frequency of occurrence were selected as representative of automatic processing, whereas, an auditory free-recall task was selected as representative of effortful processing. Age-related performance declines were observed for the free-recall task, but no such age-dependent association was observed for frequency and location memory. With regard to the influence of physical fitness; the Middle-Aged and Older participants were divided into High and Low Fitness groups and significant differences were observed between these groups for the effortful but not the automatic memory tasks. These data suggest that the relationship between physical fitness and cognitive performance in old age is task dependent. Furthermore, the apparent prophylactic effects of physical fitness on effortful memory, do not appear to extend to cognitive tasks requiring less effortful processing.

Age Factors↗

PubMed1999

Comparison of rebiopsy rates after stereotactic core needle biopsy of the breast with 11-gauge vacuum suction probe versus 14-gauge needle and automatic gun.

OBJECTIVE: The 11-gauge vacuum suction probe is an alternative to the 14-gauge needle and automatic gun for performing stereotactic core needle biopsies. This study compares rebiopsy rates after stereotactic core needle biopsies that were performed with the two methods. The study also assesses the outcomes of those repeat biopsies. MATERIALS AND METHODS: Five hundred ninety-two stereotactic core needle biopsies using a 14-gauge needle and automatic gun and 354 using an 11-gauge vacuum suction probe were performed consecutively. Excluding malignancies, the number of cases requiring rebiopsy and the reasons for rebiopsy were determined for each group. The histologic diagnoses of the repeat biopsies were assessed. RESULTS: The rebiopsy rate was significantly lower with the 11-gauge vacuum suction probe (9.0%) than with the 14-gauge needle and automatic gun (14.9%) (p = .013). Significant reductions were found in cases of insufficient sampling (probe, 1.7%; needle, 4.4%; p = .042) and mammographic-pathologic discrepancy (probe, 0.8%; needle, 3.4%; p = .026). The rebiopsy rate for masses was 6.1% with the vacuum probe versus 10.7% with the 14-gauge needle (p = .12) and for calcifications was 11.6% with the vacuum probe versus 23.7% with the 14-gauge needle (p = .003). After rebiopsy, the percentage of cases in which malignancy was found was 18.5% with the vacuum probe versus 13.7% with the 14-gauge needle. On rebiopsy, the percentage of malignancies found in each category were atypical hyperplasia: probe 26.7%, needle 20.0%; insufficient sample: probe 0%, needle 9.5%; pathologist recommendation: probe 50.0%, needle 12.5%; and lobular carcinoma in situ: probe 0%, needle 100%. CONCLUSION: Use of the 11-gauge vacuum-assisted device significantly decreases but does not eliminate the need for rebiopsy after stereotactic core needle biopsy. The rebiopsy rate for calcifications was significantly reduced by using the vacuum suction probe rather than the 14-gauge needle; however, the rate for masses was reduced only slightly. On rebiopsy, malignancies were found in both groups.

Biopsy, Needle↗

PubMed2000

Automaticity, spelling, and second language learning.

This study investigated the relationship between a chronometric estimate of automaticity for the spelling of French words (Automaticity) and performance on four tests of French language attainment among a sample of Year 11 students of French as a foreign language. Fifty participants each completed a computerized test of French spelling and attainment tests in four aspects of French language learning: reading comprehension, writing fluency, oral fluency, and aural comprehension. Correlations were significant between Automaticity and performance on all four tests of French language attainment as well as on overall attainment.

Achievement↗

PubMed1996

Automatic analysis of sleep spindles--assessment in one case treated with a benzodiazepine anxiolytic drug.

Wave-form analysis and detection of sleep spindles should be automatically performed to achieve objective and highly precise determination of the pattern of appearance of sleep spindles. The conditions for constructing the automatic analysis and detection are as follows: 1) it is recommended that EEGs be sampled at 500 Hz or higher intervals; 2) the digital filter with the threshold that is most appropriate for removal of artifacts should be used; 3) various conditions for the analysis and detection of wave-forms are widely used; and 4) a procedure for inspecting and reading record paper should also be included in the set-up. Taking these points into consideration, the authors developed an automatic analysis system for sleep spindles, which employs a computer. The system was applied to a case preliminarily treated with a benzodiazepine anxiolytic drug, ethyl loflazepate (CM6912). The assessment using this system revealed that the CM6912 administration induced an increase in sleep spindles, delayed frequency, and caused amplitude increases and a prolonged duration.

Anti-Anxiety Agents↗

PubMed1996

An automatic sleep-stage analysis system with off-line high-speed processing using a super mini-computer.

An automatic sleep analysis system using a super mini-computer was developed. The system improved and expanded the data processed by the mini-computer. It had the following features: 1) wave-forms were collected and analyzed at a high speed (reproduced at 10 or 20 times the speed of a data recorder) by an off-line procedure to utilize the computer resources more efficiently; 2) all information and the original wave-forms were output to a laser printer because of the lower cost and more efficient arrangement of the data; 3) various wave-form parameters were measured by wave-form analysis; 4) the application program was based on general-purpose language; and 5) wave-form reanalysis and reconstruction of the logic was easily implemented for automatic evaluation of the sleep stages. Automatic analysis of the sleep stages was impossible for 15 of 1484 periods (20 sec per period) with one of the cases analyzed, and 142 of 1484 periods had to be corrected because of erroneous identification.

Adult↗