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Intraoperative guidance of pre-planned bone deformations with a surface scanning system.

Computer- and robot-based systems to support interventions become more and more important in modem surgery. In general these systems provide methods to plan an intervention pre-operatively and to execute it with support from a autonomous robot-system. Due to the principle restriction of a robot to comparatively simple work steps, there are some complex work steps which the surgeon may plan but which he/she has to execute manually. In craniofacial surgery osteotomised bone segments are deformed by hand to a shape given by the planning system. We support the execution of pre-planned deformation by comparison of the actual shape of an object with the target shape. The actual shape is obtained intra-operatively with a surface scanning device, the deviation from the target shape are visualised by projecting colour-coded error values directly on the object to be deformed. The surgeon uses these projections to adjust further deformation steps. The system is therefore able to validate the correct execution of planned deformations, especially of bony structures.

Computer Simulation↗

Insights from models of rhythmic motor systems.

Computational models of rhythmic motor systems are valuable tools for the study of motor pattern generation and control. Recent modeling advances, together with experimental results, suggest that rhythmic behaviors, such as breathing or walking, are influenced by complex interactions among motor system components. Such interactions occur at all levels of organization, from the subcellular through to the cellular, synaptic, and network levels to the level of neuromuscular interactions and that of the whole organism. Simultaneously, safety mechanisms at all levels contribute to network stability and the generation of robust motor patterns.

Animals↗

[Computer-assisted monitoring systems. Use of computer networks and internet technologies].

The automated workplace (AWP) of anesthesiologist developed by the early 1990s provided data collection and processing, viewing of all monitors, and printing of anesthesiological chart (AC). AWP is a subject of continuous modification and adaptation to variable conditions. Computer monitoring including various measuring devises equipped with series interface RS-232 was implemented in Russian Research Center for Surgery. Rapid progress in computer network technologies made it necessary to adapt AWP to operation in computer networks. Since 1999 the computer network has been connected to the Internet. The use of computer technologies, including Internet, provides remote access to AC, thereby providing conditions for remote monitoring. AWP of anesthesiologist can be regarded as an automated control system of the patient state operated by anesthesiologist. Specific features of data processing in AWP are described. The AWP system is planed to be multiprocessor with distributed data flow. The suggested structure of computer network system for surgery rooms meeting the requirements of WWW-technology connected to the Internet is a promising approach to remote monitoring in medicine.

Anesthesia↗

[Development and utilization of the integral system of computer monitoring in anesthesiology in clinical obstetrics and gynecology].

An original computer monitoring system for preoperative monitoring was developed at the department of anesthesiology and intensive care of the Research Center for Obstetrics and Gynecology of the Russian Academy of Medical Sciences. The system includes a bedside monitor Athena (S&W + Artema, Denmark) and two special monitors ABM-100 (Datex, Finland) and NCCOM (Bomed, USA). The potentialities of the system are discussed; physiological parameters were monitored and estimated in the real time mode. Variants of graphic interface of the system are presented, including an original multisystem integral nomogram. Utilization of the system demonstrated the advantages of objective physiological information recorded by the system, a high informative values of integral estimated parameters in the real time mode. The use of the multisystem integral nomogram helps the anesthesiologist rapidly and unambiguously to interpret the clinical situation and essentially accelerates the decision-making on further treatment strategy. The work with the system does not require any special knowledge and skills, the system is simple and easy in use.

Anesthesia, Obstetrical↗

Computer experience and computer attitude: a model to predict the use of computerised information systems.

Computers are now essential technology in use by health workers. The literature shows that a number of factors effect the use of computers and many of them are related to attitude towards automation. Computer experience has been mostly used as a factor that effects computer attitude and its relationship with computer anxiety and computer use is not simple. Survey data from a study of 302 health workers, employed in a community setting was used to model the prediction of intention to use computers. The final model shows that 'positive computer experience' had a significant effect on computer attitude, computer anxiety and intention to use computers (both directly and indirectly). The model also confirms that those with a positive attitude towards computers had stronger intention to use computers. The value of these findings to health organisations in implementing automated systems is discussed.

Attitude to Computers↗

Integration of distributed multi-analyzer monitoring and control in bioprocessing based on a real-time expert system.

A computer system solution for integration of a distributed bioreactor monitoring and control instrumentation on the laboratory scale is described. Bioreactors equipped with on-line analyzers for mass spectrometry, near-infrared spectroscopy, electrochemical probes and multi-array gas sensors and their respective software were networked through a real-time expert systems platform. The system allowed data transmission of more than 1800 different signals from the instrumentation, including signals from gas sensors, electrodes, spectrometer detectors, balances, flowmeters, etc., and were used for processing and carrying out a number of computational tasks such as partial least-square regression, principal component analysis, artificial neural network modelling, heuristic decision-making and adaptive control. The system was demonstrated on different cultivations/fermentations which illustrated sensor fusion control, multivariate statistical process monitoring, adaptive glucose control and adaptive multivariate control. The performance of these examples showed high operational stability and reliable function and meet typical requirements for production safety and quality.

Algorithms↗

Application of magnetic resonance (MR) imaging for the development and validation of computational fluid dynamic (CFD) models of the rat respiratory system.

Computational fluid dynamic (CFD) models of the respiratory system provide a quantitative basis for extrapolating the localized dose of inhaled materials and improving human health risk assessments based upon inhalation studies conducted in animals. Nevertheless, model development and validation have historically been tedious and time-consuming tasks. In recognition of this, we previously reported on the use of proton (1H) magnetic resonance (MR) imaging for visualizing nasal-sinus passages in the rat, and for speeding computational mesh generation. Here, the generation and refinement of meshes for rat nasal airways are described in more detail and simulated airflows are presented. To extend the CFD models to the complete respiratory tract, three-dimensional (3D) 1H MR imaging of rat pulmonary casts was also utilized to construct pulmonary airway meshes using procedures developed for the nasal airways. Furthermore, the feasibility of validating CFD predictions with MR was tested by imaging hyperpolarized 3He gas at physiological flow rates in a straight pipe with a diameter comparable to the rat trachea. Results from these diverse studies highlight the potential utility of MR imaging not only for speeding CFD development but also possibly for model validation.

Animals↗

Can computer-aided systems engineering tools enhance the development of health care information systems? A critical analysis.

Computer-aided systems engineering (CASE) is a software technology that helps systems developers write complex application programs. CASE has been identified as having the potential to help health information systems developers complete large-scale projects such as the computer-based patient record or community health information network. The article evaluates the current use of CASE in health care and other settings through a review of the literature. There is no consensus on the value of CASE. Many experts believe that it is an emerging technology that will become widespread, whereas others see it as expensive and cumbersome to use.

Community Networks↗

The measurement and analysis of circadian locomotor activity and body temperature rhythms by a computer-based system.

A new computer-based system for collection and analysis of circadian body temperature and locomotor activity rhythms is described. This system makes possible the simultaneous measurements of body temperature and locomotor activity rhythms from 16 animals kept in separate cages. Several programs were developed for measurement and analysis of the data. This system is available not only in the study of circadian rhythms but also in other biological studies where long-term recordings of rest-activity cycles and body temperature are required.

Animals↗

The effect of thermodynamic data on computer model predictions of uranium speciation in natural water systems.

Computer models have found widespread application in order to help elucidate and predict changes in environmental systems. One such application is the prediction of trace metal speciation in aqueous systems. This is achieved by solving a set of non-linear equations involving equilibrium constants for all the components in the system, within mass and charge balance constraints. In this study a comparison of the predicted uranium speciation from two computer programs, WHAM and PHREEQCI, is used to illustrate the effect variations in thermodynamic data can have on the models produced. Using the original thermodynamic data provided with the models, WHAM predicted the UO2(2+) ion as the major species (84%) while PHREEQCI predicted UO2(HPO4)2(2-) as the major species (86%). Substituting uranium data from the Nuclear Energy Agency Thermochemical Database project (NEA-TDB) into both programs produced similar results from each program, with UO2F+ predicted to dominate (68%) in a groundwater sample. Natural water samples often contain humic substances. The possible interaction of such substances with uranium was also modelled. The WHAM program includes a discreet site electrostatic humic substance model, however in order to use the PHREEQCI program to model humic substance interactions, a 'model fulvic acid' dataset was added to the program. These models predicted 85 to 98% uranium-humic substance species at neutral pH. This indicates that humic substances do need to be taken into account when modelling uranium speciation in natural water samples.

Computer Simulation↗

Acceptance testing of Computed Radiography systems.

Acceptance testing of computed radiography systems (CR) is required to verify not only image quality but also compliance with the manufacturer's specifications. Therefore, CR acceptance testing is manufacturer-specific. This paper describes a series of performance tests performed on a large number of CRs (FCR 5000, Fuji) recently acquired by our institution. In particular we describe the following tests: dark noise, uniformity, exposure calibration, linearity and autoranging, limiting resolution, noise and low-contrast resolution, spatial accuracy, laser-beam function, erasure thoroughness, aliasing, grid response. Special attention is given to the practical aspects related to measurement and subsequent image analysis. We report the results obtained in the various tests. No significant variations from the reference levels were found. Nonetheless, in some cases the operating procedures had to be adapted.

Artifacts↗

Design and evaluation of a computer reminder system to improve prescribing behaviour of GPs.

OBJECTIVE: To evaluate the implementation of a decision support system with reactive computer reminders to improve drug prescribing behaviour. METHODS: A clustered RCT with an incomplete block design was carried out in the south of the Netherlands: 25 GPs received reminders on antibiotics and asthma/COPD prescriptions, 28 GPs received reminders on cholesterol prescriptions. Prescribing guidelines were integrated into the GP information system, which was installed in the GPs practices of the intervention group. When the computer program was in use, a reminder popped up if the GP deviated from the guidelines during prescribing. PRIMARY OUTCOME: prescription according to the guidelines as a percentage of total prescriptions of a specific drug. Furthermore, an evaluation on the user-friendliness of the CRS in the GP's practice was carried out through questionnaires and interviews. RESULTS: Presently analyses are being carried out. Preliminary results indicate that the CRS study supported our expectations. In general, there seems to be a reduction in the numbers of prescriptions according to the advices of the computerised guidelines not to prescribe certain drugs. Final analysis will be performed shortly. In general, the Computer Reminder System was perceived as stable and user friendly. CONCLUSION: We created a stable and user friendly Computer Reminder System which was adjusted to the needs and demands of GPs. Preliminary results regarding the effectiveness of the system seem to indicate that the implementation of a Computer Reminder System with reactive reminders improves drug prescribing behaviour.

Drug Prescriptions↗

Evaluation of a computer interview system for use with neuro-otology patients.

The effectiveness, feasibility and credibility of a computer assessment package was evaluated in a group of 60 neuro-otological outpatients. The computer system was compared with a standard questionnaire and used to elicit basic neuro-otological information prior to clinical interview. The majority of patients (81%) preferred computer assessment. There were no differences in attitude or difficulties between diagnostic groups. Older patients had more difficulties and took longer than younger patients. The computer system was also more efficient than the form from an information handling and administrative point of view.

Attitude to Computers↗

Computed tomography-anatomy of the normal feline nasolacrimal drainage system.

Computed tomography (CT) of the nasolacrimal drainage system with and without contrast medium (barium sulfate) was used to create an anatomic basis for clinical evaluation in domestic cats. To evaluate and compare the anatomical findings, three casts were carried out and were followed by CT examinations. These CT series were also used for a three-dimensional (3D) reconstruction of the nasolacrimal drainage system within surrounding structures. In noncontrast CT images, osseous structures limiting the nasolacrimal drainage system are easily recognizable. In most cats, this allows the identification of the nasolacrimal drainage system even without contrast enhancement. A distal part of the lacrimal sac adjoins directly to the respiratory mucosa of the nasal cavity without an osseous protection. Thus, this may represent a predilection site for infiltration of adjacent pathologic processes from the nasal cavity onto the lacrimal sac. The nasolacrimal duct begins on level with the maxillary third premolar tooth. The apex of the root of the canine tooth is situated very close to the nasolacrimal duct. This close topographic relation may lead to problems with the nasolacrimal drainage system. In domestic cats the nasolacrimal drainage system consists of a descending and a horizontal part, which form an angle of approximately 90 degrees for unhindered drainage of the lacrimal fluid.

Animals↗

Use of computed tomography for a three-dimensional treatment planning system.

Computed tomography (CT) can generate a set of serial contiguous slices which form a volume of medical image data. We have developed new techniques for creating computer synthesized 3-D images directly from a volume encoded as a three-dimensional array. The operator can place the eye anywhere in object space to selectively view a portion of the volume from any angle. A set of volume processing tools have been recently developed to allow interactive manipulation of image data within the volume. These tools allow the system to be used for surgical planning, and craniofacial implant design.

Image Processing, Computer-Assisted↗

Automated metabolic profiling analysis of urinary steroids by a gas chromatography mass spectrometry data system.

A computer system (MSSMET), using methylene unit retention indices for an off-line reverse library search analysis of selected ion chromatograms from gas-liquid chromatographic mass spectrometric data, has been applied for the qualitative and quantitative determination of daily variations in the excreted levels of urinary steroids of two individuals, using capillary column gas-liquid chromatography. Aliquots of 24 h urine collections and morning spot urine samples were examined. The daily excretion pattern of most of the major steroid metabolites was fairly consistent from day to day (i.e. 3 alpha-hydroxy-5 alpha-androstane-17-one, androsterone; 3 alpha-hydroxy-5 beta-androstane-17-one, etiocheolanolone; 3 alpha, 17 alpha, 21-trihydroxy-5 beta-pregnane-11,20-dione, THE; 3 alpha, 11 beta, 17 alpha, 21-tetrahydroxy-5 beta-pregnane-20-one, THF; 3 alpha, 11 beta, 17 alpha, 21-tetrahydroxy-5 alpha-pregnane-20-one; allo-THF; 3 alpha, 17 alpha, 20 alpha, 21-tetrahydroxy-5 beta-pregnane-11-one, cortolone; 3 alpha, 17 alpha, 20 beta, 21-tetrahydroxy-5 beta-pregnane-11-one, beta-cortolone; 5 beta-pregnane-3 alpha, 11 beta,17 alpha,20 alpha,21-pentol, cortol; 5 beta-pregnane-3 alpha, 11 beta, 17 alpha, 20 beta, 21-pentol, beta-cortol), while certain other steroid metabolites had a less consistent excretion pattern (3 beta-hydroxy-5-androstene-17-one, for example). Advantages and disadvantages of using capillary columns for the automated metabolic profile analysis of urinary steroids by reverse library search of selected mass chromatograms.

Adult↗