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A multifrequency magnetic induction tomography system using planar gradiometers: data collection and calibration.

We developed a 14-channel multifrequency magnetic induction tomography system (MF-MIT) for biomedical applications. The excitation field is produced by a single coil and 14 planar gradiometers are used for signal detection. The object under measurement was rotated (16 steps per turn) to obtain a full data set for image reconstruction. We make measurements at frequencies from 50 kHz to 1 MHz using a single frequency excitation signal or a multifrequency signal containing several frequencies in this range. We used two acquisition boards giving a total of eight synchronous channels at a sample rate of 5 MS s(-1) per channel. The real and imaginary parts of DeltaB/B(0) were calculated using coherent demodulation at all injected frequencies. Calibration, averaging and drift cancellation techniques were used before image reconstruction. A plastic tank filled with saline (D = 19 cm) and with conductive and/or paramagnetic perturbations was measured for calibration and test purposes. We used a FEM model and an eddy current solver to evaluate the experimental results and to reconstruct the images. Measured equivalent input noise voltage for each channel was 2 nV Hz(-1/2). Using coherent demodulation, with an integration time of 20 ms, the measured STD for the magnitude was 7 nV(rms) (close to the theoretical value only taking into account the amplifier's thermal noise). For long acquisition times the drift in the signal produced a bigger effect than the input noise (typical STD was 10 nV with a maximum of 35 nV at one channel) but this effect was reduced using a drift cancellation technique based on averaging. We were able to image a 2 S m(-1) agar sphere (D = 4 cm) inside the tank filled with saline of 1 S m(-1).

Calibration↗

Synchrotron X-ray data collection and restrained least-squares refinement of the crystal structure of proteinase K at 1.5 A resolution.

The structure of the serine endopeptidase proteinase K (279 amino acid residues; 28,790 daltons) has been refined by restrained least-squares methods to a conventional R value of 16.7% employing synchrotron film data of 30,812 reflections greater than 3 sigma in the 5.0 to 1.5 A resolution range. During refinement, the molecular structure was restrained to known stereochemistry, with root-mean-square (r.m.s.) deviation of 0.015 A from ideal bond lengths. The average atomic temperature factor, B, is 11.1 A2 for all atoms. The final model comprises 2020 protein atoms and 174 solvent molecules (which were given unit occupancies). Four corrections to the amino acid sequence were made, which were confirmed later by sequence analysis of the proteinase K gene: a deletion of one glycine in position 80; a change of sequence in position 207-208 and insertions of the dipeptide 210-211 and of residue 270. The r.m.s. deviation in the alpha-C atomic positions between the final refined model and the initial model built on the basis of a 3.3 A mini-map is 1.72 A for 227 out of 266 residues, which were originally traced in the mini-map without sequence information. The positions of the remaining 39 residues deviate by more than 8 A from the original ones and are located in regions where extensive revision of the structural model was necessary.

Crystallization↗

A computerized system for continuous physiologic data collection and analysis: initial report on mean arterial blood pressure in very low-birth-weight infants.

A system for continuous measurement and analysis of mean arterial blood pressure (MABP) by microcomputer is presented. The system allows prolonged recording and maintenance of fine detail by sequential evaluation and storage of up to 3,600 data points per hour. Fifteen preterm appropriate-for-gestational-age (AGA) infants weighing less than or equal to 1,500 g (very low birth weight) who were free of pulmonary and neurologic disease were monitored continuously from birth to 5 days of age. MABP was recorded via an umbilical arterial catheter with a pressure transducer and module interfaced with the microcomputer. Software was developed to analyze this stored data rapidly. MABP was found to correlate significantly with gestational age from 3 to 15 hours of age (P less than .05). Significant correlation was rare after 20 hours of age. MABP increased as a function of postnatal age in 11 infants. This increase was greater (0.31 to 0.54 mm Hg/h) for the least mature infants (27 to 29 weeks of gestation). The increase for the most mature infants (31 to 32 weeks of gestation) was low (0 to 0.24 mm Hg/h), and in three infants a small negative slope was seen. The steep rise in MABP during the first 40 hours of life in the least mature infants may be due to the perfusion requirements of extrauterine life. These pressures may be at or near the threshold for rupture of immature vascular beds such as are found in the subependymal germinal matrix and thus predispose to intraventricular hemorrhage.

Blood Pressure Determination↗

The effectiveness of the best linear unbiased prediction of beef sires using field data collected from small farms.

Beef sire evaluation using BLUP was investigated under field conditions at small-scale farms. The 6,848 records on fattened Japanese Black cattle steers were obtained from 1981 through 1987. The average number of steers in the subclass of market-year-farm was 5.2. A sire-maternal grandsire mixed model with relationships was used to analyze the data to yield BLUP for the sire and maternal grandsire effects. The regression coefficients of the realized value of progeny on the predicted value calculated using BLUP procedures for daily gain, carcass weight, and marbling score were 1.027, 1.054, and .917, respectively (i.e., the regression almost equaled 1). Therefore, BLUP was shown to be very effective in predicting offspring performance, even using field records collected from small-scale farms.

Animals↗

Photogrammetry for documentation of vehicle deformations--a tool in a system for advanced accident data collection.

Vehicle deformations are important sources for information about the performance of safety systems. Photogrammetry has developed vastly under recent years. In this study modern photogrammetrical methods have been used for vehicle deformation analysis. The study describes the equipment for documentation and recording in the field (semi-metric camera), and a system for photogrammetrical measurements of the images in laboratory environment (personal computer and digitizing tablet). The material used is approximately 500 collected and measured cases. The study shows that the reliability is high and that accuracies around 15mm can be achieved even if the equipment and routines used are relatively simple. The effects of further development using video cameras for data capture and digital images for measurements are discussed.

Accidents, Traffic↗

An overview of the Australian Physiotherapy Association accredited practice data collection.

The Accreditation Committee of the Australian Physiotherapy Association (APA) undertook a national survey of accredited private practices from September to November 1995. It aimed to describe patient and episodes of care characteristics, and provide accredited practices with large scale quality improvement opportunities. Of the private practices accredited in August 1995, 40.6 per cent (122) participated. Data were generated on 12,403 rooms-based patients. Practice-specific information on patient and episode characteristics was sent to each participant, allowing individual comparison with the group data. Lessons were learnt, not only in the administration of multi-centre studies, but also in the focus of future studies. This study highlighted the need to develop standard diagnosis coding and robust outcome measurements for use in private physiotherapy practice.

Journal Article↗

Computerized graphic display of physiological data collected during human stereotactic surgery.

An on-line computerized graphic display has been developed for use during stereotactic operations. This depicts in the form of figurine charts and alph-numeric symbols, appropriately oriented on saggital brain diagrams, the results of serial threshold stimulation of the brain. The display facilitates choice of target sites and the data can be stored in a tape library from which search-and-plot programs can be activated for any type or combination of types of response.

Brain↗

Collecting client data: a phenomenological study of midwives' experiences.

This phenomenological study explored the experiences of a small group of South Australian midwives engaged in client data collection within a unique midwifery triage model. Gadamerian hermeneutic principles guided data collection through unstructured interviews with the midwives and the identification of key themes. Findings included a philosophy of dialogue, the dynamics of dialogue, protection and advocacy issues and individual practices and concerns.

Communication↗

Re-examination of the cost-effectiveness of surgical versus medical therapy in patients with gastroesophageal reflux disease: the value of long-term data collection.

OBJECTIVES: For patients with reflux esophagitis, long-term therapeutic options include proton pump inhibitor (PPI) therapy and/or antireflux surgery. An earlier cost-effectiveness analysis concluded that at 5 yr, medical therapy was less expensive but similarly effective to fundoplication, but the results were sensitive to estimates on quality of life and long-term medication usage, which were derived from "expert opinion." Recently, data from randomized controlled trials addressing these variables have become available. We have incorporated these new data into a revised Markov model to examine the cost-effectiveness of surgical versus medical therapy in patients with severe reflux esophagitis. METHODS: A Markov simulation model was constructed using specialized software (DATA PRO 4.0, Williamstown, MA). Total expected costs and quality-adjusted life-years were calculated for long-term medical therapy and for laparoscopic Nissen fundoplication. Probabilities were obtained from the medical literature using Medline. Procedural and hospitalization costs used were the average Medicare reimbursements at our institution. Medication costs were the average wholesale price. The analysis was extended over a 10-yr time horizon at a discount rate of 3%. RESULTS: The discounted analysis shows that medical therapy is associated with total costs of 8,798 dollars and 4.59 quality-adjusted life-years, whereas the surgical strategy is more expensive (10,475 dollars) and less effective (4.55 quality-adjusted life-years). The results were robust to most one-way sensitivity analyses. CONCLUSIONS: Long-term medical therapy with proton pump inhibitors is the preferred strategy for patients with gastroesophageal reflux disease and severe esophagitis. Our study highlights the importance of using primary, patient-derived data rather than expert opinion.

Analysis of Variance↗

Analog-to-digital clinical data collection on networked workstations with graphic user interface.

An innovative respiratory examination system has been developed that combines physiological response measurement, real-time graphic displays, user-driven operating sequences, and networked file archiving and review into a scientific research and clinical diagnosis tool. This newly constructed computer network is being used to enhance the research center's ability to perform patient pulmonary function examinations. Respiratory data are simultaneously acquired and graphically presented during patient breathing maneuvers and rapidly transformed into graphic and numeric reports, suitable for statistical analysis or database access. The environment consists of the hardware (Macintosh computer, MacADIOS converters, analog amplifiers), the software (HyperCard v2.0, HyperTalk, XCMDs), and the network (AppleTalk, fileservers, printers) as building blocks for data acquisition, analysis, editing, and storage. System operation modules include: Calibration, Examination, Reports, On-line Help Library, Graphic/Data Editing, and Network Storage.

Analog-Digital Conversion↗

Structure of Ti2P solved by three-dimensional electron diffraction data collected with the precession technique and high-resolution electron microscopy.

The crystal structure of Ti(2)P has been analysed using electron diffraction and high-resolution electron-microscopy techniques. A new unit cell was found, the compound is hexagonal with a = 19.969 (1) and c = 3.4589 (1) A. The structure was first solved in space group P-62m in projection using direct methods on electron diffraction data from the [001] zone axis. A three-dimensional solution was obtained using again direct methods but on a three-dimensional set of electron diffraction data recorded with the precession technique. Ti(2)P is a distorted Fe(2)P structure and, based on high-resolution images, it is possible to explain that the tripling of the unit cell is due to the ordering of P vacancies that reduces the symmetry to P-6.

Journal Article↗

[The impact of the data collection method on the medico-economic classification of admissions for myocardial infarction at the public hospitals in Lyon].

The aim of the PMSI (Programme de Médicalisation du Système d'Information) is to describe the activity of hospitals for budget allocation. To control the quality of this information, the authors carried out a study comparing the classification in homogenous disease groups (HDG) obtained from the PMSI with that obtained from the epidemiological data base of the PRIMA trial for patients admitted to the Civil Hospitals of Lyon for myocardial infarction between September 1st 1993 and January 31st 1995. Six hundred and fifty standardised hospital summaries were reconstituted form PRIMA data and grouped using the GENRSA 3 software. Five hundred and forty-one of these hospital stays were found in the PMSI data base and grouped. The concordance not due to chance between the two classifications was then assessed by the global kappa coefficient. It was less than the 40% threshold under which concordance not due to chance is considered to be unlikely. The discordances were essentially due to the presence of an associated diagnosis classifying the hospital stay in the HDG corresponding to complicated myocardial infarction. The presence of a classifying associated diagnosis was observed significantly more often in the PRIMA than in the PMSI data base. This results in an underestimation of the hospital activity and could have important repercussions in terms of budget allocation.

Budgets↗

Assessment of antihypertensive drug use in primary care in Ravenna, Italy, based on data collected in the PANDORA project.

BACKGROUND: In the clinical-practice setting, only a small percentage of patients treated with antihypertensive drugs become normotensive. Furthermore, the diversity of drug classes used makes comparison of treatments difficult. OBJECTIVE: The goal of this study was to characterize the types and efficacy of antihypertensive treatments used in primary care in the area of Ravenna, Italy. The study was conducted in the context of the PANDORA Project, an open-ended global outcome study. METHODS: Data were gathered from general practitioners (GPs) and were stored by the GPs or through links with national health service databases. The population of interest was patients with essential hypertension taking antihypertensive medication, each of whom was observed for 365 days. Blood pressure was measured in the morning or afternoon using an automated device, in accordance with normal clinical practice. At each office visit, the GP reviewed and made any necessary adjustments to the patient's antihypertensive treatment. Antihypertensive drug use was assessed by calculating the mean daily dose (MDD) of the prescribed drug and the duration of treatment (DT). A DT > or = 273 days constituted continuous therapy, and a DT <273 days constituted discontinuous therapy. Adverse events were not collected. RESULTS: Twenty-one GPs took part in the study. The study population included 969 patients (443 men, 526 women), all of them white, whose ages ranged from 23 to 88 years. At enrollment, 327 patients were normotensive (blood pressure <140/90 mm Hg) and 642 were hypertensive despite drug treatment. More than 25 treatment regimens were identified. Over the course of follow-up, 49 patients had discontinuous therapy and 920 had continuous therapy. Among those who had continuous therapy, 117 (12.7%) took an MDD of <0.5 tablet/d; 297 (32.3%) took > or = 0.5 and <1 tablet/d; 364 (39.6%) took > or = 1 and <2 tablets/d; and 142 (15.4%) took > or = 2 tablets/d. At the end of the observation period, the proportion of normotensive patients had increased by 5.7% (P < 0.001). CONCLUSION: Based on the findings of this study, improper use of antihypertensive drug therapy appears to be one of the reasons for the relatively small proportion of patients who attain blood pressure control with treatment.

Adult↗

Reliability of HLA-Cw data collected in unrelated bone marrow registry and their usefulness for preliminary donor selection.

In the present study, we addressed the question of how often HLA-DRB1-matched donors can be found by further typing of AB-matched donors and whether Cw preselection can be helpful. Sixty-eight patients and 174 donors were enrolled in the study. In all donors, confirmatory DNA Cw typing was performed to check reliability of registry Cw data. Among the 129 Cw serologically typed donors, 11 (8.5%) were not confirmed by DNA typing and for 77 (60%) at least one Cw blank antigen was genetically confirmed. In healthy controls, haplotype frequency higher than 1% has been found for 21 (55%) out of 38 Cw-DRB1 haplotypes observed. A subtotal delta made up 67% of subtotal haplotype frequency fraction of 21 haplotypes confirming strong linkage disequilibrium of Cw-DRB1 loci. After Cw preselection 12 (15.4%) out of 78 donors were matched in both DRB1. On the other hand, only two (2.1%) out of 96 AB-matched donors with unknown or incompatible Cw were matched in both DRB1 at low-resolution level (OR = 8.55; P = 0.0060; 95%CI 1.85-39.5). We found at least one DRB1-matched donor for 12 (26.1%) out of 46 patients with Cw-matched donors for which 1-5 (median = 1) of Cw-preselected donors were chosen for further typing. Cw preselection of HLA AB-matched donors for further DRB1 typing may improve the efficacy of stem cell donor search process.

Donor Selection↗

[Digital x-ray system (data collection, processing, storage and transmission of diagnostic information)].

The paper deals with the system that allows the conventional procedures for obtaining diagnostic X-ray images to be integrated with direct digital ones. It presents patterns of introducing digital roentgenography into practical medicine and describes the system how diagnostic X-ray images are obtained, processed, stored, and transmitted, which consists of automatic working places for X-ray laboratory assistant and an X-ray physician. The requirements for long-term diagnostic archives data base and for the software support of input of the data accompanying each X-ray film are discussed in the paper. The information presented reflects the authors' experience in using the system in a multidisciplinary hospital having an unselected stream of patients (n = 6,000).

Hospitals↗

Optimizing pharmacodynamic target attainment using the MYSTIC antibiogram: data collected in North America in 2002.

The OPTAMA Program is intended to examine typical antimicrobial regimens used in the treatment of common nosocomial pathogens and the likelihood of these regimens attaining appropriate pharmacodynamic exposure in different parts of the world. A 5,000-subject Monte Carlo simulation was used to estimate pharmacodynamic target attainment for meropenem, imipenem, ceftazidime, cefepime, piperacillin-tazobactam, and ciprofloxacin against Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa. Standard dosing regimens from North America were used. Pharmacokinetic parameter variability was derived from existing healthy volunteer data, and MIC data came from the 2002 MYSTIC Program. Ciprofloxacin displayed the lowest target attainment against all bacterial species (41 to 46% for A. baumannii, 53 to 59% for P. aeruginosa, and 80 to 85% for the Enterobacteriaceae). Increasing the dose to 400 mg every 8 h did not significantly increase target attainment against nonfermenters. Piperacillin-tazobactam target attainments were similar to that of ceftazidime against all pathogens. Higher doses of both compounds were needed to achieve better target attainments against P. aeruginosa. Overall, meropenem, imipenem, and cefepime attained the highest probabilities of attainment against the Enterobacteriaceae (99 to 100%). The carbapenems appear to be the most useful agents against A. baumannii (88 to 92%), and these agents, along with higher doses of any of the beta-lactams, would be the most appropriate choices for empirical therapy for P. aeruginosa infection. Given the lack of agreement between percent susceptibility and probability of target attainment for certain antimicrobial regimens, a methodology employing stochastic pharmacodynamic analyses may be a more useful tool for differentiating the most-optimal compounds and dosing regimens in the clinical setting of initial empirical therapy.

Algorithms↗