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PubMed1989

Designing and implementing a computer learning center in a college of medicine.

This report describes the approach taken at the Penn State College of Medicine to develop a central Computer Learning Center (CLC) and the use characteristics during the first 21 months of operation. A task force was created to establish the CLC, and a 12-month timetable was used from initial planning until the CLC was operational. In the first 21 months of operation, the CLC use increased linearly from 48 users per month to 388 users per month. More than half of the users were medical students, with the remainder distributed among faculty, staff, graduate students, nursing students, and medical residents. The growth of CLC use and the diversity of computer-assisted applications have occurred due to its central location within the medical center library and to CLC operation being shared by the library and the Department of Educational Resources.

Computer User Training↗
PubMed1998

Personal computers in forensic psychiatry.

Because forensic psychiatry is a relatively small field, there are few computer applications designed particularly for it. Forensic psychiatrists use personal computer in many ways that are similar to other psychiatrists, but certain aspects of forensic practice, such as an emphasis on precise reports, regular interactions with attorneys, use of legal databases and materials, and travel, call for utilizing available programs in different ways. Since forensic psychiatry draws on the knowledge of psychiatry, law, and criminology, the World Wide Web has become a particularly useful resource for information. An array of applications and resources of particular interest to forensic psychiatrists are presented. Computer education, "telemedicine," and teleconferencing are still in their infancy in forensic psychiatry, but are likely to increase in use as these technologies mature.

Forensic Psychiatry↗
PubMed1999

Using semantic constraints to help verify the completeness of a computer-based clinical guideline for childhood immunization.

The paper describes Commander, a prototype computer program designed to help verify the completeness of a computer-based clinical practice guideline built using if then rules. It also describes the application of Commander to a guideline for childhood immunization. Commander is designed to help identify incomplete rule sets, where there are clinically meaningful conditions to which the guideline does not respond. To allow this, the user defines semantic constraints, in the form of if-then statements, which indicate combinations of conditions which are not meaningful. In an iterative process, Commander takes the guideline rules, together with an increasingly refined set of constraints and helps focus in on any combinations of conditions to which the guideline does not respond. When applied to the clinical guideline for childhood immunization, Commander was able to dramatically reduce the number of potential combinations of conditions for consideration and also identified several areas of incompleteness in the rules.

Child↗
PubMed2001

The anatomic features of the radial head and their implication for prosthesis design.

OBJECTIVE: To establish the anatomical features of the radial head of an average normal human being and to verify the hypothesis that no significant difference exists between the geometry of the left and right normal radial heads. DESIGN: 17 proximal ends of the radius from the left and right forearms of fresh male (average age 50 and range 40-70) cadavers were measured. BACKGROUND: A reconstruction of anatomical features of the normal bone is important for prosthesis design. METHODS: A morphologic study of the radial head was performed using a co-ordinate measuring machine integrated with a computer aided design system. For comparative purposes, a statistical analysis including linear regression and correlation was performed. RESULTS: The maximum diameter (mean 23.36 mm (SD, 1.14 mm)) and height (mean 10.14 mm (SD, 1.38 mm)) of the radial head as well as the depth (mean 1.92 mm (SD, 0.32 mm)) and maximum radius (mean 20.27 mm (SD, 4.61 mm)) of the concave articulate surface are the most important anatomical features, which should be implicated in prosthesis design. The inclinations mean 2.50 degrees (SD, 0.41 degrees ) and mean 9.50 degrees (SD, 0.52 degrees ) and shift (mean 1.71 mm (SD, 0.35 mm)) of the radial head relative to its neck should also be taken into account in prosthetic design. CONCLUSIONS: The results of the study showed that "left is equal to right" (no significant differences between sides were obtained, for probability value P>0.05). RELEVANCE: This paper describes a morphological study of the proximal radius. The results can be used to reconstruct the geometry of the injured radial head based on the obtained geometric features of the contra-lateral side. These results can be also used to design radial head prosthesis.

Adult↗
PubMed2004

Preprocessing of rotamers for protein design calculations.

We have developed a process that significantly reduces the number of rotamers in computational protein design calculations. This process, which we call Vegas, results in dramatic computational performance increases when used with algorithms based on the dead-end elimination (DEE) theorem. Vegas estimates the energy of each rotamer at each position by fixing each rotamer in turn and utilizing various search algorithms to optimize the remaining positions. Algorithms used for this context specific optimization can include Monte Carlo, self-consistent mean field, and the evaluation of an expression that generates a lower bound energy for the fixed rotamer. Rotamers with energies above a user-defined cutoff value are eliminated. We found that using Vegas to preprocess rotamers significantly reduced the calculation time of subsequent DEE-based algorithms while retaining the global minimum energy conformation. For a full boundary design of a 51 amino acid fragment of engrailed homeodomain, the total calculation time was reduced by 12-fold.

Algorithms↗
PubMed2006

Enzyme isoselective inhibitors: application to drug design.

Common methodologies of computer-assisted drug design focus on noncovalent enzyme-ligand interactions. We introduced enzyme isoselective inhibition trend analysis as a tool for the expert analysis of covalent reversible inhibitors. The methodology is applied to predict the binding affinities of a series of transition-state analogue inhibitors of medicinally important serine and cysteine hydrolases. These inhibitors are isoselective: they have identical noncovalent recognition fragments (RS) and different reactive chemical fragments (CS). Furthermore, it is possible to predict the binding affinities of a series of isoselective inhibitors toward a prototype enzyme and to extrapolate the data to a target medicinally important enzyme of the same family. Rational design of CS fragments followed by conventional RS optimization could be used as a novel approach to drug design.

Drug Design↗
PubMed1991

Optimization of a trileaflet valve design.

This study investigates the fundamental principles that should govern the basic design of an optimal trileaflet valve. The geometry of the leaflets is described in terms of radius of the base (Rb), radius of the commissures (Rc), height of the valve (H), height of the commissures (Hs), and angle of the open leaflet to vertical (beta). Using computer-aided design software and these design parameters, a computer model of the valve was constructed. Choosing the parameters empirically did not produce an optimal valve. The four criteria for optimal performance were defined as: (1) a certain minimum coaptation height, (2) no folds in the leaflet, (3) minimum valve height, and (4) minimum leaflet flexion. Mathematical relationships were established between the design parameters and the performance parameters. These relationships indicated that the parameters Rc, Hs, and beta could be used to minimize valve height; however, a reduction in valve height must be balanced against the accompanying increase in leaflet flexion. For an optimal valve, the design parameters were Rb = 10 mm, then Rc = 8 to 10 mm, H = 11.5 mm, Hs = 2.4 to 2.6 mm, and beta = 4 degrees to 11 degrees . The optimal valve of any radius can be designed by scaling Rc, H, and Hs with respect to Rb. These design parameters were similar to those of the natural aortic valve. Trileaflet bioprosthetic valves designed on these principles are expected to have enhanced efficiency and longevity.

Bioprosthesis↗
PubMed2005

The design and production of Co-Cr alloy implants with controlled surface topography by CAD-CAM method and their effects on osseointegration.

Improved fixation and increased longevity are still important performance criteria in the development of orthopaedic prostheses. The osseointegration of a series of implant designs made of conventional cobalt-chromium alloy was investigated, the shape of each implant being the critical variable. The shape was defined by computer-aided design with a view to maximising interdigitation of new bone with the implant. Two different process routes, conventional casting and selective laser sintering were employed, each process yielded implants that had identical surface topology but different microstructures. Hydroxyapatite (HA) was used to coat some samples by plasma spraying. Bone formation associated with each implant design was delineated through the administration of fluorescent vital dyes at three time points following their implantation into New Zealand white rabbits. After one month, specimens were harvested, resin embedded, serial sectioned and examined under fluorescent light microscopy. The amount of bone growth was quantified using image analysis. Plasma spray HA-coated samples promoted better osteogenesis and integration than uncoated samples. The extent of bone growth associated with identically shaped specimens fabricated by the SLS route was markedly greater, attributed to the microstructure of these implants.

Animals↗
PubMed2006

A combined study of heat and mass transfer in an infant incubator with an overhead screen.

The main objective of this study is to investigate the major physical processes taking place inside an infant incubator, before and after modifications have been made to its interior chamber. The modification involves the addition of an overhead screen to decrease radiation heat losses from the infant placed inside the incubator. The present study investigates the effect of these modifications on the convective heat flux from the infant's body to the surrounding environment inside the incubator. A combined analysis of airflow and heat transfer due to conduction, convection, radiation and evaporation has been performed, in order to calculate the temperature and velocity fields inside the incubator before and after the design modification. Due to the geometrical complexity of the model, computer-aided design (CAD) applications were used to generate a computer-based model. All numerical calculations have been performed using the commercial computational fluid dynamics (CFD) package FLUENT, together with in-house routines used for managing purposes and user-defined functions (UDFs) which extend the basic solver capabilities. Numerical calculations have been performed for three different air inlet temperatures: 32, 34 and 36 degrees C. The study shows a decrease of the radiative and convective heat losses when the overhead screen is present. The results obtained were numerically verified as well as compared with results available in the literature from investigations of dry heat losses from infant manikins.

Algorithms↗
PubMed1999

Three-dimensional computer-assisted simulation combining facial skeleton with facial morphology for orthognathic surgery.

The purpose of this study was to use a 3-dimensional (3D) computer-aided design (CAD) simulation system to plan surgical procedures and predict postoperative changes in orthognathic surgery patients. A computer-generated imaging model was developed by combining a 3D reconstructed cephalometric skeletal image and a laser-scanned facial surface image. Moreover, postoperative data were studied and linked to the simulator model for programming and executing simulated surgical procedures. Interactive editing capabilities allow surgeons to operate CAD surgical simulation, and predicted results can be presented graphically and numerically. The results indicate that the integration of 3D images and CAD techniques have a potential for simulating surgery and providing graphic information to patients in obtaining an informed consent.

Adult↗
PubMed2001

Computational approaches towards the rational design of drug-like compound libraries.

During the practice of combinatorial chemistry, it has been realized that molecular diversity is not the only essential feature in a synthetically feasible library. In addition, it is of utmost importance to enrich potential libraries with those molecules which could be converted to viable drug candidates. Given the enormous number of potentially synthesizable compounds, there is a need to design a subset of true "drug-like" compounds. In addition, a paradigm shift in drug discovery has resulted in the integration of pharmacokinetic and drug development activities into early stages of lead discovery. In particular, in silico filters are being developed and used to help identify and screen out compounds that are unlikely to become drugs. This paper highlights recent computational approaches towards the design of drug-like compound libraries, in particular, the prediction of drug-likeness in a more general sense as well as intestinal absorption through passive transport, the permeation of the blood-brain barrier and recent developments towards identification of potentially metabolically unstable molecules. Current computational tools for library design allow the incorporation of medicinal chemistry knowledge into library planning by a variety of methods, ranging from the use of privileged building blocks and simple counting of structural properties (e.g. number of hydrogen bonding partners) to relatively complex regression or neural network-based models to explain oral bioavailability and other pharmacokinetic properties by structural features. These tools are being incorporated more frequently into drug design according to the "rule-of-five" which refers to simple descriptors correlated to oral drug absorption. Combining experimental knowledge with effective computational filtering and prediction of various aspects of drug-likeness thus facilitates the rapid and cost-effective elimination of poor candidates prior to synthesis and helps focus attention on interesting molecules.

Animals↗
PubMed2003

A computer-based microarray experiment design-system for gene-regulation pathway discovery.

This paper reports the methods and evaluation of a computer-based system that recommends microarray experimental design for biologists - causal discovery in Gene Expression data using Expected Value of Experimentation (GEEVE). The GEEVE system uses causal Bayesian networks and generates a decision tree for recommendations. To evaluate the GEEVE system, we first built an expression simulation model based on a gene regulation model assessed by an expert biologist. Using the simulation model, we conducted a controlled study that involved 10 biologists, some of whom used GEEVE and some of whom did not. The results show that biologists who used GEEVE reached correct causal assessments about gene regulation more often than did those biologists who did not use GEEVE.

Area Under Curve↗
PubMed2002

Physical workload on neck and upper limb using two CAD applications.

The aim was to evaluate (1) the physical workload on neck and upper limb in computer-aided design (CAD) work; (2) the impact of two applications (PROFESSIONAL-CADAM and PRO/Engineering) and (3) two input devices (computer mouse and keyboard), as well as (4) sitting and standing work positions. Fifteen CAD operators were interviewed and examined physically. For nine subjects, the physical workload was measured: electromyography (EMG) of trapezius and forearm extensor muscles, inclinometry of the head, the upper back and upper arms, as well as wrist goniometry. The muscular load was low in CAD work, but the inter-individual variation was considerable. Neither the positions were extreme, nor the movements. The applications, per se, did not have a large impact on the workload, but because of the need for different input devices the effect was strong. Using a keyboard meant higher angular velocities than using a mouse. Hence, when choosing a new software, which requires mainly a mouse as input device, this has to be balanced against the risk of disorders.

Adult↗
PubMed1999

Evaluation of a computer-aided learning program in removable partial denture framework designing.

Assessment of a computer-assisted learning (CAL) program dealing with designing removable partial dentures was performed as both formative and summative evaluation. Formative evaluation was obtained through open-ended questions in a written questionnaire administered to 60 junior students from two Australian Dental Schools and through observation of four groups of these students as they worked through the program. Formative evaluation, fundamental to completion of the program, led to several changes and additions. Observation of the students using the program during its final stages of development was one of the most informative and helpful parts of the evaluation. It allowed nuances of expression and body language to be noted that would not have been apparent in written or numerical data. Summative evaluation was obtained through structured questions in the questionnaire and through a post-CAL test under examination conditions. Summative assessment showed that students could attain a desired standard of knowledge if a lecture series was replaced by the CAL program; that the program was user-friendly, even for students with little or no computer experience; and that most students considered it to be a useful learning resource. More than half the students were concerned about using CAL to replace human instruction. It is significant that students were particularly impressed by aspects of the program that could not be duplicated by a book; the interactive nature of the learning process and the ability to rotate the diagnostic casts. This highlights the need for CAL programs to use the full potential of computer capability, rather than merely replicate a textbook on a screen.

Computer-Assisted Instruction↗
PubMed2001

The effectiveness of a self-care management interactive multimedia module.

PURPOSE/OBJECTIVES: To develop and test an interactive multimedia module prototype designed to accommodate adults with limited literacy and without computer skills. DESIGN: Experimental, randomized, controlled, pretest, post-test. SETTING: Cancer treatment centers in California, Louisiana (pilot). New Hampshire, Pennsylvania, and Texas. SAMPLE: Outpatients who were at least 18 years old with a minimum fifth-grade reading level; 86 experimental treatment, 88 control. METHODS: Experimental treatment involved use of the interactive multimedia module; the control group received customary Instruction. FINDINGS: As compared to the control group, subjects in the experimental group had significant improvement (p = 0.0001; 257% gain) in self-care ability regardless of age, sex race, education, geographic location, reading ability, computer experience, or preferred learning style; a 6.515% increase in fatigue content covered and 16.775% Increase in instructional duration; and significantly greater benefit from sleep-related activities and a consistent, positive pattern of self-care behavior. CONCLUSIONS: The program is instructionally effective, appropriate for a wide and geographically diverse audience, and feasible for use in the ambulatory setting. IMPLICATIONS FOR NURSING PRACTICE: The interactive multimedia module is an effective, self-directed resource for individualized patient fatigue education.

Adaptation, Psychological↗