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1995 Volvo Award in clinical sciences. Determinants of lumbar disc degeneration. A study relating lifetime exposures and magnetic resonance imaging findings in identical twins.

STUDY DESIGN: Retrospective cohort. OBJECTIVES: To investigate the effects of lifetime exposure to commonly suspected risk factors on disc degeneration using magnetic resonance imaging, and to estimate the effects of these suspected risk factors relative to age and familial aggregation, reflecting genetic and shared environmental influences. SUMMARY OF BACKGROUND DATA: Structural and biochemical changes associated with disc degeneration are suspected as the underlying conditions of many back-related symptoms. Little is known about the determinants of disc degeneration. METHODS: Based on lifetime discordance in suspected environmental risk factors for disc degeneration, 115 male identical twin pairs were selected. An in-depth interview was conducted of occupational and leisure time physical loading, driving, and smoking. Disc degeneration was evaluated using observational and digital magnetic resonance imaging assessment methods. RESULTS: Heavier lifetime occupational and leisure physical loading was associated with greater disc degeneration in the upper lumbar levels (P = 0.055 - 0.001), whereas sedentary work was associated with lesser degeneration (P = 0.006). These univariate associations did not reach statistical significance in the lower lumbar region. In multivariate analyses of the upper lumbar levels, the mean job code explained 7% of the variability in observational disc degeneration scores; the addition of age explained 16%, and familial aggregation improved the model such that 77% of the variability was explained. In the lower lumbar levels, leisure time physical loading entered the multivariate model, explaining 2% of the variability. Adding age explained 9%, and familial aggregation raised the variability in disc degeneration scores explained to 43%. CONCLUSIONS: The present study findings suggest that disc degeneration may be explained primarily by genetic influences and by unidentified factors, which may include complex, unpredictable interactions. The particular environmental factors studied, which have been among those most widely suspected of accelerating disc degeneration, had very modest effects.

Adult↗

[Research and development in medical technology industry--status in Germany].

In today's operating room, innovative methods and tools increase productivity, reduce patient trauma, and improve health care economics. Digital imaging and networking assist decision-making-practically, in real time during surgery and with 3-D reconstructions of surgical planning. The operating environment is further enhanced by nonstop monitoring and life-support equipment. Accordingly, research and clinical studies are becoming more important for medical technology assessment and thus deserve more financial support.

Clinical Trials as Topic↗

Development of software tools at BioInformatics Centre (BIC) at the National University of Singapore (NUS).

There is burgeoning volume of information and data arising from the rapid research and unprecedented progress in molecular biology. This has been particularly affected by the Human Genome Project which is trying to completely sequence three billion nucleotides of the human genome (1),(1a). Other genome sequencing projects are also contributing substantially to this exponential growth in the number of DNA nucleotides and proteins sequenced. The number of journals, reports and research papers and tools required for the analysis of these sequences has also increased. For this the life sciences today needs tools in information technology and computation to prevent degeneration of this data into an inchoate accretion of unconnected facts and figures. The recently formed BioInformatics Centre (BIC) at the National University of Singapore (NUS) provides access to various commonly used computational tools available over the World Wide Web (WWW)--using a uniform interface and easy access. We have also come up with a new database tool. BioKleisli, which allows you to interact with various geographically scattered, heterogeneous, structurally complex and constantly evolving data sources. This paper summarises the importance of network access and database integration to biomedical research and gives a glimpse of current research conducted at BIC.

Animals↗

Concepts, knowledge and language in healthcare information systems: follow-up 30 months later.

The paper reviews the last IMIA-WG6 recommendations, issued along two themes: (1) how to better share common results and (2) how to conduct new research and development efforts. Some of the major discrepancies in the field are reviewed. The paper intends to offer insight into two areas, first, in the issue of knowledge representation and, second, in the science of meaning, incorporating the broad intersection of computational linguistics, semantics, conceptual approach, and denotation. The Ogden-Richards meaning triangle is used as a convenient organizing principle to maximize the scope of understanding among the different schools, particularly in areas of linguistics and semantics on the one side and denotation and conceptual approach on the other. In conclusion, there is a need for clarification and for more scientific pragmatism.

Artificial Intelligence↗

Aliasing-tolerant color Doppler quantification of regurgitant jets.

Conservation of momentum transfer in regurgitant cardiac jets can be used to calculate the flow rate from color Doppler velocities. In this study, turbulent jets were simulated by finite elements; pseudocolor Doppler images were interpolated from the computations, with aliasing introduced artificially. Jets were also imaged by color Doppler in an in vitro flow system. To suppress aliasing errors, jet velocities were fitted iteratively to a fluid mechanical model constrained to match the orifice velocity (measured without aliasing by continuous-wave Doppler). At each iteration, the model was used to detect aliased velocities, which were excluded during the next iteration. Iteration continued until the flow rate calculated by the model and number of calculated nonaliased pixels were unchanged. The good correlations between measured and calculated flow rates in the experimental (R2 = 0.933) and computational studies (R2 = 0.990) suggest that this may be a clinically useful approach even in aliased images. Published by Elsevier Science Inc.

Algorithms↗

[Genogeography of human populations: computer mapping of population genetics data].

Genogeography as a field of interdisciplinar investigation was introduced into science in 1928 by Russian geneticist A. S. Serebrovsky an today is well known in human genetics as gene geography. This work was undertaken to introduce a new method of computer cartography of gene frequencies in human and in any other populations. The method is different from known one of P. Menozzi, A. Piazza and L. Cavalli-Sforza. Two key moments of the method are principle of fusion-fission of gene in the homogeneous geographical space equally free-for-all human genes, and principle of local-linear (but not of the high-orders) interpolation of gene frequencies onto spheric surface of geographical space. Such procedure was used for mapping of human AB0-B gene frequencies among native populations of Central Asia.

ABO Blood-Group System↗

Computer-Aided Design and Computer-Aided Manufacture (CAD-CAM) applications in cosmetic below-elbow prostheses.

Computer-Aided Design and Computer-Aided Manufacture (CAD/CAM) techniques, though often technologically associated with engineering and applied sciences, has opened new horizons in the medical field. In CAD, a product is first geometrically modelled in three dimensions in a computer and it can be viewed and examined from any direction. This model can then be used for many downstream applications such as manufacturing and analysis. In CAM, numerically controlled machining processes are used for cutting out a prosthetic device of the hand for prosthesis. The paper aims at establishing the basis of using CAD/CAM techniques in prostheses in particular, a review of our present work done in the area of below-elbow prostheses using CAD/CAM. A laser scanning device has been used to capture the geometry of human hands. The algorithm used in processing the images is discussed. The processed 3D data file is then interfaced with a CAD modeller where reconstruction, mirroring, scaling, etc., can be performed. The resultant CAD model is then passed on to CAM, which concentrates purely on producing a "positive core" mould for moulding the prosthetic device.

Algorithms↗

Biomedical informatics training at Stanford in the 21st century.

The Stanford Biomedical Informatics training program began with a focus on clinical informatics, and has now evolved into a general program of biomedical informatics training, including clinical informatics, bioinformatics and imaging informatics. The program offers PhD, MS, distance MS, certificate programs, and is now affiliated with an undergraduate major in biomedical computation. Current dynamics include (1) increased activity in informatics within other training programs in biology and the information sciences (2) increased desire among informatics students to gain laboratory experience, (3) increased demand for computational collaboration among biomedical researchers, and (4) interaction with the newly formed Department of Bioengineering at Stanford University. The core focus on research training-the development and application of novel informatics methods for biomedical research-keeps the program centered in the midst of this period of growth and diversification.

Biomedical Engineering↗

Computational models in immunological methods: an historical review.

The utilization of computational models in immunology dates from the birth of the science. From the description of antibody-antigen binding to the structural models of receptors, models are utilized to bring fundamental understandings of the processes together with laboratory measurements to uncover implications of these data. In this review, an historical view of the role of computational models in the immunology laboratory is presented, and short mathematical descriptions are given of fundamental assays. In addition, the range of current uses of models is explored -- especially as seen through papers which have appeared in the Journal of Immunological Methods from volume 1 (1971/1972) to volume 208 (1997). Each paper which introduced a new mathematical, statistical, or computer simulation model, or introduced an enhancement to an instrument through a model in those volumes is cited and the type of computational model noted.

History, 20th Century↗

Cross-site study of the implementation of information technology innovations in health sciences centers.

An interpretive oral history technique was used to identify factors most important in the implementation stage of information technology innovation diffusion. Electronic mail, end user literature searching, and aspects of the computer-based patient record were the innovations selected for study at academic health sciences centers. Transcripts of thirty-four interviews with key individuals were analyzed to determine six categories of factors. Word counts were then used to determine underlying emphases. Analysis of variance tested whether there were significant differences in uses of words by categories of individuals, by those at different institutions, and when different innovations were described. Results indicate that the innovations themselves correlate significantly with different word categories, where category of individual and institution do not. Words related to the computer based patient record characterize further critical factors in implementing that particular innovation.

Academic Medical Centers↗

The CyberDoc project: using portable computing to enhance a community-based primary care clerkship.

In July 1995, MCP-Hahnemann School of Medicine of the Allegheny University of the Health Sciences introduced its first-ever required clerkship in family medicine. It was decided that computer skills and applications would be an integral part of this rotation, and a special program, CyberDoc, was developed for the clerkship by some of the university's informatics professionals and family medicine faculty. CyberDoc is a suite of laptop-computer applications, based almost exclusively on "off-the-shelf" database and connectivity programs and designed expressly for students at community-based training sites. CyberDoc allows faculty members to track students' progress at off-site clerkships, and allows the students to access pharmaceutical and drug-interaction databases, the university's online academic information system (including MEDLINE), all basic Internet functions, e-mail, and an array of other applications. The authors briefly describe the background, goals, and structure of the CyberDoc project, as well as the preliminary outcomes of CyberDoc's pilot year.

Clinical Clerkship↗

Data reduction in headspace analysis of blood and urine samples for robust bacterial identification.

This paper demonstrates the application of chemical headspace analysis to the problem of classifying the presence of bacteria in biomedical samples by using computational tools. Blood and urine samples of disparate forms were analysed using a Cyrano Sciences C320 electronic nose together with an Agilent 4440 Chemosensor. The high dimensional data sets resulting from these devices present computational problems for parameter estimation of discriminant models. A variety of data reduction and pattern recognition techniques were employed in an attempt to optimise the classification process. A 100% successful classification rate for the blood data from the Agilent 4440 was achieved by combining a Sammon mapping with a radial basis function neural network. In comparison a successful classification rate of 80% was achieved for the urine data from the C320 which were analysed using a novel nonlinear time series model.

Bacteremia↗

In vitro, in vivo, in silico: computational systems in tissue engineering and regenerative medicine.

The emergence of computational systems in tissue engineering and regenerative medicine is paralleling the rapid rise of new technology. Developments in software and hardware have allowed access to the huge data streams that are now available. The Human Genome Project led the way and opened many avenues for other branches of science and biology with extensive but contained databanks. The availability of vast amounts of data means nothing without the ability to integrate the information into a useful form. Tissue engineering has always been a practical science in which function and utility are key objectives. This review delineates key areas of this rapidly ascending branch of science and illustrates examples central to the successful integration of computational methods.

Animals↗

Biocomputational methodology an adjunct to theory and applications.

The role of "methodology", as distinguished from "theory" and "application", is discussed and illustrated. It is argued that research in the biomedical sciences is moving towards a degree of complexity different in both kind and extent from that usually encountered in other disciplines. Certain biocomputational methodology can be viewed as a bridge between the data forms commonly encountered in biomedicine, and the statistical and computational machinery which had previously been developed to deal with physical science information. Examples are given of three promising research subareas, all of which concern methods for dealing with highly complex forms of health and medical data.

Computers↗

Communicating original research in chemistry and related sciences.

The availability of scientific information in electronic form is the convergence of traditional journal publishing, electronic communications, and the widespread availability of computer technology. This revolution in scientific communication has its roots in developments that started in the mid-19th century and culminated with the extraordinary progress in telecommunications and computer technology in the latter years of the 20th century. Eighty-three percent of scientific journals are now available online. The benefits of electronic journals include rapid publication, instantaneous linking to external information sources, and the capability to deliver new types of information. To date neither electronic-only nor preprint servers have been well received by the chemical sciences community. Continued advances in telecommunications, computer technology, and acquisition of scientific data in structured formats hold promise for even greater advances in communication of scientific information.

Journal Article↗

Assessing and enhancing medical students' computer skills: a two-year experience.

In 1984, the Association of American Medical Colleges (AAMC) issued recommendations for the reform of medical education. One recommendation was that information sciences be incorporated into the medical curriculum. In fall 1996, a survey was conducted to learn more about computer use by medical students at the Rockford regional site of the University of Illinois at Chicago College of Medicine. The purpose of the survey was to gather information not only about computer skills, but also about overall comfort level in using computers and about expectations for enhancing computer skills while attending medical school. Over a two year period, 208 students representing four classes received this survey in their e-mail. Non-respondents received a follow-up print copy in their student mailboxes. Results, based on a 60% response rate, showed a majority of Rockford students entered medical school with good skills in using e-mail and word processing, but many lacked the skills necessary to search the medical literature or to use computer-assisted instructional programs. Overall, 80% of students expected to learn more about computers while attending medical school. Results contributed to an increased effort to integrate computer applications into the medical curriculum and to use computers as a means of communicating with students.

Computer Communication Networks↗