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PubMed1996

Movement and signal analysis by means of a computer-assisted system.

The aim of this study was to evaluate the suitability of an optoelectronic system for recording mandibular movements and the conformity of simultaneous recordings of the electromyographic activity in the masseter, the temporal and the suprahyoid muscles. A simulator test to identify the inherent noise of the MacReflex motion analysis system was performed by means of a micrometer screw. The test showed a very small noise inherent in the clinical set-up of the monitoring system. The values obtained also reflected external vibrations. A clinical pilot study was performed to find a feasible site for attaching the reflective markers, either to the incisal teeth of the mandible or as chin marker. In tests including the muscle activity, the conformity between the curves of the movement and muscle activity was good. The method was easy to use in clinical tests, the software of the system reduced the analysis time to a minimum and a number of variables could be measured with a high degree of precision.

Artifacts↗
PubMed1986

Determination of L-ascorbic acid in tomato by isotachoelectrophoresis. Application of computer simulation system for setting of determination conditions to avoid the mixed-zone problem.

When the isotachoelectrophoretical method is used with HCl-beta-alanine as the leading electrolyte solution (pH 3.6), ascorbic acid forms a mixed zone with glutamic acid, and it is difficult to separate the two. Therefore, the application of a computer simulation system to separate the two acids was investigated. This system can be used with compounds for which the absolute electrophoretical mobility and dissociation constant have already been determined. Values for glutamic acid alone were entered in the data bank "SIPS-1", and then those for ascorbic acid were estimated from the values of similar compounds. Values for aspartic acid were used, and the electrophoretical behavior of ascorbic and glutamic acids was simulated at pH range from 3 to 9.9. Based on this simulation, separation appeared possible at pH 9.0 to 10.0, and indeed, experimental determination of ascorbic acid was successfully performed with a leading electrolyte solution composed of HCl-ethanolamine (pH 9.4) without any glutamic acid interference. Even though ascorbic acid is highly susceptible to oxidation in an alkaline medium, because the ascorbic acid solution is injected at the interface of the leading and terminal electrolyte solutions in the electrophoretical procedure, it does not come in contact with air during electrophoresis. This explains why ascorbic acid can be determined in an alkaline medium.

Ascorbic Acid↗
PubMed1994

Performance of four computer-based diagnostic systems.

BACKGROUND: Computer-based diagnostic systems are available commercially, but there has been limited evaluation of their performance. We assessed the diagnostic capabilities of four internal medicine diagnostic systems: Dxplain, Iliad, Meditel, and QMR. METHODS: Ten expert clinicians created a set of 105 diagnostically challenging clinical case summaries involving actual patients. Clinical data were entered into each program with the vocabulary provided by the program's developer. Each of the systems produced a ranked list of possible diagnoses for each patient, as did the group of experts. We calculated scores on several performance measures for each computer program. RESULTS: No single computer program scored better than the others on all performance measures. Among all cases and all programs, the proportion of correct diagnoses ranged from 0.52 to 0.71, and the mean proportion of relevant diagnoses ranged from 0.19 to 0.37. On average, less than half the diagnoses on the experts' original list of reasonable diagnoses were suggested by any of the programs. However, each program suggested an average of approximately two additional diagnoses per case that the experts found relevant but had not originally considered. CONCLUSIONS: The results provide a profile of the strengths and limitations of these computer programs. The programs should be used by physicians who can identify and use the relevant information and ignore the irrelevant information that can be produced.

Analysis of Variance↗
PubMed1993

What is a HISS? Hospital Information Support System.

A HISS is a Hospital Information Support System and the idea is that it is primarily there to support clinical activity not to provide management information. When the concept of a HISS first emerged it was seen as a very large system where all hospital departments shared one computer system and that is the model used by the first few HISS sites. As the Health Service has changed and the difficulties of replacing all the computer systems in a hospital with one large system have been appreciated, so the concept of HISS has developed. We now talk about an incremental approach to HISS. This means looking at the present systems and deciding which ones should be retained and 'interfaced' with the new system. No system is the best for every department and this approach allowing 'foreign' systems to be attached to the main system (usually centred on the Patient Administrative System) does provide a good fit with the needs of the department. This does not need to be implemented immediately but can be introduced at the end of the life of an existing system, thus protecting the past investment in systems.

Hospital Information Systems↗
PubMed1998

Incremental cost of department-wide implementation of a picture archiving and communication system and computed radiography.

PURPOSE: To determine the incremental cash flows associated with department-wide implementation of a picture archiving and communication system (PACS) and computed radiography (CR) at a large academic medical center. MATERIALS AND METHODS: The authors determined all capital and operational costs associated with PACS implementation during an 8-year time horizon. Economic effects were identified, adjusted for time value, and used to calculate net present values (NPVs) for each section of the department of radiology and for the department as a whole. RESULTS: The chest-bone section used the most resources. Changes in cost assumptions for the chest-bone section had a dominant effect on the department-wide NPV. The base-case NPV (i.e., that determined by using the initial assumptions) was negative, indicating that additional net costs are incurred by the radiology department from PACS implementation. PACS and CR provide cost savings only when a 12-year hardware life span is assumed, when CR equipment is removed from the analysis, or when digitized long-term archives are compressed at a rate of 10:1. CONCLUSION: Full PACS-CR implementation would not provide cost savings for a large, subspecialized department. However, institutions that are committed to CR implementation (for whom CR implementation would represent a sunk cost) or institutions that are able to archive images by using image compression will experience cost savings from PACS.

Academic Medical Centers↗
PubMed1975

[Current problems of data processing in clinical nuclear medicine. Symposium of Rhine-Westphalian Society for Nuclear Medicine in Bonn, Dezember 7, 1974].

Practical aspects of the use of computer systems in Nuclear Medicine were discussed in a symposium sponsored by the "Rheinisch-Westfälische Gesellschaft für Nuklearmedizin" which was held at Bonn in December '74. In the opening session the president of the Society, Prof. Winkler (Bonn), gave a brief survey upon the development of data processing procedures for radionuclide diagnostics. He pointed out that at present computer application is not only of essential significance for camera scintigraphy but also for most of the other test methods as well as for the solution of organizing problems when running departments of Nuclear Medicine. For the performance of all these tasks and also for scientific purposes a special process control computer system has been developed in the Institute of Nuclear Medicine at the University of Bonn. A detailed description of this system was given by R. Knopp (Bonn). He emphasized in his paper that the rather bulky Bonn System, which consists of a dual computer (Siemens 305/306) and an extensive operating system, can not be regarded as a standard device for routine use in hospitals. However, on the basis of experiences which have been gathered on hand of the research system in Bonn efforts are in full activity for developing a compact Nuclear Medicine Computer system (CNMCS) suitable for the application within departments of any size. The CNMCS (which will be commercially available in the near future) is based on a 64 K, 16 bit central unit with a highly flexible operating system which permits a simultaneous multi user application of the computer. For CNMCS a comprehensive user software package will be at the clinician's disposal which can be easily handled.

Brain Diseases↗
PubMedDate not supplied

An anthropologist's viewpoint: observations and commentary regarding "Implementation of nursing vocabularies in computer-based systems".

Those who work in the area of vocabularies, like all researchers, bring some assumptions to that work. Such assumptions include both cultural notions and beliefs specific to particular social worlds within the broader society. In this article, assumptions and beliefs expressed by participants during the conference on "Implementation of Nursing Vocabularies in Computer-based Systems" are summarized. Questions are raised concerning the relationship between cultural notions and beliefs and nursing vocabularies.

Anthropology↗
PubMed2001

CMEIAS: A Computer-Aided System for the Image Analysis of Bacterial Morphotypes in Microbial Communities.

A major challenge in microbial ecology is to develop reliable and facile methods of computer-assisted microscopy that can analyze digital images of complex microbial communities at single cell resolution, and compute useful quantitative characteristics of their organization and structure without cultivation. Here we describe a computer-aided interactive system to analyze the high degree of morphological diversity in growing microbial communities revealed by phase-contrast microscopy. The system, called "CMEIAS" (Center for Microbial Ecology Image Analysis System) consists of several custom plug-ins for UTHSCSA ImageTool, a free downloadable image analysis program operating on a personal computer in a Windows NT environment. CMEIAS uses various measurement features and two object classifiers to extract size and shape measurements of segmented, digital images of microorganisms and classify them into their appropriate morphotype. The first object classifier uses a single measurement feature to analyze relatively simple communities containing only a few morphotypes (e.g., regular rods, cocci, filaments). A second new hierarchical tree classifier uses an optimized subset of multiple measurement features to analyze significantly more complex communities containing greater morphological diversity than ever before possible. This CMEIAS shape classifier automatically categorizes each cell into one of 11 predominant bacterial morphotypes, including cocci, spirals, curved rods, U-shaped rods, regular straight rods, unbranched filaments, ellipsoids, clubs, rods with extended prostheca, rudimentary branched rods, and branched filaments. The training and testing images for development and evaluation of the CMEIAS classifier were obtained from 1,937 phase-contrast grayscale digital images of various diverse communities. The CMEIAS shape classifier had an accuracy of 96.0% on a training set of 1,471 cells and 97.0% on a test set of 4,270 cells representing all 11 bacterial morphotype classes, indicating that accurate classification of rich morphological diversity in microbial communities is now possible. An interactive edit feature was added to address the main sources of error in automatic shape classification, enabling the operator to inspect the assigned morphotype of each bacterium based on visual recognition of its distinctive pseudocolor, reassign it to another morphotype class if necessary, and add up to five other morphotypes to the classification scheme. The shape classifier reports on the number and types of different morphotypes present and the abundance among each of them, thus providing the data needed to compute the morphological diversity within the microbial community. An example of how CMEIAS can augment the analysis of microbial community structure is illustrated by studies of morphological diversity as an indicator of dynamic ecological succession following a nutrient shift-up perturbation in two continuously fed, anaerobic bioreactors with morphologically distinct start communities. Various steps to minimize the limitations of computer-assisted microscopy to classify bacterial morphotypes using CMEIAS are described. In summary, CMEIAS is an accurate, robust, flexible semiautomatic computing tool that can significantly enhance the ability to quantitate bacterial morphotype diversity and should serve as a useful adjunct to the analysis of microbial community structure. This first version of CMEIAS will be released as free, downloadable plug-ins so it can provide wide application in studies of microbial ecology.

Journal Article↗
PubMed2001

Clinical application of a new compact computed tomography system for evaluating the outcome of regenerative therapy: a case report.

BACKGROUND: The limitations of conventional 2-dimensional (2-D) radiographs have been emphasized in many studies. Because the image is a 2-D map of the 3-dimensional (3-D) tooth and periodontal tissue, these structures may be superimposed on each other. Recently, 3-D image analysis by computed tomography (CT) was introduced to dentistry, but it has been used only rarely in the periodontal field. METHODS: The purpose of this case report was to introduce the clinical application of a newly developed, compact computed tomography system for evaluating the outcome of regenerative therapy in an adult patient with periodontitis (male, aged 55 years). To evaluate the bone defects including furcation involvement, we took an intraoral radiograph and performed CT scanning on tooth #19. We recorded a number of clinical parameters at the time of surgery. We compared the images of the bone defect obtained by CT images and the conventional radiograph with the true bone defect morphology at the surgical site. RESULTS: One year after the periodontal surgery, we again took CT scans and a conventional radiograph, and the new images of the bone defect were compared and evaluated. The new CT images were reconstructed for 3-D evaluation and compared with those taken before surgery. The CT provides 3-D images of excellent quality for evaluating the morphology of the periodontal bone defect and furcation involvement. CONCLUSIONS: We consider that CT is a useful aid in periodontal examination and diagnosis, and in the prediction and evaluation of periodontal treatment outcomes.

Alveolar Bone Loss↗
PubMed1991

Clinical trial of a computer-aided system for orthopaedic shoe upper design.

A trial has been conducted to produce the uppers for orthopaedic shoes using an existing commercial computer-aided design system. The aims of the trial were to confirm that a CAD system developed for the volume shoe trade (Shoemaster from Clarks Shoes) could be used for the upper design of orthopaedic shoes and to assess the contribution of professional shoe design on cosmesis and acceptability of these shoes. A small number of adult diabetic patients and children with foot deformities were selected, all of who had previously been prescribed and issued with special shoes. The existing lasts for these patients were digitised, and new styles developed on the CAD system over a 3D image of the last. Pattern pieces were cut automatically and the uppers closed. Lasting was done as normal at the two collaborating orthopaedic companies and the shoes supplied to the patients. The CAD system proved successful in coping with orthopaedic last shapes and shoe requirements. Professional design produced fashionable and cosmetically-pleasing styles within the constraints imposed by the underlying medical conditions.

Adolescent↗
PubMed2004

Verification of the computational dosimetry system in JAERI (JCDS) for boron neutron capture therapy.

Clinical trials for boron neutron capture therapy (BNCT) by using the medical irradiation facility installed in Japan Research Reactor No. 4 (JRR-4) at Japan Atomic Energy Research Institute (JAERI) have been performed since 1999. To carry out the BNCT procedure based on proper treatment planning and its precise implementation, the JAERI computational dosimetry system (JCDS) which is applicable to dose planning has been developed in JAERI. The aim of this study was to verify the performance of JCDS. The experimental data with a cylindrical water phantom were compared with the calculation results using JCDS. Data of measurements obtained from IOBNCT cases at JRR-4 were also compared with retrospective evaluation data with JCDS. In comparison with phantom experiments, the calculations and the measurements for thermal neutron flux and gamma-ray dose were in a good agreement, except at the surface of the phantom. Against the measurements of clinical cases, the discrepancy of JCDS's calculations was approximately 10%. These basic and clinical verifications demonstrated that JCDS has enough performance for the BNCT dosimetry. Further investigations are recommended for precise dose distribution and faster calculation environment.

Algorithms↗
PubMed2005

Quantitative cartilage volume measurement using MRI: comparison of different evaluation techniques.

This study was aimed to investigate the accuracy and time saving of MRI Argus application in the assessment of cartilage volume in osteoarthritic knees. Twelve knees of patients suffering from osteoarthritis were scanned with a 1.5 T MRI using a 3D gradient echo sequence with selective water excitation. Cartilage volume of the tibial and patellar compartment was determined with a validated multiprocessing computer system (Octane Duo, Silicon Graphics, Mountain View, Calif., USA). The calculated cartilage volumes were compared to the results acquired by the Argus (Siemens Inc., Erlangen, Germany) application software using the MRI data sets. Compared to the multiprocessing computer system a time saving of at least 30 min for cartilage volume determination was achieved. The mean differences of Argus versus the multiprocessing computer system were 4.26+/-0.84 and 7.80+/-0.87% for the medial and lateral tibial plateau and 5.94+/-0.59% for the patella (no statistical significant difference; P>0.05). The applied Argus software can be used for fast and accurate determination of cartilage volume in the knee joint.

Aged↗
PubMedDate not supplied

A review of major nursing vocabularies and the extent to which they have the characteristics required for implementation in computer-based systems.

Building on the work of previous authors, the Computer-based Patient Record Institute (CPRI) Work Group on Codes and Structures has described features of a classification scheme for implementation within a computer-based patient record. The authors of the current study reviewed the evaluation literature related to six major nursing vocabularies (the North American Nursing Diagnosis Association Taxonomy 1, the Nursing Interventions Classification, the Nursing Outcomes Classification, the Home Health Care Classification, the Omaha System, and the International Classification for Nursing Practice) to determine the extent to which the vocabularies include the CPRI features. None of the vocabularies met all criteria. The Omaha System, Home Health Care Classification, and International Classification for Nursing Practice each included five features. Criteria not fully met by any systems were clear and non-redundant representation of concepts, administrative cross-references, syntax and grammar, synonyms, uncertainty, context-free identifiers, and language independence.

Evaluation Studies as Topic↗
PubMed2006

Nonlinear effects in the interaction of time-dependent fields and chiral systems: A computational investigation.

The nonlinear changes induced in the refractive index and in the optical rotatory dispersion when radiation interacts with a chiral system are studied computationally. The molecular parameters describing these effects are determined for methyloxirane, employing Hartree-Fock and density functional frequency dependent analytical response theory, the latter with the use of Becke three-parameter Lee-Yang-Parr functional. Their contribution to several circular and axial birefringences, which could be observed in pump-and-probe experiments for various combinations of polarization status and propagation direction of the two beams, is ascertained.

Journal Article↗
PubMedDate not supplied

Challenges and issues related to implementation of nursing vocabularies in computer-based systems.

As key stakeholders from the clinical setting and vendor communities, the authors share a summary of their collective experience related to the challenges and issues associated with implementing the vocabularies recognized by the American Nurses Association in several installations of commercially available clinical information systems. Although the focus of the article is on summarizing the challenges and issues, it is of note that the authors' experiences across care settings suggest that the experience and effort of using one of the ANA-recognized vocabularies in a computer-based system are essentially worthwhile and positive. The issues and challenges fall into two categories: 1) those related to the developmental status of nursing vocabularies, and 2) those related to the adoption or implementation of new technology.

American Nurses' Association↗
PubMed2005

Performance comparison of an active matrix flat panel imager, computed radiography system, and a screen-film system at four standard radiation qualities.

Four standard radiation qualities (from RQA 3 to RQA 9) were used to compare the imaging performance of a computed radiography (CR) system (general purpose and high resolution phosphor plates of a Kodak CR 9000 system), a selenium-based direct flat panel detector (Kodak Direct View DR 9000), and a conventional screen-film system (Kodak T-MAT L/RA film with a 3M Trimax Regular screen of speed 400) in conventional radiography. Reference exposure levels were chosen according to the manufacturer's recommendations to be representative of clinical practice (exposure index of 1700 for digital systems and a film optical density of 1.4). With the exception of the RQA 3 beam quality, the exposure levels needed to produce a mean digital signal of 1700 were higher than those needed to obtain a mean film optical density of 1.4. In spite of intense developments in the field of digital detectors, screen-film systems are still very efficient detectors for most of the beam qualities used in radiology. An important outcome of this study is the behavior of the detective quantum efficiency of the digital radiography (DR) system as a function of beam energy. The practice of users to increase beam energy when switching from a screen-film system to a CR system, in order to improve the compromise between patient dose and image quality, might not be appropriate when switching from screen-film to selenium-based DR systems.

Radiographic Image Enhancement↗
PubMed1995

Integrating a health IC card system into a hospital information system.

As an experiment, a health IC card has been linked into the hospital information system of the National Cheng Kung University (NCKU) Hospital. The NCKU Hospital Information System (NCKU-HIS) services all the procedures for patient registration, billing, prescriptions, and the processing and storing of test results. The health IC card system provides good quality information to the doctors, the hospital, the patients, and the insurance organizations. For a fully comprehensive system, it is essential to integrate the health IC card system into the operational NCKU-HIS, the communication protocols, and the national insurance procedures. The experiment was designed to see if the development of such a system was feasible, and the results have been impressive. It has proved possible to operate the health IC card system, linking into different machines under different computing environments. A single computer system to store all the data of all the patients and to process all the nation's healthcare information would require almost unlimited mainframe processing power and unlimited storage. It would be very difficult to construct such a large computerized information system. All the hospitals would be required to use the same data format to process their information, and a large national healthcare network would have to be built, making the collection and storage of personal medical information very difficult and probably inefficient and unsatisfactory. Even if it was possible, it would be a very costly and time-consuming task. An IC card is cheap and easy to use, and offers an alternative solution to the problem of handling the nation's healthcare information. The original healthcare IC card experiment (started in 1990) was limited to the NCKU Hospital and the Taiwan Government Employees' Clinic. The experimental system was designed to be fully integrated into the NCKU-HIS and has been widely accepted by the users, especially the IC card-holding patients. It is also well-suited to the management of healthcare insurance. An expanded healthcare IC card system was implemented from the end of 1993 and covers six clinics and six hospitals in Penghu County. The operation of the registration and billing subsystems are supported by PC workstations in a client/server network as these subsystems are used very frequently. Some of the other computerized functions in the NCKU-HIS are supported by the mainframe TANDEM computer system. The interfaces with the communication protocols and application software provide for the effective two-way transfer of data and programs. For future use, consideration is being given to the employment of the Health Level Seven (HL/7) protocol for electronic data interchange. National standards such as Chinese information processing, the use of standard codes, the authorization of the content of the IC card, and communication protocols are already incorporated in the system.

Hospital Information Systems↗