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PubMed2004

Computer keyboard and mouse as a reservoir of pathogens in an intensive care unit.

OBJECTIVE: User interfaces of patient data management systems (PDMS) in intensive care units (ICU), like computer keyboard and mouse, may serve as reservoirs for the transmission of microorganisms. Pathogens may be transferred via the hands of personnel to the patient causing nosocomial infections. The purpose of this study was to examine the microbial contamination of computer user interfaces with potentially pathogenic microorganisms, compared with other fomites in a surgical intensive care unit of a tertiary teaching hospital. METHODS: Sterile swab samples were received from patient's bedside computer keyboard and mouse, and three other sites (infusion pumps, ventilator, ward round trolley) in the patient's room in a 14 bed surgical intensive care unit at a university hospital. At the central ward samples from keyboard and mouse of the physician's workstation, and control buttons of the ward's intercom and telephone receiver were obtained. Quantitative and qualitative bacteriological sampling occurred during two periods of three months each on eight nonconsecutive days. RESULTS: In all 14 patients' rooms we collected a total of 1118 samples: 222 samples from keyboards and mice, 214 from infusion pumps and 174 from the ward's trolley. From the central ward 16 samples per formites were obtained (computer keyboard and mouse at the physician's workstation and the ward's intercom and telephone receiver). Microbacterial analysis from samples in patients' rooms yielded 26 contaminated samples from keyboard and mouse (5.9%) compared with 18 positive results from other fomites within patients' rooms (3.0%; p < 0.02). At the physician's computer terminal two samples obtained from the mouse (6.3%) showed positive microbial testing whereas the ward's intercom and telephone receiver were not contaminated (p = 0.15). CONCLUSIONS: The colonization rate for computer keyboard and mouse of a PDMS with potentially pathogenic microorganisms is greater than that of other user interfaces in a surgical ICU. These fomites may be additional reservoirs for the transmision of microorganisms and become vectors for cross-transmission of nosocomial infections in the ICU setting.

Bacteria↗
PubMed2001

Programmable and autonomous computing machine made of biomolecules.

Devices that convert information from one form into another according to a definite procedure are known as automata. One such hypothetical device is the universal Turing machine, which stimulated work leading to the development of modern computers. The Turing machine and its special cases, including finite automata, operate by scanning a data tape, whose striking analogy to information-encoding biopolymers inspired several designs for molecular DNA computers. Laboratory-scale computing using DNA and human-assisted protocols has been demonstrated, but the realization of computing devices operating autonomously on the molecular scale remains rare. Here we describe a programmable finite automaton comprising DNA and DNA-manipulating enzymes that solves computational problems autonomously. The automaton's hardware consists of a restriction nuclease and ligase, the software and input are encoded by double-stranded DNA, and programming amounts to choosing appropriate software molecules. Upon mixing solutions containing these components, the automaton processes the input molecule via a cascade of restriction, hybridization and ligation cycles, producing a detectable output molecule that encodes the automaton's final state, and thus the computational result. In our implementation 1012 automata sharing the same software run independently and in parallel on inputs (which could, in principle, be distinct) in 120 microl solution at room temperature at a combined rate of 109 transitions per second with a transition fidelity greater than 99.8%, consuming less than 10-10 W.

Adenosine Triphosphate↗
PubMed1989

[Recording and analysis of the electrooculography using a personal computer. Initial experiences with normal probands and patients with diseases of the posterior eye segment and intraocular foreign bodies].

The electro-oculogram (EOG) is recorded by a personal computer and analyzed during the examination. If the results obtained with this method in normal subjects are compared with the conventional method (with which data recorded in analog form have to be measured manually), there is no significant difference. In patients with diseases of the posterior segment (e.g., posterior uveitis) or intraocular foreign bodies the results of computer and manual analysis are also practically identical. There are two computer analysis techniques: for subjects with almost normal EOGs the trigger-independent method is sufficiently accurate. In patients with pathologic EOGs, however, and in particular those with small potential differences, the trigger-related method is more likely to lead to correct results. The analysis path can be displayed on the computer monitor at any time, so that the examiner can always check whether it is correct. In contrast to manual analysis, the computer analysis cannot be influenced subjectively by the examiner. This considerably improves the comparability of examination results. A further advantage of computer analysis is its speed: the result is available immediately following the examination. It is a low-cost system which is easy to install and use, and thus suitable for routine clinical work.

Chorioretinitis↗
PubMed2002

Tele-3-dimensional computer-assisted functional endoscopic sinus surgery: new dimension in the surgery of the nose and paranasal sinuses.

One of the main objectives of our 3-dimensional (3D) computer-assisted functional endoscopic sinus surgery was to design a computer-assisted 3D approach to the presurgical planning, intraoperative guidance, and postoperative analysis of the anatomic regions of the nose and paranasal sinuses. Such an extremely powerful approach should allow better insight into the operating field, thereby significantly increasing the safety of the procedure. The last step to implementing the technology in the operating room was to connect the computer workstations and video equipment to remote locations by using a high-speed, wide-bandwidth computer network. During patient preparation, the surgeon in the operating room consulted remote experienced and skillful surgeons by viewing CT images and 3D models on computer workstations. The surgeon and consultants used software for CT image previews and 3D model manipulations on top of collaboration tools to define the pathosis, produce an optimal path to the pathosis, and decide how to perform the real surgical procedure. With tele-flythrough or tele-virtual endoscopy rendered through the use of 3D models, both surgeons can preview all the characteristics of the region (ie, anatomy, pathosis) and so predict and determine the next steps of the operation. This ensures greater safety thanks to the operation guidance and reduces the possibility of intraoperative error. The duration of the teleconsultation is thus shortened, which may prove the greatest benefit of tele-3D computer-assisted surgery. If this method were used, clinical institutions would spend less money for telesurgical consultation.

Adult↗
PubMed2000

Text entry on handheld computers by older users.

Small pocket computers offer great potential in workplaces where mobility is needed to collect data or access reference information while carrying out tasks such as maintenance or customer support. This paper reports on three studies examining the hypothesis that data entry by older workers is easier when the pocket computer has a physical keyboard, albeit a small one, rather than a touch-screen keyboard. Using a counter-balanced, within-subjects design the accuracy and speed with which adults over 55 years of age could make or modify short text entries was measured for both kinds of pocket computer. The keyboard computer was the Hewlett Packard 360LX (HP), but the touch-screen computers varied across studies (experiment 1: Apple Newton and PalmPilot; experiment 2: Philips Nino; experiment 3: Casio E10). All studies showed significant decrements in accuracy and speed when entering text via the touch-screen. Across studies, most participants preferred using the HP's small physical keyboard. Even after additional practice with the touch screen (experiments 2 and 3) many entries still contained errors. Experiment 3 showed that younger people were faster but not more accurate than older people at using the touch-screen keyboard. It is concluded that satisfactory text entry on palm-size computers awaits improvements to the touch-screen keyboard or alternative input methods such as handwriting or voice. Interface developments that assist older people typically benefit younger users too.

Aged↗
PubMed2002

Prospective randomised trial of computer-aided diagnosis and contrast radiography in acute small bowel obstruction.

OBJECTIVE: to compare the ability of computer-aided diagnosis and contrast radiography for the diagnosis of acute mechanical small bowel obstruction. DESIGN: Prospective randomised trial. SETTING: Kaunas University of Medicine, Lithuania. SUBJECTS: 80 patients with small bowel obstruction with no clinical evidence of strangulation who were randomised into two groups (n = 40 in each) to be investigated by computer-aided diagnosis and contrast radiography. INTENVENTIONS: 37 patients required operation (46%). MAIN OUTCOME MEASURES: specificity, sensitivity, false positive and negative predictive values of the 2 methods; time necessary to make the diagnosis; and morbidity and mortality. RESULTS: The specificity, sensitivity, positive and negative predictive values in the diagnosis of complete acute small bowel obstruction for the computer-aided group were 100%, 87.5%, 100% and 92.3%, and for the contrast radiography group 100%, 76.9%, 100% and 90%, respectively. The mean time period for making the diagnosis was 1 hour in the computer-aided group and 16 hours in the radiography group (p < 0.001). The overall mortality was 3% and morbidity 9%. CONCLUSION: Computer-aided diagnosis had no significant advantage over contrast radiography in the accuracy of diagnosis of the character of small bowel obstruction. However, significantly less time was needed to make the diagnosis in the computer-aided group.

Adolescent↗
PubMed2005

Is a computer questionnaire of childhood asthma acceptable in general practice?

OBJECTIVES: To determine whether a previously-validated touch screen computer program of symptoms and management of childhood asthma is acceptable to parents who accompany their children to consult a GP, and to examine whether any parent characteristics are associated with acceptability. METHODS: Conducted in general practice in Newcastle, NSW, Australia. A cross sectional pen and paper survey was given to parents of children consulting a GP after completing the computer questionnaire on childhood asthma in the waiting room. Measurements were frequencies of Likert scale responses to statements concerning the computer questionnaire, compared with demographic and personal characteristics. RESULTS: High levels of acceptability of the asthma computer questionnaire were reported by the 198 respondents, with most being willing to do the same program once or twice a year (87%), or to do similar programs on other topics (91%). Most respondents (81%) agreed that the computer program was enjoyable, and very few (8%) would have preferred to answer the asthma questions by pen and paper rather than by computer. Two or more children accompanying the parent was the characteristic most associated with less positive responses. CONCLUSIONS: Overall the high acceptability of this questionnaire suggests that this computerised format is an appropriate method of screening children for asthma and determining their current management. As a large component of underdiagnosis of asthma is lack of reporting to the doctor, this valid and acceptable diagnostic aid has the potential to improve detection of unreported asthma, and also to identify high-risk individuals.

Adolescent↗
PubMed2006

PROFEAT: a web server for computing structural and physicochemical features of proteins and peptides from amino acid sequence.

Sequence-derived structural and physicochemical features have frequently been used in the development of statistical learning models for predicting proteins and peptides of different structural, functional and interaction profiles. PROFEAT (Protein Features) is a web server for computing commonly-used structural and physicochemical features of proteins and peptides from amino acid sequence. It computes six feature groups composed of ten features that include 51 descriptors and 1447 descriptor values. The computed features include amino acid composition, dipeptide composition, normalized Moreau-Broto autocorrelation, Moran autocorrelation, Geary autocorrelation, sequence-order-coupling number, quasi-sequence-order descriptors and the composition, transition and distribution of various structural and physicochemical properties. In addition, it can also compute previous autocorrelations descriptors based on user-defined properties. Our computational algorithms were extensively tested and the computed protein features have been used in a number of published works for predicting proteins of functional classes, protein-protein interactions and MHC-binding peptides. PROFEAT is accessible at http://jing.cz3.nus.edu.sg/cgi-bin/prof/prof.cgi.

Algorithms↗
PubMedDate not supplied

Abdominal computed radiography: evaluation of low-constrast lesions.

Computed radiography has proved useful as a localization device for computed tomography. In an attempt to evaluate computed radiography as a primary diagnostic device, 16 patients were evaluated with various degrees of gallbladder opacification following standard oral cholecystograms, and 15 patients were evaluated with renal masses, identified on standard excretory urography. Subjective evaluation of computed radiographs as compared to the standard radiographs demonstrated no diagnostic advantage to computed radiography. The poor spatial resolution of the computed radiographs was not overcome by the improvement in contrast resolution.

Cholecystography↗
PubMed2003

The role of soft computing in intelligent machines.

An intelligent machine relies on computational intelligence in generating its intelligent behaviour. This requires a knowledge system in which representation and processing of knowledge are central functions. Approximation is a 'soft' concept, and the capability to approximate for the purposes of comparison, pattern recognition, reasoning, and decision making is a manifestation of intelligence. This paper examines the use of soft computing in intelligent machines. Soft computing is an important branch of computational intelligence, where fuzzy logic, probability theory, neural networks, and genetic algorithms are synergistically used to mimic the reasoning and decision making of a human. This paper explores several important characteristics and capabilities of machines that exhibit intelligent behaviour. Approaches that are useful in the development of an intelligent machine are introduced. The paper presents a general structure for an intelligent machine, giving particular emphasis to its primary components, such as sensors, actuators, controllers, and the communication backbone, and their interaction. The role of soft computing within the overall system is discussed. Common techniques and approaches that will be useful in the development of an intelligent machine are introduced, and the main steps in the development of an intelligent machine for practical use are given. An industrial machine, which employs the concepts of soft computing in its operation, is presented, and one aspect of intelligent tuning, which is incorporated into the machine, is illustrated.

Algorithms↗
PubMed2005

Scientific Grid computing.

We introduce a definition of Grid computing which is adhered to throughout this Theme Issue. We compare the evolution of the World Wide Web with current aspirations for Grid computing and indicate areas that need further research and development before a generally usable Grid infrastructure becomes available. We discuss work that has been done in order to make scientific Grid computing a viable proposition, including the building of Grids, middleware developments, computational steering and visualization. We review science that has been enabled by contemporary computational Grids, and associated progress made through the widening availability of high performance computing.

Computer Simulation↗
PubMed2005

The challenge of computer mathematics.

Progress in the foundations of mathematics has made it possible to formulate all thinkable mathematical concepts, algorithms and proofs in one language and in an impeccable way. This is not in spite of, but partially based on the famous results of Gödel and Turing. In this way statements are about mathematical objects and algorithms, proofs show the correctness of statements and computations, and computations are dealing with objects and proofs. Interactive computer systems for a full integration of defining, computing and proving are based on this. The human defines concepts, constructs algorithms and provides proofs, while the machine checks that the definitions are well formed and the proofs and computations are correct. Results formalized so far demonstrate the feasibility of this 'computer mathematics'. Also there are very good applications. The challenge is to make the systems more mathematician-friendly, by building libraries and tools. The eventual goal is to help humans to learn, develop, communicate, referee and apply mathematics.

Algorithms↗
PubMed1999

A computational model for tracking subsurface tissue deformation during stereotactic neurosurgery.

Recent advances in the field of stereotactic neurosurgery have made it possible to coregister preoperative computed tomography (CT) and magnetic resonance (MR) images with instrument locations in the operating field. However, accounting for intraoperative movement of brain tissue remains a challenging problem. While intraoperative CT and MR scanners record concurrent tissue motion, there is motivation to develop methodologies which would be significantly lower in cost and more widely available. The approach we present is a computational model of brain tissue deformation that could be used in conjunction with a limited amount of concurrently obtained operative data to estimate subsurface tissue motion. Specifically, we report on the initial development of a finite element model of brain tissue adapted from consolidation theory. Validations of the computational mathematics in two and three dimensions are shown with errors of 1%-2% for the discretizations used. Experience with the computational strategy for estimating surgically induced brain tissue motion in vivo is also presented. While the predicted tissue displacements differ from measured values by about 15%, they suggest that exploiting a physics-based computational framework for updating preoperative imaging databases during the course of surgery has considerable merit. However, additional model and computational developments are needed before this approach can become a clinical reality.

Animals↗
PubMed1998

Computers in medical education 3: A possible tool for the assessment of clinical competence?

BACKGROUND: Computers and other forms of information technology are increasingly used in medical education. We undertook a study to evaluate the place of the computer in the assessment of clinical skills of junior medical students. METHODS: The history taking and physical examination skills of 136 third-year students were assessed in a series of structured and observed clinical stations and compared to their performance in similar computer-based problems. RESULTS: Students scored equally on the computer-based tasks and in the observed stations, but the weaker students who failed one or another component of the examination were more likely to pass at a clinical station and fail the computer task. CONCLUSIONS: This study has shown that computer-based clinical simulations can be constructed to supplement conventional assessment processes in clinical medicine and may have a role in increasing their reliability.

Clinical Competence↗
PubMed2004

Transitions: noninvasive coronary angiography using electron beam computed tomography: technique, clinical application, future prospective.

Electron beam computed tomography has been available clinically for 20 years. It is the only computed tomography scanner specifically developed for cardiac imaging. Over the past decade, with improvements in methodology and computer software, electron beam computed tomography has been shown to provide an excellent method to perform noninvasive coronary angiography. This article looks at the historical aspects of electron beam computed tomography and comments on how to perform and interpret electron beam angiography studies. The expanding development of noninvasive coronary and peripheral angiography methods using computed tomography will have a significant influence on cardiovascular specialists and their practices.

Coronary Angiography↗
PubMed2005

German dental faculty attitudes towards computer-assisted learning and their correlation with personal and professional profiles.

BACKGROUND: Compared with its potential, computer technology use is still lacking in medical/dental education. OBJECTIVES: To investigate the primary advantages of computer-assisted learning (CAL) systems in German dental education, as well as the reasons for their relatively low degree of use correlated with personal and professional profiles of respondents. METHOD: A questionnaire was mailed to heads in the departments of conservative dentistry and prosthetic dentistry in all dental schools in Germany. Besides investigating the advantages and barriers to the use of computer technology, the questionnaire also contained questions regarding each respondent's gender, age, academic rank, experience in academia and computer skills. RESULTS: The response rate to the questionnaire was 90% (112 of 125). The results indicated a distinct discrepancy between the desire for and actual occurrence of lectures, seminars, etc. to instruct students in ways to search for and acquire knowledge, especially using computer technology. The highest-ranked advantages of CAL systems in order, as seen by respondents, were the possibilities for individual learning, increased motivation, and both objective theoretical tests and practical tests. The highest-ranked reasons for the low degree of usage of CAL systems in order were the inability to finance, followed equally by a lack of studies of CAL and poor cost-advantage ratio, and too much effort required to integrate CAL into the curriculum. Moreover, the higher the computer skills of the respondents, the more they noted insufficient quality of CAL systems (r = 0.200, P = 0.035) and content differences from their own dental faculty's expert opinions (r = 0.228, P = 0.016) as reasons for low use. CONCLUSION: The correlations of the attitudes towards CAL with the personal and professional profiles showed not only statistical significant reinforcements of, but also interesting deviations from, the average responses.

Adult↗
PubMed2000

Computer imaging versus conventional esthetic consultation: a prospective clinical study.

Computer imaging can be helpful in demonstrating to patients the potential outcome of esthetic dental procedures. The current clinical study assesses the effectiveness of computer imaging by comparing the reactions of patient and dentist to conventional consultations versus the use of computer imaging. The responses from 35 subjects show that computer imaging consultations are more effective in helping patients decide to accept treatment. Patient satisfaction was higher (93.75%) with computer consultations than with conventional methods (83.3%). Computer imaging consultations were easier to conduct but significantly (p < .05) more time consuming.

Adult↗
PubMedDate not supplied

Characterizing the use of health care services delivered via computer networks.

OBJECTIVE: Evaluators must develop methods to characterize the use of the rapidly proliferating electronic networks that link patients with health services. In this article the 4-S framework is proposed for characterizing the use of health services delivered via computer networks. The utility of the 4-S framework is illustrated using data derived from a completed, randomized field experiment in which 47 caregivers of persons who had Alzheimer's disease accessed ComputerLink, a special computer network providing information, communication, and decision support to homebound caregivers of persons who have Alzheimer's disease. DESIGN: Human-computer interaction theories characterize the use of health services delivered via computer networks in behavioral terms. The 4-S framework incorporates perspectives based on user (subject) behavior: access to and use of the total system, use of specific services, behavior within single sessions, and enduring behavioral characteristics. The 4-S framework was tested in a secondary analysis of data from over 3,800 uses of ComputerLink. MEASUREMENT: The 4-S framework was instantiated using data obtained from the ComputerLink evaluation. Three types of secondary data were obtained. A passive monitor of access to the computer network provided quantitative information, such as time of day when access occurred, duration of access, and sequence of services used. Full-text messages were available from the public message postings. Subjective appraisal of use was obtained from self-reporting by users at the end of the experiment. RESULTS: The components of the 4-S framework were suitable to characterize operational aspects of ComputerLink use by Alzheimer's disease caregivers. Through application of the 4-S framework, an understanding of both quantitative use and qualitative use emerged (e.g., insight was gained into the differential use of specific services). CONCLUSIONS: The 4-S framework provided a mechanism for combining various measures of use into a coherent whole. The framework promotes a precise characterization of use and thereby facilitates evaluation of health services delivered via computer networks. It is suitable for evaluation of user satisfaction, measurement of needs resolution, and ascertainment of selected clinical outcomes.

Alzheimer Disease↗