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Metaphor graphics to support integrated decision making with respiratory data.

Support for data integration in the intensive care unit (ICU) often includes efforts to improve the display of data. An electronic version of a flowsheet (table of numbers) with optimal line graphs is by far the most common format in current ICU computer workstation technology, yet there is little evidence that this format provides particularly good support for human integration of data. The present work introduces a new form of graphic representation, one that is far more metaphoric, far more tailored to the intensive care unit than a line graph. This graphic system, called volume rectangles represents mechanical ventilator data in such a way that is easy to keep different types of variables conceptually separated, yet easy to see how they relate in a truly integrated way. Volume rectangles are one example of a general approach to display of data called the metaphor graphic approach, which is being evaluated in this and other contexts. Metaphor graphics are custom tailored visual displays designed to look like the real world situation from which the data is collected but not in a literal sense of 'look like'. Anecdotal observation suggests that such graphics are easy to learn, are remembered over long period, and are good decision support tools when the task is finding patterns in a mass of data.

Artificial Intelligence↗

Accommodative response changes with age measured by pattern electroretinogram.

To evaluate whether the transient pattern electroretinogram reflects accommodation, we studied the amplitudes of the P-N component of transient pattern electroretinograms that were elicited in normal volunteers by reversing the checkerboard pattern. The stimuli were presented at a rate of three-reversals per second at a viewing distance of 20 cm. Each subject wore a lens that corrected for distance vision. The ophthalmic lenses were placed in front of the eye. A +12-diopter lens was used first, followed by lenses in decreasing 1-diopter steps, including minus lenses, until no response was recordable. The P-N amplitude was then plotted against increased accommodative stimulus. The graph showed a rapid increase to around 4 diopters, and then a slow decrease with increasing minus lens power. The gradually decreasing part of the graph became steeper under cycloplegic conditions. The amplitude of accommodative response was defined as the difference in diopters between the lens powers for eliciting an electroretinogram amplitude after cycloplegia was achieved and in the untreated pupil. The amplitude of accommodative response attenuated significantly in those subjects older than 40 years.

Accommodation, Ocular↗

Computer-assisted multidimensional atlas for functional stereotaxy.

Functional stereotactic operations are currently performed primarily for medically uncontrollable Parkinson's disease and pain. In contrast to the targets in neuro-oncology, those in functional stereotaxy cannot be represented directly by modern imaging methods. The target co-ordinates must therefore be calculated with the aid of special stereotactic atlases. These are publications in which a model brain has been constructed from autopsy examinations on a number of brains, or the data obtained have been compiled in the form of tables and histograms on which the calculation is then based. The target can then be determined based on the classic stereotactic landmarks and reference lines, such as the anterior commissure (AC), the foramen of Monro (FM), the posterior commissure (PC) or the base line FM-PC or AC-PC and the height of thalamus, taking into account the interindividually different anatomical proportions. Since the computational procedures involve repetitious algorithms, it was obvious that such procedures should be run by a computer program. For the most common stereotactic targets, we have developed a computer program for data storage on the one hand and computation and graphic output on the other. The output can be displayed on the monitor and can also be plotted out on paper or overhead transparency. Calibrating between the program and printer renders a 1:1 reproduction, i.e. the graph can be superimposed directly onto original x-rays or images from computed tomography or nuclear magnetic imaging. The graph can be plotted in the three dimensions of the Cartesian co-ordinate system. An additional dimension can be attained by simultaneously including and plotting the data from different atlases and thus from different authors, including one's own data. In addition to the information capacity which this system offers, it also makes possible a considerable reduction in the time for computing the target while at the same time increasing the reliability.

Algorithms↗

Noninvasive continuous blood pressure measurement: a clinical evaluation of the Cortronic APM 770.

The Cortronic APM 770 (Cortronic, Ronkonkoma, NY) is a commercial device that claims to measure blood pressure noninvasively and continuously with the use of a standard blood pressure cuff. The aim of our study was to assess the performance of the continuous-mode blood pressure readings of the Cortronic during anesthesia and surgery. We recorded blood pressure in 5 patients bilaterally. An interaarterial pressure (IAP) curve was recorded from 1 arm and the Cortronic pressure curve (CPC) was recorded from the other. For statistical analysis the period between 2 Cortronic recalibrations was defined as the intercalibration interval. The duration of these intervals ranged from 20 to 0.5 minutes. Four paired samples were drawn from each interval. The first sample in an interval represented the recalibration blood pressure; the other samples represented the continuous blood pressure. A total of 1,232 samples were taken, of which 308 were recalibration. The median of the differences and the 2.5th and 97.5th percentile limits of agreement were determined. Their respective values for diastolic and systolic recalibration measurements were 5, -17, and 34 mm Hg, and 6, -12, and 38 mm Hg. Their values for continuous measurements were 4, -23.5, and 32 mm Hg, and 6, -30, and 70 mm Hg. Changes in CPC were evaluated against changes in the corresponding IAP by plotting them in 4-quadrant graphs. In these graphs the Spearman rank correlations were between r = -0.17 and r = 0.01. We observed opposite CPC and IAP trends on 24 occasions during this study. We performed a simple simulation study to better understand the measurement method of the Cortronic.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

A birth weight for gestational age standard based on data in the Swedish Medical Birth Registry, 1985-1989.

Birth weight curves according to gestational length are presented based on data from more than 480,000 singleton births, registered in the Medical Birth Registry and with gestational age based on ultrasound examinations in the majority of cases. Curves were constructed from the most common weights in each week (modes) for each sex and standard deviations were estimated under the assumption of a fixed coefficient of variation, the size of which was estimated from 40 weeks infants. This methodology makes it possible to construct graphs for specific subgroups of infants: such graphs for boys and girls for primiparous and multiparous women are given in the paper.

Birth Weight↗

Model-based technique for the measurement of skin thickness in mammography.

A model-based method is proposed for the measurement of breast skin thickness from digitised mammograms that takes into account both the geometric and radiographic properties of the skin region. The method initially identifies a salient feature that discriminates the skin from the other anatomical structures of the breast. Its identification is based on a multi-scale grey-level gradient estimation, using a wavelet decomposition of the image. The spatial distribution of this feature is organised as a graph, with each of its nodes associated with a binary set of interpretation labels. A Markov random field is defined on the set of labels, and the best graph labelling is finally determined with a maximum a posteriori (MAP) probability criterion. The method was applied on 11 mammograms with improved contrast characteristics at the breast periphery, obtained by an exposure equalisation technique during image acquisition. The validation of the approach was performed by calculating the root mean square (RMS) error between the detected skin thickness and manual measurements performed on each of the films. The resulting error values ranged from 0.1 mm to 0.2 mm for normal cases and reached a maximum of 0.5mm in pathological cases with advanced skin thickening.

Breast Neoplasms↗

Assessment of peripheral blood flow using a pulse oximeter.

We investigated the bar graph on a pulse oximeter as an indicator of peripheral blood flow. Because blood flow is known to increase in the lower extremities during spinal analgesia, we chose patients receiving spinal analgesia as the experimental model. Although they are indirect indicators, we used laser Doppler readings and skin temperature to reflect peripheral blood flow. These measurements were made from each patient's foot and hand before and after spinal analgesia and were compared with the deflection on the pulse oximeter bar graph. After subarachnoid injection of bupivacaine, laser Doppler readings from the foot increased to 620 +/- 120% (P less than 0.05) of the control reading. The pulse oximeter signal amplitude increased from 5.2 +/- 0.4 to 9.4 +/- 0.3 bars (P less than 0.05) and mean skin temperature increased from 24.6 +/- 0.5 to 31.2 +/- 0.8 degrees C (P less than 0.05). No changes were noted in readings obtained from the hand. A Nellcor N-200 pulse oximeter may be used to evaluate the effect of sympathetic nerve block as indicated by an increase in peripheral blood flow.

Adult↗

Model TJ-IV computer-assisted vectorcardiogram analysis system.

During last 16 years we have successfully developed the computer-assisted vectorcardiogram analysis systems: model TJ-I, TJ-II, and TJ-III, but some technical problems remained unresolved, such as the recognition accuracy for vectorcardiograms, measurement of the parameters of complicated QRS waves, the ratio of T loop length to width, and the area of spatial vectors etc. A new system, model TJ-IV was designed to resolve these technical problems. The system was equipped with a 586 computer with a CPU of 120 MHz. Special new low-noise amplifier was employed and C language was used for programming. Three graph recognition techniques were used to enhance the accuracy of VCG recognition. 32 orthogonal electrocardiograms and vectorcardiograms were displayed and printed, and 566 parameters of vectorcardiograms were calculated. Our results with 150 cases showed that the system had high accuracy of graph recognition, and parameter calculation and the results were essentially consistent with those of manipulative methods. We were led to concluded when compared with TJ-III system, the new version has higher accuracy of processing and measurement for vectorcardiograms, is able to process more vectorcardiographic parameters, with higher processing speed.

Adult↗

An analysis of laryngoscope blade shape and design: new criteria for laryngoscope evaluation.

Laryngoscope blade design has tended to be relatively arbitrary and so far scientific analysis has not allowed useful comparisons between blade shapes. A new theoretical method of analysing laryngoscope blades is introduced and uses the depth of insertion profiles of two angular measurements. One represents eyeline displacement and the other the forward space that the blade occupies at the level of the mandible. Photographs of straight and curved blades were studied on Cartesian graphs with the tip T, at the origin and handle fittings parallel to the x-axis of the graph. Then, IT is any line from the origin to the incisor surface and represents a point of contact with the upper incisors for a given depth of blade insertion. Angle EIT (eyeline displacement) is to a tangent from I along the lower lingual surface of the blade. Point M is on the upper lingual surface of the blade, at right angles to IT, 1/3 of the distance from I along IT. Angle MIT (forward space) may be positive or negative depending on whether M is in front of or behind IT. The angles EIT, MIT and their additive combination are used in blade analysis. Negative MIT compensates for eyeline displacement as Macintosh size 3 and 4 blades have better combination scores than Miller size 3. All three are superior to the straight Soper size 3 blade. The Macintosh size 1 and 2 blades are quite different from the larger Macintosh blades. This theoretical basis for blade analysis is consistent with commonly expressed clinical opinions and may influence blade design in the future.

Equipment Design↗

Syntactic analysis and languages of shape feature description in computer-aided diagnosis and recognition of cancerous and inflammatory lesions of organs in selected x-ray images.

We present new algorithms for the recognition of morphologic changes and shape feature analysis, which have been proposed to be used in a diagnosis of pathologic symptoms characteristic of cancerous and inflammatory lesions. These methods have been used so far for early detection and diagnosis of neoplastic changes in pancreas and chronic pancreatitis based on x-ray images acquired by endoscopic retrograde cholangiopancreatography (ERCP). Preliminary processing of x-ray images involves binarization, and, subsequently, pancreatic ducts shown in the pictures are subjected to the straightening transformation, which enables obtaining two-dimensional width graphs that show contours of objects with their morphologic changes. Recognition of such changes was performed using attributed context-free grammars. Correct description and diagnosis of some symptoms (e.g., large cavitary projections) required two-dimensional analysis of width graphs. In such cases, languages of shape feature description with special multidirectional sinquad distribution were additionally applied.

Algorithms↗

The evolution of domain arrangements in proteins and interaction networks.

Proteins are composed of domains, which are conserved evolutionary units that often also correspond to functional units and can frequently be detected with reasonable reliability using computational methods. Most proteins consist of two or more domains, giving rise to a variety of combinations of domains. Another level of complexity arises because proteins themselves can form complexes with small molecules, nucleic acids and other proteins. The networks of both domain combinations and protein interactions can be conceptualised as graphs, and these graphs can be analysed conveniently by computational methods. In this review we summarise facts and hypotheses about the evolution of domains in multi-domain proteins and protein complexes, and the tools and data resources available to study them.

Amino Acid Sequence↗

Analytical potential of the reaction between p-phenylenediamines and peroxodisulfate for kinetic spectrophotometric determination of traces of ascorbic acid.

The analytical potential of the redox reactions between N, N-dimethyl- or N, N, N', N'-tetramethyl- p-phenylenediamine (DMPPD or TMPPD, respectively) and peroxodisulfate in acidic media for kinetic spectrophotometric determination of trace amounts of ascorbic acid (AA) has been investigated. The goal was to explore reaction conditions ensuring an excess or a deficit of S(2)O(8)(2-), and to identify some kinetic features of the global process for the purpose of calibration. Because the induction period of the overall reaction increases significantly in the presence of micromolar amounts of AA, the most suitable calibration graphs are generated by plots of induction period against the analyte concentration. The best sensitivity was achieved for oxidation of DMPPD with a deficit of S(2)O(8)(2-). The calibration line obtained has an RSD of 2.6% for 4 x 10(-6) mol L(-1) AA (n=3) and the detection limit is 4 x 10(-8) mol L(-1) (7 micro g L(-1)), a value comparable with the best mentioned by the literature. No systematic study of interferents was performed. Instead, the effect of buffer reagents (phosphate, phthalate, citrate) and dissolved oxygen on the results is discussed. Experiments were performed under closely controlled conditions. This is the first report of ascorbic acid analysis in which "contamination" by environmental oxygen was prevented by rinsing all vessels and saturating all solutions with argon, an approach which enables determination of the actual ascorbic acid content. Because of the effort involved, however, the method might not be suitable for routine analysis. Analysis of a commercially available vitamin C pellet gave good results when a "special" calibration graph, obtained in the presence of all other constituents of the sample except AA, was employed. The AA was "removed" from the pellet by oxidation with environmental air. Although it seems rather elaborate, this procedure did not require prior preparation of the sample nor extraction and/or concentration of ascorbic acid from it.

Journal Article↗

Voltammetric behaviour and determination of moxifloxacin in pharmaceutical products and human plasma.

The oxidative behaviour of moxifloxacin was studied at a glassy carbon electrode in different buffer systems using cyclic, differential pulse, and Osteryoung square-wave voltammetry. The oxidation process was shown to be irreversible over the entire pH range studied (2.0-10.0) and was diffusion-controlled. The methods were performed in Britton-Robinson buffer and the corresponding calibration graphs were constructed and statistical data were evaluated. When the proposed methods were applied at pH 6.0 linearity was achieved from 4.4 x 10(-7) to 1.0 x 10(-5) mol L(-1). Applicability to tablets and human plasma analysis was illustrated. Furthermore, a high-performance liquid chromatographic method with diode-array detection was developed. A calibration graph was established from 4.0 x 10(-6) to 5.0 x 10(-5) mol L(-1) moxifloxacin. The described methods were successfully employed with high precision and accuracy for estimation of the total drug content of human plasma and for pharmaceutical dosage forms of moxifloxacin.

Aza Compounds↗

Flow injection chemiluminescence determination of naftopidil based on potassium permanganate oxidation in the presence of formaldehyde or formic acid.

A flow injection method is proposed for the determination of naftopidil based upon the oxidation by potassium permanganate in a sulfuric acid medium and sensitized by formaldehyde and formic acid. The optimum chemical conditions for the chemiluminescence emission were 0.25 mM potassium permanganate and 4.0 M sulfuric acid. Two manifolds were tested and instrumental parameters such as the length of the reactor, injection volume and flow rate were compared. When using the selected manifold in the presence of 0.4 M formaldehyde, naftopidil gives a second-order calibration graph over the concentration range 0.1-40.0 mg L(-1) with a detection limit calculated (as proposed by IUPAC) of 92.5 ng mL(-1) and a standard deviation of 0.12 mg mL(-1) for ten samples of 10.0 mg L(-1) naftopidil. In the presence of 1.15 M formic acid, naftopidil gives a second-order calibration graph over the concentration range 0.05-40.0 mg L(-1) with a detection limit of 14.2 ng mL(-1) and a standard deviation of 0.37 mg mL(-1) for ten samples of 10.0 mg L(-1) naftopidil. In both cases, the determination is free from interferences from common excipients such as sucrose, glucose, lactose, starch and citric acid.

Antihypertensive Agents↗

Validation of a screening method for the simultaneous identification of fat-soluble and water-soluble vitamins (A, E, B1, B2 and B6) in an aqueous micellar medium of hexadecyltrimethylammonium chloride.

Simultaneous determination of the fat-soluble vitamins A and E and the water-soluble vitamins B1, B2 and B6 has been carried using a screening method from fluorescence contour graphs. These graphs show different colour zones in relation to the fluorescence intensity measured for the pair of excitation/emission wavelengths. The identification of the corresponding excitation/emission wavelength zones allows the detection of different vitamins in an aqueous medium regardless of the fat or water solubility of each vitamin, owing to the presence of a surfactant which forms micelles in water at the used concentration (over the critical micelle concentration). The micelles dissolve very water insoluble compounds, such as fat-soluble vitamins, inside the aggregates. This approach avoids the use of organic solvents in determining these vitamins and offers the possibility of analysing fat- and water-soluble vitamins simultaneously. The method has been validated in terms of detection limit, cut-off limit, sensitivity, number of false positives, number of false negatives and uncertainty range. The detection limit is about microg L(-1). The screening method was applied to different samples such as pharmaceuticals, juices and isotonic drinks.

Beverages↗

Bulk analysis by IR laser ablation inductively coupled plasma atomic emission spectrometry.

Two laser ablation systems dedicated to bulk analysis were evaluated for steel and PVC samples, using inductively coupled plasma atomic emission spectrometry detection. These systems were characterized by the use of a Nd:YAG laser operating at 1064 nm, the absence of observation device and a large laser spot size. The 1064 nm wavelength was selected to avoid the use of frequency-multiplying optics, and to be less critical to the sampling position. Calibration graphs and limits of detection are given for both types of materials. LODs were in the range 3-120 microg/g for steel, and in the range 0.07-15 microg/g for PVC. In the case of steel samples, similar calibration graph slopes were obtained between polished and unpolished samples.

Journal Article↗

Determination of magnesium and calcium ions in seawater by capillary zone electrophoresis.

Capillary zone electrophoresis is proposed for the determination of magnesium and calcium ions in seawater. A carrier solution containing EDTA was adopted for the complexation of these ions and the effect of sodium chloride concentration in the sample solutions on the results was examined. It was found that magnesium and calcium ions could be determined without any pretreatment by injecting 100-fold diluted seawater samples. Linear calibration graphs were obtained for standard solutions containing up to 10.0 mg/l of calcium ion when both peak area and peak height were used. On the other hand, a linear calibration graph was obtained for standard solutions containing up to 20.0 mg/l of magnesium ion when the peak area was used, while a curved one was obtained when the peak height was used. Relative standard deviations were 0.8 and 1.2% when a standard solution containing 5.0 mg/l of magnesium and 8.0 mg/l of calcium ions was analysed 8 times using the peak area. Limits of detection for magnesium and calcium ions were 0.13 and 0.26 mg/l, respectively. The proposed method was applied to the determination of magnesium and calcium ions in surface and bottom seawater samples.

Journal Article↗

Coronary normograms and the coronary-aorta index: objective determinants of coronary artery dilatation.

This is a prospective study to establish the normal ranges of the proximal left (LCA) and right (RCA) coronary artery diameters in normal children. Echocardiographic measurements of the internal diameters of the LCA, RCA, and the aortic annulus (AoA) were performed on 390 Asians with normal hearts, between the ages of 2 months to 8 years. The maximal diameters of the LCA and RCA in diastole were measured at predetermined sites. The LCA and RCA diameters correlated linearly with age, height, weight, body surface area, as well as the AoA (Pearson's R > 0.8, p <0.005). Regression equations and z-score graphs were constructed. The coronary-aorta index (coronary artery to aortic annulus ratio) falls within a narrow range- LCA/AoA = 0.15 +/- 0.02 (range 0.09-0.21), RCA/AoA = 0.13 +/- 0.02 (range 0.09-0.20). This is independent of age, sex, weight, height, and body surface area. We have established reference ranges for proximal coronary artery diameters in normal children. The regression equations and z-score graphs for the LCA and RCA provide objective determination of coronary size abnormalities. The coronary-aorta index can serve as a quick guide to detect coronary dilatation.

Age Factors↗