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[Computer simulation of the 10-year outcome of a cohort of heroin addicts in Ile-de-France].

The aim of this study is to develop a computer simulation model to describe imaginary cohorts of heroin users in the Ile de France (greater Paris) region. Because of the lack of well-designed cohort studies in France, this model is based on epidemiological data found in various different studies. The results of the simulation reveal horrifying outcomes in ten years' time: in the more optimistic scenario (an annual non-Aids mortality rate of 1%, an annual rate of permanent addiction curtailment of 10% and a syringe exchange rate of 10%), only 50% of heroin users curtail their consumption permanently without being HIV carriers after 10 years, 16% are HIV carriers and 10% have died. In conclusion, medical care should play an important part in the management of drug users, and secondary prevention aimed at reducing the health problems involved in heroin use should be intensified.

Acquired Immunodeficiency Syndrome

Computer simulation of the Wolff-Parkinson-White syndrome utilizing a human heart model.

The relationship between the location of an accessory pathway and body surface ECG waveforms was investigated by computer simulation of the WPW syndrome using a human heart model. The 3-dimensional heart model is composed of 50,000 units so as to represent the details of ventricular excitation. Ten typical accessory pathways near the A-V groove were examined, which correspond to Gallagher's classification of the WPW syndrome based on their surgical experience. Twelve-lead ECG waveforms were calculated for these 10 cases and were compared with the clinical observations of Gallagher et al. The polarities of the delta waves at 40 msec after the onset of the QRS were listed. The agreement of our model with the clinical data obtained by Gallagher et al is 87%. Details of changes in the ECG waveforms were also examined by changing ther terminal location of the accessory pathway along the radial and longitudinal directions in the ventricles, and it was found that the ECG waveforms of the limb leads are more sensitive to this difference in the preexcited location than those of the chest leads. The simulated epicardial isochronic patterns also agree with the measurements.

Computer Simulation

Computer simulation of arcuate keratotomy for astigmatism.

BACKGROUND: The development of refractive corneal surgery involves numerous attempts to isolate the effect of individual factors on surgical outcome. Computer simulation of refractive keratotomy allows the surgeon to alter variables of the technique and to isolate the effect of specific factors independent of other factors, something that cannot easily be done in any of the currently available experimental models. METHODS: We used the finite element numerical method to construct a mathematical model of the eye. The model analyzed stress-strain relationships in the normal corneoscleral shell and after astigmatic surgery. The model made the following assumptions: an axisymmetric eye, an idealized aspheric anterior corneal surface, transversal isotropy of the cornea, nonlinear strain tensor for large displacements, and near incompressibility of the corneoscleral shell. The eye was assumed to be fixed at the level of the optic nerve. The model described the acute elastic response of the eye to corneal surgery. RESULTS: We analyzed the effect of paired transverse arcuate corneal incisions for the correction of astigmatism. We evaluated the following incision variables and their effect on change in curvature of the incised and unincised meridians: length (longer, more steepening of unincised meridian), distance from the center of the cornea (farther, less flattening of incised meridian), depth (deeper, more effect), and the initial amount of astigmatism (small effect). CONCLUSIONS: Our finite element computer model gives reasonably accurate information about the relative effects of different surgical variables, and demonstrates the feasibility of using nonlinear, anisotropic assumptions in the construction of such a computer model. Comparison of these computer-generated results to clinically achieved results may help refine the computer model.

Animals

Computer simulations of enzymatic reactions: examination of linear free-energy relationships and quantum-mechanical corrections in the initial proton-transfer step of carbonic anhydrase.

Computer simulation approaches can provide a powerful tool for correlating the structure of enzymes with their catalytic activity. One of the most effective ways of simulating enzymatic reactions is provided by the empirical valence bond method. The general applicability of this method has been demonstrated in several enzymatic reactions and it is reexamined here in a study of the initial proton-transfer step in the catalytic reaction of carbonic anhydrase. The simulations produce a rate constant which is in agreement with the observed kinetic data and emphasizes the importance of the electrostatic effect associated with the catalytic zinc ion. The calculations are also used to examine the validity of linear free-energy relationships (LFERs) in enzyme catalysis and to evaluate quantum-mechanical corrections of the calculated rate constant. It is found that LFERs are valid in the present case and it is argued that this reflects the fact that the protein responds linearly to the development of electrostatic forces during the reaction. It is concluded that the present approach can be used to augment experimental studies in establishing the general validity of LFERs. It is noted, however, that such relationships are much more valid for transitions between different resonance structures than for transitions between reactants and product states.

Carbonic Anhydrases

Computer simulations of figure-ground discrimination in the visual system of the fly.

Figure-ground discrimination and pattern discrimination represent one of the most important problems in computer vision. Based on computational neuronal network model proposed by Reichardt et al. for figure-ground discrimination in the visual system of the fly, entire systematic computer simulations were carried out under nonstationary conditions. Results show that the model network and simulations have predictive power for behavioural experimental results. This paper proposes that motion perception and elementary pattern discrimination in human visual system may be mediated by some kind of figure-ground system with movement detectors as input layer.

Animals

The behaviour of common measures of association used to assess a vaccination programme under complex disease transmission patterns--a computer simulation study of malaria vaccines.

Case-control studies have been evoked as important alternatives to randomized clinical trials in the evaluation of infectious disease interventions. Using computer simulations, we compare the behaviour of common measures of association derived from case-control studies in the context of a malaria vaccine programme administered under complex transmission conditions. Several simplifying assumptions of previous workers have been relaxed and the simulated conditions are endemic rather than epidemic. The common estimators of association used in case-control studies remain unbiased only in limited circumstances. The term dependent happenings, first defined by Ross in 1916, is resurrected. Since the number of people becoming infected is dependent on the number of people already infected, control programmes in infectious diseases produce direct as well as indirect effects. Three different study designs with different pairs of comparison populations are defined. The choice of comparison population can be used to differentiate direct from indirect effects. In order to clarify the direct effects of a vaccination programme the comparison groups must be subjected to identical transmission intensities. In contrast, the referent group must remain unaffected by consequences of the intervention to determine indirect effects.

Brazil

Computer simulation for the prediction of separation as a function of pH for reversed-phase high-performance liquid chromatography. I. Accuracy of a theory-based model.

Computer simulation software (DryLab I/mp) is described for predicting high-performance liquid chromatographic separation as a function of changes in mobile phase pH. Three experimental runs with pH (only) varied are used to derive values of pKa plus capacity factors (k') for the ionized and non-ionized form of each ionizable solute. Various tests of the experimental data then allow classification of each solute as acidic, basic, neutral (including strong or weak acids or bases) and amphoteric. Experimental data are reported for the separation of several substituted anilines as a function of pH and solvent composition (%B). Experimental requirements for the accurate prediction of separation (ca. +/- 2-4% in alpha) as a function of pH are discussed. The reliability of the software is demonstrated for three different samples: mixtures of (a) substituted benzoic acids, (b) substituted anilines and (c) catecholamine-related compounds.

Aniline Compounds

Computer simulation of the circulatory system during support with a rotary blood pump.

In order to investigate the performance characteristics of nonpulsatile centrifugal pumps and their interaction with the pulsating heart, a computer simulation model was developed. A model of the pump, including the cannulae and the interference of the cannula and the left atrial wall, was added to a simulator of the circulation. It was implemented on a PC-AT using the analog simulating software AGO1000. An interval of 1 msec real-time per calculation step was evaluated to provide stable results. The calculation speed was approximately 100 msec per step. First simulation studies showed that both the positioning and resistance of the cannulae exert a major influence on system performance and equalized the different pressure-flow characteristics of vaneless and impeller pumps (difference of dp/dQ decreases from more than 6 times without cannulae to 130% with cannulae). In addition, the effects of suction in the atrial cannula, and changes of ventricular performance during changes in pumping power, could be properly simulated. The comparison with animal tests proved that the model is a suitable tool for testing control algorithms for centrifugal pumps.

Algorithms

Theoretical considerations on the "spine of hydration" in the minor groove of d(CGCGAATTCGCG).d(GCGCTTAAGCGC): Monte Carlo computer simulation.

A theoretical description of aqueous hydration in the minor groove of a B-form DNA is presented on the basis of a liquid-state Monte Carlo computer simulation on a system consisting of the oligonucleotide duplex d(CGCGAATTCGCG).d(GCGCTTAAGCGC) in a canonical B-form together with 1777 water molecules contained in a hexagonal prism cell and treated under periodic boundary conditions. The results are analyzed in terms of solvent density distributions. The calculated minor-groove solvent density shows considerable localization, indicative of discrete solvation sites and providing theoretical evidence for a well-defined ordered water structure. In the AATT sequence, this corresponds to the "spine of hydration" described by H. R. Drew and R. E. Dickerson [(1981) J. Mol. Biol. 151, 535-556] based on the x-ray crystal structure of the dodecamer hydrate. We find, however, that the calculated ordered water structure also extends into the CGCG flanking sequences, supported by the N2 hydrogen bond donors of the guanine residues and indicating that the spine of hydration could thus extend throughout the minor groove of a B-form DNA. This provides a possible explanation of the positive binding entropies observed by L. A. Marky and K. J. Breslauer [(1984) Proc. Natl. Acad. Sci. USA 84, 4359-4363] for both A.T and C.G sequences on the complexation of netropsin to the minor groove of DNAs. Implications of these results with regard to the thermodynamic stability of DNA in water and the sequence specificity of the minor groove hydration are discussed.

Computer Simulation

Computer simulations of chondrocytic clone behaviour in rabbit growth plates.

The growth behaviour of chondrocytic clones in the cell columns of the proximal tibial growth plates of young rabbits was modelled in computer simulations. Simulations were performed, modelling either clones in large groups of columns or clones in one single column. The former were based on morphological data and measurements of cell columns from an earlier study while the latter utilised previous findings of cellular kinetics in rabbit growth plates. Simulation results that resembled most closely the actual observations on rabbit growth plates were those in which a distribution of values was assumed both for clone length (ranging from 1000 to 2000 microns) and for the lengths of the discontinuities between clones. When the assumption was made in the models that the disappearing (metaphyseal) end of an 'old' clone moved more rapidly than the developing (epiphyseal) end of a 'new' clone, replacing the former, the length of the discontinuity between these two clones increased with time. This assumption, which could be modelled in the simulations of clones in a single column based on cell growth behaviour, was found to provide an explanation for an earlier finding that there are more short columns at the epiphyseal side than at the metaphyseal side of a growth plate.

Animals

Computer simulation model of swine production systems: II. Modeling body composition and weight of female pigs, fetal development, milk production, and growth of suckling pigs.

Theoretical concepts and relationships used to develop a deterministic computer simulation model of female pigs during their reproductive life are described. The model predicts, in a continuous form, body composition and weight of female pigs, fetal development, sow milk yield, and growth of suckling pigs according to genotype, diet, and management conditions. The model simulates growth of adult female pigs. Dietary nutrients are used first for maintenance and second for fetal growth or milk production. Any surplus is retained in the body. Energy and protein body reserves are mobilized when a nutrient deficit occurs during gestation or lactation. However, the rates of body protein and fat accretion as well as the fat/protein ratio are limited by boundaries, the values of which depend on the nutritional and physiological status of the pig. The model's ability to simulate sow body weight changes and composition, fetal growth, milk production, and suckling pig's growth is illustrated.

Animals

Urea handling by the renal countercurrent system: insights from computer simulation.

The renal handling of urea has been investigated with the aid of a computer model of the countercurrent system in which active electrolyte reabsorption occurs along the entire ascending limb of Henle's loop. In this model, summarized in Fig.9, the buildup of a corticopapillary gradient for urea is optimized if there is net addition of urea to loops of Henle only in the outer medulla. This added urea remains within the tubular system until it is reabsorbed from collecting ducts in the inner medulla. Thus, a net transfer of urea from outer to inner medulla is accomplished (via distal tubule and cortical collecting duct). There is no net addition of urea to loops of Henle within the inner medulla; in this region, the loops act simply as countercurrent exchangers for urea. Computer simulation of systematic variation in the urea permeabilities of each nephron segment shows that interference with any element of the above schema results in impairment of the medullary accumulation of urea relative to plasma. Simulation of varying rates of urinary urea excretion demonstrates that this model can account for the ability of the kidney to excrete substantial amounts of urea without an accompanying osmotic loss of water. The major insight gained from this study is that net addition of urea to loops of Henle in the outer medulla greatly enhances the medullary accumulation of urea, whereas, net addition of urea to loops within the inner medulla tends to defeat such accumulation and hence the urinary concentrating process. This general principle applies also to an alternate model of the countercurrent system, in which electrolyte reabsorption from thin ascending limbs of Henle is passive.

Computers

The management of small abdominal aortic aneurysms: a computer simulation using Monte Carlo methods.

Many small abdominal aortic aneurysms can now be identified by ultrasound screening and it is necessary to decide whether the risks of enlargement and rupture justify elective surgery. A computer simulation of the behaviour of small aneurysms has been constructed using Monte Carlo methods to model patterns of enlargement and rupture. The effect of policy with regard to the observation and timing of intervention has been evaluated for different patient groups. The results demonstrate the value of early intervention in otherwise fit patients with expected operative mortality rates of 5% or below, whereas, for older patients (over 70 years old) 6-monthly screening and operation if the aneurysm exceeds 5 cm is suggested. Higher risk patients with expected operative mortality of over 10% may be better treated conservatively up to an aneurysm diameter of 7 or 8 cm. The method used for simulation is flexible, being easily adjusted to take account of new information, and may have applications in other areas of clinical decision making.

Aged

Gap junction uncoupling and discontinuous propagation in the heart. A comparison of experimental data with computer simulations.

The effects of octanol on longitudinal propagation in guinea pig papillary muscles were measured by intracellular microelectrodes. These data were compared with alterations in conduction induced by stepwise removal of gap junction channels in computer simulations of propagation based on a discontinuous cable model. Octanol reduced the velocity (theta) of propagating action potentials (APs) from 53.2 +/- 3.5 to less than 6.6 +/- 2.1 cm/s before block occurred. The maximal rate of rise (Vmax) changed in a biphasic manner, increasing from 133.1 +/- 5.4 in controls to 201.7 +/- 11.0 V/s when theta was 20.5 +/- 2.8 cm/s, and then declining to less than 58.6 +/- 15.2 V/s just before block. The input resistance and time constant of the AP foot increased, and the ascending limb of phase-plane loops became increasingly nonlinear and notched during octanol treatment. All effects of octanol reversed upon washout. A strand of cardiac tissue was modeled as a discontinuous cable composed of 40 cells, each with 10 isopotential membrane segments described by Beeler-Reuter kinetics, and coupled by a variable number of gap junction channels (156 pS). Decreasing the number of channels from 40,000 to 400 to 60 slowed conduction from 62.6 to 16.4 to 3.1 cm/s. As noted in the experimental data, Vmax increased from 103 to 130 and then fell to less than 96 V/s. The AP foot increased and became nonexponential. Distinct notches developed during phase 1 of the APs at slower propagation velocities in the experiments and simulations. The close similarities between the experimental and theoretical data obtained in this study supports the applicability of a discontinuous cable model for describing longitudinal propagation in the heart.

1-Octanol

[A computer simulated test for the long-time change of heterozygote. Analysis of possibility on preserving the heterozygote for long-time in population].

Under the conditions of random mating and selecting. The research by computer simulation analysed the possibility of long-time conserving heterozygote in colong. An important conclusion was obtained. It was impossible to conserve heterozygote for a long time in colong. Therefore it is not necessary to control inbreeding for conserving all genes of colong by reducing gene purity in the work of conserving breeds for farm animal and poultry.

Animals

An evaluation of the effectiveness of a computer simulation of anaesthetic uptake and distribution as a teaching tool.

Gas Man is an interactive, microcomputer-based simulation and tutorial designed to teach the principles of anaesthetic uptake and distribution. Using two resident groups, one at a primary university-teaching hospital and the other at a medical school affiliated community hospital, the authors compared residents' knowledge of the subject prior to exposure to the tutorial and the average time spent using the program during a self-paced instruction period. Both groups not only significantly improved their knowledge of uptake and distribution 8 weeks after using this program, but wished to spend additional time with it, implying that it was a pleasant and satisfying way to learn. Computer simulation has the potential to be an important teaching tool in an anaesthesia residency training programme.

Anesthesiology

Computer simulation of the precordial QRS complex: effects of simulated changes in ventricular wall thickness and volume.

The cardiac electric field generated by depolarization of the human ventricle is simulated with a computer model which utilizes 1,500 dipoles. The configuration of the ventricles utilized in the model assumed that the cross-sectional shape of the left ventricle was circular and the right ventricular free wall was a portion of an ellipse. The torso was assumed to be homogeneous and infinite. The activation sequence was based on the measurements of Durrer. The depolarizational wave was simulated by dipole layers. The output of the model is presented as a standard multilead precordial ECG. The ECG complexes generated by the model closely resemble the precordial QRS complexes of normal man. Simulated increases in wall thickness (1 to 2.2 X control) were associated with changes in the calculated precordial QRS complexes which were characteristic of left ventricular hypertrophy. Voltage (R in V5 or V6 and S in V1) and QRS duration increased linearly as a function of calculated left ventricular mass. Increases in ventricular activation time were related nonlinearly to changes in left ventricular mass and did not occur in the absence of a simulated increase in wall thickness. The effects of simulated changes in left ventricular volume (0.6 to 3.0 X control) on the QRS complex were mainly dependent on the resultant increase in left ventricular mass. This model may be useful in simulating the precordial QRS complexes that result from isolated or combined changes in ventricular volume or wall thickness or other disorders of the heart. Furthermore, it may be useful whenever a simulation of a QRS generator is needed.

Cardiac Volume

Assessment of split-sample proficiency testing for cholesterol by use of a computer simulation model.

We developed a computer model to study the use of patients' specimens to assess compliance of cholesterol measurement performance with the 1992 goals of the Laboratory Standardization Panel of the National Cholesterol Education Program. The model uses Monte Carlo techniques to simulate cholesterol measurements that are subject to both systematic and random error. Split-sample measurements by a clinical laboratory and by a reference laboratory are compared by using linear regression to estimate clinical laboratory bias and imprecision; subsequently, according to specified decision limits, the performance of the clinical laboratory is classified as acceptable or deficient. We have quantified the influence of the bias and imprecision of the clinical laboratory, the imprecision of the reference laboratory, the number of split samples compared, and the decision limits on the accuracy of the classification of clinical laboratory performance. Unless the decision limits are carefully selected and a sufficient number of split samples are used, clinical laboratory performance will be frequently misclassified.

Cholesterol