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At least 217 records · Page 12Linked to original sources

PubMed1995

Three dimensional planning target volumes: a model and a software tool.

PURPOSE: Three dimensional (3D) target volumes are an essential component of conformal therapy because the goal is to shape the treatment volume to the target volume. The planning target volume (PTV) is defined by ICRU 50 as the clinical target volume (CTV) plus a margin to ensure that the CTV receives the prescribed dose. The margin must include all interfractional and intrafractional treatment variations. This paper describes a software tool that automatically generates 3D PTVs from CTVs for lung cancers and immobile head and neck cancers. METHODS AND MATERIALS: Values for the interfractional and intrafractional treatment variations were determined by a literature review and by targeted interviews with physicians. The software tool is written in Common LISP and conforms to the specifications for shareable software of the Radiotherapy Treatment Planning Tools Collaborative Working Group. RESULTS: The tool is a rule-based expert system in which the inputs are the CTV contours, critical structure contours, and qualitative information about the specific patient. The output is PTV contours, which are a cylindrical expansion of the CTV. A model for creating PTVs from CTVs is embedded in the tool. The interfractional variation of setup uncertainty and the intrafractional variations of movement of the CTV (e.g., respiration) and patient motion are included in the model. Measured data for the component variations is consistent with modeling the components as independent samples from 3D Gaussian distributions. The components are combined using multivariate normal statistics to yield the cylindrical expansion factors. Rules are used to represent the values of the components for certain patient conditions (e.g., setup uncertainty for a head and neck patient immobilized in a mask). The tool uses a rule interpreter to combine qualitative information about a specific patient with rules representing the value of the components and to enter the appropriate component values for that patient into the cylindrical expansion formula. CONCLUSION: The portable software tool allows the rapid, consistent, and automatic generation of 3D PTVs from CTVs.

Head and Neck Neoplasms↗

PubMed1994

Refinement of the HEPAR expert system: tools and techniques.

Methods and tools for the static and dynamic verification and validation of software systems are commonplace in the field of software engineering. In the field of expert systems, where it is more difficult to ensure that a system meets the specifications and expectations than in traditional software engineering, such tools are generally not available. In this paper, the need for more support of the development process by methods and tools is illustrated by the approach taken in building the HEPAR system, a rule-based expert system that can be used as a supportive tool in the diagnosis of disorders of the liver and biliary tract. At a certain stage in the development of this system an incremental development methodology has been adopted, in which implementation of parts of the expert system was followed by dynamic validation. For this purpose, a collection of software tools were implemented as extensions to a rule-based expert-system shell. These tools provide valuable information about the effects of modification of the HEPAR knowledge base, and indicate places in the knowledge base for refinement. It is believed that similar software tools may prove helpful in the development of other expert systems as well.

Artificial Intelligence↗

PubMed2006

A tool for measuring physician readiness to manage intimate partner violence.

BACKGROUND: Intimate partner (domestic) violence (IPV) is a common problem in medical practice that is associated with adverse health outcomes. There are widespread calls to improve IPV education for physicians, but there are few valid, reliable, easily available, and comprehensive measures of physician IPV knowledge, attitudes, and practices that can be used to assess training effectiveness. METHODS: In 2002, expert consensus and previous surveys were used to develop a new survey-based IPV self-assessment tool that included more information on current IPV knowledge and practices than previous tools. The draft tool was evaluated using standard psychometric techniques in a group of 166 physicians in 2002, revised, and then retested in a second group of 67 physicians on three occasions in 2003 and 2004. Analyses were conducted in 2005. RESULTS: The draft IPV survey tool demonstrated good internal consistency reliability, with Cronbach's alpha >/=0.65 for ten final scales. The developed scales were closely correlated with theoretical constructs and predictive of self-reported behaviors. On repeat testing, a revised version of the tool was found to have good stability of psychometric properties in a different physician population (Cronbach's alpha>/=0.65, and internal correlations as predicted), good correlation with measured office IPV practices, and stable results in this population over 12 months. CONCLUSIONS: The final version of this instrument, named the PREMIS (Physician Readiness to Manage Intimate Partner Violence Survey) tool, is a 15-minute survey that is a comprehensive and reliable measure of physician preparedness to manage IPV patients. This tool is publicly available and can be used to measure the effectiveness of IPV educational programs.

Attitude of Health Personnel↗

PubMed2004

Neural representations of graspable objects: are tools special?

Recent cognitive and neuroimaging studies have examined the relationship between perception and action in the context of tools. These studies suggest that tools "potentiate" actions even when overt actions are not required in a task. Tools are unique objects because they have a visual structure that affords action and also a specific functional identity. The present studies investigated the extent to which a tool's representation for action is tied to its graspability or its functional use. Functional magnetic resonance imaging (fMRI) was used to examine the motor representations associated with different classes of graspable objects. Participants viewed and imagined grasping images of 3D tools with handles or neutral graspable shapes. During the viewing task, motor-related regions of cortex (posterior middle temporal gyrus, ventral premotor, and posterior parietal) were associated with tools compared to shapes. During the imagined grasping task, a frontal-parietal-temporal network of activation was seen with both types of objects. However, differences were found in the extent and location of premotor and parietal activation, and additional activation in the middle temporal gyrus and fusiform gyrus for tools compared to shapes. We suggest that the functional identity of graspable objects influences the extent of motor representations associated with them. These results have implications for understanding the interactions between "what" and "how" visual processing systems.

Adult↗

PubMed2004

Computer simulation tool for rhinoplasty planning.

Rhinoplasty is a collection of surgical procedures performed on nose for the purpose of correcting functional and shape deformities. Nose is a facial feature which naturally draws attention during everyday contact. Any operation performed on nose has to blend well with the other facial features of the face. For this reason rhinoplasty is a type of surgery which requires artistic skills from surgeon as well as surgical skills. In this paper we present an artistic simulation tool which manipulates the shape of the nose on the bases of rhinoplasty procedures to be used during the surgery. Unlike other artistic simulation tools which can modify shape with no constraints, this tool simulates the effect of individual operations. Simulation tool can be valuable only if it predicts the outcome of the surgery with accuracy. Ultimately the outcome of the simulation depends largely on the experience of the surgeon. This is also the case with the tool presented in this study, so with experience the tool can be useful for predicting outcome more and more accurately. In this paper, the mechanical model of the nose and tools used for simulation are discussed. The simulation results are compared with actual rhinoplasty results to see the fidelity of the approach. A flowchart of the decision process and how rhinoplastic simulation together with the ideal nose data can be used to aid actual rhinoplastic surgery is given at the end.

Computer Simulation↗

PubMed2006

Framework for use of toxicity screening tools in context-based decision-making.

One of the principal applications of toxicology data is to inform risk assessments and support risk management decisions that are protective of human health. Ideally, a risk assessor would have available all of the relevant information on (a) the toxicity profile of the agent of interest; (b) its interactions with living systems; and (c) the known or projected exposure scenarios: to whom, how much, by which route(s), and how often. In practice, however, complete information is seldom available. Nonetheless, decisions still must be made. Screening-level assays and tools can provide support for many aspects of the risk assessment process, as long as the limitations of the tools are understood and to the extent that the added uncertainty the tools introduce into the process can be characterized and managed. Use of these tools for decision-making may be an end in itself for risk assessment and decision-making or a preliminary step to more extensive data collection and evaluation before assessments are undertaken or completed and risk management decisions made. This paper describes a framework for the application of screening tools for human health decision-making, although with some modest modification, it could be made applicable to environmental settings as well. The framework consists of problem formulation, development of a screening strategy based on an assessment of critical data needs, and a data analysis phase that employs weight-of-evidence criteria and uncertainty analyses, and leads to context-based decisions. Criteria for determining the appropriate screening tool(s) have been identified. The choice and use of the tool(s) will depend on the question and the level of uncertainty that may be appropriate for the context in which the decision is being made. The framework is iterative, in that users may refine the question(s) as they proceed. Several case studies illustrate how the framework may be used effectively to address specific questions for any endpoint of toxicity.

Animals↗

PubMed2005

Promoting care for acutely ill children-development and evaluation of a paediatric early warning tool.

The primary purpose of this paper was to develop and evaluate a physiologically based system for the identification of acutely ill children in hospital environments. The dependency of children in hospital is increasing and ensuring the appropriate and timely intervention by a team of health personnel experienced in the care of these children is paramount to ensure their optimal outcome. A paediatric early warning (PEW) tool was designed and demographic and physiological data collected on all children (n = 360) who triggered the tool over a 6-month period, between September 2003 and February 2004. Analysis of the data was undertaken on each criterion within the tool and by reviewing it against patient outcome, the decision for its retention or removal was made. The modified tool showed a 99% sensitivity and a 66% specificity. The resultant Paediatric Early Warning Tool has been validated for use in a tertiary children's hospital in the United Kingdom (UK). The use of such a tool by all staff caring for acutely ill children in hospital environments can help to ensure their early recognition and timely treatment. The tool together with an action plan must, however, be appropriate for use in individual ward or hospital areas.

Child↗

PubMed2004

Additional self-monitoring tools in the dietary modification component of The Women's Health Initiative.

Self-monitoring promotes behavior changes by promoting awareness of eating habits and creates self-efficacy. It is an important component of the Women's Health Initiative dietary intervention. During the first year of intervention, 74% of the total sample of 19,542 dietary intervention participants self-monitored. As the study progressed the self-monitoring rate declined to 59% by spring 2000. Participants were challenged by inability to accurately estimate fat content of restaurant foods and the inconvenience of carrying bulky self-monitoring tools. In 1996, a Self-Monitoring Working Group was organized to develop additional self-monitoring options that were responsive to participant needs. This article describes the original and additional self-monitoring tools and trends in tool use over time. Original tools were the Food Diary and Fat Scan. Additional tools include the Keeping Track of Goals, Quick Scan, Picture Tracker, and Eating Pattern Changes instruments. The additional tools were used by the majority of participants (5,353 of 10,260 or 52% of participants who were self-monitoring) by spring 2000. Developing self-monitoring tools that are responsive to participant needs increases the likelihood that self-monitoring can enhance dietary reporting adherence, especially in long-term clinical trials.

Aged↗

PubMed2006

Effect of dental tool surface texture and material on static friction with a wet gloved fingertip.

Hand injuries are an important cause of pain and disability among dentists and dental hygienists and may be due to the high pinch forces involved in periodontal work. The pinch forces required to perform scaling may be reduced by increasing the friction between the tool and fingers. The purpose of this study was to determine whether modifying the tool material, surface texture, or glove type altered the coefficient of static friction for a wet gloved finger. Seven tools with varying surface topography were machined from 13 mm diameter stainless steel and Delrin and mounted to a 6-component force plate. The textures tested were a fine, medium and coarse diamond knurled pattern and a medium and fine annular pattern (concentric rings). Thirteen subjects pulled their gloved, wet thumb pad along the long axis of the tool while maintaining a normal force of 40 N. Latex and nitrile gloves were tested. The coefficient of static friction was calculated from the shear force history. The mean coefficients of static friction ranged from 0.20 to 0.65. The coefficient of static friction was higher for a smooth tool of Delrin than one of stainless steel. Differences in the coefficient of static friction were observed between the coarse and medium knurled patterns and the fine knurled and annular patterns. Coefficients of static friction were higher for the nitrile glove than the latex glove for tools with texture. These findings may be applied to the design of hand tools that require fine motor control with a wet, gloved hand.

Biomechanical Phenomena↗

PubMed2005

A rapid dietary assessment tool to determine intake of folate was developed and validated.

BACKGROUND AND OBJECTIVE: Estimates of dietary folate intake are currently of considerable interest, but no rapid tools are available to assess dietary intake of folate that are well suited to everyday health promotion activities. We developed and tested the reliability and validity of two prototypes of a rapid dietary assessment tool (a folate intake tool, FIT) to determine dietary intake of folate. STUDY DESIGN AND SETTING: Five hundred and sixty eight men and women aged 33-83 years from Perth, Western Australia, completed one of the two prototypes of the tool and gave a fasting blood sample for measurement of serum folate. A subset (n=277) of participants completed the same tool on a second occasion 3-6 weeks later. RESULTS: The Pearson correlations (r) between folate score from the tool and serum folate were moderately high for both prototypes (FIT-A r=0.54; FIT-B r=0.49). The folate scores for the two prototypes were similar on repeat testing and correlated strongly (FIT-A r=0.75; FIT-B r=0.68). CONCLUSIONS: The rapid dietary assessment tool described here, FIT, provides a valid and reliable measurement of dietary intake of folate for both men and women.

Adult↗

PubMed2003

Subjective and Objective Numerical Outcome Measure Assessment (SONOMA). A combined outcome measure tool: findings on a study of reliability.

OBJECTIVE: To determine the reliability of a combined tool, namely that of Subjective and Objective Numerical Outcome Measure Assessment (SONOMA). METHODS: Testing was conducted, limited to patients with neck, midback, or lower back pain, with or without radiculopathy, in an outpatient chiropractic office setting. Test-retest reliability of the objective analysis of SONOMA was carried out on the same day (n = 50) with an interval time period of less than 60 minutes. Between-day reliability of the subjective analysis of SONOMA was carried out with an interval time period of 24 hours (n = 50). Individual and combined parameter reliability was established for the tool. RESULTS: Short-term objective and between-day subjective reliability coefficients were high. The Pearson correlation coefficient for the combined tool was .96, and the coefficient for the individual parameters ranged from .55 through .93. All these correlations were statistically significant, with a P value not more than .0001. CONCLUSIONS: The SONOMA combined numerical outcome measure tool demonstrated a high degree of reliability. This outcome tool measures directly and therefore reflects patient pain perception, functional status, and provider-driven objective assessment. We believe this tool provides the unique combination of both subjective and objective functional capacity assessment. It should be valuable for day-to-day practical application, as well as considered for future clinical trials and quality-of-care studies. This combined tool shows promise as having a high degree of reliability and, hence, may demonstrate a comprehensive representation of the patient-clinical picture, particularly in regard to functional capacity assessment.

Activities of Daily Living↗

PubMed2003

Individual variation in the rate of use of tree-hole tools among wild orang-utans: implications for hominin evolution.

Primate tool use varies among species, populations, and individuals. Individual variation is especially poorly understood. Orang-utans in the Sumatran swamp forest of Suaq Balimbing varied widely in rates of tool use to extract honey, ants or termites from tree holes and in the degree to which they specialized on this tree-hole tool use. We tested whether individual variation was best explained by effects of social dominance, habitat differences, or by opportunities for socially learning the skills during ontogeny. There was no evidence for the first two hypotheses. However, we found a strong relationship between tool use specialization and mean female party size, which was used as a proxy for the opportunities for socially mediated learning in a foraging context during their development. This use was justified because females are rather philopatric and their mean party size remained stable over time, thus reflecting long-term tendencies. The correlation was not an artifact of a direct effect of party size on tool use tendencies, and did not hold for males, the dispersing sex. Thus, variation in the number of opportunities for social learning explains tool use variation within populations, corroborating hypotheses for between-population variation. The emergence of human culture was accompanied by vastly improved mechanisms of social learning. In order for these improvements to be favored by natural selection, the cultural potential must have actually been expressed. Thus, a combination of strong sociability and a reliance on tool-using or other technical skills acquired through social learning must have characterized early hominins.

Animals↗

PubMed1992

Revision arthroplasty facilitated by ultrasonic tool cement removal. An evaluation of whole bone strength in a canine model.

Ultrasonic driven tools have been developed to facilitate the removal of bone cement during revision arthroplasty. The effect on whole bone strength of cement removal by ultrasonic tools was examined in a canine femur model. Paired, fresh-frozen canine femora were divided into two groups. In group A, one femur from each pair was subjected to cement extraction with ultrasonic tools. In group B, one femur from each pair was subjected to manual cement extraction. Contralateral femora from each pair served as controls to determine the strength of intact femora. Torsional fractures were produced using a servocontrolled hydraulic testing machine (Minneapolis Testing System, Minneapolis, MN). Maximum torque, maximum angle, and energy capacity to failure were determined. Results were recorded as a reduction in percent value of the tested specimen versus the contralateral control. When comparing femora with cement removal by ultrasonic tools to the contralateral control femur, there were no statistical differences in ultimate torque (P = .83), maximum angle (P = .89), and energy capacity (P = .74) by analysis of variance. In addition, there were no significant differences between the group with ultrasonic tool cement removal and the group with manual tool removal. The authors conclude that in this canine model, removal of cement with ultrasonically driven tools has no adverse effects on whole bone strength.

Animals↗

PubMed2003

Decision support tools for clinical trial design.

Many published clinical trials are poorly designed, suggesting that the protocol was incomplete, disorganised, or contained errors. This fact motivated the development of a suite of decision support tools for the design of randomised controlled clinical trials. In this paper we describe these tools, discussing both underlying theoretical issues and usage of the tools. The core tool--Design-a-Trial (DaT)--critiques data entered so as to guide design of a scientifically and ethically sound trial. DaT outputs a text protocol describing the trial, and a corresponding symbolic representation. Linked to DaT is a tool for authoring plans that form part of the trial. A key feature of this tool is the provision of macros for describing commonly occurring plan constructs. We describe another linked tool which generates solutions to Prolog queries requesting advice on how a plan should be revised so as to comply with safety and efficacy requirements. The user is able to navigate a path through the solution search space by interacting with natural language representations of the Prolog sub-goals. This provides the flexibility to generate useful and informative partial solutions, symbolic and textual, for inclusion in the symbolic plan representation and protocol document, respectively.

Clinical Trials as Topic↗

PubMed2003

How do tufted capuchin monkeys (Cebus apella) understand causality involved in tool use?

Four tufted capuchin monkeys (Cebus apella) were trained to choose from 2 hook-like tools, 1 of which successfully led to collecting food, whereas the other did not because of inappropriate spatial arrangement of the tool and the food. In Experiment 1, all of the monkeys successfully learned the basic task. The monkeys performed successfully with tools of novel colors and shapes in Experiments 2-5. These results demonstrate that the monkeys used the spatial arrangement of the tool and the food as a cue. However, they failed when there were obstacles (Experiment 6) or traps (Experiment 7) on the path along which the monkeys dragged tools. These results may suggest that capuchin monkeys understand the spatial relationship between 2 items, namely, food and the tool, but do not understand the spatial relationship among 3 items, namely, food, tool, and the environmental condition. The possible role of stimulus generalization is also considered.

Animals↗

PubMed2003

Haptically creating affordances: the user-tool interface.

Successful use of a hand-held tool requires overcoming the rotational inertia of the hand-plus-tool system. Where an object is grasped affects this rotational inertia. Appropriate choice of grip position may be crucial in the safe, effective, and efficient control of a hand-held tool. In 3 experiments, the authors investigated how choice of grip position on a tool was constrained by task demands. The results suggest that choice of grasp position serves to establish relationships among 3 variables derived from the inertial ellipsoid of the hand-object system (volume, symmetry, and eigenvector angle) in a way that specifically reflected the power or precision constraints of the given task. These variables have previously been shown to play a role in haptic perception of tool function. Changing grasp position on a tool is a way to exert control over the nuances of the user-tool interface.

Choice Behavior↗

PubMed1999

Determining older people's need for registered nursing in continuing healthcare: the contribution of the Royal College of Nursing's Older People Assessment Tool.

This paper presents an overview of the work of the Royal College of Nursing (RCN) in developing an assessment tool to determine the need for registered nursing by older people in continuing care. In the past, healthcare has been provided free and social care 'means-tested'. The erosion of the NHS's responsibility for continuing care provision through the development of eligibility criteria has resulted in the majority of older people having their care services means-tested, including their nursing care. The RCN has argued that older people have inter-related health and social care needs, that nursing care is an integral component of healthcare provision and that therefore older people should not have to pay for nursing care. This paper describes the work undertaken by the RCN to develop a tool for use in assessing older people's need for registered nursing--'The RCN Nursing Older People Assessment Tool'. The underpinning theoretical framework is outlined and the process of constructing the tool is described. In addition, the stages of assessment using the tool are outlined. A pilot study in seven nursing homes managed by three different companies was undertaken to test the reliability and acceptability of the tool. 178 paired assessments were completed (89% of the intended sample). The results of the pilot study demonstrated that the tool has a high degree of reliability and acceptability.

Aged↗

PubMed2001

The validation of a nursing nutritional assessment tool for use on acute elderly wards.

BACKGROUND: Elderly people are at great risk of poor nutritional status. Identifying those at nutritional risk is complex owing to its multifactorial nature and highlights the need for an easily administered nutritional screening tool. AIM: To test the robustness of a tool used to identify those patients who require further dietetic assessment. METHOD: The tool was tested on an 'acute elderly' ward to assess its statistical robustness, i.e. test-retest reliability, inter-rater reliability, internal consistency and factor structure, concurrent and construct validity. The research was carried out by a dietitian and two nurses on an overall sample of 185 consecutive admissions. RESULTS: Test-retest results reflect that the tool is capable of yielding consistent assessments over time. Inter-rater reliability results revealed that when comparisons of agreement between nurses and dietitians were examined there was consistent disagreement. Internal consistency was found to be low but the rotated factor analysis suggested a relationship between the items in the tool. Concurrent validity was exhibited with body mass index, albumin and American Nutrition Risk Index only. Construct validity was not sufficiently exhibited with any of the measures used. CONCLUSION: The tool has not demonstrated reliability as determined by the statistical measures and hence validity at this stage. Issues which need to be addressed to allow this tool to be used appropriately are discussed.

Aged↗