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Efficacy of antiseptic-impregnated central venous catheters in preventing catheter-related bloodstream infection: a meta-analysis.

CONTEXT: Central venous catheters impregnated with chlorhexidine and silver sulfadiazine have recently been introduced for the prevention of catheter-related infections. However, there remains some uncertainty regarding the efficacy of these catheters because of conflicting reports in the literature. OBJECTIVE: To evaluate the efficacy of chlorhexidine-silver sulfadiazine-impregnated central venous catheters in the prevention of catheter-related bloodstream infection. DATA SOURCES: Studies identified from a computerized search of the MEDLINE database from January 1966 to January 1998, reference lists of identified articles, and queries of principal investigators and the catheter manufacturer. STUDY SELECTION: Randomized trials comparing chlorhexidine-silver sulfadiazine-impregnated central venous catheters with nonimpregnated catheters were included. The outcomes assessed were catheter colonization and catheter-related bloodstream infection confirmed by catheter culture. DATA EXTRACTION: Twelve studies met the inclusion criteria for catheter colonization and included a total of 2611 catheters. Eleven studies with a total of 2603 catheters met the inclusion criteria for catheter-related bloodstream infection. Most patients in these studies were from groups considered to be at high risk for catheter-related infections. Summary statistics were calculated using Mantel-Haenszel methods under a fixed-effects model. DATA SYNTHESIS: The summary odds ratio for catheter colonization was 0.44 (95% confidence interval [CI], 0.36-0.54; P<.001), indicating a significant decrease in catheter colonization associated with impregnated catheters. The studies examining the outcome of primary interest, catheter-related bloodstream infection, had a summary odds ratio of 0.56 (95% CI, 0.37-0.84; P = .005). CONCLUSIONS: Central venous catheters impregnated with a combination of chlorhexidine and silver sulfadiazine appear to be effective in reducing the incidence of both catheter colonization and catheter-related bloodstream infection in patients at high risk for catheter-related infections.

Anti-Infective Agents, Local↗

Comparison of automated microbroth dilution and agar dilution for antimicrobial susceptibility of Campylobacter jejuni isolated from dairy sources.

OBJECTIVES: To compare the agreement between microbroth dilution and agar dilution for antimicrobial susceptibility testing of Campylobacter jejuni. METHODS: Utilizing commercially prepared antimicrobial panels, microbroth dilution was compared with agar dilution for determining antimicrobial susceptibility in C. jejuni isolates. To assess the performance of both techniques for ampicillin, 190 C. jejuni isolates from dairy cattle were utilized. A group of 172 C. jejuni isolates from dairy sources were used to compare the susceptibility to ciprofloxacin, erythromycin, nalidixic acid and tetracycline. RESULTS: Our results indicate that microbroth dilution and agar dilution agree within +/-1 log2 dilution for 86.7% of the isolates tested. Ciprofloxacin had the highest level of agreement for isolates tested by both techniques, resulting in a kappa of 0.886 and 97.1% agreement +/-1 log2 dilution. The least agreement was observed in determining the susceptibility of isolates to ampicillin and erythromycin (82.1 and 79.7% agreement +/-1 log2 dilution). However, kappa statistics were considered to have good agreement for these antimicrobials. There were no significant differences in the summary statistics for any of the five antimicrobials evaluated for the isolates analysed by the percentage of resistant isolates, MIC50, MIC75 or MIC90 beyond +/-1 log2 dilution. There was no association in the classification of resistance by the testing methods employed. We also demonstrated that the quality control strain of C. jejuni ATCC 33650 performed in a consistent manner for both agar dilution and microbroth dilution. CONCLUSIONS: Microbroth dilution may be an acceptable alternative to agar dilution for determining susceptibility of C. jejuni in research or surveillance where flow of samples, labour efficiency and cost may restrict the use of agar dilution.

Ampicillin↗

Application of multilevel models to morphometric data. Part 2. Correlations.

Multilevel organization of morphometric data (cells are "nested" within patients) requires special methods for studying correlations between karyometric features. The most distinct feature of these methods is that separate correlation (covariance) matrices are produced for every level in the hierarchy. In karyometric research, the cell-level (i.e., within-tumor) correlations seem to be of major interest. Beside their biological importance, these correlation coefficients (CC) are compulsory when dimensionality reduction is required. Using MLwiN, a dedicated program for multilevel modeling, we show how to use multivariate multilevel models (MMM) to obtain and interpret CC in each of the levels. A comparison with two usual, "single-level" statistics shows that MMM represent the only way to obtain correct cell-level correlation coefficients. The summary statistics method (take average values across each patient) produces patient-level CC only, and the "pooling" method (merge all cells together and ignore patients as units of analysis) yields incorrect CC at all. We conclude that multilevel modeling is an indispensable tool for studying correlations between morphometric variables.

Algorithms↗

Meta-analysis of the studies assessing temporal changes in coronary plaque volume using intravascular ultrasound.

To assess the temporal effect of statin therapy on coronary atherosclerotic plaque volume measured by intravascular ultrasound (IVUS), we searched PubMed for eligible studies published between 1990 and January 2006. Inclusion criteria for retrieved studies were (1) IVUS volume analysis at baseline and follow-up and (2) statin therapy in > or =1 group of patients. All data of interest were abstracted in prespecified structured collection forms. Statistical analysis was performed with Review Manager 4.2. Random-effect weighted mean difference (WMD) was used as summary statistics for comparison of continuous variables. Nine studies of 985 patients (with 11 statin treatment arms) were selected. After a mean follow-up of 9.8 +/- 4.9 months, we found a significant decrease in coronary plaque volume (WMD -5.77 mm(3), 95% confidence interval -10.36 to -1.17, p = 0.01), with no significant heterogeneity across studies (p = 0.47). Prespecified subgroup analyses showed similar trends. Studies in which the achieved low-density lipoprotein (LDL) cholesterol level was <100 mg/dl showed a trend for plaque regression (WMD -7.88 mm(3), 95% confidence interval -16.31 to 0.55, p = 0.07), whereas studies in which the achieved level of LDL cholesterol was > or =100 mg/dl, the trend was less evident (WMD -4.22 mm(3), 95% confidence interval -10.27 to 1.82, p = 0.17). Plaque volume remained essentially unchanged in patients not treated with statins (WMD 0.13 mm(3), 95% confidence interval -4.42 to 4.68, p = 0.96). In conclusion, statin therapy, particularly when achieving the target LDL level, appears to promote a significant regression of coronary plaque volume as measured by IVUS.

Cholesterol, LDL↗

Using the Delphi technique to examine the content validity of nursing diagnoses.

Official labeling of phenomena that nurses diagnose and treat requires that researchers validate the existence of proposed diagnoses. One part of the validation process is the examination of content validity. The Delphi technique is a useful methodologic technique for such an examination. This article describes the characteristics, background, advantages, and disadvantages of the Delphi technique, as well as suggested strategies for using it to validate nursing diagnoses. In discussing strategies for using the Delphi technique to validate nursing diagnoses, the format, essential components, and steps of each round of the traditional and modified Delphi procedure are addressed. Round I of the traditional Delphi technique involves selection of a panel of content experts, developing and mailing questionnaires and content analysis, and generating a list of defining characteristics and operational definitions for a nursing diagnosis. Round II involves developing and mailing questionnaires, determining percentage of agreement, and providing statistical analysis. Round III includes developing and mailing questionnaires and providing statistical analysis of data. Round IV consists of developing and mailing the final report, which includes a statistical summary of individual and grouped responses in round III, as well as a minority report. The format and statistical analysis of the modified Delphi procedure is similar to rounds II, III, and IV of the traditional Delphi technique, except the modified technique usually will require only three rounds.

Delphi Technique↗

Association of genetically proxied cancer-targeted drugs with cardiovascular diseases through Mendelian randomization analysis.

BACKGROUND: Cancer-targeted therapies are progressively pivotal in oncological care. Observational studies underscore the emergence of cancer therapy-related cardiovascular toxicity (CTR-CVT), impacting patient outcomes. We aimed to investigate the causal relationship between different types of cancer-targeted therapies and cardiovascular disease (CVD) outcomes through a two-sample Mendelian randomization (MR) study. METHODS: This genome-wide association study was conducted using a two-sample Mendelian randomization framework. Genetic instruments for drug target gene expression were extracted from the eQTLGen consortium (31684 individuals, 37 cohorts). Genome-wide association study (GWAS) summary statistics for 19 cardiovascular diseases were derived from the FinnGen database. Primary analysis was carried out using the summary-data-based MR (SMR) method, with sensitivity analysis for validation. Colocalization analysis identifies shared causal variants between exposure eQTLs and CVD-associated single-nucleotide polymorphisms (SNPs). RESULTS: Among the 39 drug target genes, 8 were identified with detectable cis-eQTLs and were subsequently validated through positive control analysis for further investigation. In the SMR and sensitivity analyses, genetically proxied VEGFA inhibition showed significantly strong association with stroke (odds ratio [OR]&#x2009;=&#x2009;1.17, 95% confidence interval [CI]&#x2009;=&#x2009;1.09-1.26, p&#x2009;=&#x2009;1.33&#x2009;&#xd7;&#x2009;10-&#x2009;5). Additionally, the inhibition of FGFR1, FLT1, and MAP2K2 exhibited suggestive association with corresponding cardiovascular disease outcomes. Nevertheless, only VEGFA expression and stroke shared a causal variant (93.6%), whereas FGFR1, MAP2K2, and FLT1 did not share causal variants with corresponding cardiovascular diseases in the colocalization analysis. CONCLUSIONS: This genetic association study revealed evidence supporting the genetic association between the use of VEGFA inhibitors and increased stroke risk, highlighting the need for enhanced pharmacovigilance. These findings underscore the delicate balance between cardiovascular toxicity risk and the benefits of cancer-targeted therapy.

Humans↗

Responses from area 3b of somatosensory cortex to textured surfaces during active touch in primate.

(1) The purpose of this experiment was to characterize the responses of neurons in somatosensory cortex while the hand was actively moved (stroked) across a textured surface. Surfaces consisted of horizontal gratings that varied by spatial period or ridge-groove ratio (roughness). Surfaces were attached to rectangular blocks. TOP and BOTTOM halves of each block could contain surfaces of different roughness. (2) Velocity and force of the stroke were behaviorally constrained within certain limits and continuously measured and recorded during the stroke. (3) Response samples for each neuron were obtained for repeated presentations of each surface. Statistical analyses consisted of analysis of variance and t tests across surfaces on the data of each neuron, and summary statistics on groups of neurons with similar response characteristics. The interaction effects of behavioral variables (velocity and force) were examined and found not to be significant. (4) The sample mainly consisted of rapidly adapting neurons in area 3b of somatosensory area I (SI). Three main response types were found: (a) GRADED cells showed a monotonic increase in firing rate to increasingly rougher surfaces. This effect was seen in one-third of cells studied and is consistent with other reports. These cells seem to code roughness in the magnitude of their response. (b) In some cells, response to a BOTTOM surface depended on the roughness of the preceding TOP surface. This is analogous to contrast in the visual system. These CONTRAST cells are a novel finding in the somatosensory system. (c) Some cells only responded to surfaces that were completely smooth. These "OFF"-response-type cells were seen in proximity to other cells that responded in a reciprocal fashion to surfaces with ridges, but not to smooth surfaces. SMOOTH cells did not respond to punctate or passively applied stimuli, and therefore could not be classified by adaptation of the responses. (5) An increase in firing rate as spatial period (roughness) increases (with a constant ratio of ridge to groove) seems contrary to vibratory models of texture perception. As spatial period increases, temporal frequency decreases, and thus "tuned" cells should show a decreased response rate. Yet GRADED cells showed an increased response. In addition, response varied on surfaces with different groove size, where spatial period, and thus temporal period, was constant. This suggests that in rapidly adapting neurons, at least for these simple surfaces, texture is coded by the magnitude of the firing rates rather than by its temporal fidelity.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Misleading statistical calculations in far-advanced glaucomatous visual field loss.

OBJECTIVE: In this study, the capability of statistical analysis indices to characterize static automated visual fields (VFs) accurately in cases of far-advanced glaucoma was assessed. DESIGN: Retrospective observational case series. PARTICIPANTS: Sixteen eyes of 15 patients with end-stage glaucoma and evidence of collapse of VF statistical analysis indices were included in the study. METHODS: End-stage glaucoma was defined as vertical cup-to-disc ratio of 0.9 or more, mean deviation less than -24 dB and with only a central or temporal island remaining in the VF gray scale. Collapse of statistical indices was defined as any of the following: pattern deviation probability plot without a single VF location showing P < 0.5%; corrected pattern standard deviation (CPSD) and pattern standard deviation (PSD) probability less than 5% or within normal limits (WNL); short-term fluctuation (SF) probability WNL; glaucoma hemifield test (GHT) not outside normal limits (ONL); or presence of a low patient reliability comment triggered by 40% or more false-negative (FN) responses. MAIN OUTCOME MEASURES: Visual field statistical indices. RESULTS: Of the 16 VFs showing misleading statistical calculations, 9 of 16 eyes had a normal pattern deviation probability plot. The PSD, SF, and CPSD parameters were normal or barely outside the normal range in 4 of 16, 10 of 16, and 5 of 16 eyes, respectively. The GHT was ONL in 7 of 13 eyes, borderline with generalized reduction of sensitivity (GRS) in three eyes, and only GRS in two additional eyes. Low patient reliability was triggered because of an FN score of 40% or more in 10 of 16 eyes. CONCLUSIONS: Statistical indices are crucial for the interpretation of automated static VFs. However, in end-stage glaucomatous VF loss, both summary statistical indices and reliability indices may not detect abnormality, thus misleading the casual observer.

Data Interpretation, Statistical↗

Probabilistic diffusion tractography: a potential tool to assess the rate of disease progression in amyotrophic lateral sclerosis.

The goal of probabilistic tractography is to obtain a connectivity index along a white matter pathway that reflects fibre organization and is sensitive to pathological abnormalities contributing to disability. Here, we present the development of voxel-based connectivity measures along the tractography-derived corticospinal tract (CST). We investigated whether these connectivity measures are different in patients with amyotrophic lateral sclerosis (ALS) and correlate with the rate of disease progression. We also investigated whether fractional anisotropy (FA), which reflects directional coherence of fibre tracts, is reduced in the CST of ALS patients and relates to disease progression rate. Thirteen patients with probable or definite ALS and 19 healthy subjects were studied. The probabilistic tractography algorithm segmented the bilateral CST, along which FA and connectivity values were obtained. To take into account the asymmetric distribution of connectivity values, two summary statistic measures that focused on voxels with higher connectivity values were selected and then used in the analysis, together with the mean connectivity and the mean FA. To complete the analysis, the same summary measures for FA were included. Differences in all these indices between patients with moderate or rapid disease progression rate and controls were investigated using linear regression, adjusted for age and white matter fraction. The association between FA or connectivity in the CST and the disease progression rate was assessed using linear regression. Patients with a rapid disease progression rate had significantly lower summary connectivity measures than controls in the left CST, but there was only a borderline statistical difference in mean connectivity. Patients with rapid progression had a significantly lower mean FA, and any other FA measure, in both CSTs than controls. When only patients were considered, strong associations between the rate of disease progression and all the connectivity measures in the left CST were found (P-values between P < 0.001 and P = 0.002, partial correlation coefficients between -0.90 and -0.82). However, there was no evidence of an association between disease progression rate and any of the FA measures in the bilateral CST. Our findings suggest that FA and connectivity provide complementary information, since FA is sensitive to the detection of all the group differences, whereas the summary connectivity measures correlate with disease progression rate. The development of such connectivity measures raises their potential as markers of disease progression in ALS, and provides guidance for their use in other neurological diseases.

Adult↗

Meta-analysis of normative cervical motion.

STUDY DESIGN: Meta-analysis of normative cervical range of motion literature performed by applying summary statistics to range of motion and reliability values reported among studies. OBJECTIVES: To identify reliable and valid methods for measuring active and passive cervical range of motion and to estimate normative values. SUMMARY OF BACKGROUND DATA: Range of motion studies use a variety of measuring instruments and statistical analyses, making it difficult to select the most suitable instruments, procedures, and normative values for clinical application. Reviews of the literature, being limited in scope, have not quantitatively synthesized the literature. METHODS: Range of motion and reliability data were grouped by technology and types of motion, then summarized by deriving means and variabilities. Clinical validity was assessed by examining discrepancies, variabilities, and correlations. Change in range of motion as a function of age was determined by comparing range of motion ratios (fourth:third and seventh:third decades). RESULTS: Nine technologies were identified. Overall, passive motion was greater than active motion, and range of motion decreased as age increased, with women exhibiting greater range of motion than men. Variations within each technology were as large as or larger than those between technologies, indicating that clinical procedures are as important as the accuracy and precision of the technology itself. Reliability has not been adequately tested for the majority of technologies. CONCLUSIONS: Clinical procedures appear to be as important as accuracy and precision in determining the reported range of motion values. Further research is needed to establish a gold standard for normative values and to identify an instrument that is reliable for all motions.

Adult↗

The impact for causal associations between common diseases and inflammatory bowel disease: a disease-wide bidirectional Mendelian randomization study.

OBJECTIVES: Observational studies on associations between various diseases and inflammatory bowel disease (IBD) are often limited by confounding and reverse causation. We aimed to assess potential causal relationships between a wide range of diseases and IBD, including Crohn's disease (CD) and ulcerative colitis (UC). METHODS: We performed a comprehensive bidirectional Mendelian randomization (MR) analysis of 104 common diseases and IBD traits using the generalized summary-data-based MR (GSMR) approach. Genome-wide association study (GWAS) summary statistics for diseases were obtained from the MRC Integrative Epidemiology Unit, and IBD data from the International IBD Genetics Consortium. Summary-data-based MR (SMR) integrating GWAS and expression quantitative trait locus data was applied to identify pleiotropic genes associated with IBD. RESULTS: MR analyses identified 38, 34, and 52 exposures significantly associated with IBD, UC, and CD, respectively. Childhood- and adult-onset asthma showed distinct causal effects on UC and CD. Reverse MR indicated associations between IBD traits and 15 diseases, including multiple sclerosis. SMR identified RGS14 and CARD9 as pleiotropic genes linked to IBD, suggesting shared genetic mechanisms with asthma and multiple sclerosis. CONCLUSIONS: These findings provide evidence for causal links and shared immune-related genetic mechanisms underlying IBD, highlighting potential targets for future research.

Humans↗

A novel management database in obstetrics and gynaecology to introduce the electronic healthcare record and improve the clinical audit process.

OBJECTIVES: To design a system capable of recording complete and accurate electronic patient records with respect to obstetrics and gynaecology, with the ability to perform instant statistically summaries of data. BACKGROUND: Electronic patient records have been shown to provide numerous benefits for the clinician, with respect to patient consultation, accurate recording of data, medical audit and statistical analysis. In Northern Ireland there is no database designed to cover all the major clinical aspects of obstetrics and gynaecology. This project incorporates all aspects of obstetrics and gynaecology into a single database. METHODS: Database designed using Filemaker pro 7, Macromedia Fireworks 8, and Microsoft photodraw. Problems specific to obstetrics and gynaecology included recording multiple pregnancy data, and the lack of a unique patient number (the current system in Northern Ireland gives patients a unique hospital number, and a separate maternity number for each pregnancy). Linking all of these sources was a major component of this database. The database contains many intrinsic tabulations, relationships, programming scripts and calculations to combine files and calculate important statistical information for clinicians automatically. RESULTS: A successful audit of delivery statistics for December 05 was performed using the system. Several additional audits are currently under completion using the database. The major audit, completion date end April 06, is a 5 month summary of delivery data (Dec-April) based on mode of delivery, Robson groups, and Caesarian -Section rate among specified patient sub-groups. CONCLUSION: The system has been successful in its initial stages with obvious improvements to the medical audit process already apparent. The system should prove to be a valuable addition to the department and ultimately improve patient care. The ability to provide instant access to clinical data and statistics will simplify and improve the audit process, improving clinical governance. The management of the OB/GYN department should benefit greatly.

Computer Communication Networks↗

Recruitment in NHLBI population-based studies and randomized clinical trials: data analysis and survey results.

Data on screening and recruitment from current and previous NHLBI population-based studies (PBSs) and randomized clinical trials (RCTs) were examined. In only two of the studies examined was the projected recruitment completed within the planned recruitment period. The shape of the graph of the relation between enrollment of participants and time varies by study. A single summary statistic for measuring the efficiency of recruitment in RCTs and PBSs is proposed and applied to the examined studies. In addition to providing summary data on recruitment for several studies, this article reports the survey results of a questionnaire sent to the coordinating centers of currently and previously funded National Heart, Lung, and Blood Institute and Veteran's Administration studies. The purpose was to ascertain the desirability of recommending that a generic core of information be collected on recruitment and screening in future studies. Most respondents believed that comparing data collected uniformly and prospectively might be helpful in designing further studies. The variables most respondents believed to be potentially useful are described.

Clinical Trials as Topic↗

Methodology used for producing ONS's small area population estimates.

The Office for National Statistics (ONS) has set up a project to investigate the feasibility of producing postcensal small area population estimates on a nationally consistent basis for England and Wales. Following on from earlier investigations to identify potential data sources and methods, ward and Super Output Area population estimates have been released as 'experimental statistics'. This article covers the methodology used to produce these estimates, feedback from user consultation with the initial estimates released at ward level, summary statistics on the population estimates for mid-2001 to mid-2003, and future developments for small area population estimates.

Adult↗

Statistical analysis of data in support of the Barker hypothesis, advantages of using random effects regression model in hierarchical data.

In a recent note by Walters and Edwards (2004), the authors argued that summary statistics should be used in analysing hierarchical data from our earlier analysis of a rat model of developmental programming and the Barker hypothesis (Kwong et al., 2000, 2004). We reiterate here why such a view is inappropriate. Hierarchical data merits multilevel analysis using a 'random effects' model to enable estimation of variances at different levels and easy assessment of other parameters in a complex data structure.

Analysis of Variance↗

Estimating the rate of gene conversion on human chromosome 21.

There is a growing recognition that gene conversion can be an important factor in shaping fine-scale patterns of linkage disequilibrium in the human genome. We devised simple multilocus summary statistics for estimating gene-conversion rates from genomewide polymorphism data sets. In addition to being computationally feasible for very large data sets, these summaries were designed to yield robust estimates of gene-conversion rates in the presence of variation in crossing-over rates. Using our summaries, we analyzed 21,840 biallelic single-nucleotide polymorphisms (SNPs) on human chromosome 21. Our results indicate that models including both crossing over and gene conversion fit the overall short-range data (0-5 kb) of chromosome 21 much better than do models including crossing over alone. The estimated ratio of gene-conversion rate to crossing-over rate has a range of 1.6-9.4, depending on the assumed conversion tract length (in the range of 500-50 bp). Removal of the 5,696 SNPs that occur in known mutational hotspots (CpG sites) did not significantly change our conclusions, suggesting that recurrent mutations alone cannot explain our data.

Chromosome Aberrations↗

Selected issues in the design and analysis of sport performance research.

The aim of this review is to discuss some issues in the design and statistical analysis of sport performance research, rather than to supply an authoritative 'cookbook' of methods. In general, we try to communicate some possible solutions to the conundrum of how to maintain both internal and external validity, as well as optimize statistical power, in applied sport performance research. We start by arguing that some sport performance research has been overly concerned with physiological predictors of performance, at the expense of not providing a valid and reliable description of the exact nature of the task in question. We show how the influence of certain factors on competitive performances can be described using linear or logistic regression. We discuss the choice of analysis for factorial repeated-measures designs, which is complicated by the assumption of 'sphericity' in a univariate general linear model, and the relatively low statistical power of the multivariate approach when used with small samples. We consider a little-used and simpler technique known as 'analysis of summary statistics'. In multi-group pre- and post-test designs, a useful technique can be to pair-match individuals on their performance scores in a counterbalanced fashion before the intervention or control has been introduced. Finally, we outline how confidence intervals can help in making statements about the probability of the population difference in performance exceeding the value designated as being worthwhile or not.

Humans↗

Isolation by distance, web service.

BACKGROUND: The population genetic pattern known as "isolation by distance" results from spatially limited gene flow and is a commonly observed phenomenon in natural populations. However, few software programs exist for estimating the degree of isolation by distance among populations, and they tend not to be user-friendly. RESULTS: We have created Isolation by Distance Web Service (IBDWS) a user-friendly web interface for determining patterns of isolation by distance. Using this site, population geneticists can perform a variety of powerful statistical tests including Mantel tests, Reduced Major Axis (RMA) regression analysis, as well as calculate FST between all pairs of populations and perform basic summary statistics (e.g., heterozygosity). All statistical results, including publication-quality scatter plots in Postscript format, are returned rapidly to the user and can be easily downloaded. CONCLUSION: IBDWS population genetics analysis software is hosted at http://phage.sdsu.edu/~jensen/ and documentation is available at http://www.bio.sdsu.edu/pub/andy/IBD.html. The source code has been made available on Source Forge at http://sourceforge.net/projects/ibdws/.

Computer Graphics↗