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At least 307 records · Page 17Linked to original sources

PubMed1994

Medical data capture and display: the importance of clinicians' workstation design.

The Department of Veterans Affairs is developing, testing and evaluating the benefits of physicians' workstations as an aid to medical data capture in an outpatient clinic setting. The physician's workstation uses a graphical user interface to aid the clinician in recording encounter data. Various input devices including keyboard, mouse, pen, voice, barcode reader, and tablet are available on the workstations, and user preferences will be examined. Access to general services such as electronic mail and reference databases is also available. The workstation provides a wide variety of patient specific data from the hospital information system, including image data. The single data collection process by the clinician will also provide data for the cost recovery process.

Computer Peripherals↗

PubMed2000

The novel anticonvulsant retigabine activates M-currents in Chinese hamster ovary-cells tranfected with human KCNQ2/3 subunits.

Retigabine (D-23129) is a novel antiepileptic compound with broad spectrum and potent anticonvulsant properties, both in vitro and in vivo. The compound was shown to activate a K(+) current in neuronal cells. The pharmacology of the induced current displays concordance with the published pharmacology of the M-channel, which recently was correlated to the KCNQ2/3 K(+) channel heteromultimere. We examined the effect of retigabine on KCNQ2/3 expressed in Chinese hamster ovary cells. The compound concentration-dependently activated a K(+) current in transfected cells clamped at -50 mV. The activation was induced by a shift of the opening threshold to more negative potentials. The effect was not mediated by an interaction with the cAMP modulatory site and could be partially blocked by the M-channel antagonist linopirdine. The data display that retigabine is the first described M-channel agonist and support the hypothesis that M-channel agonism is a new mode of action for anticonvulsant drugs. Since the function of this channel is reduced in a hereditary epilepsy syndrome, retigabine may be the first anticonvulsant to directly target the deficit observed in a channelopathy.

Animals↗

PubMed1999

Volume rendering using seed-filling acceleration: supporting cut planes by fast reseeding.

OBJECTIVE: Seed filling in view lattice is a method for accelerating volume rendering. Our previously published results on using seed filling had the limitation that they did not support cut planes. Cut planes are one of the main advantages of using volume rendering over surface rendering. In this article we describe the seed-filling acceleration technique and propose two fast reseeding processes that may be performed for each frame. MATERIALS AND METHODS: The reseeding process performs a connected component search on the cut plane within the volume data set. The amount of processing done by a connected component search algorithm is proportional to N(2), assuming the data set size is N(3). We implemented two connected component search algorithms: one for orthogonal cut planes and another for oblique cut planes. We measured the time taken by the cutting and estimated the effect on the rendering performance when the cut plane was moved interactively. RESULTS: Our measurements show that rendering rates of several frames per second can be achieved with a 266-MHz Pentium II PC, even when the object is interactively modified with cut planes during the rendering. CONCLUSIONS: We have shown that the seed-filling algorithm is also applicable in situations where the displayed data is modified interactively using cut planes or objects. Applications in this regard include, for example, computer-aided surgery systems, where the instrument may be used to interactively perform the simulated cut in the data set.

Algorithms↗

PubMed2001

Finding the optimal picture archiving and communication system (PACS) architecture: a comparison of three PACS designs.

PURPOSE: At present, there are two basic picture archiving and communication system (PACS) architectures: centralized with a central cache and controller, and distributed with a distributed cache and central controller. A third architecture proposed here is an autonomous one with a distributed cache and no controller. This report will investigate the performance (as measured be central processing unit [CPU] and network load, scalability, and examination retrieval and display latency) of these three types. METHODS: The distributed PACS architecture will be simulated using an IMPAX R3.5 (AGFA, Ridgefield Park, NJ) PACS, while the centralized design will be simulated using an IMPAX R4 (AGFA) PACS. The autonomous system will be designed and implemented in-house. The autonomous system consists of two types of entities: basic components such as acquisition gateways, display stations, and long-term archives, and registry servers, which store global state information about the individual PACS components. The key feature of the autonomous system will be the replacement of the central PACS controller by the registry servers. In this scenario the registry servers monitor the interactions between the components, but do not directly govern them. Instead each component will contain the application logic it requires and will use the state information from the registry servers to take the appropriate action, such as routing images, prefetching studies, and expiring images from near line cache. In addition the routing of examinations will be optimized to reduce the duplication of image data. Display stations will be categorized by specialty (neuroradiology, pediatrics, chest, etc) and will retrieve studies for display on demand from intermediate servers dedicated to the corresponding specialty. Studies will be routed only to the intermediate servers and not to display stations. RESULTS: By distributing the application logic, an autonomous PACS architecture can provide increased fault tolerance and therefore increased uptime. In addition, the lack of a central controller and the use of intermediate servers improve the scalability of the system, as well as reduce CPU and network loads.

Computer Communication Networks↗

PubMed1994

Frameless stereotaxy for surgery of the epilepsies: preliminary experience. Technical note.

Frameless stereotactic techniques used in conjunction with three-dimensional images allow accurate planning and performance of a variety of neurosurgical procedures. The authors have used the frameless stereotactic Allegro Viewing Wand system to provide real-time correlation of the operating field and computerized images in 42 neurosurgical operations, including 31 epilepsy procedures. The system consists of an image-processing computer that creates three-dimensional and triplanar images; a mobile computer to display reformatted magnetic resonance images; and a hand-guided, articulated, position-sensing arm with a probe. At the start of the operation, the probe identifies the patient's facial and scalp features and correlates these with the computerized images. The position-sensing arm can then guide the operation and locate anatomical structures and lesions of interest. This system can be used to advantage in performing smaller craniotomies and intraoperatively locating anatomical structures and lesions to be removed. Postoperative magnetic resonance images demonstrate that this technique was accurate to within 3 mm in measuring the anteroposterior resection of fixed structures, such as hippocampus and corpus callosum. Disadvantages include longer preoperative preparation for data analysis and lack of both real-time computer analysis of tissue removal and angiographic data display. Preliminary experience suggests that the viewing wand system's advantages outweigh the disadvantages, and it is most helpful as an adjunctive navigational device in the microsurgical treatment of epilepsy.

Adolescent↗

PubMed1984

A computer program for analyzing enzyme kinetic data using graphical display and statistical analysis.

A computer program, PENNZYME (M. C. Kohn, L. E. Menten, and D. Garfinkel, Comput. Biomed. Res. 12, 461, 1979), that fits trial rate laws to enzyme and transport steady-state kinetic data by nonlinear regression has been enhanced. The new version includes a set of mnemonic commands which can be displayed in a menu at the user's option. Graphic displays of measured data and computed curves, as well as deviations between them (residual plots) have been added to aid the user in determining if a model is free of bias or systematic error. Other features include the ability to display the variance-covariance matrix of the parameters, to hold individual parameters constant during an optimization, and to optimize error models for the experimental data by the extended-least-squares technique.

Computers↗

PubMed2000

Structural and thermodynamic aspects of cooperativity in the homodimeric hemoglobin from Scapharca inaequivalvis.

The homodimeric cooperative hemoglobin from the mollusk Scapharca inaequivalvis displays an unusual subunit assembly with respect to vertebrate hemoglobins. The intersubunit contact region is formed by the two heme-carrying E and F helices, which bring the two hemes in contact with each other. At variance with tetrameric vertebrate hemoglobins, the ligand binding is not accompanied by a significant quaternary transition. The major ligand-linked changes are tertiary and are limited to the heme pocket and subunit interface. These unique structural features of HbI are not easily reconciled with the classical thermodynamic models used to describe cooperative ligand binding in vertebrate hemoglobins. The lack of distinct quaternary states and the absence of allosteric effectors suggested that cooperativity in HbI is entirely homotropic in origin. Thereafter, high resolution X-ray crystallographic data displayed the preferential binding of water molecules at the intersubunit interface in the unliganded protein with respect to the liganded one. These ordered water molecules were thus proposed to act as heterotropic effectors in HbI. The contribution of specific water binding to the observed cooperativity in HbI is discussed in the framework of the enthalpy-entropy compensation effect emerging from previous accurate equilibrium oxygen binding measurements.

Allosteric Regulation↗

PubMed2005

Characterization of trypsin immobilized on the functionable alkylthiolate self-assembled monolayers: a preliminary application for trypsin digestion chip on protein identification using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.

Self-assembled monolayers (SAMs) on coinage metal provide versatile modeling systems for studies of interfacial electron transfer, biological interactions, molecular recognition and other interfacial phenomena. Recently the bonding of enzyme to SAMs of alkanethiols onto Au electrode surfaces was exploited to produce a bio-sensing system. In this work, the attachment of trypsin to a SAMs surface of 11-mercaptoundecanoic acid was achieved using water soluble N-ethyl-N '-(3-dimethylaminopropyl)carbodiimide hydrochloride and N-hydroxysuccinimide as coupling agent. The thickness of SAMs was determined by optical ellipsometer; contact angles of the modified Au surfaces were measured in air using a goniometer. The Second Harmony Generation data displays the last few percents of the alkylthiol molecules adsorbed and produced the complete monolayer by inducing the transition from a high number of gauche defects to an all-trans conformation. Using X-ray Photoelectron Spectroscopy (XPS) and Fourier-Transformed Infrared Reflection-Absorption and Attenuated Total Reflection Spectroscopes (FTIR-RAS and ATR), we examined the chemical structures of samples with different treatments. By matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), we demonstrated the digestion of bovine serum albumin (BSA) on the trypsin-immobilized SAMs surface. Experimental results have revealed that the XPS C1s core levels at 286.3 and 286.5 eV (Amine bond), 288.1 eV (Amide bond) and 289.3 eV (Carboxylic acid) illustrate the immobilization of trypsin. These data were also in good agreement with FTIR-ATR spectra for the peaks valued at 1659.4 cm(-1) (Amide I) and 1546.6 cm(-1) (Amide II). Using MALDI-TOF MS observations, analytical results have demonstrated the BSA digestion of the immobilized trypsin on the functionalized SAMs surface. For such surfaces, BSA was digested on the trypsin-immobilized SAMs surface, which shows the enzyme digestion ability of the immobilized trypsin. The terminal groups of the SAMs structure can be further functionalized with biomolecules or antibodies to develop surface-base diagnostics, biosensors, or biomaterials.

Biosensing Techniques↗

PubMed2006

A prospective comparison of 3 new-generation pulse oximetry devices during ambulation after open heart surgery.

OBJECTIVE: To assess the clinical performance of 3 new-generation pulse-oximetry signal-processing software systems (Philips FAST, Masimo SET, and Nellcor N-3000) during ambulation after open-heart surgery. DESIGN: Prospective, convenience sample. SETTING: Cardiac surgical progressive care unit in a 629-bed, not-for-profit, tertiary-care teaching hospital. PATIENTS: Status post-cardiac-surgery patients (n = 36) during their first postoperative ambulation. INTERVENTIONS: None. PROTOCOL: Randomization was used for digit and hand selection, and all 3 devices were used continuously during ambulation. Data on dropouts, false alarms, and correlation with heart rate were recorded. We continuously measured arterial oxygen saturation via pulse oximetry during ambulation with all 3 devices. RESULTS: Pairwise comparisons indicated significant differences among the 3 devices for data dropout and false alarm. In repeated-measures analysis, the Nellcor N-3000 had the greatest likelihood of data dropout (odds ratio of 31.9 to Masimo and 5.6 to Philips, at the 95% confidence interval). However, the converse was true for false alarms; the Masimo had the most false alarms, with an odds ratio of 17.9 to Nellcor and 2.3 to Philips, at the 95% confidence interval. There were also significantly more dropouts with all 3 devices when readings were taken on a hand on an arm from which a radial graft had been taken (p = 0.004). For heart-rate correlation, the mean absolute difference among the 3 devices was similar: Philips = 4.3 beats/min, Masimo = 5.1 beats/min, and Nellcor = 3.0 beats/min. CONCLUSIONS: There are significant differences among the 3 devices with regard to dropout and false alarms. High numbers of dropouts are problematic because no pulse-oximetry patient information is available during dropout. However, false alarms are even more problematic, because they desensitize clinicians to alarms and call into question the accuracy of displayed data. While our data highlight the statistical differences between the studied oximeters, the clinical implications of these differences warrant further study.

Adult↗

PubMed1995

Low-stringency single specific primer PCR, DNA sequencing and single-strand conformation polymorphism of PCR products for identification of genetic variants of human papillomavirus type 16.

Two fragments from within the long control region of the genome of human papillomavirus type 16 (HPV16) were amplified using the polymerase chain reaction (PCR). Putative genetic variation among the parent viruses was assessed by complete sequence analysis and single-strand conformation polymorphism (SSCP) analysis of one of the fragments and by application of the recently described low-stringency single specific primer (LSSP) PCR to both PCR products. The study comprised 34 HPV16 positive samples, derived from seventeen different individuals. It is demonstrated that under experimentally standardised conditions the LSSP PCR-, sequencing- and SSCP-data display differing degrees of resolution. Based on combined LSSP PCR analyses, 33 out of 34 samples can be discriminated, whereas SSCP and direct sequencing identify 4 and 8 types, respectively. Although the variability observed among LSSP PCR patterns may be the consequence of small quantities of mutated viral amplimers, no concordant grouping of strains, identical by sequencing and SSCP analysis, can be established by either of the four theoretically possible LSSP PCR assays. Results are discussed in the context of experimental variability of the procedures or genetic heterogeneity of HPV16 pools derived from cervical swabs.

Base Sequence↗

PubMed2004

How does your searching grow? A survey of search preferences and the use of optimal search strategies in the identification of qualitative research.

The objective was to gain an overview of researchers experiences of searching the literature, with particular reference to the use of optimal search strategies (OSSs) and searching for qualitative research studies. A 13-item semi-structured questionnaire investigating search behaviour was distributed to members of the Cochrane Qualitative Methods Network. Follow-up interviews were conducted with a subset of respondents to explore issues raised and clarify points of ambiguity. Findings were analysed using data reduction, data displays and verification techniques. Eighty-six per cent of distributed questionnaires were returned. All respondents reported searching electronic databases as part of their literature search, with 80% expressing a preference for searching alone or with colleagues. Forty-one per cent indicated that they consider a database search to be only one aspect of a comprehensive literature search. The rigour and availability of OSSs was a concern for 30% of respondents. Twenty-five per cent of respondents had searched for qualitative studies, although the difficulty of locating this type of literature was considered problematic because of the varied use of the term 'qualitative'. Whilst the majority of respondents reported using OSSs in some capacity, reservations were expressed about their ability to facilitate a comprehensive search. Replies indicated a belief that OSSs can reduce the sensitivity of a search, and might limit the breadth of coverage required. A greater appreciation of the availability and purpose of OSSs-including the ability to optimize either sensitivity or recall-is needed if this enhanced approach to accurate data retrieval and potential improvement in time management is to become widespread.

Information Storage and Retrieval↗

PubMed2005

Redox sensitive cysteine residues in calbindin D28k are structurally and functionally important.

Human calbindin D(28k) is a Ca(2+) binding protein that has been implicated in the protection of cells against apoptosis. In this study, the structural and functional significance of the five cysteine residues present in this protein have been investigated through a series of cysteine-to-serine mutations. The mutants were studied under relevant physiological redox potentials in which conformational changes were monitored using ANS binding. Urea-induced denaturations, as monitored by intrinsic tryptophan fluorescence, were also carried out to compare their relative stability. It was shown that the two N-terminal cysteine residues undergo a redox-driven structural change consistent with disulfide bond formation. The other cysteine residues are not by themselves sufficient at inducing structural change, but they accentuate the disulfide-dependent conformational change in a redox-dependent manner. Mass spectrometry data show that the three C-terminal cysteine residues can be modified by glutathione. Furthermore, under oxidizing conditions, the data display additional species consistent with the conversion of cysteine thiols to sulfenic acids and disulfides to disulfide-S-monoxides. The biological function of calbindin D(28k) appears to be tied to the redox state of the cysteine residues. The two N-terminal cysteine residues are required for activation of myo-inositol monophosphatase, and enzyme activation is enhanced under conditions in which these residues are oxidized. Last, oxidized calbindin D(28k) binds Ca(2+) with lower affinity than does the reduced protein.

Amino Acid Sequence↗

PubMedDate not supplied

Nurses caring for the spirit: patients with cancer and family caregiver expectations.

PURPOSE/OBJECTIVES: To determine what patients with cancer and primary family caregivers expect from nurses with regard to having their spiritual needs addressed. RESEARCH APPROACH: Descriptive, cross-sectional, qualitative study using Miles and Huberman s approach to data reduction. SETTING: Outpatient and inpatient settings in a county hospital and a comprehensive cancer center, both located in a large, southwestern, metropolitan area. PARTICIPANTS: 28 African American and Euro-American adult patients with cancer and primary family caregivers were purposively selected to provide variation of experiences (e.g., religious backgrounds). METHODOLOGIC APPROACH: In-depth, semistructured, tape-recorded interviews conducted by the investigator. Analysis of transcribed interviews concurrently with data collection followed a process of data concentration, data display, and conclusion drawing. MAIN RESEARCH VARIABLES: Spiritual needs, spiritual care. FINDINGS: Informants identified nursing approaches for spiritual needs, including kindness and respect; talking and listening; prayer; connecting with symmetry, authenticity, and physical presence; quality temporal nursing care; and mobilizing religious or spiritual resources. To provide spiritual care, nurses must possess requisites of a personal, relational, or professional nature. CONCLUSIONS: Although some patients or caregivers do not want overt forms of spiritual care, others are eager for them. Many recognize nonreligious actions or attitudes that nurses can practice to care for spiritual needs. INTERPRETATION: Nurses must consider how they can address patient preconceptions and requisites for spiritual caregiving. Nurses may need to educate the public regarding their role as holistic and spiritual healthcare providers.

Adolescent↗

PubMed2002

Kinetic modeling of virus transport at the field scale.

Bacteriophage removal by soil passage in two field studies was re-analyzed with the goal to investigate differences between one- and two-dimensional modeling approaches, differences between one- and two-site kinetic sorption models, and the role of heterogeneities in the soil properties. The first study involved removal of bacteriophages MS2 and PRDI by dune recharge, while the second study represented removal of MS2 by deep well injection. In both studies, removal was higher during the first meters of soil passage than thereafter. The software packages HYDRUS-ID and HYDRUS-2D, which simulate water flow and solute transport in one- and two-dimensional variably saturated porous media, respectively, were used. The two codes were modified by incorporating reversible adsorption to two types of kinetic sites. Tracer concentrations were used first to calibrate flow and transport parameters of both models before analyzing transport of bacteriophages. The one-dimensional one-site model did not fully describe the tails of the measured breakthrough curves of MS2 and PRD1 from the dune recharge study. While the one-dimensional one-site model predicted a sudden decrease in virus concentrations immediately after the peaks, measured data displayed much smoother decline and tailing. The one-dimensional two-site model simulated the overall behavior of the breakthrough curves very well. The two-dimensional one-site model predicted a more gradual decrease in virus concentrations after the peaks than the one-dimensional one-site model, but not as good as the one-dimensional two-site model. The dimensionality of the problem hence can partly explain the smooth decrease in concentration after peak breakthrough. The two-dimensional two-site model provided the best results. Values for k(att2) and k(det2) could not be determined at the last two of four monitoring wells, thus suggesting that either a second type of kinetic sites is present in the first few meters of dune passage and not beyond the second monitoring well, or that effects of soil heterogeneity and dimensionality of the problem overshadowed this process. Variations between single collector efficiencies were relatively small, whereas collision efficiencies varied greatly. This implies that the nonlinear removal of MS2 and PRD1 is mainly caused by variations in interactions between grain and virus surfaces rather than by physical heterogeneity of the porous medium. Similarly, a two-site model performed better than the one-site model in describing MS2 concentrations for the deep well injection study. However, the concentration data were too sparse in this study to have much confidence in the fitted parameters.

Adsorption↗

PubMed2000

Detection of emerging resistance patterns within longitudinal surveillance systems: data sensitivity and microbial susceptibility. MYSTIC Advisory Board. Meropenem Yearly Susceptibility Test Information Collection.

Communicating information from antimicrobial resistance surveillance study data to microbiologists and physicians can be challenging. Large amounts of data, commonly reaching millions of MICs or zone diameter endpoints, must be analysed and condensed to easily-read tables or figures. Furthermore, data must not be prejudged relative to susceptibility categories, because of the diverse nature of interpretive criteria available internationally. An attempt must be made to present results of all surveillance studies in a mode that can be reinterpreted for immediate use in different geographical areas, or used to compare future data with relative ease and high accuracy. Such data displays require peer-reviewed journals to permit greater numbers of more complex tables to present results. The Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) study is a year-on-year global surveillance programme in medical centres where meropenem is available for use. We have developed a presentation strategy that expands the long-term clinical value of MYSTIC results. In addition to statistical parameters, tables of cumulative percentages or numbers of strains inhibited at each tested antimicrobial concentration will be presented. Alternative figures (Finland-o-grams) could also be used, but these generally lack precise extractable rates and require more journal space. Regardless of study design, promotion of this presentation philosophy enhances any surveillance study's value to each reader or user and facilitates application to locally appropriate interpretations. The widespread use of these analysis and presentation principles as benchmarks by various resistance studies and networks is strongly encouraged, particularly by investigations across international boundaries.

Anti-Bacterial Agents↗

PubMed2005

Ability of navigated 3D ultrasound to delineate gliomas and metastases--comparison of image interpretations with histopathology.

BACKGROUND: The objective of the study was to test the ability of a 3D ultrasound (US) based intraoperative imaging and navigation system to delineate gliomas and metastases in a clinical setting. The 3D US data is displayed as reformatted 2D image slices. The quality of the displayed 3D data is affected both by the resolution of the acquired data and the reformatting process. In order to investigate whether or not 3D US could be used for reliable guidance in tumour surgery, a study was initiated to compare interpretations of imaged biopsy sites with histopathology. The system also enabled concomitant comparison of navigated preoperative MR with histopathology. METHOD: Eighty-five biopsies were sampled between 2-7 mm from the tumour border visible in the ultrasound images. Biopsies were collected from 28 operations (7 low-grade astrocytomas, 8 anaplastic astrocytomas, 7 glioblastomas and 6 metastases). Corresponding cross-sections of preoperative MR T1, MR T2 and intraoperative US were concomitantly displayed, steered by the biopsy forceps equipped with a positioning sensor. The surgeons' interpretation of the images at the electronically indicated biopsy sites were compared with the histopathology of the samples. FINDINGS: The ultrasound findings were in agreement with histopathology in 74% (n = 31) for low-grade astrocytomas, 83% (n = 18) for anaplastic astrocytomas, 77% (n = 26) for glioblastomas and 100% (n = 10) for metastases. Excluding irradiated patients, the results for glioblastomas improved to 80% concurrence (n = 20). As expected tumour cells were found in biopsies outside the US visible tumour border, especially in low-grade gliomas. Navigated 3D US have a significantly better agreement with histopathology than navigated MR T1 for low-grade astrocytomas. CONCLUSION: Reformatted images from 3D US volumes give a good delineation of metastases and the solid part of gliomas before starting the resection. Navigated 3D US is at least as reliable as navigated 3D MR to delineate gliomas and metastases.

Adult↗

PubMed2005

MDCT evaluation of the coronary arteries, 2004: how we do it--data acquisition, postprocessing, display, and interpretation.

OBJECTIVE: Cardiac CT is rapidly becoming part of clinical practice. The objective of this article is to discuss and illustrate the current practice of coronary artery MDCT, including data acquisition, postprocessing, image display, and interpretation. The practice described reflects our experience with a series of patients referred in routine clinical practice. CONCLUSION: The reader should gain an insight into the current clinical application of coronary artery CT.

Contrast Media↗

PubMed1982

Conversion of linear histogram flow cytometry data to a logarithmic display.

A routine is described that readily allows the rescaling of linear histographic data to a corresponding logarithmic histogram. This procedure significantly improves data display, particularly where a wide range in the measured parameter is encountered. The logarithmic scale displays peaks with band widths more proportional to their respective coefficients of variation than is the case in a linear display. Rescaling several linear histograms to a common logarithmic scale allows the combination of these linear data even though the linear ranges are different. This routine is presented as a program written in BASIC for execution on a microcomputer.

Computers↗