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At least 415 records · Page 23Linked to original sources
PubMed1991

Critically ill patients have high basal growth hormone levels with attenuated oscillatory activity associated with low levels of insulin-like growth factor-I.

OBJECTIVE: The aim was to study the relationship between growth hormone (GH) and insulin-like growth factor-I (IGF-I) in critically ill patients. DESIGN: Case-control study of critically ill patients admitted to the intensive care unit was carried out. PATIENTS: Six critically ill patients (51-78 years) who required ventilation and parenteral nutrition and six age, weight, height, and sex-matched healthy adults were studied. MEASUREMENTS: The patients and controls were studied for two 24-hour periods; the patients before and after starting parenteral feeding, and the controls during a 36-hour fast and when taking meals equivalent in calories and protein to the patients' parenteral feed. Serum GH was measured at 20-minute intervals and analysed by a pulse detection algorithm (Pulsar) and Fourier transformation. IGF-I was measured at 0, 12, and 24 hours. RESULTS: Patients had low serum IGF-I levels compared with controls, whether fasted or fed, despite having mean GH levels similar to fasted controls. For fasted patients vs fasted controls the mean (+/- 1 SD) GH levels were 4.5 +/- 2.0 vs 4.0 +/- 2.4 mU/l respectively, and IGF-I levels at the end of the fast were 0.17 +/- 0.11 vs 0.78 +/- 0.29 U/ml (P = 0.003). Patients showed elevated baseline GH levels compared with controls when fasted and during parenteral feeding (patients vs controls fasted 3.1 +/- 1.9 vs 0.8 +/- 0.5 mU/l, P = 0.01; patients vs controls fed 4.2 +/- 4.5 vs 0.5 +/- 0.04 mU/l, P = 0.028). Fourier transformation confirmed oscillatory GH levels in the controls, fasted or fed, but this activity was attenuated in the patients. Parenteral feeding had no effect on the GH profiles or IGF-I levels of patients, but controls showed greater mean GH levels during their fast than when fed. CONCLUSIONS: We have demonstrated that critically ill patients have low IGF-I levels associated with augmented baseline GH levels which show reduced oscillatory activity. The results would be compatible with the hypothesis that there is an adaptive change in critically ill patients away from the indirect effects of GH (stimulation of IGF-I production and anabolism) and toward the direct effects (lipolysis and insulin antagonism) which increase the availability of energy substrates. The pattern of GH levels seen in our patients may be important in this adaptation.

Abdomen↗
PubMed1990

Segmentation of coronary arteriograms by iterative ternary classification.

A segmentation algorithm for extracting arterial structures in coronary angiograms is presented. The algorithm mimics the process of interactive interpretation in human vision by iteratively implementing a ternary classification and learning process. Two gray-scale thresholds are computed to define three pixel classes: artery, background, and undecided. Then, two new thresholds for undecided pixels are computed using statistics conditioned upon the current classification. The threshold adaptation is governed by a learning algorithm based on the line and consistency measurements around each pixel. The process converges and results in a binary image. The performance of this algorithm on human coronary arteriograms was compared qualitatively to that of a relaxation algorithm and of a scattering based algorithm. Quantitative comparison was also made possible with computer generated images, which were obtained with the help of a model of the imaging chain and a process of interactive visualization of the modeled data. The iterative ternary classifier showed the best performance over a broad range of image quality. The study also demonstrated the use of visualization and user interaction in model building and algorithm development.

Algorithms↗
PubMedDate not supplied

Variation in the lung inhomogeneity correction factor with beam energy. Clinical implications.

In order to determine the magnitude of the dosimetry error introduced by failing to correct for increased transmission through lung tissue in treating thoracic malignancies, measurements in a phantom were taken using different field sizes, inhomogeneity thicknesses and photon qualities. The results indicate that the error introduced by neglecting the inhomogeneity correction is greatest at lower photon energies, smaller field sizes and greater thickness of inhomogeneity. Correction factors to account for the lung inhomogeneity were obtained from phantom measurements and were compared with those calculated using the tissue-air ratio and Batho-Young algorithms; correlation coefficients describing the relationship between measured and calculated values exceeded 0.995. The calculated values tended to overestimate the correction factor and differed most from the measured correction factors at lower energies, smaller field sizes, and greater inhomogeneity thicknesses. The importance of these results in clinical radiation therapy is discussed.

Cobalt Radioisotopes↗
PubMed1998

An image registration scheme applied to verification of radiation therapy.

The introduction of modern conformal radiation therapy techniques requires high geometric precision in treatment delivery which must be verified. For that purpose we have developed an automated system based on registration of portal and simulation (or planning) image pairs. The image registration is performed on anatomical features which are automatically extracted from the portal image. The portal image is then registered with a planning or simulation radiographic image which represents the geometric prescription for the treatment, using an optimized version of the chamfer matching algorithm. Subsequently, the magnitude of the radiation field displacement during treatment is measured by registering the prescribed and treated field boundaries. Algorithms based on chamfer matching and polygon matching have been used for the field boundary registration. Performance of the entire scheme was evaluated on a series of 15 portal images of a pelvic phantom representing various known degrees of the radiation field displacement. The measurements of the radiation field displacements performed by the automated system proved very reliable and after correction for systematic bias agreed to within 1.5 mm or 1 degree with the displacements applied. Second test series involved comparisons between the automated registrations and those performed manually/visually by an experienced human observer, on 31 portal images acquired during treatments of 18 pelvic patients. These tests showed close agreement (in 80% of cases discrepancies were smaller than 1.5 mm or 1.5 degrees) between the automated scheme and the human observer. It is concluded that the developed scheme would be suitable for online geometric verification of radiation therapy treatments.

Algorithms↗
PubMed2026

Methods for defining equity-stratifying variables: a systematic review of validation studies.

BACKGROUND AND OBJECTIVE: Disease burden is often disproportionally higher among those who are socially disadvantaged by factors defined in the PROGRESS-Plus framework (ie, Place of residence, Race/ethnicity/culture/language, Occupation, Gender/sex, Religion, Education, Socioeconomic status, and Social capital, with "Plus" covering features like age and disability). The accuracy and applicability of case definitions to identify these variables from administrative and clinical health data are unknown. We conducted a systematic review to explore how equity-stratifying variables, as categorized by the PROGRESS-Plus framework, have been defined and validated in epidemiologic studies using administrative health, population-level, or electronic health record (EHR) data. METHODS: Medline, EMBASE, CINAHL, Web of Science, and Google Scholar were searched from the inception of the databases to 2024 for validation studies of equity-stratifying variables in adults using administrative health datasets, health registries, or EHR data. Titles and abstracts, followed by relevant full-text articles, were screened in duplicate by two reviewers for eligibility. The data sources utilized, algorithms employed, and their associated performance measures were extracted and synthesized from included studies. Given substantial heterogeneity in study design, equity-stratifying variable definition, and performance metrics, meta-analysis was not possible. RESULTS: Of the 9099 unique citations screened, 188 full texts were reviewed and 116 were included in this review. Most studies were published between 2019 and 2024 (n = 64, 55%) and were validation studies of race/ethnicity definitions that used race/ethnicity codes or surname list algorithms (n = 66, 57%). No studies examined religion. Regarding the reported performance measure estimates, the race/ethnicity/culture/language equity-stratifying variables category had the largest variability across sensitivity, positive predictive value (PPV), and Cohen's Kappa. Occupation validation studies had the lowest variation in sensitivity and PPV. CONCLUSION: Despite an increasing number of publications reporting on the validation of equity-stratifying variables relevant to the PROGRESS-Plus framework, performance measures varied widely across studies. The significant heterogeneity in equity-stratifying variable definitions and methods used to validate them support the need for further rigorous validation of equity-stratifying variables in administrative and clinical health data. PLAIN LANGUAGE SUMMARY: Disease burden is often higher in people who experience financial hardships, lower level of education, discrimination due to race/ethnicity, and unstable housing. These social factors can be considered health equity factors and are important for understanding health inequalities. Health researchers often use large datasets, such as hospital or electronic health records (EHRs), to study these health equity factors. However, it is not clear how accurately these data sources capture information about people's social circumstances and how these factors are defined. In this study, we reviewed existing research to understand how health equity factors have been defined across health data sources and how accurate they are at measuring aspects of health equity and social disadvantage. Of the more than 9000 studies we identified, we included 116 that met our criteria for this systematic review. Most included studies focused on identifying race and ethnicity, often using codes or surname-based methods. We found that the accuracy of these methods varied widely across studies, meaning results may not always be reliable or comparable. Overall, our findings show that there are inconsistencies in how social factors are defined and measured in health data. This makes it difficult to fully understand and address health inequalities using routinely collected health data. More work is needed to develop and validate better quality and more consistent methods for capturing these important social factors.

Humans↗
PubMed1985

Sex determination from chest plate roentgenograms.

Precise sexing--97% to 99% accuracy--of adult chest plates is possible when highly predictive costal cartilage ossification patterns are combined with four simple metric determinations. More than 1100 chest plate roentgenograms were evaluated for ossification pattern, fourth rib width, corpus width, sternal length and sternal area in an adult decedent population. An elementary, empirically obtained algorithm using the patternings and measurements, along with simple derivations (sternal length and area indices) was developed and then applied in chest plate sexing. This technique is not only easy, rapid and inexpensive, but it also results in a permanent and easily stored record.

Adult↗
PubMed1986

Advantages and limitations of the spatially adaptive program SAPRO in clinical perimetry.

The SAPRO program devised for the OCTOPUS 201 automated perimeter, consists of a number of program components. It is designed to be used on the Octopus 201 computer. In its measurement mode, it employs an algorithm which achieves high speed and efficiency. This is made possible by a threshold bracketing strategy which is simpler than the normal OCTOPUS bracketing. Moreover, three grids with test location distributions of increasing resolution are superimposed in succession on the whole or on part of the visual field to be analyzed. Out of the distribution of test locations, only those which fulfill a number of criteria are actually utilized. These criteria must be given and are adaptable to any given clinical problem. As a result, despite the high spatial resolution achieved, only a fraction of the test locations are utilized using SAPRO as compared with a program using a fixed pattern of test locations. The algorithm is thus able to imitate human intelligence, which tends to concentrate stimuli at places which appear to be relevant for the solution of a problem. The results of program SAPRO are disturbed by short- and long-term fluctuations. Their validity is limited, in a manner similar to that encountered in any other threshold determination procedure. A number of printout modes is available which are oriented towards an optimal understanding of the information contained in various examinations. These principles will be illustrated by one case of inactive disseminated chorioretinitis.

Computers↗
PubMed1991

Calculation of pulse-wave velocity using cross correlation--effects of reflexes in the arterial tree.

The need to investigate the elastic properties of arterial vessels in situ for the early recognition of degenerative disorders in arteries has long been apparent. Pulse-wave diagnostics has been used in traditional medicine, but only in a qualitative way. By measuring the vessel diameter change, simultaneously at two levels along an artery, it should be possible to calculate the pulse-wave velocity (PWV). A newly developed ultrasonic instrument, DIAMOVE, was designed to provide a two-dimensional, real time, B-mode image for display of the exact position of two measurement sites; a computer-controlled digital phased-locked loop detector for the measurement of diameter changes; and a personal computer for the display of the momentary displacement of the artery walls. The cross-correlation technique was used on the information from the vessel wall movements to calculate the resulting PWV. Early measurements on healthy patients showed some unexpected artifacts, which were found to be due to reflected waves, affecting the shape of the pulse-wave at the sites of measurement. A modified PWV estimation algorithm, where only the foot of the pulse-wave in every beat is utilized, seems to have solved this problem and now makes the method suitable for clinical use.

Algorithms↗
PubMed1989

Evaluation of lung dose correction methods for photon irradiations of thorax phantoms.

Radiation absorbed dose in lung is measured and calculated using several algorithms available on commercial treatment planning systems. Phantoms resembling the human thorax are used and irradiated with small and large photon beams of 60Co, 4, 6, and 10 MV X ray energies. The applicability and usefulness of the different calculation methods in clinical situations is discussed.

Lung↗
PubMed1996

Neural networks to identify glaucoma with structural and functional measurements.

PURPOSE: Neural networks can recognize patterns and classify complex variables. We assessed the ability of neural networks to discriminate between normal and glaucomatous eyes by using structural and functional measurements. METHODS: Several neural network algorithms were tested with a database of 185 eyes of patients with early glaucomatous visual field loss (average mean defect, 4.5 dB) and 54 eyes of age-matched normal control subjects. The information used included automated visual field indices (mean defect, corrected loss variance, and short-term fluctuation) and structural data (cup/disk ratio, rim area, cup volume, and nerve fiber layer height) from computerized image analysis. RESULTS: A back propagation network with two intermediate layers assigned an estimated probability of being glaucomatous to each eye and correctly identified 88% of all eyes with 90% sensitivity and 84% specificity. The same neural network trained with only structural data correctly identified 80% of the eyes with 87% sensitivity and 56% specificity, and when trained with functional data only, it correctly identified 84% of the eyes with 84% sensitivity and 86% specificity. CONCLUSION: Analysis of several optic nerve and visual field variables by neural networks can help identify early glaucomatous damage and assign an estimated probability that early damage is present in individual patients.

Algorithms↗
PubMed1987

Effects of cognitive training on primary mental ability structure.

We report results of the first empirical test, as far as we know, of the assumption of structural invariance of latent constructs from pretest to posttest in cognitive training research on the elderly. In all, 401 participants in the Seattle Longitudinal Study, over 62 years old, received a 5-hr test battery at pre- and posttest that included 16 ability tests, marking the five primary abilities of Spatial Orientation, Inductive Reasoning, Numerical Ability, Verbal Ability, and Perceptual Speed. A total of 229 of our subjects received 5 hr of individual training on either Spatial Orientation or Inductive Reasoning. Restricted factor analysis with the LISREL algorithm tested the hypothesis of measurement equivalence across test occasions, separately for the control subjects and for each of the training groups. When ability-specific cognitive training intervenes, no structural change is observed for abilities not subject to intervention. However, slight shifts occurred in the optimal regression weights for the different markers for the training target abilities.

Aged↗
PubMed1998

Detecting periodic patterns in biological sequences.

MOTIVATION: The search for repeated patterns in DNA and protein sequences is important in sequence analysis. The rapid increase in available sequences, in particular from large-scale genome sequencing projects, makes it relevant to develop sensitive automatic methods for the identification of repeats. RESULTS: A new method for finding periodic patterns in biological sequences is presented. The method is based on evolutionary distance and 'phase shifts' corresponding to insertions and deletions. A given sequence is aligned to itself in a certain sense, trying to minimize a distance to periodicity. Relationships between different such periodicity measures are discussed. An iterative algorithm is used, and the running time is nearly proportional to the sequence length. The alignment produces a periodic consensus pattern. A 'phase score' is used to indicate a statistical significance of the periodicity. Three examples using both DNA and protein sequences illustrate how the method can be used to find patterns. AVAILABILITY: On request from the authors. CONTACT: evindc@mat nu.no; finn.drablos@unimed.sintef.no

Algorithms↗
PubMed1997

Electrical impedance tomography of complex conductivity distributions with noncircular boundary.

Electrical impedance tomography (EIT) uses low-frequency current and voltage measurements made on the boundary of a body to compute the conductivity distribution within the body. Since the permittivity distribution inside the body also contributes significantly to the measured voltages, the present reconstruction algorithm images complex conductivity distributions. A finite element model (FEM) is used to solve the forward problem, using a 6017-node mesh for a piecewise-linear potential distribution. The finite element solution using this mesh is compared with the analytical solution for a homogeneous field and a maximum error of 0.05% is observed in the voltage distribution. The boundary element method (BEM) is also used to generate the voltage data for inhomogeneous conductivity distributions inside regions with noncircular boundaries. An iterative reconstruction algorithm is described for approximating both the conductivity and permittivity distributions from this data. The results for an off-centered inhomogeneity showed a 35% improvement in contrast from that seen with only one iteration, for both the conductivity and the permittivity values. It is also shown that a significant improvement in images results from accurately modeling a noncircular boundary. Both static and difference images are distorted by assuming a circular boundary and the amount of distortion increases significantly as the boundary shape becomes more elliptical. For a homogeneous field in an elliptical body with axis ratio of 0.73, an image reconstructed assuming the boundary to be circular has an artifact at the center of the image with an error of 20%. This error increased to 37% when the axis ratio was 0.64. A reconstruction algorithm which used a mesh with the same axis ratio as the elliptical boundary reduced the error in the conductivity values to within 0.5% of the actual values.

Algorithms↗
PubMed1995

Autotransfusion after open heart surgery: the oxygen delivery capacity of shed mediastinal blood is maintained.

Autotransfusion of mediastinal shed blood after open heart surgery has become a common and accepted procedure in reducing the need for homologous transfusion during the last 15 years. The objectives of the present study were to investigate the oxygen delivery capacity of autotransfused shed mediastinal blood, compared to patient-blood, during cardiopulmonary bypass and in the postoperative period. Ten consecutive patients undergoing elective cardiac surgery were studied. Mediastinal shed blood was collected in the cardiotomy reservoir and retransfused during the first 18 postoperative hours. The oxygen delivery capacity of the blood to the tissues was calculated by use of the oxygen status algorithm (OSA 2.0) programme and measurement of the 2,3-diphosphoglycerate (2,3-DPG) concentration. Autotransfusion volume ranged from 450-1530 ml per patient (median 824 ml). Shed blood had a mean haemoglobin level of 8.8 g/dl and 7.4 g/dl at 1 h and 6 h of autotransfusion, respectively. There were no significant changes of 2,3-DPG concentration in the patient-blood during cardiopulmonary bypass or after autotransfusion compared to preoperative values. P50 for oxygen (3.6 and 3.6 kPa) and 2,3-DPG concentrations (5.3 and 5.1 mikromol/ml erythrocyte) in shed mediastinal blood (1h and 6h postoperatively) were not significantly different compared to patient-blood. The results demonstrate that the oxygen delivery capacity of shed mediastinal blood is maintained and that the oxygen affinity of patient-blood is not influenced by autotransfusion.

2,3-Diphosphoglycerate↗
PubMed1995

Autotransfusion after open heart surgery: quality of shed mediastinal blood compared to banked blood.

The need to conserve a patient's own blood and avoid homologous transfusion is now well recognized. Therefore, techniques designed to reduce requirements for homologous blood transfusions have been developed. One of the methods is autotransfusion of shed mediastinal blood after open-heart surgery. The objectives of the present study were to investigate osmotic fragility and oxygen transport capacity of shed mediastinal blood compared to patient blood and stored packed red blood cells (SAGM). Shed mediastinal blood from ten consecutive patients undergoing elective cardiac surgery (coronary bypass grafting) was studied and compared to patient blood, 10 units of 3 weeks old and 10 units of 5 weeks old stored packed red blood cells (SAGM). Oxygen transport capacity was investigated by calculation of p50 for oxygen by use of the oxygen status algorithm (OSA 2.0) programme and measurement of 2,3-diphosphoglycerate (2,3-DPG) concentrations. The osmotic fragility was determined using increasing concentrations of saline. 2,3-DPG concentrations in shed mediastinal blood (5.3 mikromol/ml erythrocyte) were within the range measured in patient blood, but significantly higher than SAGM blood (P < 0.001). P50 for oxygen (3.5 kPa) in shed mediastinal blood was not significantly different compared to patient blood, but significantly higher (P < 0.01) compared with stored SAGM blood. The osmotic fragility in shed mediastinal blood was not significantly different compared to patient blood, but significantly lower (P < 0.001) than the osmotic fragility in stored SAGM blood. This suggests that red cells saved from shed mediastinal blood have better oxygen transport capacity and may have longer survival compared to stored blood.

Aged↗
PubMedDate not supplied

Monte Carlo evaluation of Compton scatter subtraction in single photon emission computed tomography.

In single photon emission computed tomography (SPECT), Compton scattering produces a background that degrades the image quality and contributes erroneously to quantitative measurements. A clinically implementable compensation algorithm has previously been reported that subtracts a Compton scatter image, acquired in an energy window set below the energy of the photopeak, from the primary image acquired in the photopeak window. We present an evaluation and justification of the assumptions made in the previous empirical development of the subtraction algorithm. A Monte Carlo model of the SPECT system in which the Compton scattered vents may be followed independently of the nonscattered events was used to evaluate this subtraction technique. Simulation shows that the assumptions made in the experimental application of this algorithm were valid. Specifically (1) the "scatter" energy window used in the experiment (91-125 keV for imaging Tc-99m) contains only scattered events, (2) the shape of the line spread function (LSF) for the events in the scatter window is a reasonable approximation to the shape of the scatter in the photopeak window, and (3) the ratio of the number of scattered events in the photopeak window to the number of events in the scatter window is 0.57, close to the value of 0.5 derived heuristically. Thus, Monte Carlo simulation validates the basic assumptions underlying the empirical implementation of the scatter subtraction algorithm.

Humans↗
PubMed1985

Localization of cortical areas activated by thinking.

These experiments were undertaken to demonstrate that pure mental activity, thinking, increases the cerebral blood flow and that different types of thinking increase the regional cerebral blood flow (rCBF) in different cortical areas. As a first approach, thinking was defined as brain work in the form of operations on internal information, done by an awake subject. The rCBF was measured in 254 cortical regions in 11 subjects with the intracarotid 133Xe injection technique. In normal man, changes in the regional cortical metabolic rate of O2 leads to proportional changes in rCBF. One control study was taken with the subjects at rest. Then the rCBF was measured during three different simple algorithm tasks, each consisting of retrieval of a specific memory followed by a simple operation on the retrieved information. Once started, the information processing went on in the brain without any communication with the outside world. In 50-3 thinking, the subjects started with 50 and then, in their minds only, continuously subtracted 3 from the result. In jingle thinking the subjects internally jumped every second word in a nine-word circular jingle. In route-finding thinking the subjects imagined that they started at their front door and then walked alternatively to the left or the right each time they reached a corner. The rCBF increased only in homotypical cortical areas during thinking. The areas in the superior prefrontal cortex increased their rCBF equivalently during the three types of thinking. In the remaining parts of the prefrontal cortex there were multifocal increases of rCBF. The localizations and intensities of these rCBF increases depended on the type of internal operation occurring. The rCBF increased bilaterally in the angular cortex during 50-3 thinking. The rCBF increased in the right midtemporal cortex exclusively during jingle thinking. The intermediate and remote visual association areas, the superior occipital, posterior inferior temporal, and posterior superior parietal cortex, increased their rCBF exclusively during route-finding thinking. We observed no decreases in rCBF. All rCBF increases extended over a few square centimeters of the cortex. The activation of the superior prefrontal cortex was attributed to the organization of thinking. The activation of the angular cortex in 50-3 thinking was attributed to the retrieval of the numerical memory and memory for subtractions. The activation of the right midtemporal cortex was attributed to the retrieval of the nonverbal auditory memory.(ABSTRACT TRUNCATED AT 400 WORDS)

Brain Mapping↗