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A low-cost digital filing system for echocardiography data with MPEG4 compression and its application to remote diagnosis.

The high cost of digital echocardiographs and the large size of data files hinder the adoption of remote diagnosis of digitized echocardiography data. We have developed a low-cost digital filing system for echocardiography data. In this system, data from a conventional analog echocardiograph are captured using a personal computer (PC) equipped with an analog-to-digital converter board. Motion picture data are promptly compressed using a moving pictures expert group (MPEG) 4 codec. The digitized data with preliminary reports obtained in a rural hospital are then sent to cardiologists at distant urban general hospitals via the internet. The cardiologists can evaluate the data using widely available movie-viewing software (Windows Media Player). The diagnostic accuracy of this double-check system was confirmed by comparison with ordinary super-VHS videotapes. We have demonstrated that digitization of echocardiography data from a conventional analog echocardiograph and MPEG 4 compression can be performed using an ordinary PC-based system, and that this system enables highly efficient digital storage and remote diagnosis at low cost.

Analog-Digital Conversion↗

The impact of non-injury-related factors on disability secondary to whiplash associated disorder type II: a retrospective file review.

BACKGROUND: There is evidence to suggest that Whiplash Associated Disorders (WADs) are influenced by physical trauma and psychosocial factors, as well as by medicolegal and compensation systems. OBJECTIVE: To investigate the impact of noninjury related variables on self-reported disability at initial assessment among patients presenting with WAD type II injuries. DESIGN AND SETTING: We reviewed a total of 1101 consecutive files of patients presenting to a single chiropractor's office in British Columbia, Canada. We included those who met the inclusion criteria. We extracted demographic variables and noninjury related information from 33 eligible patient files. We calculated correlations between variables and created a multivariable linear regression model to evaluate their relative associations with Neck Disability Index (NDI) scores on presentation. RESULTS: Higher NDI scores on initial assessment correlated with female sex (r = 0.40, P =.02), a greater number of subsequent treatments (r = 0.44, P =.01), a higher number of providers seen before presentation (r = 0.40, P =.02), and most strongly with the involvement of a lawyer (r = 0.73, P <.01). A multivariable linear regression model found that only female sex (P =.03) and the involvement of a lawyer (P =.01) remained significantly associated with higher NDI scores on presentation (adjusted R2 = 0.68 for the model). Female sex was associated with a 10-point increase in NDI scores on presentation (beta coefficient = 10.5; 95% confidence interval [CI] 2.8-18.2), and involvement of a lawyer was associated with a 15-point increase in NDI scores on presentation (beta coefficient = 14.9; 95% CI 5.0-24.7). CONCLUSION: Our analysis of WAD type II patients in receipt of compensation found that higher self-reported disability on initial assessment was associated with female sex and in particular by retaining a lawyer. Large prospective studies are needed to establish the validity of these findings.

Adult↗

Variability of the diameter and taper of size #30, 0.04 nickel-titanium rotary files.

This investigation examined the variability of tip diameter (D0) and taper measurements among four different brands of #30, 0.04 nickel-titanium (NiTi) rotary files (n=15/brand). With all brands, the mean percent D0 difference from the manufacturer's reported (nominal) diameter (Profile GT, 1.73+/-2.03%; Endo Sequence, 3.38+/-3.91%; K3, 4.56+/-2.36%; Profile, 6.13+/-4.07%) indicated that files tended to be larger than the nominal diameter. A 1-factor ANOVA and Tukey's post hoc test revealed a statistically significant difference (p 0.05) of brand on the mean percent difference of the measured taper compared to the nominal taper with the majority of measurements at either 0.039 or 0.040 taper.

Analysis of Variance↗

Event files: feature binding in and across perception and action.

The primate brain codes perceived events in a distributed fashion, which raises the question of how the codes referring to the same event are related to each other. Recent findings suggest that they are integrated into 'object files', episodic bindings of object-related information. However, the problem of integrating distributed codes is not restricted to perception but applies to action planning and sensorimotor processing as well. Here I argue that the brain addresses these problems by creating multi-layered networks of bindings - 'event files' - that temporarily link codes of perceptual events, the current task context, and the actions performed therein. These bindings produce systematic but often surprising and counter-intuitive interactions between, and impairments in, perception and action planning.

Brain↗

Behavioural factors in accidents at road junctions: the use of a genetic algorithm to extract descriptive rules from police case files.

In-depth studies of behavioural factors in road accidents using conventional methods are often inconclusive and costly. To explore an alternative approach, 200 cross-flow junction road accidents were sampled from the files of Nottinghamshire Constabulary, England, coded for computer analysis using a specially devised 'Traffic Related Action Analysis Language', and then examined using a genetic algorithm (or 'rule-finder' program). For comparison, the same analyses were carried out on 100 descriptions of safe turns, and 100 of hypothetical accident descriptions provided by experienced drivers. A number of findings emerged, distinguishing between accidents turning onto and off major roads; those of younger and older drivers; those that resulted in injury or in damage only; and so on. The study suggests that multiple case-studies based on police case files could be very promising, provided homogeneous samples of accidents are used. Genetic algorithms could play a useful role in preliminary assessment, but an 'information bottleneck' remains to be overcome in capturing enough detail from each case for analysis.

Accidents, Traffic↗

[Drug registration file prerequisites for European procedures].

The pharmacokinetic content of the drug registration file is now well standardized. The objectives of the pharmacokinetic documentation is to provide evidence supporting the dosing regimen in patients, to take into account the pathophysiological states of the populations at risk and to anticipate drug-drug interactions. Recommendations on study design and evaluation of parameters of interest are listed in various documents Issued by the Committee for Proprietary Medicinal Products and the International conferences on Harmonization, i.e. the Concept Papers, the Points to Consider and Notes for Guidance. The pharmacokinetic data of the registration file are used to document many sections of the Summary of the Product Characteristics.

Europe↗

Preattentive object files: shapeless bundles of basic features.

A considerable body of recent evidence shows that preattentive processes can carve visual input into candidate objects. Borrowing and modifying terminology from Kahneman & Treisman (1984), this paper investigates the properties of these preattentive object files. Experiments 1-3 show that preattentive object files are loose collections of basic features. Thus, we can know preattentively that an object has the attributes "red" and "vertical" and yet have no idea if any part of the object is red and vertical. Experiment 4 shows that some information about the structure of an object is available preattentively, but Experiments 5-12 search for and fail to find any preattentive representation of overall shape. Appreciation of the overall shape of an object appears to require the binding together of local form features--a process that requires attention.

Adult↗

A comparison of weights of debris extruded apically by conventional filing and Canal Master techniques.

Sixty extracted human teeth were divided into three groups of 20 each. Apically extruded debris and irrigant were collected, dried, and weighed by the following three instrumentation techniques: (a) group 1, filing 1 mm short of the foramen; (b) group 2, Canal Master instrumentation to the foramen; and (c) group 3, filing to the foramen (for a relative comparison). The results indicated that all three groups were significantly different from one another. Group 1 had the least amount of debris extruded. Of the two groups instrumented to the foramen, group 3 had twice as much debris extruded as group 2. An apical dentinal plug was frequently found in group 1 and was probably a major reason why this group had the least amount of extruded debris. The significance of this dentinal plug and possible indications for instrumentation to the foramen are discussed.

Analysis of Variance↗

Comparison of the Canal Master endodontic instrument and K-type files for enlargement of curved root canals.

Twenty mandibular molars with 40 mesial curved root canals were instrumented with a circumferential technique using K files and the Canal Master instrumentation technique by junior dental students whose only endodontic experience had been completion of a preclinical endodontic course. Preoperative and postoperative radiographs were taken facially and mesially with instruments in place. The canals were evaluated radiographically for transportation 1 mm and 4 mm from the apex. The mesial roots were cross-sectioned at the same level. The sections were evaluated for roundness of the canal preparation. It was concluded that the Canal Master instrumentation technique transported the root canal less and produced rounder preparations than the K file circumferential technique. There appears to be a greater tendency for breakage with the Canal Master.

Dental Pulp Cavity↗

Effects of cleaning, disinfection, and sterilization procedures on the cutting efficiency of endodontic files.

The effects of various cleaning, chemical disinfection, and sterilization procedures on the cutting efficiency of endodontic instruments Unifile (De Trey, Bois Colombes, France), (Flexofile Maillefer, Ballaigues, Switzerland), and H-File (Maillefer)) were investigated. The cross-infection control treatment procedures investigated were as follows: chemical disinfection--NaOCl (2.5%) for 12 and 48 h, and NH4 (5%) for 1 and 4 h; ultrasonic cleaning for 4 and 16 cycles of 15 min; and sterilization methods with chemiclave for 5 and 10 cycles of 20 min, Poupinel for 5 and 10 cycles of 120 min at 180 degrees C and glass beads for 10 and 40 cycles of 40 at 250 degrees C. Cutting efficiency was evaluated as the mass of Plexiglas cut per unit of energy expended by the instrument in microgram/Joule. The cutting efficiency decreased from 1 to 77%, depending on the file design and type of treatment procedures. Heat sterilization (Poupinel) did not modify the cutting efficiency of Unifile and Flexofile. The decrease in cutting efficiency was independent of frequency and duration of treatment procedures.

Ammonia↗

Hardness and strength of endodontic files and reamers.

No information could be found in the dental literature on the hardness or strength of the materials in root canal instruments. Hardness testing is a convenient method for examining these products, and strength properties can be deduced from available strength-hardness data. The Vickers hardness of cross-sections of stainless steel root canal files and reamers #15 and #40 made by three well-known manufacturers were determined. Significant differences in hardness were found between manufacturers and between the two sizes of two manufacturers' products. The Vickers hardness range was from 400 to 651, exceeding the range permitted by the AS 1411, and falling below the hardness required for many cutting instruments. The measurements indicate that the instruments are made from high-strength wire. The values obtained suggest that the properties of materials used for some endodontic files could be improved and provide a basis for the selection of superior materials for the future.

Analysis of Variance↗

Determination of impedance changes at varying frequencies in relation to root canal file position and irrigant.

This study was conducted on 10 anterior and premolar teeth that were scheduled for endodontic treatment. After length of tooth determination, a series of test K-file handles were locked at lengths varying from 3 mm short to 0.5 mm long of the foramen. Samples of impedance were taken at each length with a digital signal processor at six different frequencies and for each of seven different irrigants or canal conditions. A total of five different root canal irrigants were used in each tooth (RC Prep, 70% isopropyl alcohol, 14.45% EDTA sodium solution, normal saline, and 5.25% NaOCl), along with two variations of a dry canal. The greatest impedance changes occurred +/- 0.25 mm from the foramen. No significant difference was noted in prediction error at different frequencies (p > 0.05); however, prediction error was significant with respect to different irrigants (p < 0.02). Conductive irrigants demonstrated less change of electrical characteristics with length than nonconductive irrigants, thus allowing a greater prediction of file position in relation to the foramen using electrically nonconductive irrigants.

Bicuspid↗

Effect of rotational speed on nickel-titanium file distortion.

Separation of instruments while performing root canals is something that has plagued all practitioners. The purpose of this study was to evaluate the effect of rotational speed on nickel-titanium file distortion and separation. Forty extracted human molars were instrumented with Profile (Dentsply Tulsa Dental Products, Tulsa, OK) ISO .04 rotary nickel-titanium instruments at 166.67 or 333.33 rpm. The instruments were evaluated after instrumentation for separation and/or distortion. The results of this study were statistically significant and indicate that file distortion and/or separation is four times as likely to occur at 333.33 rpm vs. 166.67 rpm.

Dental High-Speed Technique↗

Single-file diffusion and neurotransmitter transporters: Hodgkin and Keynes model revisited.

Norepinephrine transporters (NETs) use the Na gradient to remove norepinephrine (NE) from the synaptic cleft of adrenergic neurons following NE release from the presynaptic terminal. By coupling NE to the inwardly directed Na gradient, it is possible to concentrate NE inside cells. This mechanism, which is referred to as co-transport or secondary transport (Läuger, 1991, Electrogenic Ion Pumps, Sinauer Associates) is apparently universal: Na coupled transport applies to serotonin transporters (SERTs), dopamine transporters (DATs), glutamate transporters, and many others, including transporters for osmolites, metabolites and substrates such as sugar. Recently we have shown that NETs and SERTs transport norepinephrine or serotonin as if Na and the transmitter permeated through an ion channel together 'Galli et al., 1998, PNAS 95, 13260-13265; Petersen and DeFelice, 1999, Nature Neurosci. 2, 605-610'. These data are paradoxical because it has been difficult to envisage how NE, for example, would couple to Na if these ions move passively through an open pore. An 'alternating access' model is usually evoked to explain coupling: in such models NE and Na bind to NET, which then undergoes a conformational change to release NE and Na on the inside. The empty transporter then turns outward to complete the cycle. Alternating-access models never afford access to an open channel. Rather, substrates and co-transported ions are occluded in the transporter and carried across the membrane. The coupling mechanism we propose is fundamentally different than the coupling mechanism evoked in the alternating access model. To explain coupling in co-transporters, we use a mechanism first evoked by 'Hodgkin and Keynes (1955) J. Physiol. 128, 61-88' to explain ion interactions in K-selective channels. In the Hodgkin and Keynes model, K ions move single-file through a long narrow pore. Their model accounted for the inward/outward flux ratio if they assumed that two K ions queue within the pore. We evoke a similar model for the co-transport of transmitter and Na. In our case, however, coupling occurs not only between like ions but also between unlike ions (i.e. the transmitter and Na ). We made a replica of the Hodgkin and Keynes mechanical model to test our ideas, and we extended the model with computer simulations using Monte Carlo methods. We also developed an analytic formula for Na coupled co-transport that is analogous to the single-file Ussing equation for channels. The model shows that stochastic diffusion through a long narrow pore can explain coupled transport. The length of the pore amplifies the Na gradient that drives co-transport.

Computer Simulation↗

The effect of surface treatments of nickel-titanium files on wear and cutting efficiency.

OBJECTIVES: This study was designed to verify whether nitridation treatment of the cutting surfaces resulted in surface or subsurface changes that produced an increase in the resistance to wear in nickel titanium (NiTi) endodontic files. STUDY DESIGN: Some experimental samples were exposed to ionic implantation by using 150 keV of nitrogen ions and doses of 1 x 10(17) ions per cm(2). Other samples were exposed to thermal nitridation processes performed for 480 minutes at 500 degrees C temperature. Control samples were not exposed to any process. The chemical composition of the surface layers of each sample was determined by means of x-ray photoelectron spectroscopy. The cutting efficiency was tested on an endotraining bloc. RESULTS: The experimental instruments showed in-depth distributions of chemical composition that were different from those seen in the control group; thermal-nitridated instruments demonstrated a surface ratio of nickel to titanium of 0.5. Implanted samples had a higher N/Ti ratio (1.2); this ratio may be due to the presence of a layer of titanium nitride. Samples in the experimental groups showed an increase in cutting ability as compared with the controls. CONCLUSIONS: Thermal nitridation and nitrogen-ionic implantation treatment of nickel-titanium files produced a higher wear resistance and an increased cutting capacity.

Dental Alloys↗

Effect of experience on quality of canal preparation with rotary nickel-titanium files.

OBJECTIVE: The purpose of this study was to compare inexperienced third-year dental students and experienced dentists with respect to their ability to use rotary nickel-titanium files, specifically with respect to root canal shape and instrument fracture. STUDY DESIGN: A total of 102 simulated endodontic plastic blocks were used. Twelve untrained dental students and 12 practitioners prepared 3 blocks each, and an endodontist and a trained student completed 15 blocks each. Blocks were filmed before instrumentation and then prepared to ISO 35; they were filmed again after canal preparation. Before-preparation images and after-preparation images were then superimposed. The canal deviation during preparation was measured at 9 levels, beginning at the apex. RESULTS: In total, 16 of 170 instruments fractured (9.4%). Nearly all preparations (98%) exhibited good taper, smooth walls, and definite apical stops. Material removal on the outer aspect of the canal was greatest near the apex (levels 1-4: 0.11-0.24 mm). The inner aspect of the canal was most instrumented at level 6 (0.23-0.27 mm). CONCLUSIONS: These findings show that both students lacking endodontic experience and experienced dentists used the rotary nickel-titanium files with success and achieved good root canal geometry.

Analysis of Variance↗

Clustering files of chemical structures using the fuzzy k-means clustering method.

This paper evaluates the use of the fuzzy k-means clustering method for the clustering of files of 2D chemical structures. Simulated property prediction experiments with the Starlist file of logP values demonstrate that use of the fuzzy k-means method can, in some cases, yield results that are superior to those obtained with the conventional k-means method and with Ward's clustering method. Clustering of several small sets of agrochemical compounds demonstrate the ability of the fuzzy k-means method to highlight multicluster membership and to identify outlier compounds, although the former can be difficult to interpret in some cases.

Journal Article↗