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Limited sampling of conformational space by the distance geometry algorithm: implications for structures generated from NMR data.

Calculations with a metric matrix distance geometry algorithm were performed that show that the standard implementation of the algorithm generally samples a very limited region of conformational space. This problem is most severe when only a small amount of distance information is used as input for the algorithm. Control calculations were performed on linear peptides, disulfide-linked peptides, and a double-stranded DNA decamer where only distances defining the covalent structures of the molecules (as well as the hydrogen bonds for the base pairs in the DNA) were included as input. Since the distance geometry algorithm is commonly used to generate structures of biopolymers from distance data obtained from NMR experiments, simulations were performed on the small globular protein basic pancreatic trypsin inhibitor (BPTI) that mimic calculations performed with actual NMR data. The results on BPTI and on the control peptides indicate that the standard implementation of the algorithm has two main problems: first, that it generates extended structures; second, that it has a tendency to consistently produce similar structures instead of sampling all structures consistent with the input distance information. These results also show that use of a simple root-mean-square deviation for evaluating the quality of the structures generated from NMR data may not be generally appropriate. The main sources of these problems are identified, and our results indicate that the problems are not a fundamental property of the distance geometry algorithm but arise from the implementations presently used to generate structures from NMR data. Several possible methods for alleviating these problems are discussed.

Algorithms

A new algorithm for diagnosis of anemia.

Studies of the cognitive processes of diagnosis have shown that use of heuristics (eg, shortcuts, rules of thumb) dominates clinical problem solving. Thus, an algorithmic approach to diagnosis can be particularly useful. Because the sensitivity and specificity of many tests are not known, however, this approach is not perfect. Therefore, algorithms should be taken as a general guide to diagnosis but should not be applied too rigidly. In the past, algorithms for anemia did not apply any principles of decision analysis. The algorithm presented in this article is based on test operating characteristics reported in the literature. Disease is excluded by highly sensitive tests (screening tests) and confirmed by highly specific tests (pathognomonic findings). This algorithm can reduce the need for expensive, complex procedures, including radioisotope studies (eg, chromium 51 red blood cell study, ferrokinetics). It provides a rational and semiquantitative estimation of diagnostic possibilities. Alternate pathways to diagnosis may arise in individual cases. Also, the algorithm is difficult to apply to multifactorial anemias.

Algorithms

A three-dimensional electron pencil-beam algorithm.

We describe the implementation of a three-dimensional electron-dose algorithm based on a Gaussian pencil-beam model. The algorithm calculates dose to an arbitrarily distributed set of points in a heterogeneous volume. Multiple non-coplanar beams can be positioned relative to the volume. The algorithm consists of three basic components: (i) the transport of a pencil-beam through a heterogeneous volume, (ii) the evaluation of the pencil-beam fluence at a given depth in the volume in the presence of irregular fields, and (iii) the matching of points in the volume receiving a significant fluence contribution from a pencil-beam at a given depth in the volume and the calculation of dose to those points. An efficient point-matching algorithm reduces the computation time to the level of conventional two-dimensional implementations. The algorithm uses an optimised subdivision for irregular fields, and accurately predicts output factors for irregular fields placed between the final collimators and the patient. We show comparisons between the new algorithm and conventional two-dimensional calculations using measurements and calculations for finite heterogeneities, irregular fields and output factors.

Algorithms

A finite state machine algorithm for finding restriction sites and other pattern matching applications.

Existing algorithms for finding restriction endonuclease recognition sites use brute-force algorithms which run in time 0(NM) where N is the number of nucleotides in the sequence under analysis and M is the total number of nucleotides in all the different sites being searched for. This paper presents a deterministic finite state machine algorithm which runs in time 0(N). Memory use can be as high as 0(M4) but a slight modification to the basic algorithm can impose a theoretical upper bound of 0(M) at the cost of some added complexity in the execution of the state machine. The algorithm can operate with a single pass through the sequence under analysis, with no need to back up or (for non-circular sequences) store more than a single input character at a time. This type of algorithm can be adapted to many pattern-matching tasks and is simple enough to implement in hardware that it could, for example, be built into a disk controller as part of a specialized database machine.

Algorithms

Improved algorithms for searching restriction maps.

We present algorithms for searching a DNA restriction enzyme map for a region that best matches a shorter 'probe' map. Our algorithms utilize a new model of map alignments, and extensive experiments prove our model superior to earlier approaches for certain applications. Let M be the number of map sites and P be the number of probe sites. Our first algorithm, which optimizes only over a restricted class of alignments, requires O(MP log P) worst-case time and O(M + P) space. Our second algorithm, which optimizes over all alignments, runs in O(MP3) time and O(M + P2) space, under reasonable assumptions about the distribution of restriction enzyme cleavage sites. Combining the algorithms gives a map-searching method that optimizes over all alignments in O(MP log P) time in practice. The algorithms' effectiveness is illustrated by searches involving a genomic restriction map of Escherichia coli.

Algorithms

Counting algorithms for linkage: correction to Morton and Collins.

In a recent paper, Morton & Collins (1990) claimed: (1) that the Lander-Green algorithm for genetic linkage analysis is not the EM algorithm for finding the maximum likelihood map; and (2) that a proposed alternative algorithm does have these properties. Here, we show that these assertions are both incorrect: the Lander-Green algorithm is an EM algorithm, while the Morton-Collins algorithm is not. We note that Morton and Collins concur with these conclusions.

Algorithms

Heart rate correlation, response time and effect of previous exercise using an advanced pacing rate algorithm for temperature-based rate modulation.

A temperature-based algorithm to produce pacing rate that resembles chronotropic response to activity was developed. Measurement criteria for the algorithm included workload dependent rate increases with activity and response time within 60 seconds of exercise onset. To evaluate the algorithm, right ventricular blood temperature was recorded during rest and treadmill exercise in 25 patients with implanted Kelvin 500 pacemakers (Cook Pacemaker). Patients included 16 males and nine females, ages 44-81 (mean 72). Indications for pacing were sinus node disease, atrioventricular block and atrial fibrillation with slow ventricular response. Temperature changes reflected physical activity as well as emotional stress. The algorithm was based on the rate of change (dT/dt), the relative change (delta T) and the baseline history (T) of temperature. At exercise onset, a rapid, brief drop in temperature (dT/dt) typically occurred due to peripheral vasodilation, causing prompt increase in pacing rate. As exercise continued, the increase in metabolic rate caused dT/dt as well as delta T to increase, further increasing pacing rate. After exercise, temperature returned to resting level which correspondingly decreased the pacing rate. Sensitivity of the algorithm to temperature variations, and the upper and lower pacing rate limits were programmable to adapt to individual patient needs. The rates produced by the algorithm mimicked intrinsic rate response for various activity levels and produced a mean response time of 16 seconds from exercise onset. Previous exercise had no significant effect on response time. Correlation between normal chronotropic response and simulated pacing rate from five exercise tests was 0.92. These results show good specificity and refute the statement that blood temperature yields a slow response.

Adult

Endless-loop tachycardias: description and first clinical results of a new fully automatic protection algorithm.

Endless-loop tachycardia (ELT) is one of the most common pacemaker mediated tachycardia. An innovative ELT protection algorithm has proven to be clinically effective. A new improved version that will eliminate the need to program any parameter is now under clinical evaluation. Nine patients entered the study: six men and three women, aged 52 +/- 22 years. This automatic algorithm needs only 10 cycles to detect and confirm an ELT. Three hundred thirty-three ELTs lasting more than 9 cycles have been induced and analyzed. The total results are the following: mean duration: 6.7 sec +/- 3.1; mean ELT rate: 137 +/- 21.9 bpm, mean programmed upper rate limit (URL): 142.5 +/- 26.5 bpm (Only 70% of ELTs presented rates equal to programmed URL). (1) ELTs reduced by postventricular atrial refractory period (PVARP) extension on one cycle: 291 ELTs (87%). ELT rate: 128.5 +/- 18.2 bpm. (2) Retrograde block: algorithm operation may induce a retrograde block due to a short atrioventricular delay (AVD) applied during the confirmation phase to discriminate an ELT from a stable sinus rhythm. Thirty-two ELTs (10%) have been reduced and detected on a retrograde block occurrence. (3) Algorithm failure due to an unstable ventriculoatrial conduction time (VACT) even at fixed rate or to a retrograde Wenckebach behavior on AVD reduction during the confirmation phase. A total of 10 algorithms failed to detect or confirm an ELT have been recorded (3%). Mean duration: 8.2 +/- 4.2 sec, mean ELT rate: 148.9 +/- 14.3 bpm. This new fully automatic algorithm has reduced 97% of ELTs, including high rate episodes (100-175 bpm).(ABSTRACT TRUNCATED AT 250 WORDS)

Algorithms

A comparison of the speeds of three convolution algorithms.

The speeds of three computer algorithms suitable for use in three-dimensional radiotherapy planning codes were compared. Two of the algorithms are based on ray-tracing methods, the first algorithm uses a fast ray-tracing procedure directly and the second employs a table lookup procedure; the table was originally calculated by ray tracing. The third algorithm was a convolution procedure using the fast Fourier transform. Benchmark programs were written to compare the fundamental running speeds of the three algorithms operating on three-dimensional arrays of various sizes. The convolution procedure employing the three-dimensional fast Fourier transform had the shortest running times on a VAX/750 (Digital Equipment Corp.) computer. We concluded that this algorithm holds significant potential for practical three-dimensional dose calculations.

Algorithms

Synthesizing a color algorithm from examples.

A lightness algorithm that separates surface reflectance from illumination in a Mondrian world is synthesized automatically from a set of examples, which consist of pairs of input (intensity signal) and desired output (surface reflectance) images. The algorithm, which resembles a new lightness algorithm recently proposed by Land, is approximately equivalent to filtering the image through a center-surround receptive field in individual chromatic channels. The synthesizing technique, optimal linear estimation, requires only one assumption, that the operator that transforms input into output is linear. This assumption is true for a certain class of early vision algorithms that may therefore be synthesized in a similar way from examples. Other methods of synthesizing algorithms from examples, or "learning," such as back-propagation, do not yield a significantly better lightness algorithm.

Algorithms

Algorithms in radiology and medical imaging.

As a tool in clinical decision making, algorithms deserve careful consideration. The potential use or abuse of algorithms in rationing health care renders such consideration essential. In radiology and medical imaging, algorithms have been applied as teaching tools in the conference room setting. These teaching decision trees, however, may not be applicable in the clinical situation. If an algorithmic approach to clinical radiology is pursued, several issues should be considered. Specifically, the application, design, designer, economics, and universality of the algorithms must be addressed. As an alternative to the wide dissemination of clinical algorithms, the authors propose the development of consensus opinions among specialists and the promulgation of the principle of radiologist-consultant-decision maker. A decision team is preferable to a decision tree.

Algorithms

Prospective evaluation of a sequential pacing and high-energy bidirectional shock algorithm for transvenous cardioversion in patients with ventricular tachycardia.

Rapid ventricular pacing alone or in combination with low- or intermediate-energy shocks has limited efficacy in cardioverting rapid ventricular tachycardia (VT) when delivered through two transvenous catheter electrodes. This prospective study determined the efficacy and safety of an algorithm that used a sequence of rapid ventricular pacing (RVP) and intermediate-energy (5 and 15 J) and high-energy (25J) single, bidirectional shocks delivered by two transvenous catheter electrodes in conjunction with a cutaneous electrode in patients with sustained VT. The bidirectional shock was simultaneously delivered over two electrical vectors via a common right ventricular apical cathode and tow anodes consisting of the superior vena caval catheter electrode and cutaneous patch. The electrical therapy delivered was determined by the cycle length of VT. Slow VT (cycle length greater than 300 msec) was sequentially treated by RVP followed by incremental bidirectional shocks of 5, 15, and 25 J. Rapid VT (cycle length less than 300 msec) was treated with no incremental bidirectional shocks of 15 and 25 J. VT was reinduced to determine reproducibility of the algorithm for episodes that were successfully terminated. For patients in whom the primary algorithm failed, a second algorithm was used that excluded 5 and 15 J shocks and went directly to a 25 J shock. VT was reinduced twice and the secondary algorithm was evaluated. Thus, reproducibility of termination of VT with the primary and secondary algorithm was examined. Fifty episodes of slow VT and 40 episodes of rapid VT were induced in 22 patients (mean left ventricular ejection fraction 31 +/- 14%). Six patients had rapid VT, nine patients had slow VT, and seven patients had both.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Evaluation of shading algorithms for surface display: depth information, surface orientation, colour and transparency.

When interpreting a shaded surface image the observer must infer a three-dimensional shape from a two-dimensional image. The principal monocular cues used in this process are surface orientation and apparent depth. Four shading algorithms were compared, ranging from pure depth to pure surface orientation with two intermediates. Eight observers assessed these algorithms using 40 sets of images showing test objects derived from emission computed axial tomograms, X-ray computed tomograms and simulated data. The results demonstrated a highly significant preference (p less than 0.01) for surface orientation over depth information for all observers and both imaging modalities. The coefficient of concordance showed that the observers were in good agreement as to the rank order of the algorithms, with significant agreement (p less than 0.05) for 37 of the 40 sets of images. The overall preferred algorithm was based on a local polynomial fitting procedure and contained primarily surface information. This shading algorithm was extended to include colour, which was used both as an arbitrary surface property to identify parts of a complex object and as a means of conveying temporal information. Further extension of the algorithm to the display of transparent surfaces was facilitated by an illumination model based on purely isotropic light. This enabled even irregular surfaces to be displayed as transparent objects, and was combined with opaque shading for displaying nested surfaces in nuclear magnetic resonance data.

Algorithms

An annotated algorithm approach to clinical guideline development.

The Urinary Incontinence in Adults Guideline Panel facilitated the ready elucidation of its guideline's management recommendations through the use of an annotated algorithm approach. The algorithms created as part of this guideline differ from previous algorithms in two ways: (1) they employ systematic annotation to link explicitly the algorithms' recommendations to the literature, and (2) they contain patient counseling and decision nodes to depict the major preference-dependent decision or branch points in the algorithm. We believe that these two innovations can help ensure the clinical validity of guidelines' algorithms while preserving appropriate clinical flexibility and respecting patient preferences.

Algorithms

Exploring a new best information algorithm for Iliad.

Iliad is a diagnostic expert system for internal medicine. One important feature that Iliad offers is the ability to analyze a particular patient case and to determine the most cost-effective method for pursuing the work-up. Iliad's current "best information" algorithm has not been previously validated and compared to other potential algorithms. Therefore, this paper presents a comparison of four new algorithms to the current algorithm. The basis for this comparison was eighteen "vignette" cases derived from real patient cases from the University of Utah Medical Center. The results indicated that the current algorithm can be significantly improved. More promising algorithms are suggested for future investigation.

Algorithms

Stochastic simulation algorithms for query networks.

One of the barriers to using belief networks for medical information retrieval is the computational cost of reasoning as the networks become large. Stochastic simulation algorithms allow one to compute approximations of probability values in a reasonable amount of time. We previously examined the performance of five stochastic simulation algorithms applied to four simple belief networks networks and found that the Self-Importance algorithm performed well. In this paper, we examine how the same five algorithms perform when applied to a belief network derived from the cardiovascular subtree of the Medical Subject Headings (MeSH). Both the Likelihood Weighting and Self-Importance algorithms perform well when applied to the MeSH-derived network, suggesting that stochastic simulation algorithms may provide reasonable performance in medical information retrieval settings.

Algorithms

Use of immunoglobulin heavy-chain and light-chain measurements in a multicenter trial to investigate monoclonal components: II. Classification by use of computer-based algorithms.

We describe a computer algorithm for classifying serum monoclonal proteins (MC) based on serum protein electrophoresis (SPE) and the automated measurement of kappa and lambda light chains and IgG, IgA, and IgM. We developed the algorithm by using a large database of unselected samples containing MC collected in a multicenter study. The performance of the algorithm was optimized by using iterative computational procedures and was tested on both the development database and on an independent set of MC-containing samples. With the development database, the algorithm correctly classified 50% and misassigned 2.5% of the MC. Where the MC were present in concentrations greater than 10 g/L, the rate of successful classification increased to 72% with 3% misclassification. When the algorithm was tested on a group of 101 MC-containing samples from an independent source, 67% were correctly classified and 8% misclassified, half of the latter being unusual IgD myelomas. We discuss the scope for the application of the algorithm in routine laboratory practice involving personal computer software.

Algorithms

Algorithm to predict triple-vessel/left main coronary artery disease in patients without myocardial infarction. An international cross validation.

Logistic regression was applied to the clinical, risk factor, and exercise data of consecutive angiographic referrals without prior myocardial infarction to determine an algorithm predicting the probability of triple-vessel/left main coronary artery disease. These data were obtained from a total of 1,074 such subjects from patient populations at four centers (Cleveland Clinic Foundation, Cleveland, Ohio; Hungarian Institute of Cardiology, Budapest, Hungary; the university hospitals, Zurich and Basel, Switzerland; and the Veterans Administration Medical Center, Long Beach, Calif.) and used to derive four separate probability algorithms. Each algorithm is based on patient data from study samples at three of the four centers and consists of 272 logistic functions, which are related to linear combinations of 13 variables (age, sex, type of chest pain, systolic blood pressure, resting electrocardiogram, serum cholesterol, fasting blood sugar, achieved exercise work load, achieved heart rate, exercise-induced angina and hypotension, heart rate-adjusted resting ST depression, and exercise ST slope). The four algorithms were cross validated by testing them on the populations not involved in their derivation. The resulting probabilities in the four test groups were then compared with the angiographic findings of triple-vessel/left main coronary artery disease. The discriminatory power of all the algorithms was fair to good (area under receiver operating characteristic curve, 0.68, 0.75, 0.82, 0.85) in the test groups. The algorithm did not significantly underestimate or overestimate disease probability except in one center (Long Beach).(ABSTRACT TRUNCATED AT 250 WORDS)

Algorithms