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At least 595 records · Page 33Linked to original sources

PubMed2005

Use of CD-ROM-based tool for analyzing contouring variations in involved-field radiotherapy for Stage III NSCLC.

BACKGROUND: Interclinician variability in defining target volumes is a problem in conformal radiotherapy. A CD-ROM-based contouring tool was used to conduct a dummy run in an international trial of involved-field chemoradiotherapy for Stage III non-small-cell lung cancer. METHODS AND MATERIALS: The CT scan of an eligible patient was installed on an "auto-run" CD-ROM incorporating a contouring program based on ImageJ for Windows, which runs on any personal computer equipped with a CD-ROM drive. This tool was initially piloted at four academic centers and was subsequently mailed, together with all relevant clinical, radiologic, and positron emission tomography findings, to all participating centers in the international trial. Clinicians were instructed to contour separate gross tumor volumes (GTVs) for the tumor and two enlarged nodes and a clinical target volume for the hilus. A reference "consensus" target volume for each target was jointly generated by three other clinicians. RESULTS: The data received from the four academic centers and 16 study participants were suitable for analysis. Data from one center was unsuitable for detailed analysis because the target volumes were contoured at 1.2-cm intervals. GTVs were available for a total of 21 tumors and 19 nodes, and 15 hilar clinical target volumes were available. The mean GTV of the primary tumor was 13.6 cm(3) (SD, 5.2; median, 12.3; range, 8.3-26.9). The variation in the center of the mass relative to the mean center of the mass in the left-right, ventrodorsal, and craniocaudal axes was 1.5, 0.4, and 1.0 mm, respectively. The largest volume variation was observed for the right hilar clinical target volume (mean, 33.7 cm(3); SD, 31.2; median, 20.3; range, 4.8-109.9). Smaller variations were observed for the subcarinal node (mean, GTV, 1.9 cm(3); SD, 1.2; median, 1.7; range, 0.5-5.3), except caudally where the node was difficult to distinguish from the pericardium. The "consensus" volumes for all targets were generally close to the median of the contoured values. CONCLUSION: Most clinicians were able to use this CD-ROM tool to contour target volumes in compliance with the study protocol. The rapid completion of the dummy run indicated the suitability of this approach for quality assurance in multicenter clinical trials. Routine use of similar tools will reduce the risk that new techniques (or study objectives) are misunderstood and/or misapplied in clinical trials.

CD-ROM↗

PubMed2004

Activation of the human primary motor cortex during observation of tool use.

Tool use is a characteristic human trait, requiring motor skills that are largely learned by imitation. A neural system that supports imitation and action understanding by directly matching observed actions and their motor counterparts has been found in the human premotor and motor cortices. To test whether this "mirror-neuron system" (MNS) would be activated by observation of tool use, we recorded neuromagnetic oscillatory activity from the primary motor cortex of 10 healthy subjects while they observed the experimenter to use chopsticks in a goal-directed and non-goal-directed manner. The left and right median nerves were stimulated alternatingly, and the poststimulus rebounds of the approximately 20-Hz motor-cortex rhythms were quantified. Compared with the rest condition, the level of the approximately 20-Hz rhythm was suppressed during observation of both types of tool use, indicating activation of the primary motor cortex. The suppression was on average 15-17% stronger during observation of goal-directed than non-goal-directed tool use, and this difference correlated positively with the frequency of subjects' chopstick use during the last year. These results support the view that the motor-cortex activation is related to the observer's ability to understand and imitate motor acts.

Adult↗

PubMed2005

Placing a tool in the spotlight: spatial attention modulates visuomotor responses in cortex.

Visual spatial attention has long been associated with facilitatory effects on visual perception. Here, we report that spatial attention can also modulate implicit visuomotor processing in dorsal regions of human cortex. Participants underwent fMRI scanning while performing a voluntary attentional orienting task that varied the category of a task-irrelevant object in the attended location (tool vs. non-tool). Data were then analyzed as a function of the attended location (left vs. right visual field) and the object category in that location. We found that the fMRI BOLD response in two visuomotor-related regions--the supplementary motor area (SMA) and the left inferior parietal lobule (IPL)--showed an interaction between the location of attention and the location of the tool in the bilateral display. Further, these responses were statistically distinct from those regions in dorsal cortex showing activity modulated only by the tool location or only by the attended location. While the effects of attending non-foveally within the visual field have been well documented in relation to visual perception, our findings support the proposal that voluntary visuospatial attention may also have consequences for the implicit planning of object-directed actions.

Adult↗

PubMed2005

On the nature of near space: effects of tool use and the transition to far space.

Many researchers have proposed that the near space immediately surrounding the body is represented differently than more distant space. Indeed, it has often been suggested that near space encompasses that within arm's reach. The present study used a line bisection task in healthy adults to investigate the effects of tool use on space perception, and the nature of the transition between near and far space. Subjects bisected lines at four distances controlled for both veridical and angular size using a laser pointer and a set of sticks. When the laser pointer was used, a left to right shift in bias was observed as stimuli were moved from near to far space. When a tool was used, however, a leftward bias was observed at all distances, similar to that observed with the laser pointer in near space. These results suggest that the tool expanded the range of near space. Additionally, the transition from near to far space was gradual, with no abrupt shift at arm's length (or at any other distance). In contrast to theories describing near space as that within arm's reach, these findings suggest that the representation of near space is less rigid, extending with tool use and gradually transitioning into far space.

Adolescent↗

PubMed2005

Doctor-patient interaction in a randomised controlled trial of decision-support tools.

In this paper, we draw on the analytic perspectives of ethnomethodology to explore doctor-patient encounters in an experimental trial of a complex intervention: an efficacy randomised controlled trial (RCT) of decision-support tools in the UK. We show how the experimental context in which these encounters take place pervades the interactions within them. We argue that two interactional orders were at work in the encounters that we observed: (i) the ceremonial order of the consultation and (ii) the assemblage of the decision-support tool trial. We demonstrate how doctors in the trial oscillate between positions as authoritative clinician and neutralistic decision-support tool-implementer, and patients move between positions as passive recipients of clinical knowledge and as active subjects required to render their experience as calculable in terms of the demands of the decision-support tools and the broader trial they are embedded in. We demonstrate how the RCT coordinates the world of the clinical environment and the world of experimental evidence.

Decision Support Systems, Clinical↗

PubMed2004

Tools for the body (schema).

What happens in our brain when we use a tool to reach for a distant object? Recent neurophysiological, psychological and neuropsychological research suggests that this extended motor capability is followed by changes in specific neural networks that hold an updated map of body shape and posture (the putative "Body Schema" of classical neurology). These changes are compatible with the notion of the inclusion of tools in the "Body Schema", as if our own effector (e.g. the hand) were elongated to the tip of the tool. In this review we present empirical support for this intriguing idea from both single-neuron recordings in the monkey brain and behavioural performance of normal and brain-damaged humans. These relatively simple neural and behavioural aspects of tool-use shed light on more complex evolutionary and cognitive aspects of body representation and multisensory space coding for action.

Animals↗

PubMed2002

Tool-use changes multimodal spatial interactions between vision and touch in normal humans.

In a visual-tactile interference paradigm, subjects judged whether tactile vibrations arose on a finger or thumb (upper vs. lower locations), while ignoring distant visual distractor lights that also appeared in upper or lower locations. Incongruent visual distractors (e.g. a lower light combined with upper touch) disrupt such tactile judgements, particularly when appearing near the tactile stimulus (e.g. on the same side of space as the stimulated hand). Here we show that actively wielding tools can change this pattern of crossmodal interference. When such tools were held in crossed positions (connecting the left hand to the right visual field, and vice-versa), the spatial constraints on crossmodal interference reversed, so that visual distractors in the other visual field now disrupted tactile judgements most for a particular hand. This phenomenon depended on active tool-use, developing with increased experience in using the tool. We relate these results to recent physiological and neuropsychological findings.

Adult↗

PubMedDate not supplied

[Comparison of two assessment tools of antidepressant side-effects: UKU scale versus spontaneous notification].

BACKGROUND AND AIM OF THE STUDY: Overall, the efficacy of the newer antidepressants: serotonin selective reuptake inhibitors (SSRI), selective serotonin/norepinephrine reuptake inhibitor (SNRI), noradrenergic and specific serotonergic antidepressant (NaSSA) and tianeptine is similar to that of the tricyclics, and so their acceptability/safety becomes a selection criterion for the clinician. However, side-effect assessment comes up against several difficulties: distinguishing between somatic symptoms caused by the depression and those caused by the treatment -- which assessment tool to use (spontaneous notification, standardized scales that are not specific for the side effects caused by psychotropic drugs, standardised scales specific for the side effects caused by psychotropic drugs, meta-analysis, etc.) -- which data sources to consult (anecdotal reports, reviews, prospective studies), and which data set to use, etc. As a result, the question of the exhaustiveness and reliability of the data consulted by the clinician can arise. We therefore conducted a comparative study in patients treated with these newer antidepressants, of 2 antidepressants side-effect assessment tools: spontaneous notification (SN) versus the UKU scale, a standardised scale specific for the side effects of psychotropic drugs. METHODOLOGY: The depressed outpatients were selected from a psychiatric unit in a French psychiatric hospital and from a non-hospital consulting room. The main inclusion criteria were: male or female subjects, suffering from major depression without melancholia or psychotic features or suffering from mood disorders (according to DSM IV criteria), who had been treated for at least 4 weeks with one of the newer antidepressants. The main exclusion criteria were: any other psychiatric disorder, a serious physical disorder, treatment with neuroleptics, mood-changing drugs or other antidepressants, and patients who were not able to understand the questionnaire. The investigation was carried out by a clinical pharmacist. RESULTS: Fifty patients were included in the study. There were 18 men and 32 women. The mean age was 53.5 15.9 years [22 - 77], the mean period of treatment was 24 30.5 months [1 - 127] and 52% of the patients received concomitant medication with anxiolitic or hypnotic drug(s). The percentage of patients who reported at least one side effect was significantly higher for the UKU scale than for SN (84% vs 58%, p<0.01). The ratio between SN and UKU scale scores was 2/3. A similar pattern was found for the total number of side effects (n=177 vs n=47, p<0.001). The ratio between the total number of side effects for the SN and UKU scale was 1/4. The side effects were divided into five subgroups: psychiatric, neurovegetative, sexual, neurological and others. In all these subgroups, the number of side effects reported was significantly higher when the UKU scale was used than when SN was used. The values were as follows: psychiatric (n=44 vs n=15, p<0.001), neurovegetative (n=59 vs n=15, p<0.001), sexual (n=36 vs n=10, p<0.001), neurological (n=11 vs n=2, p<0.001) and other side effects (n=27 vs n=5, p<0.001). Nineteen side effects were only reported when SN was used (for example: dry eyes, incompatibility with alcohol, euphoria...). Twenty-four side effects were only reported when the UKU scale was used (for example: increased libido, loss of bodyweight...). The side effects had no impact on daily life in most of 80% of the patients; there was no significant difference between the patient's assessment of the discomfort caused by side effects and the clinician's assessment. In 90% of cases, the side effects did not lead to any change in the treatment. DISCUSSION: The findings of this study show that the collection of data regarding side effects depends on the assessment tool used: the number of side effects reported was significantly higher when the UKU scale was used than when SN was used. However, this finding must viewed with caution, because it has been showed that checklists can induce symptoms in suggestible patients. Neurovegetative troubles are the most commonly reported side effects, and neurological troubles the least often reported. This matches the tolerability profile of these antidepressants. The disorders that were least frequently spontaneously reported were the neurological, sexual and "other" side effects. These emerged only when the clinician asked the patient about them. The 19 side effects that were only reported when SN was used were side effects that were not included in the UKU scale or that had not been present during the three days before we started the investigation. The 34 side effects that were only reported when the UKU scale was used were either side effects with no apparent link with the treatment (for example: micturition troubles) or embarrassing effects (such as increased libido). CONCLUSION: Our findings show that the collection of data on side effects depends on the assessment tool used. These findings need to be confirmed by large-scale comparative studies, and the standardization of the assessment of side effects is a question that needs to be raised.

Adult↗

PubMed2003

A single-degree-of-freedom dynamic model predicts the range of human responses to impulsive forces produced by power hand tools.

The human operator is modelled as a single-degree-of-freedom dynamic mechanical system for predicting the response to impulsive torque reaction forces produced by rotating spindle power hand tools such as nutrunners or screwdrivers. The model uses mass, spring and damping elements to represent the standing operator supporting the tool in the hand. It was hypothesized that these mechanical elements are affected by work location and vary among individuals. These elements were ascertained by measuring the resulting frequency and amplitude of a freely oscillating defined mechanical system when externally loaded using maximal effort to oppose its motion. Twenty-five subjects (13 female, 12 male) participated in the full factorial experiment that measured the effects of gender, vertical and horizontal work location for various tool shapes (in-line, pistol, right angle), and orientations (horizontal and vertical). The mean operator stiffness decreased from 1721 to 1195 N/m when the horizontal work location increased from 30 to 90 cm in front of the ankles for a pistol-grip handle used on a vertical surface. Males had greater mass moment of inertia of (0.0099 kg m2) than females (0.0072 kg m2) for an in-line handle used on a horizontal surface. Internal validation by independently measuring apparatus torque found that the model satisfactorily explained the measured operator dynamics with an average error of 2.86%. Group variance reflects the range of operator capacities to react against power hand tool generated forces for the sample group and therefore it may also be useful for understanding the range of capacities among a group of operators performing similar tasks.

Adult↗

PubMed2003

A model for tool-use traditions in primates: implications for the coevolution of culture and cognition.

Inspired by the demonstration that tool-use variants among wild chimpanzees and orangutans qualify as traditions (or cultures), we developed a formal model to predict the incidence of these acquired specializations among wild primates and to examine the evolution of their underlying abilities. We assumed that the acquisition of the skill by an individual in a social unit is crucially controlled by three main factors, namely probability of innovation, probability of socially biased learning, and the prevailing social conditions (sociability, or number of potential experts at close proximity). The model reconfirms the restriction of customary tool use in wild primates to the most intelligent radiation, great apes; the greater incidence of tool use in more sociable populations of orangutans and chimpanzees; and tendencies toward tool manufacture among the most sociable monkeys. However, it also indicates that sociable gregariousness is far more likely to produce the maintenance of invented skills in a population than solitary life, where the mother is the only accessible expert. We therefore used the model to explore the evolution of the three key parameters. The most likely evolutionary scenario is that where complex skills contribute to fitness, sociability and/or the capacity for socially biased learning increase, whereas innovative abilities (i.e., intelligence) follow indirectly. We suggest that the evolution of high intelligence will often be a byproduct of selection on abilities for socially biased learning that are needed to acquire important skills, and hence that high intelligence should be most common in sociable rather than solitary organisms. Evidence for increased sociability during hominin evolution is consistent with this new hypothesis.

Animals↗

PubMed2003

Tools, teamwork, and tenacity: an examination of family practice office system influences on preventive service delivery.

BACKGROUND: Most research examining primary care office characteristics and preventive service delivery (PSD) has evaluated preventive service aids and equipment, while generally overlooking the complex interactions among multiple office systems where multiple factors influence the overall practice. We test a theoretical model of practice influences on PSD that accounts for Tools (preventive service aids/equipment), Teamwork (office organization), and Tenacity (prevention delivery attitudes). METHODS: Office characteristics and 4454 patient visits were observed for 138 family physicians in northeast Ohio. Utilizing U.S. Preventive Services Task Force recommendations, age- and gender-specific PSD summary scores were computed for each patient and then averaged per physician. Multivariate analysis of variance tested office characteristic associations with PSD scores. RESULTS: Tools were common, but most were not significantly associated with PSD scores. The Teamwork indicators of clear staff role expectations and shared vision among physician and staff existed, respectively, for 80 and 73% of physicians. A high average reported practice focus on prevention existed, despite low staff involvement in PSD (22.2%). Compared with Tools, more Teamwork and Tenacity characteristics were associated with the PSD scores. CONCLUSION: Teamwork and Tenacity appear to be more important than Tools in delivering preventive services in primary care practices.

Adult↗

PubMed2002

MEA-Tools: an open source toolbox for the analysis of multi-electrode data with MATLAB.

Recent advances in electrophysiological techniques have created new tools for the acquisition and storage of neuronal activity recorded simultaneously with numerous electrodes. These techniques support the analysis of the function as well as the structure of individual electrogenic cells in the context of surrounding neuronal or cardiac network. Commercially available tools for the analysis of such data, however, cannot be easily adapted to newly emerging requirements for data analysis and visualization, and cross compatibility between them is limited. In this report we introduce a free open source toolbox called microelectrode array tools (MEA-Tools) for the analysis of multi-electrode data based on the common data analysis environment MATLAB (version 5.3-6.1, The Mathworks, Natick, MA). The toolbox itself is platform independent. The file interface currently supports files recorded with MCRack (Multi Channel Systems, Reutlingen, Germany) under Microsoft Windows 95, 98, NT, and 2000, but can be adapted to other data acquisition systems. Functions are controlled via command line input and graphical user interfaces, and support common requirements for the analysis of local field potentials, extracellular spike activity, and continuous recordings, in addition to supplementary data acquired by additional instruments, e.g. intracellular amplifiers. Data may be processed as continuous recordings or time windows triggered to some event.

Action Potentials↗

PubMed1998

Database tools for integrating and searching membrane property data correlated with neuronal morphology.

A critical problem in neuroscience is the lack of database tools for integrating neuronal property data. We report here the development of a combined object oriented-relational database (NeuronDB, http://senselab.med.yale.edu/neurondb) that meets these needs by providing tools for integrating data within neurons and comparing data across neurons. It focuses on three types of neuronal properties voltage-gated channels, neurotransmitter receptors, and neurotransmitters. The data are organized in relation to different regions of neurons as represented in canonical forms; using simple canonical models of complex cells as a vehicle for indexing information permits the database to be searchable across different neurons. Using these multidimensional search tools, users can locate specific properties in specific regions of a neuron; obtain integrated summaries of all properties within a region; and carry out searches to compare properties across equivalent compartments in different neurons. These tools thus permit searches of the multidimensional neuron property space equivalent to homology searches of sequence databases. NeuronDB is accessible over the Internet; it provides immediate links to citation indexes and abstracts supporting the deposited data, and annotations that indicate the state of acceptance of the data. Users are encouraged to contribute data. The ability to input the data from NeuronDB directly to NEURON and GENESIS is being developed. As a shared Web resource, NeuronDB should enhance the efforts of neuroscientists and neuronal modellers to analyze and compare the functional operations of different types of neurons.

Automation↗

PubMed2000

Exploring the IBIS data library contents: tools for data visualisation, (pre-) processing and screening. Improved Monitoring for Brain Dysfunction in Intensive Care and Surgery.

During the IBIS project a high-quality data library of continuous and intermittent physiological signals and variables from patients during intensive care and surgery has been collected. To facilitate exploration of the full content of this data library a data browser was developed, which offers a flexible graphical display of the collection of multivariate data. To supplement the functionality of the display of the 'raw' data, a set of screening and pre-processing tools has been developed. A separate trend analysis tool offers a convenient overview of an entire recording focusing on the slow changes in the general state of the patient and the interaction between different physiological subsystems seen from a long-term perspective. A frequency analysis tool for processing the electroencephalography (EEG) signals has been integrated in the data browser to facilitate a quick screening of the cerebral function. The data library is the foundation of the development and validation of biosignal interpretation methods. This process can potentially be more productive using the described tool for algorithm prototyping based on a graphical network specifying the interaction between data processing primitives.

Aged↗

PubMed2003

How much can a vibrational diagnostic tool reveal in total hip arthroplasty loosening?

OBJECTIVE: To investigate how much information a vibrational technique can reveal regarding the loosening of the femoral component of a total hip arthroplasty. DESIGN: Numerical modal analysis using finite element method and computer simulation. BACKGROUND: Existing work suggested that this technique is capable of revealing total hip arthroplasty loosening. However, the potentials of this technique are not fully studied yet. There is a need to establish the limitation of this technique. METHODS: Numerical modal analysis was conducted to obtain the natural frequencies and mode shapes of femoral models under free vibration. An absent interface portion was hypothesized at specified locations the data from modal analysis were then used in a computer simulation to visualize the vibration diagnosis. RESULTS: The effects of interface failure on the femoral component stiffness vary with the locations and sizes of failure. Nominal critical, reliable, and nondetectable levels of interface failure are found. CONCLUSION: When the size of failure is more than one-third of the stem length, this tool is able to provide a reliable diagnosis. The critical detectable interface failure size is one-fifth of the stem length. It was found that the motion at higher harmonics is the most sensitive to the interface failure. This tool is unlikely to differentiate the slight differences in natural frequencies that occur when the interface failure length is less than one-sixth of the stem length. It is likely to fail in detecting failures located at the stem central portion regardless of their length. RELEVANCE: A numerical study of the vibration tool is important prior to pursuing clinical trials of the tool and may guide the characterizations involved in the trials.

Computer Simulation↗

PubMed1999

Use of prognostic scoring and outcome assessment tools in the admission decision for community-acquired pneumonia.

Prognostic scoring and outcome assessment tools are being developed to provide decision support regarding hospitalization in community-acquired pneumonia. The tools define the risk of mortality and other adverse outcomes using variables available when patients are first seen. Comparison of the specific logic in different tools demonstrates more similarities than differences. Early data suggest that these tools may help physicians safety decrease the rate of admission to the hospital.

Adult↗

PubMed2003

Evaluating the reliability and validity of three tools to assess the quality of health information on the Internet.

The quality of Internet information needs to be evaluated and several tools exist for this purpose. However, none have demonstrated reliability and validity. This study tested the internal consistency and validity of the information quality tool (IQT), quality scale (QS) and DISCERN using 89 web sites discussing smoking cessation. The inter-rater reliability of the tools was established by exploring the agreement between two independent raters for 22 (25%) of the sites. The IQT and DISCERN possessed satisfactory internal consistency (as measured by Cronbach's alpha). The IQT, QS and DISCERN showed satisfactory inter-rater reliability (as measured by kappa and intraclass correlations). The IQT, QS and DISCERN correlated positively with each other, supporting the convergent validity of the tools. This study provides some evidence for the reliability and validity of the IQT, QS and DISCERN, although this needs testing in further research with different types of Internet information and larger sample sizes.

Authorship↗

PubMed1999

The Brief Medication Questionnaire: a tool for screening patient adherence and barriers to adherence.

Self-report tools for monitoring adherence can be useful in identifying patients who need assistance with their medications, assessing patient concerns, and evaluating new programs. The aim of this study is to test the validity of the Brief Medication Questionnaire (BMQ), a new self-report tool for screening adherence and barriers to adherence. The tool includes a 5-item Regimen Screen that asks patients how they took each medication in the past week, a 2-item Belief Screen that asks about drug effects and bothersome features, and a 2-item Recall Screen about potential difficulties remembering. Validity was assessed in 20 patients using the Medication Events Monitoring System (MEMS). Results varied by type of non-adherence, with the Regimen and Belief Screens having 80-100% sensitivity for "repeat" non-adherence and the Recall Screen having 90% sensitivity for "sporadic" non-adherence. The BMQ appears more sensitive than existing tools and may be useful in identifying and diagnosing adherence problems.

Adult↗