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ScriptWriter. A relational database to manage outpatient medical treatment.

ScriptWriter is database software designed to replicate the process of a physician writing a prescription. The software also includes standard demographic and progress note information; however the focus of the software is on automating the process of writing prescriptions. The software is especially adept at creating patient medication lists, generating medication histories and keeping track of medication expiration dates. Other strengths include its ability to organize patient assignments and assist in the generation of progress notes. The application is network capable and fully graphical. A psychiatric outpatient clinic is currently using the software. Practitioners in non-psychiatric settings can also benefit from the software.

Ambulatory Care

The integrated design of mechanical bi-leaflet prosthetic heart valves.

A flow model utilizing an irrotational, inviscid algorithm of vortex-ring elements simulating the leaflets and source/sink elements simulating the aortic root coupled with a boundary layer model has been developed to model the internal flow phenomena of bi-leaflet mechanical heart valves implanted in the aortic root. The inviscid representation evaluates the aerodynamic lift, the induced drag, the pitching moment and flow velocity along the leaflet surface thus providing data for evaluating the boundary-layer thickness, the shear stress and flow separation point by the boundary layer theory. Full integration with the geometry enables immediate updates of the flow solution when changes in geometry have been made. It is shown that the effects of the internal flow domain model are necessary in the correct evaluation of lift and drag for subsequent dynamic analysis. The environment presented provides for the ability to produce significant and immediate design changes so that crucial decisions may be made whilst still within the software design loop. New designs are shown along with data for the improved flow model.

Algorithms

Visuvalve software: an aid to the diagnosis of shunt failure.

Software designed to help the neurosurgeon in the diagnosis of shunt malfunction is presented. This software allows the possibility to record on a 3.5 diskette a patient's clinical information and four views of a CT scan performed when the patient was doing perfectly well with his shunt. This diskette, operated by MS-DOS on any IBM-compatible personal computer, can be read at any time, anywhere. The evaluation of the system demonstrated it was safe, with an excellent adhesion of the patients and of their families.

Cerebral Ventriculography

[The technology for trance exposure states].

The paper deals with the burning problem to design instrumental techniques and facilities for psychotherapy by modelling high-technology-based conventional trans-exposure facilities which have not been used in their software design and by developing basically new exposure techniques and facilities by taking into account the present-day sociocultural environment. It also presents the results of using the proposed software complex of trans-exposures in narcological care and in the normalization of patients' body weight.

Alcoholism

CT virtual simulation.

Advances in computer technology and software design have enabled the concept of virtual simulation, first suggested by George Sherouse, to be realized. This article reviews the hardware and software requirements that provide a system that feels like a simulator and can facilitate the 3D planning process. Fast digital reconstruction of a radiograph from a CT data set provides true verification of treatment field design within the constraints of the virtual method. The clinical application of this technique is discussed in detail in relation to particular treatment sites.

Breast Neoplasms

Software and hardware integration of a microprogrammable state machine for NMR imaging.

We have integrated a commercially available microprogrammable state machine (Tecmag PULSkit) for use as a magnetic resonance pulse programmer. Providing the capability for active research environment imaging protocols, it features timing resolution of 100 nsec, ten 16-bit loop counters, and individually addressable look-up tables. This integration involved hardware and software integration with a VAX 11/750 at several levels. Hardware: Each of the three gradient channels employs three digital-to-analog converters (DACs). An 8-bit, 4-quadrant, multiplying DAC generates the gradient waveform shape. A 12-bit DAC generates the multiplying DAC scaling voltage, controlling gradient amplitude and sign. A third 12-bit DAC produces a gradient offset (shim) voltage. An eddy current compensation network is present for each gradient channel. Software: The software design philosophy was to create a flexible interface (interactive window environment), while not constraining complex manipulation of the hardware (direct use of the pulse-sequence compiler primitives and microprogramming). The software levels include (a) pulse-sequence microprogramming, (b) pulse-sequence compiler, (c) interactive parameter specification, and (d) canned pulse-sequence microcode library.

Computer Systems

A novel transverse gradient coil design for high-resolution MR imaging.

The authors describe a new gradient coil design for high resolution human, animal, specimen, or phantom imaging with high gradient efficiency and a large region of excellent gradient uniformity. Important features of our new design are the simple analytical description of the wire patterns that comprise the design, and ease of construction. Wires are spaced in a sinusoidal distribution around the circumference of the cylinder, and curved in an arcsin shape along the length of the cylinder. This coil produces a magnetic field pointing in a direction transverse to the axis of the coil with a gradient in the direction parallel to the axis of the coil. The same arcsin coil can be used to create a magnetic field pointing in a direction parallel to its axis with a gradient in a direction perpendicular to the coil axis. A prototype coil was constructed; field and inductance calculations were verified. Geometric variations on this coil design were modeled and their performance characteristics compared. This coil design is ideal for rapid implementation of a transverse gradient coil, since no specialized design software is required.

Algorithms

Computerized NCLEX-RN and NCLEX-PN preparation programs. Comparative review, 1997.

The computerized test taking market continues to expand to meet the needs of nursing students studying to prepare for the NCLEX-RN and the NCLEX-PN. In addition, currently registered nurses may choose to use these software programs to review clinical knowledge in areas in which they are not currently practicing. This article reviewed software designed for personal use, review books with complete disks, on-site institutional testing and consultation, and school of nursing LANs. The costs of software for personal use is priced reasonably and provides flexibility for students to use as their schedule permits. The cost of institutional licenses is moderate and most programs provide multiple on-site use rights. The marketplace has responded to the computerized NCLEX testing now in place nationally. As new formats are developed and new uses identified, nursing faculty and students can expect to see an expanded use of computerized testing.

Computer-Assisted Instruction

Design and application of a C++ macromolecular class library.

PDBlib is an extensible object oriented class library written in C++ for representing the 3-dimensional structure of biological macromolecules. PDBlib forms the kernel of a larger software framework being developed for assiting in knowledge discovery from macromolecular structure data. The software design strategy used by PDBlib, how the library may be used and several prototype applications that use the library are summarized. PDBlib represents the structural features of proteins, DNA, RNA, and complexes thereof, at a level of detail on a par with that which can be parsed from a Protein Data Bank (PDB) entry. However, the memory resident representation of the macromolecule is independent of the PDB entry and can be obtained from other back-end data sources, for example, existing relational databases and our own object oriented database (OOPDB) built on top of the commercial object oriented database, ObjectStore. At the front-end are several prototype applications that use the library: Macromolecular Query Language (MMQL) is based on a separate class library (MMQLlib) for building complex queries pertaining to macromolecular structure; PDBtool is an interactive structure verification tool; and PDBview, is a structure rendering tool used either as a standalone tool or as part of another application. Each of these software components are described. All software is available via anonymous ftp from cuhhca.hhmi.columbia.edu.

Animals

Reproducibility and automatic measurement of QT dispersion.

This study investigated interobserver (two observers) and intrasubject (two measurements) reproducibility of QT dispersion from abnormal electrocardiograms in patients with previous myocardial infarction, and compared a user-interactive with an automatic measurement system. Standard 12-lead electrocardiograms, recorded at 25 mm.s-1, were randomly chosen from 70 patients following myocardial infarction. These were scanned into a personal computer, and specially designed software skeletonized and joined each image. The images were then available for user-interactive (mouse and computer screen), or automatic measurements using a specially designed algorithm. For all methods reproducibility of the RR interval was excellent (mean absolute errors 3-4 ms, relative errors 0.3-0.5%). Reproducibility of the mean QT interval was good; intrasubject error was 6 ms (relative error 1.4%), interobserver error was 7 ms (1.8%), and observers' vs automatic measurement errors were 10 and 11 ms (2.5, 2.8%). However QTc dispersion measurements had large errors for all methods; intrasubject error was 12 ms (17.3%), interobserver error was 15 ms (22.1%), and observers' vs automatic measurement were errors 30 and 28 ms (35.4, 31.9%). QT dispersion measurements rely on the most difficult to measure QT intervals, resulting in a problem of reproducibility. Any automatic system must not only recognize common T wave morphologies, but also these more difficult T waves, if it is to be useful for measuring QT dispersion. The poor reproducibility of QT dispersion limits its role as a useful clinical tool, particularly as a predictor of events.

Diagnosis, Computer-Assisted

Technical and audiological factors in the implementation and use of digital signal processing hearing aids.

Fully digital hearing aids, to be worn behind or within the ear, are coming on to the market. The new possibilities and challenges of such aids are both technological and audiological in character. This paper describes some of the challenges, and one manufacturer's approach to them. The signal processing structure in one current digital hearing aid is presented, and justified in audiological terms, as a background to discussions of (i) the relative urgency of further advances in technology and audiological knowledge, and (ii) the challenges to the practice of hearing aid dispensing. It is concluded that further advances in rehabilitative audiology are more pressing than further major technological progress, and that the potential client benefits of the new generation of digital hearing aids will only be realized if the challenges they present to software design and dispensing practice are recognized and met.

Correction of Hearing Impairment

Computer-aided pattern analysis of temperature differentials.

Chiropractic analysis often incorporates the evaluation of heat distribution patterns observed in skin temperature profiles. Historically, temperature recordings of the spine have been made with a heat detection instrument using a thermocouple design. The advent of refinements in infrared technology, however, have greatly enhanced temperature detection in terms of accuracy and reliability. The present research reflects the development of computer software designed to express the data obtained with a dual channel heat sensing instrument. Two phases are involved: a) digital information, received from the sensing instrument, is standardized, stored for future analysis, and retrieved for comparisons with other graphs; b) stored data is graphically displayed, statistically analyzed, and otherwise compared. The data is displayed for visual observation as a) temperature data received from either channel of the sensing instrument or b) relative temperature differences between data from both channels of the sending instrument. For statistical evaluation, corresponding readings (comparisons between graphs) are plotted against one another and analyzed by a moving Pearson Product Moment correlation and moving t-test. This evaluation is graphically represented with a numeric display of pertinent statistical values. Current work indicates that a 10 point moving correlation and t-test will yield accurate comparisons between graphs.

Algorithms

Application of optimized parallel processing digital computers and numerical approximation methods to the ultra high-speed three-dimensional reconstruction of the intact thorax.

In order to achieve the computational capability to carry out many thousands of cross-sectional reconstructions, necessary to support a prototype high temporal and spatial resolution cylindrical scanning multiaxial tomographic unit, a series of design, software simulation, and fabrication studies is underway to develop a special-purpose high-speed reconstruction computer. This processor will rely upon integrated circuit arithmetic components of advanced design, and highly parallel architecture to execute X-ray based transaxial reconstruction algorithms at the rate of hundreds of cross sections/sec.

Computers

A software for the elaboration of job histories.

This article presents a software designed to help the occupational physician elaborate, print and automatically interrogate the job histories of workers. The need for the surveillance of professional risks throughout careers is the basic assumption on which this software is based and it runs on a PC.

Forms and Records Control

[Apple-Macintosh compatible software for documentation, management and evaluation of ultrasound findings in obstetrics].

The advantage of using a computer to automate routine calculations and print out charts of the obstetrical ultrasound examination is obvious. This report describes a software designed to simplify the documentation and analysis of ultrasound data in obstetrics. The system is easy to use, even for persons with little computer knowledge. The programme was written in FoxBase+/Mac (Fox Software, Inc., USA). FoxBase+/Mac takes full advantage of the easy-to-learn, easy-to-use Macintosh interface and is also very fast. Another advantage of this software is that it can be used in teaching. Non-experienced examinators can double-check the correctness of their scanning planes by observing the ultrasound pictures with the markers indicating the right measurement sites and the lists of standard values of biometrical parameters for the corresponding gestational age on the screen. In routine obstetrical ultrasound examinations it takes less than 5 min to enter the foetal biometry data and print out reports. These reports are informative and easy to interpret.

Female

A CAD CAM method for custom below-knee sockets.

The purpose of this investigation was to develop a numerical method for fabricating prosthetic sockets for below-knee amputees. An optical/laser digitiser scans an amputee's stump and collects three dimensional numerical data describing the surface of the limb and describing specific modification site locations. The numerical data from the laser camera representing the stump and modification sites are altered by the prosthetist using a custom computer aided design software system running on a personal computer. Using the altered numerical data a programme is created for a high resolution numerically controlled milling machine and a mould is made. The prosthetist then fabricates a socket. While the system has been tested with below-knee amputees it has been designed for application in most areas of prosthetics and orthotics. Utilising this method 15 patients were fitted. All patients subjectively stated that their "computer designed" socket fitted better than their conventionally made socket. As the research progressed and experience was gained with the system patients were normally fitted with the first socket iteration. The system overcomes five limitations existing with some of the other numerical systems: 1) accurate high resolution surface topography, 2) specific identification of subject modification sites, 3) flexible, user friendly software, 4) high resolution numerically controlled milling, and 5) integrated expansion to other prosthetic and orthotic areas.

Artificial Limbs

A novel and innovative quantitative kinetic software for virological colorimetric assays.

This study addresses the limited range of quantification with colorimetric assays (ELISA) starting from the analysis of color production in a reference external curve. An automatic ELISA management software, designated Quanti-Kin Detection System (QKDS) is described, which retains the sensitivity of the end-point reading and extends the dynamic range up to five logarithms with mathematical interpretation of color production. The QKDS software is a generic system suitable for different types of ELISA with substrate incubation at room temperature, does not require dedicated instruments, performs accurate quantification (including assay quality control) and has a user friendly interface. Specific applications were developed for three types of analytes: antibodies, viral antigens and nucleic acids. Data are presented on three representative QKDS applications to HIV antibodies, p24 antigen and proviral DNA kits. The precision of quantification is strictly correlated with the precision of the kit; however, for almost all samples with known analyte amount, the error percentage was below 10%, only for two cases in quantification of HIV proviral DNA the error percentage was around 25%. The necessity for a wide quantification range has been demonstrated by measuring clinical samples, which showed a distribution in all possible quantification ranges for all kits.

Animals

Perception and visualization of human posture information for computer-aided ergonomic analysis.

This article reports three experiments that examined the effects of photographic method, computerized visualization scheme, and posture complexity on posture perception and specification for computer-aided ergonomic analysis. The subjects were presented with photographs of working postures, and were required to manipulate human forms generated by an ergonomics software program to match the postures in the photographs. The first experiment showed a clear advantage of using a three-dimensional (3-D) human form graphic with two photographs when complex, asymmetric postures were analysed. However, the use of a 3-D human graphic display and two photographs jeopardized the subjects' posture specification performance when simple, symmetric postures were analysed. The results of the second and the third experiment demonstrated the importance of achieving congruency between photographic and computer display perspectives in improving posture specification performance. Implications for ergonomic job analysis and ergonomics software design are discussed.

Adult