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PubMed1994

[Development of clinical algorithms for quality assurance in management of multiple trauma].

Resuscitation and management of high-risk multiple trauma patients require a systematic and coordinated approach to diagnostic and therapeutic interventions. Clinical algorithms with branch chain decision logic can provide a clear and organized transformation of clinical standards for trauma care. Owing to their capability in formalization and standardization, algorithms define precisely the process of care and serve as a central interface within the system of quality assurance and quality control. The standardized document symbols and conventions for information processing according to ANSI/ISO/CCITT regulations are generally applied to the flowchart design of clinical algorithms. Special starting and ending point symbols make it possible to break down complex processes in several single interrelated algorithms. Inclusion of optional criteria checklists reduces the number of decision nodes and loops and minimizes the extent of a comprehensive algorithm. Clinical algorithms are an excellent tool for converting highly complex concepts of multiple trauma management into a logical, prioritized and systematic process of care.

Algorithms↗

PubMed1996

[Verification of accuracy of several algorithms to quantitate left ventricular regional wall motion: a study using cine MR imaging with myocardial tagging].

To verify the accuracy of several algorithms used to quantitate left ventricular (LV) regional wall motion, five volunteers were examined by cine MR imaging with presaturation myocardial tagging in short-axis and 4-chamber sections. Three algorithms for the wall motion analysis, radial, centerline, and originally developed "modified-Hildreth" methods, were applied to the cine MR images, and dissociation of the end-systolic position of the tags estimated by each algorithm from the true position was examined. The modified-Hildreth method was comparable in accuracy to the other methods for estimating end-systolic tag position. Significantly worse estimation of the tag position by the three algorithms occurred in the 4-chamber section compared with the short-axis section (p < 0.001, 0.005), indicating difficulties in the wall motion analysis of "long-axis" LV images. Among the algorithms, the centerline method showed the highest accuracy of the estimation in the 4-chamber section, and the modified-Hildreth method was the best in the short-axis section. In the 4-chamber section, correction of the position of end-diastolic and end-systolic images around the luminal centroids improved the estimation (p < 0.01, 0.05). Tagging cine MR imaging was proved to be useful for determining the most suitable algorithm for quantitative wall motion analysis of LV images obtained from conventional angiocardiography and other imaging modalities.

Adult↗

PubMed1996

A modified EM algorithm for estimation in generalized mixed models.

Application of the EM algorithm for estimation in the generalized mixed model has been largely unsuccessful because the E-step cannot be determined in most instances. The E-step computes the conditional expectation of the complete data log-likelihood and when the random effect distribution is normal, this expectation remains an intractable integral. The problem can be approached by numerical or analytic approximations; however, the computational burden imposed by numerical integration methods and the absence of an accurate analytic approximation have limited the use of the EM algorithm. In this paper, Laplace's method is adapted for analytic approximation within the E-step. The proposed algorithm is computationally straightforward and retains much of the conceptual simplicity of the conventional EM algorithm, although the usual convergence properties are not guaranteed. The proposed algorithm accommodates multiple random factors and random effect distributions besides the normal, e.g., the log-gamma distribution. Parameter estimates obtained for several data sets and through simulation show that this modified EM algorithm compares favorably with other generalized mixed model methods.

Algorithms↗

PubMed1997

Evaluation of an algorithm for integrated management of childhood illness in an area of Kenya with high malaria transmission.

In 1993, the World Health Organization completed the development of a draft algorithm for the integrated management of childhood illness (IMCI), which deals with acute respiratory infections, diarrhoea, malaria, measles, ear infections, malnutrition, and immunization status. The present study compares the performance of a minimally trained health worker to make a correct diagnosis using the draft IMCI algorithm with that of a fully trained paediatrician who had laboratory and radiological support. During the 14-month study period, 1795 children aged between 2 months and 5 years were enrolled from the outpatient paediatric clinic of Siaya District Hospital in western Kenya; 48% were female and the median age was 13 months. Fever, cough and diarrhoea were the most common chief complaints presented by 907 (51%), 395 (22%), and 199 (11%) of the children, respectively; 86% of the chief complaints were directly addressed by the IMCI algorithm. A total of 1210 children (67%) had Plasmodium falciparum infection and 1432 (80%) met the WHO definition for anaemia (haemoglobin < 11 g/dl). The sensitivities and specificities for classification of illness by the health worker using the IMCI algorithm compared to diagnosis by the physician were: pneumonia (97% sensitivity, 49% specificity); dehydration in children with diarrhoea (51%, 98%); malaria (100%, 0%); ear problem (98%, 2%); nutritional status (96%, 66%); and need for referral (42%, 94%). Detection of fever by laying a hand on the forehead was both sensitive and specific (91%, 77%). There was substantial clinical overlap between pneumonia and malaria (n = 895), and between malaria and malnutrition (n = 811). Based on the initial analysis of these data, some changes were made in the IMCI algorithm. This study provides important technical validation of the IMCI algorithm, but the performance of health workers should be monitored during the early part of their IMCI training.

Algorithms↗

PubMed1998

Learning algorithms based on linearization.

The aim of this article is to investigate a mechanical description of learning. A framework for local and simple learning algorithms based on interpreting a neural network as a set of configuration constraints is proposed. For any architectural design and learning task, unsupervised and supervised algorithms can be derived, optionally using unconstrained and hidden neurons. Unlike algorithms based on the gradient in weight space, the proposed tangential correlation (TC) algorithms move along the gradient in state space. This results in optimal scaling properties and simple expressions for the weight updates. The number of synapses is much larger than the number of neurons. A constraint for neural states does not impose a unique constraint for synaptic weights. Which weights to assign credit to can be selected from a parametrization of all weight changes equivalently satisfying the state constraints. At the heart of the parametrization are minimal weight changes. Two supervised algorithms (differing by their parametrizations) operating on a three-layer perceptron are compared with standard backpropagation. The successful training of fixed points of recurrent networks is demonstrated. The unsupervised learning of oscillations with variable frequencies is performed on standard and more sophisticated recurrent networks. The results presented here can be useful both for the analysis and for the synthesis of learning algorithms.

Algorithms↗

PubMed1984

Identification and estimation algorithm for stochastic neural system.

An algorithm for the estimation of stochastic processes in a neural system is presented. This process is defined here as the continuous stochastic process reflecting the dynamics of the neural system which has some inputs and generates output spike trains. The algorithm proposed here is to identify the system parameters and then estimate the stochastic process called neural system process here. These procedures carried out on the basis of the output spike trains which are supposed to be the data observed in the randomly missing way by the threshold time function in the neural system. The algorithm is constructed with the well-known Kalman filters and realizes the estimation of the neural system process by cooperating with the algorithm for the parameter estimation of the threshold time function presented previously (Nakao et al., 1983). The performance of the algorithm is examined by applying it to the various spike trains simulated by some artificial models and also to the neural spike trains recorded in cat's optic tract fibers. The results in these applications are thought to prove the effectiveness of the algorithm proposed here to some extent. Such attempts, we think, will serve to improve the characterizing and modelling techniques of the stochastic neural systems.

Animals↗

PubMed1978

Analysis of a cooperative stereo algorithm.

Marr and Poggio (1976) recently described a cooperative algorithm that solves the correspondence problem for stereopsis. This article uses a probabilistic technique to analyze the convergence of that algorithm, and derives the conditions governing the stability of the solution state. The actual results of applying the algorithm to random-dot stereograms are compared with the probabilistic analysis. A satisfactory mathematical analysis of the asymptotic behaviour of the algorithm is possible for a suitable choice of the parameter values and loading rules, and again the actual performance of the algorithm under these conditions is compared with the theoretical predictions. Finally, some problems raised by the analysis of this type of "cooperative" algorithm are briefly discussed.

Depth Perception↗

PubMed1994

Sensitivity and specificity of a dual-chamber arrhythmia recognition algorithm for implantable devices.

Present ventricular rate-based arrhythmia detection algorithms lack specificity. Using a training set of 109 endocardial electrogram recordings, a sensitive and specific dual-chamber arrhythmia recognition algorithm has been developed. The algorithm uses atrial and ventricular rates, irregularity, degree of beat-to-beat similarity, and measure of electrogram complex distinctiveness to arrive at a diagnostic conclusion. A test set of 121 endocardial electrogram recordings obtained during provocative electrophysiology studies was then used for blinded validation of the algorithm. In normal rhythm, 1:1 tachycardia, atrial tachycardia, atrial flutter, atrial fibrillation, ventricular tachycardia, and ventricular fibrillation, the percentages of sensitivity/specificity were, respectively, 100/99, 100/99, 80/99, 89/98, 91/97, 92/100, and 100/98. Although ventricular rate alone can usually distinguish normal rhythm, ventricular tachycardia, and ventricular fibrillation, it is confounded by atrial arrhythmias and 1:1 tachycardias. When tested on a database, a ventricular rate-only algorithm resulted in sensitivity/specificity of 100/65, 90/78, and 100/99%, respectively, for these three rhythms. Therefore, the dual-chamber algorithm based on both temporal and morphologic measures provides better distinction of normal rhythm and ventricular tachycardia than existing methods, without sacrificing sensitivity.

Arrhythmias, Cardiac↗

PubMed1998

A fast neural-network algorithm for VLSI cell placement.

Cell placement is an important phase of current VLSI circuit design styles such as standard cell, gate array, and Field Programmable Gate Array (FPGA). Although nondeterministic algorithms such as Simulated Annealing (SA) were successful in solving this problem, they are known to be slow. In this paper, a neural network algorithm is proposed that produces solutions as good as SA in substantially less time. This algorithm is based on Mean Field Annealing (MFA) technique, which was successfully applied to various combinatorial optimization problems. A MFA formulation for the cell placement problem is derived which can easily be applied to all VLSI design styles. To demonstrate that the proposed algorithm is applicable in practice, a detailed formulation for the FPGA design style is derived, and the layouts of several benchmark circuits are generated. The performance of the proposed cell placement algorithm is evaluated in comparison with commercial automated circuit design software Xilinx Automatic Place and Route (APR) which uses SA technique. Performance evaluation is conducted using ACM/SIGDA Design Automation benchmark circuits. Experimental results indicate that the proposed MFA algorithm produces comparable results with APR. However, MFA is almost 20 times faster than APR on the average.

Journal Article↗

PubMed2000

Byte structure variable length coding (BS-VLC): a new specific algorithm applied in the compression of trajectories generated by molecular dynamics

Molecular dynamics is a well-known technique very much used in the study of biomolecular systems. The trajectory files produced by molecular dynamics simulations are extensive, and the classical lossless algorithms give poor efficiencies in their compression. In this work, a new specific algorithm, named byte structure variable length coding (BS-VLC), is introduced. Trajectory files, obtained by molecular dynamics applied to trypsin and a trypsin:pancreatic trypsin inhibitor complex, were compressed using four classical lossless algorithms (Huffman, adaptive Huffman, LZW, and LZ77) as well as the BS-VLC algorithm. The results obtained show that BS-VLC nearly triplicates the compression efficiency of the best classical lossless algorithm, preserving a near lossless behavior. Compression efficiencies close to 50% can be obtained with a high degree of precision, and the maximum efficiency possible (75%), within this algorithm, can be performed with good precision.

Journal Article↗

PubMed2005

Experimental implementation of heat-bath algorithmic cooling using solid-state nuclear magnetic resonance.

The counter-intuitive properties of quantum mechanics have the potential to revolutionize information processing by enabling the development of efficient algorithms with no known classical counterparts. Harnessing this power requires the development of a set of building blocks, one of which is a method to initialize the set of quantum bits (qubits) to a known state. Additionally, fresh ancillary qubits must be available during the course of computation to achieve fault tolerance. In any physical system used to implement quantum computation, one must therefore be able to selectively and dynamically remove entropy from the part of the system that is to be mapped to qubits. One such method is an 'open-system' cooling protocol in which a subset of qubits can be brought into contact with an external system of large heat capacity. Theoretical efforts have led to an implementation-independent cooling procedure, namely heat-bath algorithmic cooling. These efforts have culminated with the proposal of an optimal algorithm, the partner-pairing algorithm, which was used to compute the physical limits of heat-bath algorithmic cooling. Here we report the experimental realization of multi-step cooling of a quantum system via heat-bath algorithmic cooling. The experiment was carried out using nuclear magnetic resonance of a solid-state ensemble three-qubit system. We demonstrate the repeated repolarization of a particular qubit to an effective spin-bath temperature, and alternating logical operations within the three-qubit subspace to ultimately cool a second qubit below this temperature. Demonstration of the control necessary for these operations represents an important step forward in the manipulation of solid-state nuclear magnetic resonance qubits.

Journal Article↗

PubMed2001

Supraventricular tachycardia-ventricular tachycardia discrimination algorithms in implantable cardioverter defibrillators: state-of-the-art review.

To reduce inappropriate therapy of supraventricular tachycardia (SVT), implantable cardioverter defibrillators (ICDs) include algorithms to discriminate ventricular tachycardia (VT) from SVT. Dual-chamber algorithms analyze atrial and ventricular rates or AV relationship. They provide advantages over single-chamber algorithms, but introduce new ways to detect SVT as VT inappropriately and to underdetect VT. Unlike pacemakers, dual-chamber ICDs require accurate atrial sensing during high ventricular rates. A postventricular atrial blanking period prevents oversensing of far-field R waves as atrial electrograms, but causes underdetection of atrial fibrillation during high ventricular rates. Tachycardias with 1:1 AV relationship and VT during atrial tachyarrhythmias present specific SVT-VT discrimination problems. The first dual-chamber algorithms performed comparably to single-chamber algorithms. Present dual-chamber algorithms correct some limitations of earlier versions.

Defibrillators, Implantable↗

PubMed1979

Potential effect of self-care algorithms on the number of physician visits.

To assess the potential effect of self-care algorithms on the number of physician visits, actual visits from the Seattle Virus Watch were compared retrospectively with those recommended by clinical algorithms for common illnesses from the book, Take Care of Yourself, by Vickery and Fries. From a total of 3929 illnesses, records indicating the presence of the index symptom for eight algorithms were identified, determining whether the criteria for seeing a physician were met and whether a physician visit was recorded. The number of visits observed was compared to the number of visits recommended by the algorithms. Strict adherence would have increased the number of visits over that observed for five, remained the same for two, and decreased for one of the algorithms. These results indicate that adherence to some commonly promulgated self-care algorithms may increase rather than decrease the number of physician visits.

Activities of Daily Living↗

PubMed2004

Box length search algorithm for molecular simulation of systems containing periodic structures.

We have developed a box length search algorithm to efficiently find the appropriate box dimensions for constant-volume molecular simulation of periodic structures. The algorithm works by finding the box lengths that equalize the pressure in each direction while maintaining constant total volume. Maintaining the volume at a fixed value ensures that quantitative comparisons can be made between simulation and experimental, theoretical or other simulation results for systems that are incompressible or nearly incompressible. We test the algorithm on a system of phase-separated block copolymers that has a preferred box length in one dimension. We also describe and test a Monte Carlo algorithm that allows the box lengths to change while maintaining constant volume. We find that the box length search algorithm converges at least two orders of magnitude more quickly than the variable box length Monte Carlo method. Although the box length search algorithm is not ergodic, it successfully finds the box length that minimizes the free energy of the system. We verify this by examining the free energy as determined by the Monte Carlo simulation.

Journal Article↗

PubMed2004

An adaptive immune optimization algorithm for energy minimization problems.

Based on the immune theory of biology, a novel evolutionary algorithm, adaptive immune optimization algorithm (AIOA), is proposed. In AIOA, density regulation and immune selection is adopted to control the individual diversity and the convergence adaptively. By an application of the algorithm to the optimization of test functions, it is shown that the algorithm is a highly efficient optimization method compared with other stochastic optimization methods. The algorithm was also applied to the optimization of Lennard-Jones clusters, and the results show that the method can find the optimal structure of N</=80 with a very high efficiency. The proposed algorithm may be a good tool for fast global optimization in chemical or biological molecular simulations.

Journal Article↗

PubMed2005

Nested stochastic simulation algorithm for chemical kinetic systems with disparate rates.

An efficient simulation algorithm for chemical kinetic systems with disparate rates is proposed. This new algorithm is quite general, and it amounts to a simple and seamless modification of the classical stochastic simulation algorithm (SSA), also known as the Gillespie [J. Comput. Phys. 22, 403 (1976); J. Phys. Chem. 81, 2340 (1977)] algorithm. The basic idea is to use an outer SSA to simulate the slow processes with rates computed from an inner SSA which simulates the fast reactions. Averaging theorems for Markov processes can be used to identify the fast and slow variables in the system as well as the effective dynamics over the slow time scale, even though the algorithm itself does not rely on such information. This nested SSA can be easily generalized to systems with more than two separated time scales. Convergence and efficiency of the algorithm are discussed using the established error estimates and illustrated through examples.

Journal Article↗

PubMed2005

FBP Algorithms for Attenuated Fan-Beam Projections.

A filtered backprojection (FBP) reconstruction algorithm for attenuated fan-beam projections has been derived based on Novikov's inversion formula. The derivation uses a common transformation between parallel-beam and fan-beam coordinates. The filtering is shift-invariant. Numerical evaluation of the FBP algorithm is presented as well. As a special application, we also present a shift-invariant FBP algorithm for fan-beam SPECT reconstruction with uniform attenuation compensation. Several other fan-beam reconstruction algorithms are also discussed. In the attenuation-free case, our algorithm reduces to the conventional fan-beam FBP reconstruction algorithm.

Journal Article↗

PubMed1983

Clinical algorithms for prehospital cardiac care.

Algorithms for the prehospital management of cardiac arrhythmias were developed and their use by and value to paramedics evaluated. The algorithms, in booklet form, were distributed to half of the Philadelphia paramedic platoons; paramedics in the other platoons followed a narrative protocol that reflected identical contents. An arrhythmia recognition test given 18 months after the algorithm booklets were introduced showed that paramedics who received the booklets scored significantly higher in identifying life-threatening arrhythmias (p = 0.029) than did their counterparts without the booklets. Survival data for 459 patients in ventricular fibrillation treated by paramedics were collected 1 year before and 7 months after the introduction of the algorithm booklets. The paramedics using the algorithms improved their survival rate from 11.25 to 15.1 per cent, while the survival rate for patients treated by paramedics using the narrative protocols decreased from 12.4 to 7.7 per cent. The likelihood of obtaining a ratio of survival odds of this magnitude when there is no true difference is 0.092. Time-to-death was significantly different (p = 0.04) for the two groups of patients. Thus, the use of algorithm booklets as an inexpensive educational aid for paramedics is recommended.

Allied Health Personnel↗