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PubMed2001

Pattern of use and user satisfaction of Neuro Control Freehand system.

OBJECTIVES: Evaluation of the use and acceptability of the Neuro Control Freehand system. STUDY DESIGN: A questionnaire was sent in a single mail shot to users of the system. Administration was by a 3rd party with anonymous returns. SETTING: A supra regional spinal unit in the UK. METHODS: The Freehand system is an implanted Functional Electrical Stimulation (FES) device for restoration of lateral and palmar grasps following C5 or C6 tetraplegia. RESULTS: Replies were received from seven users of the system who had an average experience of 23 months use. All used the system daily and had increased their range of activities of daily living skills. Some problems had been experienced with equipment reliability and skin allergy to the tape used to secure external components. Six users felt more confident when using the system and seven felt their quality of life had improved. CONCLUSION: The Freehand system provides increased function that is considered by its users to be of benefit.

Activities of Daily Living↗

PubMed2002

Are referring doctors ready for enterprise and community wide immediate image and report access?

At most medical centers film-based radiology requires that single or multiple copies of patient exams and reports be distributed for results communication. A successful picture archiving and communication system (PACS) should provide a means to improve upon this inefficient paradigm, with universal access to imagery and exam results on demand at the user's convenience. Enterprise and community-wide experience with universal PACS access is reviewed. Referring physicians were surveyed about their experience with PACS, with regard to acceptance, productivity, frequency of usage, and impact on patient care. Web audit trails were used to assess physician usage. Film printing logs were reviewed. The filmless paradigm was highly regarded and frequently used by nearly all users. Significant productivity benefits were gleaned by all of the referring physicians. Patient quality of care benefitted from more efficient communication of results. Very small quantities of film were used for printing of exams, typically for patient copies.

Attitude of Health Personnel↗

PubMedDate not supplied

Perspectives on the Massachusetts Community Health Information Profile (MassCHIP): developing an online data query system to target a variety of user needs and capabilities.

The Massachusetts Community Health Information Profile (MassCHIP) has many distinctive features. These features evolved to maximize the usefulness of this query system for a broad group of users with varied needs, differing levels of knowledge about public health, and diverse experience using public health data. Three major features of MassCHIP help target our large user population. These features are as follows: (1) multiple avenues of entry to initiate queries ranging from an alphabetical list of simple topics to detailed International Classification of Disease codes; (2) the inclusion of data sets from other state agencies in addition to those of the Massachusetts Department of Public Health to reflect a broad view of public health; and (3) the capacity to retrieve data for multiple levels of geography, from the neighborhood through the state, including planning districts and hospitals. In this article, we discuss the history and design of MassCHIP, and focus on the features of MassCHIP that target a great variety of user needs and capabilities, and which are distinctive among Web-based data query systems.

Information Systems↗

PubMed2005

[Hand-held echocardiography in clinical practice].

In the last years the industry has created echocardiographic portable machines of reduced size, available for a growing number of operators. After the first experiences of the '70s, hand-held echocardiography (HHE) is earned interesting commercial positions. The transportability of these machines allows to perform examinations outside the echo-lab and provides diagnostic information in heterogeneous locations such as intensive care unit, emergency room and outpatient structures, at the bedside and even in ambulance. HHE can be useful for detection of several pathologies including aortic aneurysms and left ventricular hypertrophy, regional wall motion abnormalities, pericardial and pleural effusion. To date, four main kinds of HHE can be distinguished: a first, high-cost variety, including miniaturized machines, equipped with instrumentations of standard echocardiography and even new softwares for tissue Doppler and myocardial contrast echocardiography; a second kind of machines of high level but not miniaturized; a third (intermediate level and low cost), and a fourth one (basic level and very low cost), including "cardioscopes" corresponding to the ultrasound stethoscope, able to complete efficaciously the clinical examination. The introduction of HHE opens controversy about its diagnostic accuracy, the opportunity to establish the clinical scenario where it should be utilized and the identification of the potential users and the needed competence level. Preliminary experiences show the possibility of improving and anticipating the diagnosis of several cardiac diseases but also the need to plan specific ultrasound training to avoid inappropriate use of HHE.

Echocardiography↗

PubMed2003

GAAS: gene array analyzer software for management, analysis and visualization of gene expression data.

SUMMARY: GAAS, Gene Array Analyzer Software supports multi-user efficient management and suitable analyses of large amounts of gene expression data across replicated experiments. Its management framework handles input data generated by different technologies. A multi-user environment allows each user to store his/her own data visualization scheme, analysis parameters used, values and formats of the output data. The analysis engine performs: background and spot quality evaluation, data normalization, differential gene expression analyses in single and multiple replica experiments. Results of expression profiles can be interactively navigated through graphical interfaces and stored into output databases.

Algorithms↗

PubMed1997

Medroxyprogesterone acetate antagonizes inhibitory effects of conjugated equine estrogens on coronary artery atherosclerosis.

Although estrogen replacement therapy is associated with reduced risk of coronary heart disease and reduced extent of coronary artery atherosclerosis, the effects of combined (estrogen plus progestin) hormone-replacement therapy are uncertain. Some observational data indicate that users of combined hormone replacement consisting of continuously administered oral conjugated equine estrogens (CEE) and oral sequentially administered (7 to 14 days per month) medroxyprogesterone acetate (MPA) experience a reduction in risk similar to that of users of CEE alone. However, the effects of combined, continuously administered CEE plus MPA (a prescribing pattern that has gained favor) on the risk of coronary heart disease or atherosclerosis are not known. We studied the effects of CEE (monkey equivalent of 0.625 mg/d) and MPA (monkey equivalent of 2.5 mg/d), administered separately or in combination, on the extent of coronary artery atherosclerosis (average plaque size) in surgically postmenopausal cynomolgus monkeys fed atherogenic diets and treated with these hormones for 30 months. Treatment with CEE alone resulted in atherosclerosis extent that was reduced 72% relative to untreated (estrogen-deficient) controls (P < .004). Atherosclerosis extent in animals treated with CEE plus MPA or MPA alone did not differ from that of untreated controls. Although treatment had marked effects on plasma lipoprotein patterns, statistical adjustment for variation in plasma lipoproteins did not alter the between-group relationships in atherosclerotic plaque size, suggesting that these factors do not explain substantially the atheroprotective effect of estrogen or the MPA-associated antagonism. Although the mechanism(s) remains unclear, we conclude that oral CEE inhibits the initiation and progression of coronary artery atherosclerosis and that continuously administered oral MPA antagonizes this atheroprotective effect.

Administration, Oral↗

PubMed2005

A flexible auditory research platform using acoustic or electric stimuli for adults and young children.

A user-friendly and versatile research platform for use in auditory experiments, referred to as APEX (Application for PsychoElectrical eXperiments), is described. The platform takes care of automatic stimulus presentation and collection of the subject's responses. Acoustical auditory, as well as electrical auditory experiments with CI recipients can be conducted. The platform currently supports LAURA, Nucleus CI22 and Nucleus CI24 cochlear implants. The graphical user interface for the subjects has been extended to allow for testing very young children, by embedding the psychophysical procedures in a computer game. The research platform is available free of charge.

Acoustic Stimulation↗

PubMed2002

A strategy for the rapid identification of phosphorylation sites in the phosphoproteome.

Edman phosphate ((32)P) release sequencing provides a high sensitivity means of identifying phosphorylation sites in proteins that complements mass spectrometry techniques. We have developed a bioinformatic assessment tool, the cleavage of radiolabeled protein (CRP) program, which enables experimental identification of phosphorylation sites via (32)P labeling and Edman degradation of cleaved proteins obtained at femtomole levels. By observing the Edman cycle(s) in which radioactivity is found, candidate phosphorylation sites are identified by determining which residues occur at the observed number of cycles downstream from a peptide cleavage site. In cases where more than one residue could be responsible for the observed radioactivity, additional experiments with cleavage reagents having alternative specificities may resolve the ambiguity. Given a protein sequence and a cleavage site, CRP performs these experiments in silico, identifying resolved sites based on user-supplied experimental data, as well as suggesting combinations of reagents for additional analyses. Analysis of the PhosphoBase protein sequence database suggests that CRP data from two cleavage experiments can be used to identify unambiguously 60% of known phosphorylation sites. Data from additional cleavage experiments may increase the overall coverage to 70% of known sites. By comparing theoretical data obtained from the CRP program with (32)P release data obtained from an Edman sequencer, a known phosphorylation site was identified unambiguously and correctly. In addition, our results show that in vivo phosphorylation sites can be determined routinely by differential proteolysis analysis and Edman cycling with less than 1 fmol of protein and 1000 cpm.

Amino Acid Sequence↗

PubMed2002

Unsubscribe, pleeezz!!!: management and training of media competence in computer-mediated communication.

Computer-mediated communication (CMC) has created a new communication divide. Mostly, this division is due to technical and access problems. Overlooked is yet another divide in terms of user communication competence. This contribution focuses on media competence based on theories about communication competence and theories about CMC. Two field studies are presented: an analysis of a virtual seminar chat communication (22 participants, 3 weeks' duration) and an analysis of unsubscribe-failures within 2 years of a German mailing list (average of 1,000 subscriptions). Data from both studies reveal that help-seeking CMC users with low media-specific competence experience setbacks in terms of interpersonal relations and information gathering. There is a spiral of neutral to negative reactions and an increase in stress and aggression-related language in the reaction of the addressed peers. From the perspective of external raters, we found a contraintuitive result: The style, content, and wording of the message of the respondent is considered as an indicator for a less competent and socially attractive person behind the follow-up message than those of the initial message. On the one hand, media experts are needed and appreciated as technical problem-solvers; on the other hand, they might be perceived as socially narrow-minded freaks who are less interested in the task itself than in CMC-based task completion. This leads to the question of how sensibility for the social context, task orientation, and media competence can be combined (and trained for) in one person. Two competence trainings for text-based synchronous and asynchronous communication are introduced as interventions.

Communications Media↗

PubMed1984

Users' and nonusers' evaluations of the CPF 550 lenses.

Thirty-six subjects completed questionnaires on their experiences wearing the CPF 550 lenses. Twenty-six subjects [21 with retinitis pigmentosa (RP)] were users of the 550's and 10 subjects (6 with RP) were nonusers who had rejected the 550's after a trial period. Subjects were asked about such factors as effects on adaptation time, ocular comfort, visual functioning, acceptability of tint strength in various lighting conditions, cosmetic appearance, effects of weather, and replacement intent. Users reported reduced adaptation time in changes of illumination, increased ocular comfort, improved visual functioning with the exception of poor color discrimination, and cosmetic acceptability. Satisfaction with tint strength varied with degree of illumination; usefulness in different types of weather also varied depending on the condition. Nonusers' responses were mixed; they were less likely to report improvements with the CPF 550 lenses compared to the users' group.

Adult↗

PubMedDate not supplied

Acclimatization in wide dynamic range multichannel compression and linear amplification hearing aids.

Acclimatization was studied in hearing-impaired patients with no previous hearing aid (HA) experience who were fit bilaterally with either wide dynamic range multichannel compression (WDRMCC) or linear amplification (LA) HAs. Throughout 40 weeks of normal HA use, we monitored changes in nonsense syllable perception in speech-spectrum noise. Syllable recognition for WDRMCC users improved by 4.6% over the first 8 weeks, but the 2.2% improvement for LA users was complete in 2 to 4 weeks. Consonant confusion analyses indicated that WDRMCC experience facilitated consonant identification, while LA users primarily changed their response biases. Furthermore, WDRMCC users showed greater improvement for aided than unaided stimuli, while LA users did not. These results demonstrate acclimatization in new users of WDRMCC HAs but not in new users of LA HAs. A switch in amplification type after 32 weeks produced minimal performance change. Thus, acclimatization depended on the type of amplification and the previous amplification experience.

Adaptation, Physiological↗

PubMed2006

NCBI GEO: mining tens of millions of expression profiles--database and tools update.

The Gene Expression Omnibus (GEO) repository at the National Center for Biotechnology Information (NCBI) archives and freely disseminates microarray and other forms of high-throughput data generated by the scientific community. The database has a minimum information about a microarray experiment (MIAME)-compliant infrastructure that captures fully annotated raw and processed data. Several data deposit options and formats are supported, including web forms, spreadsheets, XML and Simple Omnibus Format in Text (SOFT). In addition to data storage, a collection of user-friendly web-based interfaces and applications are available to help users effectively explore, visualize and download the thousands of experiments and tens of millions of gene expression patterns stored in GEO. This paper provides a summary of the GEO database structure and user facilities, and describes recent enhancements to database design, performance, submission format options, data query and retrieval utilities. GEO is accessible at http://www.ncbi.nlm.nih.gov/geo/

Computer Graphics↗

PubMed2006

User modeling and adaptation in health promotion dialogs with an animated character.

In this paper, we describe our experience with the design and implementation of an embodied conversational agent (ECA) that converses with users to change their dietary behavior. Our intent is to develop a system that dynamically models the agent and the user and adapts the agent's counseling dialog accordingly. Towards this end, we discuss our efforts to automatically determine the user's dietary behavior stage of change and attitude towards the agent on the basis of unconstrained typed text dialog, first with another person and then with an ECA controlled by an experimenter in a wizard of Oz study. We describe how the results of these studies have been incorporated into an algorithm that combines the results from simple parsing rules together with contextual features using a Bayesian network to determine user stage and attitude automatically.

Artificial Intelligence↗

PubMed2002

[Experience with a group in nursing care for diabetics].

With the implementation of a diabetic group, the objective of this paper is to analyze the importance of this activity as a nurse's work tool and to evaluate it from the user's point-of-view. It is an experience report based on the information from the participating observation and the registrations in a field diary. It focuses the interpersonal relations, the understanding level of the received information, the diabetics' feelings and expectations. It was noticed that the human relationship and the experiences exchange based on cooperation contribute to the efficiency in the diabetes treatment.

Diabetes Mellitus↗

PubMed2003

Full time directional versus user selectable microphone modes in hearing aids.

OBJECTIVE: The purpose of this experiment was to systematically examine hearing aid benefit as measured by speech recognition and self-assessment methods across omnidirectional and directional hearing aid modes. These data were used to compare directional benefit as measured by speech recognition in the laboratory to hearing aid wearer's perceptions of benefit in everyday environments across full-time directional, full-time omnidirectional, and user selectable directional fittings. Identification of possible listening situations that resulted in different self reported hearing aid benefit as a function of microphone type was a secondary objective of this experiment. DESIGN: Fifteen adults with symmetrical, sloping sensorineural hearing loss were fitted bilaterally with in-the-ear (ITE) directional hearing aids. Measures of hearing aid benefit included the Profile of Hearing Aid Benefit (PHAB), the Connected Sentence Test (CST), the Hearing in Noise Test (HINT), and a daily use log. Additionally, two new subscales were developed for administration with the PHAB. These subscales were developed to specifically address situations in which directional hearing aids may provide different degrees of benefit than omnidirectional hearing aids. Participants completed these measures in three conditions: omnidirectional only (O), directional only with low-frequency gain compensation (D), and user-selectable directional/omnidirectional (DO). RESULTS: Results from the speech intelligibility in noise testing indicated significantly more hearing aid benefit in directional modes than omnidirectional. PHAB results indicated more benefit on the background noise subscale (BN) in the DO condition than in the O condition; however, this directional advantage was not present for the D condition. Although the reliability of the newly proposed subscales is as yet unknown, the data were interpreted as revealing a directional advantage in situations where the signal of interest was in front of the participant and a directional disadvantage in situations where the signal of interest was behind the listener or localization was required. CONCLUSIONS: Laboratory directional benefit is reflected in self-assessment measures that focus on listening in noise when the sound source of interest is in front of the listener. The use of a directional hearing aid mode; however, may have either a positive, a neutral, or a negative impact on hearing aid benefit measured in noisy situations, depending on the specific listening situation.

Aged↗

PubMed2004

GeneX Va: VBC open source microarray database and analysis software.

Developed by the Virginia Bioinformatics Consortium (VBC), GeneX Va is an open source, freeware database and bioinformatics analysis software for archiving and analyzing Affymetrix GeneChip data. It provides an integrated framework for management, documentation, and analysis of microarray experiments and data to support a range of users, from individual research laboratories to institutional microarray facilities. GeneX Va also provides web-based access to a PostgreSQL relational database system with a comprehensive security system. Data can be extracted from the database and delivered to interactive or scriptable statistical analysis protocols. The security system allows each investigator to manage their own array data and analysis output files and also provides custom access privileges for other users, groups, and internal/external collaborators. The analysis interface uses "Analysis Trees," an innovative user interface that allows researchers to interactively create a tree-structured flow chart of analysis routines. The latest GeneX Va software is available from and can be freely downloaded at the Sourceforge web site http://va-genex.sourceforge.net. To allow researchers to access the database and analysis capabilities of the GeneX Va system, microarray data from many VBC GeneChip experiments have been deposited into a public section of the GeneX Va system at the University of Virginia. The VBC GeneX Va sites, which include documentation, are at http://genes.med.virginia.edu/ of the University of Virginia and at http://genex.csbc.vcu.edu/ of the Virginia Commonwealth University.

Computer Security↗

PubMed2003

Cerner Millennium: the Innsbruck experience.

OBJECTIVES: A Clinical Information System, serving more than 2,000 users was to be implemented at three hospitals of TILAK (Tiroler Landeskrankenanstalten GmbH), including the University Hospital of Innsbruck. The system was intended to integrate data from radiology, laboratory, and pathology subsystems with patient data. METHODS: Using Cerner Millennium software and Health Level 7 standards, the first stage of an Electronic Patient Record (EPR) was built. Direct data entry was facilitated using either a Microsoft Word text processor (with subsequent authentication workflow) or structured forms. An enterprise-wide scheduling module allows coordination and storage of patient appointments directly in the EPR. As required by security policy, the Cerner software regulates the varying degrees of information exchange among organizations and departments within the enterprise. RESULTS: First experiences indicate satisfactory acceptance of system functionalities. The introduction of Cerner Millennium at TILAK has achieved essential goals defined at the beginning of the project. Basic functionalities--free text documentation, standardized documentation, scheduling, and some parts of order entry--are offered in a user friendly manner. Integration with existing systems to complete the EPR has been successful using standard interfaces (HL7). CONCLUSION: TILAK concluded that it was possible to successfully implement a Clinical Information System (CIS) developed mainly for the American market in a European healthcare environment. Some adaptations and functional extensions were necessary (e.g., the discharge summary "Arztbrief"). The system had enough flexibility to meet the requirements and specifications of European healthcare processes. A key factor of success was the establishment of a basic level of understanding and communication between the software vendor and the TILAK user community.

Austria↗

PubMed1995

First field trials with a portable CIS processor for the Ineraid multichannel cochlear implant.

The continuous interleaved sampling (CIS) strategy is a promising sound processing strategy for multichannel cochlear implants which provides immediate improvements in speech recognition when tested on Ineraid users: patients with only a few hours of experience (in laboratory testing) with the CIS strategy score better than with the Ineraid prosthesis they used since they, were implanted. The goal of this study was to evaluate the benefits that can be gained by the use of the new strategy in every day life. Two patients, implanted with the Ineraid multichannel cochlear implant, were equipped with a portable numerical processor programmed to implement a high rate CIS strategy. Their speech recognition was evaluated periodically with consonant and vowel identification tests for more than 6 months of use. Tests were also made with the Ineraid processor during the same experimental sessions and patients were regularly interviewed about their experience. Performance with the portable CIS processor was superior or equal to that obtained previously in the laboratory with the same strategy. Both patients achieved the best scores in 6 years of cochlear implant use. Qualitative reports from the patients suggest that the CIS strategy can improve "hearing" performance of cochlear implant users in many important situations of every day life. Altogether, these results hold great promises for all users of the Ineraid multichannel cochlear implant.

Adult↗