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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↗

Three-dimensional imaging on a CT or MR scanner.

Three-dimensional (3D) imaging on a CT or magnetic resonance scanner by the use of software that runs on the scanner's computer is one of a number of approaches to 3D imaging that have become available in recent years. It is shown that this particular approach can be made very inexpensive, provided that it is used in an appropriate manner in the clinical environment. The proposed methodology for the clinical use of 3D imaging on the scanner is illustrated by a discussion of the use of 3D98 (software designed for the GE CT/T 9800 scanner) for the 3D imaging of craniofacial surgical cases.

Head↗

Audit in restorative dentistry.

Auditing activity requires patient data to be collected and analysed to allow comparisons to be made and conclusions drawn. Within the General Dental Services the Dental Practice Board regularly collects practitioner specific clinical data and distributes this to allow dentists to compare their own clinical activity with local and national means. In hospital dentistry, a software package has been developed to enable orthodontic audit to be performed in hospital practice. The package is now being piloted in several centres. A similar software package is required for auditing restorative dentistry activity in units where consultant services are provided. Hospital patient administration systems provide demographic data and appointment systems predominantly with little opportunity for patient specific clinical analysis. Carefully designed software will allow appropriate clinical data and analysis. To ensure compliance and accurate recording both by clinical and support staff it is essential that any software system should be easy to use.

Dental Service, Hospital↗

Computers in the cognitive rehabilitation of brain-injured persons.

Currently there is a rapid expansion of work among rehabilitation professionals in applying computer-assisted instructional technology to remediate cognitive deficits resulting from brain injury. The present article presents a framework for relating the various theoretical, empirical, and clinical challenges raised by the coalescence of two such recently emerging disciplines as computer-assisted instruction and cognitive rehabilitation. These challenges are presented from the perspectives of diverse disciplines, including cognitive science, rehabilitation professions, and computer science. A set of guiding principles are derived for evaluating the potential efficacy of currently existing programs and for directing future developmental work in software design, evaluation research, and service delivery.

Animals↗

Countering advanced HIS marketing tactics.

An explosion of technological advances and system developments in the information systems industry pushes the envelope in both hardware and software design. Equipment breakthroughs--reduced instruction set computing chips, or RISC, and DEC's 64-bit Alpha chip--herald an exciting new era in price-performance computing. And object-oriented programming systems, or OOPS, and computer-assisted software engineering, or CASE tools, both promise a golden age in programming productivity. At the same time however, marketing mavens at healthcare information system, or HIS, vendors keep pace with their cohorts in Research and Development by blazing new trails in the science of sales and marketing. To help healthcare executives keep pace with new developments in selling, let's review a few infamous breakthroughs in marketing. They put a new twist on the old saw: "caveat emptor." Following each marketing "advance" are counters to new marketing tricks, each recommended to keep savvy CIOs a step ahead.

Computer Systems↗

The design of a program for the collection of 3-dimensional ultrasonic data.

This paper describes the programming mechanisms used in a program which controls the transfer of data from an ultrasonic system through a minicomputer onto a single platter disc cartridge. The system enables the collection and digitization of B scans from parallel planes. The main software design constraints in such a system are identified and discussed in general terms. The rudiments of interrupt programming necessary for such an application are described in the context of the program; and simple optimisation techniques for the bulk transfer of data onto a single platter cartridge are given. Although the particular computer used in the author's program was a Data General Nova and the language used, the corresponding assembly code, the description of the techniques used are sufficiently general to allow the methodology to be imposed upon any assembly code.

Analog-Digital Conversion↗

A new comprehensive microcomputer software programme for the urodynamics clinic.

Urodynamic investigation has undoubtedly been greatly refined and facilitated with the use of the modern generation of microcomputers. Manual techniques of data storage, analysis and interpretation are tedious, time consuming and lead to significant observer-dependent transcription errors. The logical solution to this problem is to develop a specifically designed software programme which would operate in conjunction with the microcomputer system integrated in most modern urodynamic apparatus. We describe here our experiences with the development of just such a system.

Computer Systems↗

Implementing a stand-alone packaged pharmacy computer system in a 580-bed hospital.

The problems experienced by a hospital pharmacy department in implementing a stand-alone packaged computer system are discussed, and recommendations for avoiding and managing these problems are presented. In 1984, a stand-alone packaged computer system was implemented in a 580-bed, tertiary-care institution that provides services from a central pharmacy and five satellite pharmacies. The department developed a request for proposal and contracted with a vender for a system that would support unit dose drug distribution and i.v. admixture services. During the implementation process, the following problems were experienced: The hardware was insufficient for the department's workload, the software design was limited, and personnel were frustrated with learning to use the system. These problems were intensified by the heavy workload and the large number of users. In the 18 months since implementation, the department has purchased more hardware, improved the software applications, and resolved many of the problems associated with employee frustration. Pharmacy departments at other large institutions might avoid some of these problems by training personnel adequately before implementation and by researching and estimating hardware and software needs in advance. In this large hospital, the efficiency of a stand-alone packaged pharmacy computer system has improved 18 months after implementation.

Computers↗

Philosophies for the design and development of clinical decision-support systems.

Little significance is attached by medical informatics workers to the many practical issues which affect the development of clinical decision-support systems. We examine the current state of research in clinical decision-support, the characteristics and motivations of developers, and the perceptions of intended end-users. Factors which adversely affect the success of systems are highlighted and pointers to good practice discussed. We then propose a coherent approach to system development, consisting of requirements analysis, software design, implementation, testing, evaluation and maintenance.

Computer Systems↗

BIOESTIM: software for automatic design of estimators in bioprocess engineering.

This paper describes BIOESTIM, a software package devoted to on-line estimation in bioprocess engineering. BIOESTIM enables bioengineers automatically to design state and parameter estimators from a minimal knowledge of the process kinetics. Such estimators allow development of software sensors capable of coping with the lack of reliable instrumentation suited to real-time monitoring. The estimator building procedure through BIOESTIM starts up from a dynamical material balance model of the bioprocess. This model, supplied by the user, is next completed by other information with no requirement for numerical values: the user has only to specify available measurements, coupled reactions and the known yield coefficients. On the base of this knowledge, BIOESTIM proceeds to symbolic algebraic manipulations on the model in order to study estimation possibilities and check identifiability of yield coefficients. When the design of an estimator is possible, the corresponding equations are automatically generated. Moreover, these estimators are stored in a user-specified file which is automatically interfaced with a specialized simulation software including data treatment and numerical integration packages. Thus, the user can simulate the estimator performances under various operational conditions using available experimental measurements. A typical example dealing with microbial growth and biosynthesis reactions is given in order to illustrate the main functional capabilities of BIOESTIM. BIOESTIM has been designed and written in a modular fashion. The module dealing with estimators design makes use of symbolic computation; it is written in Mathematica and runs on every computer on which this language is available.

Algorithms↗

PACS for radiology conferences--improvement of application software.

The introduction of PACS in a radiology department means that most functions that are available in the film-based system must be included. One important function is the radiology conference. The handling and application programs of digital workstations are normally not developed for demonstrations of many images in a limited time. This paper describes a workstation with specially designed software for radiology conferences. The application is separated in preparation and presentation of the cases to be demonstrated. Very fast image handling is achieved during the conference because the function is based on the principle of prefetching of the selected images. The images are presented on a large screen with high resolution. The experiences of digital radiology conferences are good. However, reference films from previous examinations create extra work because they have to be shown on the conventional lightbox.

Computer Terminals↗

Nutrient requirements for dairy cattle of the National Research Council versus some commonly used ration software.

The first edition of the Nutrient Requirements of Dairy Cattle was published by the National Research Council (NRC) in 1945. The current document is the sixth revised edition, published in 1989, and it appears that we are a few years from another edition being in print. Software designed to evaluate and formulate rations for dairy cattle commonly determine nutrient requirements using the NRC as a standard. However, the generation of new knowledge in dairy nutrition occurs more rapidly than the release of the NRC publication, and the developers of the software often modify the requirements based on more recently published research, geographical peculiarities, or factors not explicitly considered by NRC. The first step in evaluating or formulating rations is the prediction of dry matter intake (DMI). The primary variables used by NRC to predict DMI are body weight (BW) and fat-corrected milk (FCM) yield; however, developers of software programs often use different equations based on personal preference, availability of research data with given equations, and incorporation of other factors in addition to BW and FCM yield. The additional factors are included to provide a more dynamic estimation of DMI and, therefore, reduce the difference between predicted and actual DMI. Nutrients required for maintenance, lactation, and growth must be consumed in adequate quantities (e.g., kilograms or calories), but the dietary concentration of nutrients for a given animal group may differ because of DMI. Even when nutrients are fed above the requirements, dietary concentrations of nutrients may be important in some situations to minimize the risk of underfeeding caused by variability in the nutrient composition of feedstuffs and to account for interactions of certain nutrients (e.g., minerals). New research discoveries need to be incorporated into ration formulation strategies promptly, and the strategies used for ration formulation need to be dynamic.

Animal Nutritional Physiological Phenomena↗

Immunization entry at the point of service improves quality, saves time, and is well-accepted.

OBJECTIVE: Computer-based immunization tracking is a routine part of many pediatric practices; however, data quality is inconsistent and entry often relies on dedicated data entry personnel and is time-consuming, expensive, or difficult. The purpose of this study was to evaluate data quality, nursing satisfaction, and reduction in documentation burden after the introduction of a point-of-service immunization entry system in an inner-city pediatric primary care center. DESIGN: Prospective preintervention and postintervention study. METHODS: Visit records from all pediatric nonurgent care visits for patients <5 years old were collected during a 2-week period before (preintervention) and after (postintervention) the introduction of a computer-based immunization entry system. Nurses used software designed to allow rapid entry during immunization preparation followed by printing 2 adhesive labels for documentation. Satisfaction was evaluated using an 8-question survey administered 3 months after the intervention. RESULTS: One hundred forty-seven (63.6%) of 231 preintervention and 132 (51.4%) of 257 postintervention children received at least 1 immunization (immunized) during the study visit. Gender and mean age were similar for immunized children in the 2 groups. In the preintervention group, 56 (37.9%) of 147 immunized children had at least 1 dose missing (a total of 128 of 343 doses administered) from the immunization tracking database compared with none in the postintervention group. Medical record review showed that 92.6% of preintervention and 91.4% of postintervention children were on-schedule after the study visit. However, missing data lead to the misclassification of preintervention children-only 68.4% were reported by the database to be on-schedule. All 9 nurses reported using the program all the time to enter immunizations, 89% said that the program required somewhat or a lot less time, and 100% strongly recommended continued use of the program. All 9 nurses also reported that they would be somewhat or very unenthusiastic about the system if labels were not available. During the 12 months after introduction of the system, 8273 forms containing immunization information were printed, preventing nurses from having to write >101,000 dates. CONCLUSIONS: Immunization entry by nurses at the time of immunization preparation improves the quality of tracking data, reduces misclassification of immunization needs, saves time, and can be well-accepted. It is likely that poor data quality in some tracking systems has led to falsely low immunization coverage estimates. Systems such as the one in this study can improve quality and should be integrated into routine clinical practice.

Boston↗

Computer systems for dental practice management. A new generation of independent dental software.

A new generation of computer programs for dental patient management eliminates total dependence on the vendor for programming support. The software design enables information collected with the dental system to be transferred to popular off-the-shelf programs designed for business. A simplified example is used to illustrate for practitioners the advantages of this type of data structure management. Programs designed on this basis offer optimum performance and expandibility for both present and future needs.

Computer Systems↗

[The use of mathematical modelling in improving the orthodontic treatment of end defects of the dental arches].

Mathematical modelling allowed to use specially designed software package for calculation of the necessary number of variants of dimensions of denture carcass while planning the orthodontic treatment. This could be done for each patient individually, thus ensuring the correct choice of orthodontic technique to replace the end defects of the dentition.

Computer Simulation↗

Multi centre systems analysis study of primary health care: a study of socio-organizational and human factors.

The information management systems to support health programmes are inadequate. As computers become cheaper and more powerful, their application in the strengthening of the information infrastructure becomes more feasible. However, the high cost of specialized applications software limits their potential, especially in developing countries. A multi-centre systems analysis, (a descriptive study using a questionnaire), was made of District Health Sites in developing countries to analyse whether a common specialized application software design for implementation at a primary health care centre was feasible. Responses to the questionnaires by physicians at the primary health centres were compared between district health sites using contingency tables. Significant inter-site differences in social factors existed, respondents had no prior experience, but with near unanimity (98%) accepted the idea of computer assistance in their work. However, general reservations (31%) and fears (26%) about computer interference in the doctor-patient relationship were expressed. The human factor must be considered in interface design and training before implementation.

Attitude of Health Personnel↗