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Capillary net and injection modeling.

A former work proved that the physiological Krogh model is valid and can be used as a tool by physicians and biologists in order to simulate drug injections. Here, after a short critical review, a more complete model describing the capillary net is established. A numerical method which can be used to solve the associate mathematical model is explained. Then, the results are discussed and used to explain why the Krogh model is valid despite its simplifying hypotheses. Diffusion and permeability coefficients are also estimated.

Algorithms↗

Mapping clause of Arden Syntax with HL7 and ASTM E 1238-88 standard.

The Arden Syntax is a standard description syntax for modular medical knowledge. The purpose of the Arden Syntax is to allow the construction of medical knowledge bases out of elementary medical logic modules (MLMs) that may be contributed and shared by different institutions. The format of the input data is not defined in the Arden Syntax, but left to the user. Every input and output must be rewritten for the local data access definition before an MLM can be used. It is suggested that by using the Health Level Seven (HL7) interface definition to define the communication and data transfer between the MLMs and the medical data base the shareability of MLMs can be enhanced.

Artificial Intelligence↗

Evaluation of a decision support system in a medical environment.

This paper describes the impact of a decision support system on the quality of recorded diagnoses and the completeness of medical records. The assumption is that for quality assessment purposes enough data have to be recorded in an electronic medical record so that diagnostic decisions can be justified. The hypotheses were tested that active decision support will lead to better quality recorded diagnoses and more complete medical records. Three groups of ten GPs were presented with 10 cases each. The GPs had to enter the data about these cases in a GP information system. One group of GPs was not supported. The second group was presented with the ICHPPC-II-Defined criteria that had to be fulfilled when a diagnosis was entered. In a third group, the GPs were asked those data that were needed to justify an entered diagnosis (active support). It could be shown that the last group of GPs entered better quality diagnoses than the other two groups. These latter groups also entered so little data that most of their diagnoses could not be justified. It is concluded from the study that only active decision support will lead to better diagnoses and a more complete medical record that can be used for quality assessment.

Artificial Intelligence↗

Integration of data driven decision support into the HELIOS environment.

The development of large-scale, clinically accepted decision support systems (DSS) calls for powerful and commonly available methods and tools for knowledge acquisition, system realisation, and knowledge base maintenance. The paper addresses problems associated with the integration of knowledge-based systems within the clinical setting with special reference to (i) data driven decision support, (ii) the Arden Syntax as a knowledge representation format and, (iii) the HELIOS software engineering environment. Architecture of a DSS based on Arden Syntax and its integration in the HELIOS environment are presented. Realisation of the DSS is discussed in relation to client-server architecture and object-oriented databases, which are essential concepts of the HELIOS environment. Sharability and reusability of the knowledge, together with commonality of used software tools are also discussed.

Database Management Systems↗

Formulas expressing relationship among age, height and weight, and percentile in Saudi and US children aged 6-16 years.

A microcomputer program in BASIC for predicting percentile of height and weight by age for Saudi and US children aged 6-16 years is designed. The formulas used in this program are derived from the data reported by Magbool et al. (Ann Saudi Med 13 (1993) 344-349) and the data of the National Center for Health Statistics (NCHS). Magbool et al. reported measurements of height and weight of 21,638 Saudi boys and girls aged 6-16 years from the Eastern Province. A mathematical model and a computer program previously published by the author are employed in this study. Analysis of the computer-assisted, predicted values and the data reported by Magbool et al. (Saudi) and the NCHS (USA) indicates that the program is accurate and reliable with a close agreement in expressing percentile as a function of age and height or weight. The computer-assisted predictive formulas can determine the relationship among the age, the height and weight, and the percentile, and as a supplement to the clinically useful reference standards of the tables and figures of Magbool et al. and the NCHS may be of value for growth evaluation of Saudi and US children.

Adolescent↗

Formula expressing a relationship among lesion thickness and time after diagnosis and survival probability in patients with malignant melanoma.

A microcomputer program in BASIC for predicting the survival probability as a function of lesion thickness and time after diagnosis is designed. The New York University-Melanoma Cooperative Group (NYU-MCG) shows 10-year survival rates of patients with malignant melanoma broken into four lesion-thickness groups (Cancer Journal for Clinicians, 41 (1991) 201-226). The formula used in this program is derived from the survival data of NYU-MCG. A mathematical 'probacent'-probability model previously published by the author is employed in this study. Analysis of the computer-assisted predicted and the NYU-MCG reported survival probability data indicates that the program is accurate and reliable with a close agreement in expressing survival probability and that it may be of value for prognostic evaluation of patients.

Humans↗

The development and evaluation of a computerised antenatal questionnaire.

A computerised questionnaire, for convenience entitled "PAM" (Programmed Aid for use in Midwifery), was created for use at the time of first antenatal assessment. The system required simple direct input by the expectant mother; and in response to a short descriptive letter, 73.4% of 349 women were prepared to try the new method. The response of 100 consecutive women who tried the system was further analysed. Seventy women liked PAM, four disliked the technique and the remainder had no strong feelings. Asked by the midwife which they would prefer, 46 women expressed a preference for the computer questionnaire and only nine would rather have had a traditional interview with a midwife asking the same questions. PAM or similar systems provide a new opportunity, both for research and as a means of reliably decentralizing the initial assessment of a pregnancy.

Female↗

Steady flow of a viscous fluid through a network of tubes with applications to the human arterial system.

The paper presents a finite-element model for the analysis of steady flow of a viscous fluid through a connected system of elastic tubes with the aim of simulating the conditions of blood flow through the human arterial system. The governing equations of the model are non-linear in character and are solved through an iterative computational procedure. This model is capable of incorporating the effects of stenosis on flow and pressure. Typical results are presented and discussed. Quantitative results have been obtained on blood flow through a model of the human arterial system corresponding to the sets of prescribed conditions at the terminations. Also computational results on the effect of stenosis in typical arteries of the system are presented.

Aorta↗

The fabric dependence of the orthotropic elastic constants of cancellous bone.

It has been proposed that the orthotropic elastic constants of cancellous bone depend upon a tensorial measure of anisotropy called fabric as well as the tissue's structural density. Cowin (1985, Mechanics Mater, 4, 137-147; 1986, J. biomech. Engng 108, 83-88) developed explicit relationships for the elastic constant, structural density and fabric relationship. In this study the orthotropic elastic moduli, structural density, and fabric components were measured for 11 cancellous bone specimens from five bovine femora and for 75 specimens from three human proximal tibiae and fitted to these relationships using a least squares analysis. The relationships explained between 72 and 94% of the variance in the elastic constants. The relationships between the elastic constants and squared or cubed power functions of structural density had better predictive value over the entire distribution of the data than did expressions with linear functions of structural density.

Aged↗

Parallel processing of chemical information in a local area network--II. A parallel cross-validation procedure for artificial neural networks.

This paper describes a parallel cross-validation (PCV) procedure, for testing the predictive ability of multi-layer feed-forward (MLF) neural networks models, trained by the generalized delta learning rule. The PCV program has been parallelized to operate in a local area computer network. Development and execution of the parallel application was aided by the HYDRA programming environment, which is extensively described in Part I of this paper. A brief theoretical introduction on MLF networks is given and the problems, associated with the validation of predictive abilities, will be discussed. Furthermore, this paper comprises a general outline of the PCV program. Finally, the parallel PCV application is used to validate the predictive ability of an MLF network modeling a chemical non-linear function approximation problem which is described extensively in the literature.

Artificial Intelligence↗

Prehensile control of a hand prosthesis by a microcontroller.

The functional replacement of a natural hand and wrist is usually achieved by a split hook or an electrically powered and myoelectrically controlled artificial hand with one degree of freedom. In contrast to the commercial devices, this paper describes an experimental hand with four electric motors, nineteen sensors, and control algorithms which are written for a microcontroller. The hand significantly improves the prehension capabilities of an artificial device and leads to a design which is easily controlled by a user as it mimics the control system of the natural hand.

Algorithms↗

EEG data compression with source coding techniques.

A data compression algorithm for the EEG, derived from the adaptive pulse code modulation scheme, is described where the consecutively computed differences are coded by passing them through a quantizer possessing only a few levels; the range of these levels is adapted to local signal statistics. Three different versions of the algorithm with data reduction up to 75% are presented. The system was validated using several multichannel-routine EEG recordings with both visual evaluation and computation of signal-to-noise ratios.

Algorithms↗

A lung function information system.

A lung function information system (LFIS) was developed for the data analysis of pulmonary function tests at different locations. This system was connected to the hospital information system (HIS) for the retrieval of patient data and the storage of the lung function variables of patients to generate follow-up reports and to support financial and administrative management. The application programs were developed in such a way that high flexibility was obtained with respect to the patient-computer-technician interaction. The sampled data are stored on a disc to correct earlier decisions, perform recalculations and reanalyse the data for research purposes. When the measurements performed on a patient are authorized, the sampled data are deleted, except for when they are needed for future research. A distributed computer system was chosen to combine the benefits of a centralized system with those of several stand-alone systems. The main tasks of the central unit are to store collected data and computer programs, generate a final lung function report on laser printer and provide a connection to the HIS. In the satellite computers, which are located close to the lung function equipment, the signals and raw data are processed. Furthermore, the satellite computers were in use for program development and several research projects, and for the offline data processing of the lung function measurements from two other hospitals by means of a modem connection. The LFIS improved the quantity and quality of data acquisition. It resulted in an increased capacity of about 50% concerning spirometry, and facilitated time-consuming complex analyses. It also avoided miscalculations and mistakes in reports previously experienced with hand calculations.

Computer Systems↗

An ASSEMBLER routine for on-line graphic display and averaging of data acquired on a personal microcomputer.

An ASSEMBLER routine is described for data acquisition and "on-line" averaging, artefact rejection and graphic display of data on a personal microcomputer (IBM compatible). The user determines the number of input channels, sampling frequency, number of samples, input range, stimulation frequency (epoch frequency) and the number of epochs to be acquired and averaged. Data from each epoch are scanned in search of saturating artefacts and will be added to previous epochs if none is found. Data are then graphically displayed as voltage versus time before acquiring next epoch. Display options can be defined by the user at run time by means of the keyboard and include: display of last epoch, display of the average, storage screen and refreshing screen after every epoch. High data transfer rates and program speed allows for high stimulation rates in the presence of on line graphic display. The computer then behaves as a multichannel digital oscilloscope with access to large memory buffers, disk storage, high averaging capabilities, artefact rejection and wide potential for data analysis. Its applications to the recording of magnetic and electric evoked responses are illustrated. The program is available from the authors.

Computer Graphics↗

A computer-controlled system for post-stimulus time histogram and wind-up studies.

A LabVIEW 2 virtual instrument (VI)-based system is described for stimulation of sensory fibers in peripheral nerves and analysis and storage of electrophysiological data recorded from the spinal cord. The system utilizes a commercially available multifunction data acquisition (input/output; I/O) board, graphical programming environment and custom built VIs. Electrical stimuli are triggered by the I/O board and delivered at C-fiber strength to the receptive field of a multireceptive dorsal horn neuron. The stimulus frequency can be chosen between 0.1 and 1 Hz. Extracellular action potentials are recorded with a compound recording/iontophoresis carbon-fiber microelectrode and sampled by the I/O board. Post-stimulus time histograms (PSTH) are computed to visualize the preferred times of neuronal firing evoked by A- and C-fiber inputs. Responses of the neuron to repetitive stimulation are analyzed by their latency relative to the stimulus and plotted against the stimulus number. Wind-up, the progressive potentiation of C fiber-evoked response per stimulus, is increased by NMDA and decreased by MK-801 when each is applied by microiontophoresis. The system is well suited to perform combined PSTH and wind-up analysis on-line as well as to examine previously recorded data off-line. Principles of operation and diagrams of greater importance are explained in detail. To illustrate system operation, sample recordings, PSTH and wind-up analyses from a dorsal horn neuron are presented. The software is available from the author.

Action Potentials↗

Fast microcomputer-based multipurpose filtering routine.

In order to perform high-speed digital signal filtering or differentiating at reduced costs, we developed a 68000 assembler routine which runs on a 68000 coprocessor card in an Apple II computer. It achieves a remarkable saving of computational time and may also be used directly with any 68000-based microcomputer.

Microcomputers↗