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Performance of two new algorithms for estimating within- and between-method carryover evaluated statistically.

Accurate and precise algorithms for estimating within-method carryover, based on the minimization of a unique "carryover sum of squares," and between-method carryover, based on a weighted Deming regression of first sample recovery vs carryover-corrected "true" recovery, are described and compared with traditional methods by use of a Monte Carlo study. In addition, I have studied the experimental parameters that influence the accuracy and precision of carryover estimation. The new algorithm for estimating within-method carryover is unbiased under most conditions, whereas the traditional algorithm is biased low under most conditions. The new algorithm is also more precise, owing to more-efficient utilization of information contained in an analytical run performed for carryover estimation. Between-method carryover in a random-access analyzer is estimated quantitatively by the second proposed algorithm and is found to be readily and precisely determinable. Use of these methods in combination to evaluate analytical interaction should allow the prediction of carryover error under most current analytical situations.

Algorithms

Pitfalls in the use of clinical algorithms.

The algorithm is a very useful tool in medical practice. Like any other tool, it has advantages and disadvantages. The wise physician avoids a modality until he has learned how to use it. The same should be true of algorithms. Obtain some computer primers that explain the writing of algorithms. Experiment with algorithms of your own creation. When you reach the level where you can easily write your own algorithms, you are ready to use those written by others, making any modifications necessary to suit your own philosophy and experience.

Algorithms

An optimized parsing algorithm well suited to RNA folding.

The application of stochastic context-free grammars to the determination of RNA foldings allows a simple description of the sub-class of sought secondary structures, but it needs efficient parsing algorithms. The more classic thermodynamic model of folding, popularized by Zuker under the framework of dynamic programming algorithms, allows an easy computation of foldings but its use is delicate when constraints have to be introduced on sought secondary structures. We show here that S-attribute grammars unify these two models and we introduce a parsing algorithm whose efficiency enables us to handle problems until then too difficult or too large to deal with. As a matter of fact, our algorithm is as efficient as a standard dynamic programming one when applied to the thermodynamic model (yet it offers a greater flexibility for the expression of constraints) and it is faster and saves more space than other parsing algorithms used so far for stochastic grammars.

Algorithms

An inductive algorithm approach to knowledge acquisition for expert system development. A pilot study.

Knowledge acquisition, which consists of knowledge elicitation and knowledge representation, often is considered the weakest link in the design of expert systems. Systems frequently are built on the knowledge of one expert and require extensive use of knowledge engineering techniques to elicit this knowledge from the expert. Inductive algorithms are a potential alternative method of knowledge acquisition for expert system development. The aim of this pilot study was to examine the feasibility of applying machine learning techniques, specifically, inductive algorithms, to an existing research database as a method for knowledge elicitation and knowledge representation for expert system development. Two inductive algorithms (C4 and Classification and Regression Trees [CART]) that generate decision trees were selected for the analysis using a data set of 201 patients hospitalized for Pneumocystis carinii pneumonia. Neither C4 nor CART produced trees with an accuracy that was significantly better than the baseline accuracy (71.3%) for prediction of outcome in the data set. The mean accuracy of the C4 decision trees was below baseline and the mean accuracy of CART decision trees was 74.6%. The experts found both algorithms comprehensible, but not adequate, and identified important missing predictor variables. The study findings suggest that additional research is needed to examine the appropriate use of inductive algorithms in the transformation of nursing data and information into nursing knowledge.

Algorithms

Treatment of surgical emergencies with and without an algorithm.

A patient care algorithm was developed for resuscitation of patients entering the surgical emergency department with hypotension. The diagnostic workup, monitoring, and therapy were progressively excalated according to admission blood pressure and responses to therapeutic interventions. The branching-chain logic is ideally suited for rapid decision making in emergency conditions where the need is most urgent, the time constraints are most severe, and the potential improvements in terms of patient salvage are greatest. Preliminary results from these ongoing clinical trials indicate that (1) physicians can and will use an algorithm for emergency medical service resuscitation; (2) in a university hospital with a large emergency service and a commitment to emergency care, the physicians using the aigorithm performed as well as and in some instances better than those not using the algorithm; and (3) the use of the algorithm may prevent delays in resuscitation and lead to less morbidity and mortality. Thus, we conclude that the algorithm helps to organize emergency care, establish standards, and improve care.

Adult

Evaluation of the S phase distribution of flow cytometric DNA histograms by autoradiography and computer algorithms.

Cell sorting and tritiated thymidine autoradiography were used to define the distribution of S phase cells in flow cytometric DNA histograms obtained from exponential mouse lymphoma cells (L5178Y). The numbers of labeled S phase cells, autoradiographically determined from cells sorted at 2-channel intervals in the G1/early S and late S/G2M regions of the histogram, were compared with the numbers of computed S phase cells in comparable 2-channel intervals as predicted by several computer algorithms used to extract cell cycle phase distributions from DNA histograms. Polynomial and multirectangle algorithms gave computed estimates of total %S in close agreement with the tritiated thymidine labeling index for the cell population, while multi-Gaussian algorithms underestimated %S. Interval autoradiographic and algorithm studies confirmed these results in that no significant differences were found between the autoradiographic S phase distribution and S phase distributions calculated by the polynomial and multirectangle models. However, S phase cells were significantly underestimated in G1/early S by a constrained multi-Gaussian model and in both G1/early S and late S/G2 by an unconstrained multi-Gaussian model. For the particular cell line (L5178Y), staining protocol (mithramycin following ethanol fixation) and instrumentation (Coulter TPS-2 cell sorter) used in this study, close agreement between computed %S and tritiated thymidine labeling index was found to be a reliable indicator of an algorithm's success in resolving S phase cells in the G1/S and S/G2 transition regions of the DNA histograms.

Animals

An algorithm for comparing two-dimensional electrophoretic gels, with particular reference to the study of mutation.

An algorithm dedicated to the detection of presumed mutational events involving the polypeptides displayed with two-dimensional polyacrylamide gel electrophoresis has been described. Because of the large number of gels necessary in most studies of mutation, the algorithm has been designed to minimize operator intervention in its execution. The basic principle involves a comparison of the graph structures of the gels of a father, mother, and one or more children, searching for protein spots in the child not found in either parent. These so-called "orphan" spots are considered a probable manifestation of mutation only after other possible causes of such an isolated event have been excluded as rigorously as possible. At present, the analysis of gels prepared from a platelet or erythrocyte lysate yields about 2% "false-positive" findings, i.e., results in the incorrect designation of a unique spot in a child. These errors can be disposed of by technician intervention. In an experiment designed to simulate the occurrence of mutational events, the algorithm operated with 70% accuracy. Most of the "errors" ("false negatives") occurred when the position of the simulated mutant polypeptide coincided in whole or part with that of a preexisting polypeptide, resulting in a class of mutation not detectable by the eye either. With correction for this fact, the accuracy was 84%. Possible improvements in the algorithm which would substantially increase accuracy have been discussed at some length, as have some ideas as to how to manage the large body of data resulting from the operation of the algorithm. A murine experiment designed to validate the approach has been outlined.

Blood Proteins

A synaptic modification algorithm in consideration of the generation of rhythmic oscillation in a ring neural network.

In consideration of the generation of bursts of nerve impulses (that is, rhythmic oscillation in impulse density) in the ring neural network, a synaptic modification algorithm is newly proposed. Rhythmic oscillation generally occurs in the regular ring network with feedback inhibition and in fact such signals can be observed in the real nervous system. Since, however, various additional connections can cause a disturbance which easily extinguishes the rhythmic oscillation in the network, some function for maintaining the rhythmic oscillation is to be expected to exist in the synapses if such signals play an important part in the nervous system. Our preliminary investigation into the rhythmic oscillation in the regular ring network has led to the selection of the parameters, that is, the average membrane potential (AMP) and the average impulse density (AID) in the synaptic modification algorithm, where the decrease of synaptic strength is supposed to be essential. This synaptic modification algorithm using AMP and AID enables both the rhythmic oscillation and the nonoscillatory state to be dealt with in the algorithm without distinction. Simulation demonstrates cases in which the algorithm catches and holds the rhythmic oscillation in the disturbed ring network where the rhythmic oscillation was previously extinguished.

Animals

An automated algorithm for radionuclide angiocardiographic quantitation of circulatory shunting.

Circulatory shunting may be quantitated by analysis of time-activity curves obtained from radionuclide angiocardiography. A new automated algorithm for performing this analysis is proposed. The algorithm uses mathematical deconvolution techniques to increase the temporal separation of the components of this curve and thereby improves the accuracy of the analysis. The stability of the algorithm to random data errors was assessed by experiments on simulated time-activity curves degraded with pseudorandom noise. Excellent performance was obtained on a set of test problems previously used in the literature. The algorithm was used to quantitate left-to-right shunting in patients undergoing radionuclide angiocardiography during cardiac catheterization. A strong correlation (r = 0.96) was found between pulmonary to systemic flow ratios (Qp:Qs) obtained using the algorithm on radionuclide angiocardiographic data and Qp:Qs values obtained by oximetry at cardiac catheterization.

Adolescent

Algorithms for processing spatial information.

Pairs of stimuli taken from a psychometric measure of spatial aptitude were shown to 9-year-olds, 13-year-olds, and adults. The stimuli in pairs were (a) either identical or mirror images, and (b) presented in orientations that differed by 0-150 degrees. Individuals judged, as rapidly as possible, if the stimuli in a pair would be identical or mirror images if presented at the same orientation. In Experiment 1, in which the stimuli were letter-like characters, at all ages most persons solved the problems using an algorithm in which an individual encodes the stimuli in working memory, mentally rotates one stimulus to the orientation of the other, compares them to determine if they are identical, and responds. In Experiment 2, the stimuli were multielement flags; here, the modal algorithm for both 9- and 13-year-olds differed from the previously described algorithm in that if the comparison process revealed that the stimuli were dissimilar, individuals did not respond immediately, but continued processing until a self-imposed deadline was reached. Among adults, the modal algorithm was the same one used in Experiment 1. Results are discussed in terms of the roles of encoding in contributing to the use of a particular algorithm.

Adolescent

Fluid resuscitation of hypotensive emergency patients with and without an algorithm.

Seventy-seven consecutive hypotensive (mean arterial pressure (MAP) less than 80 mmHg) surgical emergency patients were resuscitated according to either physicians' individual orders (38 patients) or an algorithm (39 patients). The shock was mainly caused by accidental injuries or acute gastrointestinal bleeding. The patients of the algorithm group were given more plasma expanders than the patients of the control group, while the total amount of fluids administered was similar in both groups. The primary goal of the resuscitation (MAP greater than 80 mmHg) was reached within 30 min in three cases in the control group and in seven cases in the algorithm group. The treatment times at the emergency department and the intensive care unit were similar for the groups. The number of severe and moderate pulmonary disturbances was the same, but mild disturbances were significantly more common in the control group. Renal failure was somewhat more common in the control group and the renal function disturbances were significantly more severe among the control patients. The results suggest that the physicians in some extent altered their practices in fluid resuscitation when the algorithm was put to use, and that this change, perhaps, produced the somewhat better outcome of the patients. The authors recommend the algorithm to be used as a basis of shock treatment and particularly in those emergency departments where the resuscitation of hypotensive patients is performed by junior or inexperienced physicians.

Adolescent

An efficient string matching algorithm with k differences for nucleotide and amino acid sequences.

There are a few algorithms designed to solve the problem of the optimal alignment of one sequence, the pattern, of length m, with another, longer sequence the text, of length n. These algorithms allow mismatches, deletions and insertions. Algorithms to date run in O(mn) time. Let us define an integer, k, which is the maximal number of differences allowed. We present a simple algorithm showing that sequences can be optimally aligned in O(k2n) time. For long sequences the gain factor over the currently used algorithms is very large.

Amino Acid Sequence

A microcomputer algorithm for solving compartmental models involving radionuclide transformations.

An algorithm for solving first-order non-recycling compartment models is described. Given the initial amounts of a radioactive material in each compartment and the fundamental transfer rate constants between each compartment, the algorithm gives both the amount of material remaining at any time t and the integrated number of transformations that would occur up to time t. The method is analytical, and consequently, is ideally suited for implementation on a microcomputer. For a typical microcomputer with 64 kilobytes of random access memory, a model containing up to 100 compartments, with any number of interconnecting translocation routes, can be solved in a few seconds; providing that no recycling occurs. An example computer program, written in 30 lines of Microsoft BASIC, is included in an appendix to demonstrate the use of the algorithm. A detailed description is included to show how the algorithm is modified to satisfy the requirements commonly encountered in compartment modelling, for example, continuous intake, partitioning of activity, and transformations from radioactive progeny. Although the algorithm does not solve models involving recycling, it is often possible to represent such cases by a non-recycling model which is mathematically equivalent.

Computers

A new scan conversion algorithm for ultrasound compound scanning.

An improved scan conversion algorithm for ultrasound compound scanning is proposed. In this algorithm, the input data in the spatial domain is sampled by the concentric square raster sampling (CSRS) method, and the display pixel data are filled by one-dimensional linear interpolation. The reconstruction error of the proposed algorithm is much smaller than that of other algorithms, because only one-dimensional, rather than two-dimensional, interpolation is involved. This algorithm greatly simplifies implementation of a real-time digital scan converter (DSC) for spatial compounding of ultrasound images.

Mathematics

Image reconstruction from coded data: I. Reconstruction algorithms and experimental results.

Two algorithms have been developed for reconstructing objects from their coded images and a priori knowledge of the object class. Reconstructions from both algorithms are presented, but the results appear to be largely independent of the algorithm used. One of the algorithms, a Monte Carlo approach, is used to investigate the quality of the reconstruction of two- and three-dimensional objects from simulated coded-image data with respect to viewing geometry and multiplexing (mixing) of the data. The cases examined include reconstructions from data with and without signal-dependent photon noise. It is found that reconstructing from multiplexed data is not so serious a problem as reconstructing from data obtained with a limited viewing angle. Also, when photon noise is included in the data, reconstructions obtained from multiplexed data are better than those obtained from unmultiplexed data because of the higher photon count made available by multiplexing. It appears that the fidelity of a reconstruction depends much more strongly on the design of the data-taking system (the coded apertures) than on the reconstruction algorithm.

Models, Structural

Phased trial of a proven algorithm at a new primary care clinic.

A previous study showed that a clinical algorithm for respiratory illnesses, consisting of a checklist, a set of instructions (logic), and computer audit/feedback, could reduce costs significantly while maintaining a high quality of care. The results of this study show that the algorithm system, developed and validated at one primary care clinic, can be successfully imported to another primary care clinic. In the present study, the algorithm system significantly improved the completeness of the medical records, reduced the use of medical tests by 20 per cent-75 per cent, and reduced non-provider costs by 36 per cent per patient visit. This study also shows that all three components of the algorithm system appear to be necessary to achieve these improvements and maintain a high quality of medical care. These results suggest that a wider use of the algorithm system for minor acute medical problems is both feasible and useful in providing high-quality cost-effective care that is auditable.

Adult

Accuracy of deconvolution algorithms assessed by simulation studies: concise communication.

Deconvolution has been used to correct first-pass radionuclide angiocardiography for the time course of the delivery of radiopharmaceutical into the cardiopulmonary system. The extreme sensitivity of deconvolution to random errors in the data may account for some of the problems encountered in practice. We implemented several deconvolution algorithms that were suitable for use with the unimodal and multimodal superior vena caval and pulmonary curves found in left-to-right shunt quantification. The sensitivity of the algorithms to random errors was assessed using mathematical test problems degraded with pseudorandom noise. An algorithm that constrained the deconvolved pulmonary curve to be expressable as the non-negative sum of a set of lagged normal curves was found to have the smallest maximum error on the curves tested. Comparison with results from a previously published test problem indicated an error reduction of greater than 50% over previously used algorithms. Use of this algorithm may permit more accurate deconvolution of pulmonary time-activity curves and thereby improve shunt quantification.

Heart

[Differential diagnosis of endometrial diseases by scrapings based on setting up an algorithm of the histological study].

In order to facilitate the diagnostic analysis of histologic changes in biopsies of endometrial diseases, it is suggested that the use should be made of the first order algorithm developed on the basis of the experience gained so far. This algorithm excludes the oversight of visible changes and predetermines the subsequent activities of an assistant. During differential diagnosis of endometrial diseases the staged synthesis is effected by making up the second order algorithm from the first order algorithmic elements. The suggested diagnostic procedure developed on the basis of algorithmization and probable concepts is time-saving and creats conditions for more successful verification of the pathological process.

Biopsy