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PubMed1999

Technology and the future of medical equipment maintenance.

Maintenance of medical equipment has been changing rapidly in the past few years. It is changing more rapidly in developed countries, but changes are also occurring in developing countries. Some of the changes may permit improved maintenance on the higher technology equipment in developing countries, since they do not require onsite expertise. Technology has had an increasing impact on the development of medical equipment with the increased use of microprocessors and computers. With miniaturization from space technology and electronic chip design, powerful microprocessors and computers have been built into medical equipment. The improvement in manufacturing technology has increased the quality of parts and therefore the medical equipment. This has resulted in increased mean time between failures and reduced maintenance needs. This has made equipment more reliable in remote areas and developing countries. The built-in computers and advances in software design have brought about self-diagnostics in medical equipment. The technicians now have a strong tool to be used in maintenance. One problem in this area is getting access to the self-diagnostics. Some manufacturers will not readily provide this access to the owner of the equipment. Advances in telecommunications in conjunction with self-diagnostics make available remote diagnosis and repair. Since components can no longer be repaired, a remote repair technician can instruct an operator or an on-site repairman on board replacement. In case of software problems, the remote repair technician may perform the repairs over the telephone. It is possible for the equipment to be monitored remotely by modern without interfering with the operation of the equipment. These changes in technology require the training of biomedical engineering technicians (BMETs) to change. They must have training in computers and telecommunications. Some of this training can be done with telecommunications and computers.

Equipment Failure↗

PubMed1998

A PC-based Braille library system for the sightless.

This paper presents a novel multiclient braille reading system developed around a single low cost personal computer. The system primarily addresses the needs of the Braille libraries, where different texts are needed to be read by different users simultaneously. Moreover, the system can simultaneously cater to different texts written in different languages. This feature makes it specially suitable for use by multilingual nationalities. The major advantage of this system is its low cost, compared to the other systems available and is specially attractive for the developing or underdeveloped countries. The paper describes the system, first from the user point of view and then presents the hardware and software design details. The system performance has been evaluated by the sightless users and has shown encouraging results.

Blindness↗

PubMed1994

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 the practitioners the advantages of this type of data structure management. Programs designed on this basis offer optimum performance and expandability for both present and future needs.

Computer Systems↗

PubMed1996

An integrated system for measuring static and dynamic accommodation with a Canon Autoref R-1 refractometer.

An integrated system is described which we have found useful for efficiently collecting and analyzing both static and dynamic accommodation data using the Canon Autoref R-1 refractometer. The system consists of hardware modifications and software designed to both facilitate the measurement of accommodation and to process the resulting data. Several features of the Canon R-1, which may not be evident to some users, are also described. A program written in Microsoft C/C++ running under DOS, and designed for use on a PC, is available from the authors upon request.

Accommodation, Ocular↗

PubMed1996

An automated system for bedside verification of the match between patient identification and blood unit identification.

BACKGROUND: The administration of blood to the wrong patient remains the leading cause of acute hemolytic transfusion reactions and subsequent death. A process control system for blood administration was developed that verifies, at the bedside, the match between barcoded patient identification and blood unit identification. STUDY DESIGN AND METHODS: The system is composed of 1) a portable bedside scanner that reads barcoded patient identification and blood unit identification, 2) a host computer system capable of accepting transfusion data from the bedside scanner, 3) printed documentation of the transfusion episode, and 4) audit trail monitoring of whether all steps in the automated patient and blood unit identification process have been performed. Software design, development, and validation protocols followed industry standards. RESULTS: A pilot study was performed over a 2-month period evaluating the blood administration process using the computerized bedside transfusion identification system prototype for transfusions in 39 oncology patients. CONCLUSION: This system controls the blood administration process and includes bedside verification of the match between patient identification and blood unit identification.

Blood Transfusion↗

PubMed1988

Analysis of chromium-51 release assay data using personal computer spreadsheet software.

The Chromium-51 release assay is a widely used technique to assess the lysis of labeled target cells in vitro. We have developed a simple technique to analyze data from Chromium-51 release assays using the widely available LOTUS 1-2-3 spreadsheet software. This package calculates percentage specific cytotoxicity and lytic units by linear regression. It uses all data points to compute the linear regression and can determine if there is a statistically significant difference between two lysis curves. The system is simple to use and easily modified, since its implementation requires neither knowledge of computer programming nor custom designed software. This package can help save considerable time when analyzing data from Chromium-51 release assays.

Chromium Radioisotopes↗

PubMed2000

An automated PACS workstation interface: a timesaving enhancement.

OBJECTIVE: Interface design is a key element in the efficient use of a picture archiving and communication system (PACS) workstation. In many cases, multiple mouse clicks or keyboard commands are required to open and close a case, to mark it as complete, and to retrieve and allocate screen positions to the next case. We evaluated the work flow effect of software designed for automated image display in which all of these operations are consolidated in a single mouse click. CONCLUSION: Automated image display increases efficiency in image interpretation and remedies the normally cluttered presentation environment. At our institution, acceptance of automated image display has been overwhelmingly positive. In fact, automated image display has improved radiologist productivity.

Efficiency, Organizational↗

PubMedDate not supplied

A new real-time mapping system to detect microscopic cardiac excitation patterns.

A new fast, high-resolution measurement system has been developed to analyze the propagation of cardiac excitation on a microscopic scale. The instrument uses a microsensor array to detect microscopic excitation patterns at the cardiac surface. Ninety-six epicardial signals are recorded simultaneously with 14-bit resolution at 200-kHz samples per second per channel. The system operates like a digital oscilloscope. Preprocessing routines (offset, gain, and triggering) are executed within a sampling interval of 5 microseconds by 48 digital signal processors. Analog-to-digital (A/D) converters are provided with 12 Mb of buffer memory, allowing continuous recording of up to 64-k samples x 96 channels. The recorded dataset is transferred rapidly (8 Mb/sec) to the memory of the integrated computer system via VXIbus. Analysis and visualization of the propagating excitation are computed by custom-designed software. The performance of the system allows recording as well as visualization of the cardiac excitation spread in a beat-to-beat manner.

Analog-Digital Conversion↗

PubMed1991

Three-dimensional face shape analysis of French adults, and its application to the design of protective equipment.

The study's aim was to identify female and male face shape variability in order to establish typical profiles for the design of masks. A specific data acquisition photogrammetric station was used for this purpose. A preliminary survey using anthropometric techniques was conducted on 301 females and 208 males, randomly selected from the French military population, in order to constitute two samples of 30 males and 30 females for the stereometric survey. For each subject, the stereorestitution of face photos was made on three sets of data: (1) 37 anatomical landmarks previously identified by a black point marked on the face; (2) 7 anatomical arcs, also drawn with a black pencil; and (3) 1500-2000 points distributed on horizontal cross-sections at different vertical levels. The analysis only concerned the global face shape, and excluded the central area (eyes, nose and mouth). A common origin and reference axis system was defined. All the three-dimensional (3D) produced data was processed using computer-aided design software, after some adaptations. Subjects were selected iteratively for five levels of cross-section and three anatomical arcs so as to characterize least variation amplitudes, subject by subject. Five groups were identified. All cross-sections were verified to check the validity of the preceding step. By this method, each group was defined by a mean profile form and by the amplitude of this form for each point of the profile. Males and females were present in each group, and for each group, a greater variability was noted at the lower part of the face. This variability can be explained as the result of morphological and functional phenomena. These results can be applied to the design of new protective equipment for the fore-face indeed they were used for the design of a new mask for the French military.

Adult↗

PubMed2002

Differential isotopic mass splitting as a mass spectrometric tool for identifying protease substrates.

A method is described whereby stable isotopic signatures were partially incorporated into both termini of a peptide sequence giving rise to a characteristic cluster of four peaks in the mass spectral analysis. Cleavage of this peptide by a protease between the labeled positions generates two fragments both displaying their own individual signature peaks. The event of protease cleavage of the peptide was monitored by the changes in clusters within the spectrum. We believe that this technique could be used to aid the discovery of new cleavage substrates for proteases. Additionally, the analysis can be automated with dedicated software designed to select and interpret the data since all peaks of interest contain predefined signatures and can be easily distinguished from background noise.

Chromatography, High Pressure Liquid↗

PubMed1992

Using a computer to manage the radiation safety and quality control activities in diagnostic radiology.

Software has been developed to aid in the management of a radiation safety quality control program in diagnostic radiology. The core of the system is a data base of radiation safety activities. Software design goals were the prioritization, scheduling, and reporting of these activities. Computerization has helped organize the timely performance of surveys necessary for compliance with regulatory and accreditation agencies. Clear, concise program documentation and reporting are also provided.

Georgia↗

PubMed2001

Aortic aneurysm: construction of a life-size model by rapid prototyping.

Development of new endovascular techniques for repair of abdominal aortic aneurysm (AAA) requires the use of experimental models. Stereolithography is a rapid prototyping technique used in industry to prototype parts during the design phase. A stereolithography apparatus (STL) employs laser technology to build a digital model layer by layer with photopolymer resin. The purpose of this study was to use this technology to produce a life-size AAA model. Data were acquired by CT scan and stored in DICOM 3 format. Specifically designed software was used for 3-D imaging and conversion of data to a standard STL format. Two replicas were made: one to scale and the other 3 mm larger. The final model was made by pouring silicone rubber or polyurethane into the mold over the life-size model so as to obtain a sturdy, life-size, soft, transparent plastic casting. Arterial models made for living subjects with these rapid prototyping techniques can be used to simulate surgical procedures, calibrate imaging modalities, and design new stent grafts.

Aortic Aneurysm, Abdominal↗

PubMed2001

Towards environmental toxicogenomics -- development of a flow-through, high-density DNA hybridization array and its application to ecotoxicity assessment.

Assessment of the environmental hazard posed by soils/sediments containing low to moderate levels of contaminants using standard analytical chemical methods is uncertain due (in part) to a lack of information on contaminant bioavailability, the unknown interactive effects of contaminant mixtures, our inability to determine the species of a metal in an environmental matrix, and the relative sensitivity of bioassay species. Regulatory agencies compensate for this uncertainty by lowering cleanup goals, but in this process they effectively exclude otherwise attractive cleanup options (i.e. bioremediation). Direct evaluations of soil and sediment toxicity preclude uncertainty from most of these sources. However, the time and cost of chronic toxicity tests limits their general application to higher levels of tiered toxicity assessments. Transcriptional level (mRNA) toxicity assessments offer great advantages in terms of speed, cost and sample throughput. These advantages are currently offset by questions about the environmental relevance of molecular level responses. To this end a flow-through, high-density DNA hybridization array (genosensor) system specifically designed for environmental risk assessment was developed. The genosensor is based on highly regular microchannel glass wafers to which gene probes are covalently bound at discrete (200-microm diameter spot) and addressable (250-microm spot pitch) locations. The flow-through design enables hybridization and washing times to be reduced from approximately 18 h to 20 min. The genosensor was configured so that DNA from 28 environmental samples can be simultaneously hybridized with up to 64 different gene probes. The standard microscopic slide format facilitates data capture with most automated array readers and, thus high sample throughput (> 350 sample/h). In conclusion, hardware development for molecular analysis is enabling very tractable means for analyzing RNA and DNA. These developments have underscored the need for further developmental work in probe design software, and the need to relate transcriptional level data to whole-organism toxicity indicators.

Animals↗

PubMed1984

A comparison of methods to approximate standard errors for complex survey data.

Complex survey designs are characterized by multistage selections with stratification and clustering. The departure from simple random sampling assumptions requires special consideration with regard to variance estimation. Specially designed software packages exist to generate variance estimates for statistics from complex survey data. The variance estimation techniques used include balanced repeated replication, jackknife, and Taylor series linearization. Many complex surveys generate thousands of tables. The computational and publishing costs soar if estimates of standard error are required for all statistics. To decrease these costs, several alternative techniques to approximate the standard errors of estimates are available. These include the widely used relative variance curve, a method based on the average relative standard error, and the average design effect model. In this paper these three methods are compared with respect to accuracy, computational and publishing costs, and ease of implementation.

Health Services Research↗

PubMed1977

Computer-assisted monocyte esterase assay by flow-cytophotometry.

A Wang model 2200 computer has been interfaced with the Bio/Physics Systems, Inc. model 6300 Cytograf and model 2100 Distribution Analyzer. Using a custom designed software program, in conjunction with an azo-dye technic for staining monocytes for nonspecific esterase activity, it has been possible to obtain rapid and reliable data concerning relative values for intracellular monocyte esterase activity. The method is based on measuring the axial light-loss voltage signal for each of one thousand stained monocytes. Individual stained monocytes were assigned to one of four groups (A, B, C, D), dependent upon the magnitude of the signal and were given different rating values (1, 2, 3, 4) according to their group designation. A "score" was derived for each blood sample by multiplying the percentage of cells (monocytes) in each group category by the appropriate factor and summing these values. The technic permits rapid objective assessment of intracellular nonspecific esterase activity in monocytes suspended in a mixed cell population. Both Gaussian and bi-modal patterns for monocyte esterase were observed. The latter suggests a dual monocyte population.

Computers↗

PubMed1988

The protein identification resource (PIR).

The Protein Identification Resource consists of an integrated computer system composed of a number of protein and nucleic acid sequence databases and software designed for the identification and analysis of protein sequences and their corresponding coding sequences. The PIR serves the scientific community through on-line access, distributing magnetic tapes, and performing off-line sequence identification services for researchers.

Amino Acid Sequence↗

PubMed2000

The reliability and internal consistency of an Internet-capable computer program for measuring utilities.

OBJECTIVE: The purpose of this study was to assess the reliability and internal consistency of measurements of utilities performed with a computer program (iMPACT2) designed for Internet surveys and Internet patient decision-support systems. METHODS: We implemented the Internet Multimedia Preference Assessor Construction Tool, version 2 (iMPACT2) program using the combination of a web server, HTML files, and a web-accessible database. The program randomized subjects, screened their responses for missing data and failures of internal consistency, assisted patients with resolving certain inconsistencies, and, upon a subject's completion of the protocol, provided a report of results to the research assistant administering the program. To validate the iMPACT2 program, we recruited 60 healthy community volunteers and elicited preferences in a research-lab setting using a visual analog scale (VAS) and the standard gamble (SG) for subject's current health and three hypothetical states. For purposes of comparison, we also administered a Short Form-12 (SF-12) health-assessment questionnaire. Subjects used the computer software on two occasions separated by 2-4 weeks of time. RESULTS: Visual analog scale and standard gamble ratings for subjects' current health were reliable (intraclass correlation coefficient (ICC) of 0.82 and 0.84 (two outliers excluded -0.60 without exclusions), respectively) were comparable with the reliability of the Physical and Mental Component scales of the SF-12 (ICCs of 0.84 and 0.75, respectively). Subjects could easily discriminate between hypothetical states (D scores 0.74 for SG and 0.90 for VAS), and 94% had a completely internally consistent ordering of preference ratings for states. CONCLUSIONS: iMPACT2 produces measurements of standard gamble utilities that are reliable and have a high degree of internal consistency. Procedures for assessment of utilities developed for desktop computer programs can be translated to software designed for the Internet, facilitating the use of utilities and endpoints in clinical trials and development of web-based decision-support applications for patients. However, further testing, including direct comparisons with traditional interviewer administered utility elicitation protocols, is needed.

Analysis of Variance↗

PubMed2002

Electronic procedure logs: taking it further.

OBJECTIVE: To create an electronic procedural logbook with enhanced user interactivity and usefulness as an educational resource. DESCRIPTION: From our own work on electronic student logbooks and other studies, it is clear that compliance with complete and valid data entry remains a challenge. Without direct and visible benefit, students are reluctant to spend time logging all their cases. We developed an interactive procedural logbook using Microsoft Embedded Visual Basic and Metrowerks CodeWarrior. Interface design focused on rapid data entry with minimum requirement for text, and field-level automation where possible. We loaded it onto a mixed platform of personal digital assistants (PDAs)--Compaq iPaq Pocket PCs and HandEra 330 PalmOS devices. Our rural residents were supplied with the devices of their choice. Various built-in educational reference resources included: (1) contextual help options about each procedure, which contained diagrams and pictures; (2) diagnostic and fee coding so they could see how poorly some procedures pay; and (3) Quick Tips relevant to each procedure, which can be easily modified by the preceptor. Preceptor evaluations and comments can be entered rapidly. Using built-in database conduits, data are automatically collected from each device on every HotSync with the desktop. Data can then be collated and analyzed using Microsoft Access or via secure Web access. DISCUSSION: Improved compliance has been dramatic-one resident logged 250 procedures in just two months. However, not all residents have been successful in establishing seamless synchronization, and the resulting data loss has caused frustration. The evidence indicates the need to implement central data collection and backup right from the outset. Central data collection provides many advantages. The program director has better information for future applications. Preceptor evaluations are now spread over many interactions and yet can be collated and analyzed. Quick Tips have been very popular-we have been able to collect the tips and redistribute them. Focus-group feedback from the residents has shown that the rich data in the logbook's reference component improved its usefulness and popularity as an educational tool. Choice of device type is important for user acceptance because devotees of one platform are reluctant to switch to another. Cross-platform development does slow the process but is increasingly easy with the latest software design tools, such as AppForge. These new tools have enabled us to explore further improvements in data entry. Digital ink provides the ability to capture annotated diagrams and preceptor signatures. Voice input is built in with these devices, and our software now allows for voice annotation for more detailed commentary by preceptors or student. The compressed digital sound file is collected along with the data and transcribed centrally (on-device voice recognition is not feasible yet). Point-of-care accessibility has been the key attraction of using these devices for logging encounter data. This project demonstrates that it is important to explore all multimodal interactive capabilities to provide a truly rich educational tool.

Electronic Data Processing↗