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The burden of smoking-attributable mortality among African Americans--Indiana, 1990.

Recent trends in smoking prevalence in Indiana indicate a slow decline in smoking prevalence among adults aged 18 years of age and under. Despite this decline, the smoking prevalence has remained consistently higher among Blacks compared to Whites. The purpose of this investigation was to evaluate the extent of mortality due to cigarette smoking in 1990 among Blacks and Whites in the state of Indiana. Estimates of smoking-attributable mortality (i.e., smoking-attributable mortality [SAM] and years of potential life lost [YPLL] associated with smoking in 1990 were calculated using SAMMEC, a software program developed by the Centers for Disease Control and Prevention and designed to measure the disease impact associated with cigarette smoking. Although the SAM and YPLL for Whites accounted for the greatest percentage of total SAM and total YPLL, SAM rates and YPLL rates were higher among Blacks compared to Whites, for both men and women. The SAM rate for Black men was 4% higher than that of White men and 9% higher for Black women compared to White women. Similarly, the YPLL to life expectancy rate for Black men was 7% higher than the YPLL rate for White men and 29% higher for Black women compared to White women. The greater burden of tobacco-related mortality among Blacks is evidenced through higher SAM and YPLL rates compared to Whites. It is imperative that high-risk populations be targeted at national, state, and local levels through anti-tobacco campaigns.

Adult↗

Minimization of small bowel volume within treatment fields utilizing customized "belly boards".

Thirty consecutive patients with pelvic malignancies were evaluated prospectively for the impact of a novel bowel minimization device ("belly board") on the volume of small bowel included within a four field pelvic radiation plan. A customized polyurethane and styrofoam bowel immobilization mold was created for each patient in the prone position. Using contrast enhanced CT scanning on a dedicated radiation treatment planning scanner, we imaged the location of the small intestine in the supine position and the prone position aided by the "belly board". Custom in-house interactive image analysis software was developed to allow volumetric determination of small bowel within the treatment portals. The mean small bowel volume was reduced by 66% (299 cm3 to 102 cm3), comparing the standard supine position to the prone position assisted by the "belly board". In 13 patients without prior pelvic surgery, the small bowel volume reduction was a more dramatic 74% (334 cm3 to 88 cm3). All patients were found to benefit from this prone "belly board" setup regardless of body habitus, weight, and age. Compliance with the set-up including use of bladder distension was excellent. All patients completed their pelvic radiotherapy without requiring a treatment break. Weight loss at completion averaged less than 5%. Seventy-six percent of patients experienced little or no diarrhea. This technique is comfortable, inexpensive, highly reproducible, and permits maximal bowel displacement from standard pelvic radiotherapy fields.

Adult↗

Implementation of internal laboratory quality control procedures for the monitoring of ELISA performance at a regional veterinary laboratory.

Quality control (QC) procedures for antigen detection enzyme-linked immunosorbent assays (ELISAs) for hog cholera (HC) virus, foot and mouth disease (FMD) virus, and an antibody detection ELISA for FMD virus were established at a regional veterinary laboratory in northern Thailand. A recently developed computer software package, QCEL, was used to facilitate management and analysis of QC data. The program was used to assess test performance by producing Shewhart-CUSUM control charts which monitored control data for unacceptable fluctuations or trends. QCEL-generated control charts and analyses are presented and discussed. The use of a simple integrated computerised system for storage and analysis of QC control data provided the laboratory with the opportunity to achieve increased confidence in the results of tests performed.

Animals↗

Detection and quantification of endolymphatic hydrops in the guinea pig cochlea by magnetic resonance microscopy.

Three-dimensional magnetic resonance microscopy (MRM) was used to study normal and hydropic cochleae of the guinea pig. With this technique consecutive serial slices representing the entire volume of isolated, fixed cochleae were obtained. The voxels (volume elements) making up the contiguous slices were isotropic (25 microns 3) and in each slice the boundaries of scala media, including the position of Reissner's membrane, were clearly delineated. Three-dimensional reconstructions of the endolymphatic and perilymphatic scale were generated. Custom software was developed to quantify cross-sectional area (CSA) of all scalae. In the normal cochlea all 3 scalae, including scala media, showed a gradual decrease in CSA from base to apex. Marked differences existed between our findings and previously reported cochlear dimensions, especially for the perilymphatic scalae in the basal turn. In hydropic cochleae the scala media was enlarged to a varying extent in different turns and marked changes in the degree of distension of Reissner's membrane occurred along the cochlea. MRM and subsequent computer analysis of the isotropic data provide excellent methods for imaging and quantifying the fluid spaces of normal and hydropic cochleae.

Animals↗

Three-dimensional computed tomography of the foot: optimizing the image.

The complex anatomy of the foot can be imaged using high resolution computed tomography. High resolution serial nonoverlapping CT scans of foot anatomy have a high degree of soft tissue contrast, and excellent geometrical accuracy (no magnification error). Three-dimensional surface reconstruction from CT scans of the foot were performed using specially developed computer software. These surface reconstructions display the osseous and soft tissue anatomy of the foot in a form similar to anatomic preparations. The removal of overlying skin, disarticulation of the ankle, tarsals and metatarsals was accomplished using computer methods. Major factors necessary to optimize three-dimensional images are presented and illustrated. The technique has been applied in living subjects with arthritis, carpal coalitions, osteochondritis dissecans, and fractures. These images have been useful in communicating the findings on high resolution CT scans to referring clinicians, correlating CT findings in areas of complex anatomy, and eliminating overlying or obscuring structures by mathematically disarticulating the foot and individual tarsal bones.

Cadaver↗

Dental anatomy portrayed with microscopic volume investigations.

The clinical treatment of the root canal of teeth--called endodontics--assumes a precise idea of the spatial arrangement of the anatomy of teeth and their inner structure. By using computer-assisted data acquisition from filmed sequences of histologic serial sections and a special kind of magnetic resonance microscope--the Stray Field Imaging (STRAFI)--volume investigations were carried out using special functions of a newly developed 3D software. Possible applications and future perspectives are discussed.

Data Display↗

Three-dimensional analysis of eye movements using four times high-speed video camera.

In order to record and analyze the rapid eye movement non-invasively in human subjects, a four times high-speed video camera (4TC) with a new computer software was developed and utilized. Nine healthy volunteers and four patients with vestibular dysfunction participated in this study. Caloric stimulation was applied to the healthy subjects and the eye movements were recorded using a standard camera (SC) and a 4TC. In four patients, the positional and/or positioning nystagmus was recorded using SC and 4TC. Analysis of the eye speed of the quick phase of nystagmus was performed manually from the print out of the chart. The quick phase of the caloric nystagmus was adequately analyzed from the data using 4TC. However, using SC the sampling rate was not sufficiently enough for this purpose, as prospected. The adaptability of the 4TC in clinical examination is exactly similar to that of SC, because of the size and weight of the camera. Although the time taken to analyze eye movements using 4TC is about four times longer than that using SC, this system is quite useful and adequate for analyzing the quick eye movements in vestibular nystagmus, in an out-patient clinic set up.

Adult↗

Laboratory measurement of cumulative food intake in humans: results on reliability.

The universal eating monitor (UEM) of Kissileff for laboratory measurement of food intake was modified and used with a newly developed special software to compute cumulative intake data. To explore the measurement precision of the UEM an investigation of test-retest-reliability of food intake parameters was conducted. The intake characteristics of 61 normal weight males and females were measured repeatedly in the laboratory with a measurement interval of 1 week. Yogurt of preferred flavor served as test meal. Test-retest-reliability of intake characteristics ranged from .64 (number of bites) to .83 (bite-size) and was .73 for initial eating rate, but only .16 for change of eating rate. Sex, BMI and eating habits according to TFEQ-factors had no significant effects on reliability of intake characteristics. The retest-reliability for all but one of the laboratory intake measures is comparable to standards of personality questionnaires and seems not to be influenced by sex or trait characteristics of eating behavior.

Adult↗

A quantitative analysis of bone support comparing cementless tapered and distal fixation total hip replacements.

The purpose of this study was to develop a technique to accurately assess cementless femoral stem-bone contact. Using this technique, differences in contact patterns between tapered (Synergy) and cylindrical distal fixation (Prodigy) cementless stems were explored. Femurs were prepared and the 2 types of femoral stems were implanted. After implantation, the femurs were imaged in a spiral computed tomography scanner and analyzed using novel custom-developed imaging software. This analysis used a geometric deformable-model UNIX-based software that determined bone-prosthesis contact area. The tapered stem features proximal, cancellous bone contact and a 3-point fixation pattern. The cylindrical distal fixation stem demonstrates cortical support in the distal aspect of the stem.

Algorithms↗

Simulation model for the closed plant experiment facility of CEEF.

The Closed Ecology Experiment Facilities (CEEF) is a testbed for Controlled Ecological Life Support Systems (CELSS) investigations. CEEF including the physico-chemical material regenerative system has been constructed for the experiments of material circulation among plants, breeding animals and crew of CEEF. Because CEEF is a complex system, an appropriate schedule for the operation must be prepared in advance. The CEEF behavioral Prediction System, CPS, that will help to confirm the operation schedule, is under development. CPS will simulate CEEFs behavior with data (conditions of equipments, quantity of materials in tanks, etc.) of CEEF and an operation schedule that will be made by the operation team everyday, before the schedule will be carried out. The result of the simulation will show whether the operation schedule is appropriate or not. In order to realize CPS, models of the simulation program that is installed in CPS must mirror the real facilities of CEEF. For the first step of development, a flexible algorithm of the simulation program was investigated. The next step was development of a replicate simulation model of the material circulation system for the Closed Plant Experiment Facility (CPEF) that is a part of CEEF. All the parts of a real material circulation system for CPEF are connected together and work as a complex mechanism. In the simulation model, the system was separated into 38 units according to its operational segmentation. In order to develop each model for its corresponding unit, specifications for the model were fixed based on the specifications of the real part. These models were put into a simulation model for the system.

Agriculture↗

Influence of rice straw cooking conditions in the soda-ethanol-water pulping on the mechanical properties of produced paper sheets.

A normalized design was used to examine the influence of independent variables (alcohol concentration, cooking time and temperature) in the catalytic soda-ethanol pulping of rice straw on various mechanical properties (breaking length, burst, tear index and folding endurance) of paper sheets obtained from each pulping process. An equation of each dependent variable as a function of cooking variables (independent variables) was obtained by multiple non-linear regression using the least square method by MATLAB software for developing of empirical models. The ranges of alcohol concentration, cooking time and temperature were 40-65% (w/w), 150-180 min and 195-210 degrees C, respectively. Three-dimensional graphs of dependent variables were also plotted versus independent variables. The optimum values of breaking length, burst and tear index and folding endurance were 4683.7 (m), 30.99 (kN/g), 376.93 (mN m2/g) and 27.31, respectively. However, short cooking time (150 min), high ethanol concentration (65%) and high temperature (210 degrees C) could be used to produce papers with suitable burst and tear index. However, for papers with best breaking length and folding endurance low temperature (195 degrees C) was desirable. Differences between optimum values of dependent variables obtained by normalized design and experimental data were less than 20%.

Biotechnology↗

Automated osteoporosis risk assessment by dentists: a new pathway to diagnosis.

General dental practitioners use a vast amount of panoramic radiography in their routine clinical work, but valuable information about patients' osteoporotic status is not collected. There are many reasons for this, but one of the prime reasons must be the disruption involved in clinical routine with lengthy manual radiographic assessment. We have developed computer software, based on active shape modeling that will automatically detect the mandibular cortex on panoramic radiographs, and then measure its width. Automatic or semi-automatic measurement of the cortical width will indicate the osteoporotic risk of the patient. The aim of our work was to assess the computer search technique's ability to measure the mandibular cortical width and to assess its potential for detection of osteoporosis of the hip, spine and femoral neck. Mandibular cortical width was measured using the manually initialized (semi-automatic) method and, when assessed for diagnosing osteoporosis at one of the three measurement sites, gave an area under the ROC curve (A(z))=0.816 (95% CI=0.784 to 0.845) and for the automatically initialized searches, A(z)=0.759 (95% CI=0.724 to 0.791). The difference between areas=0.057 (95% Confidence interval=0.025 to 0.089), p<0.0001. For diagnosing osteoporosis at the femoral neck, mandibular cortical width derived from the manually initialized fit gave an area under the ROC curve (A(z))=0.835 (95% CI=0.805 to 0.863) and for the automatically initialized searches A(z)=0.805 (95% CI=0.773 to 0.835). The difference in A(z) values between active shape modeling search methods=0.030 (95% CI=-0.010 to 0.070), and this was not significant, p=0.138. We concluded that measurement of mandibular cortical width using active shape modeling is capable of diagnosing skeletal osteoporosis with good diagnostic ability and repeatability.

Absorptiometry, Photon↗

Effect of additional auditory and visual stimuli on continuous performance test (noise-generated CPT) in AD/HD children -- usefulness of noise-generated CPT.

The continuous performance test (CPT) is designed to measure sustained attention quantitatively. Several CPTs are used clinically. We have made changes to the conventional type of visual CPT, by displaying auditory and visual noise along with target or non-target stimuli. By influencing the recognition of the subjects in this way, the changes were intended to increase the sensitivity of detection of inattention and impulsiveness, to make CPT more useful for diagnosis, and to examine the effect of noise on AD/HD children during CPT performance. Its usefulness for AD/HD diagnosis and the reaction of AD/HD children to noise were examined using newly developed computer software. Using this CPT analysis, a significant difference was observed in all measurements, except mean reaction time, between the control and AD/HD groups, showing that it was useful as a supplementary diagnostic method for AD/HD, and was more useful in the younger age group than in the older age group, as the same for conventional CPTs. As compared to no-noise sessions, commission and omission errors both increased significantly in auditory and visual noise sessions. Thus, analyzing the changes in measurements during noise sessions will improve the diagnosis of inattention and combined AD/HD subtypes. Furthermore, it was suggested that analysis of the effects of noise on AD/HD children will benefit their handling in an educational environment. Since omission errors were decreased in AD/HD children by noise during the CPT performance as compared to the control group, noise may induce attention in AD/HD children. The present study presents new findings on the responses to noise of AD/HD children during the CPT.

Acoustic Stimulation↗

Brief report: validation of a system for automated measurement of knee laxity.

OBJECTIVE: To determine the accuracy and repeatability of an automated quantitative fluoroscopic imaging system for measuring knee laxity. DESIGN: Cadaveric validation study. BACKGROUND: Current methods of measuring anterior-posterior laxity lack sufficient accuracy and repeatability. A commercially developed fluoroscopic software package, capable of measuring laxity, required validation. METHODS: Five human cadaveric knees were used. A constant force of 130 N was applied anteriorly and posteriorly in turn to the tibia of each knee with the femur fixed in 30 degrees and 90 degrees of flexion. Quantitative fluoroscopic measurements of anterior-posterior laxity were determined using image analysis software. Fluoroscopic results were compared to the true anterior-posterior displacements of the tibia, which were simultaneously recorded using linear transducers directly attached to the cadaveric specimens. RESULTS: The quantitative fluoroscopic method underestimated laxity by an average of 0.40 mm with a root mean square error of 0.49 mm. The 95% confidence intervals for anterior and posterior laxity error were calculated to be -0.99 to 0.25 mm and -0.89 to 0.03 mm, respectively, where a negative error represents an underestimation. CONCLUSIONS: The quantitative fluoroscopic method offers a dramatic improvement in accuracy over current laxity measurement techniques and acceptable repeatability for assessing ligament damage. RELEVANCE: The considerably more accurate, validated measurement system of this study could improve ligament assessment and diagnosis, and the recognition of injuries otherwise undetected with current methods.

Fluoroscopy↗

Development and applications of a software tool for diarthrodial joint analysis.

This paper describes a new software environment for advanced analysis of diarthrodial joints. The new tool provides a number of elaboration functions to investigate the joint kinematics, bone anatomy, and ligament and tendon properties. In particular, the shapes and the contact points of the articulating surfaces can be displayed and analysed through 2D user-defined sections and fittings (lines or conics). Ligament behaviour can be evaluated during joint movement, through the computation of elongations, orientations, and fiber strain. Motion trajectories can be also analysed through the calculation of helical axes, instantaneous rotations, and displacements in specific user-chosen coordinate reference frames. The software has an user-friendly graphical interface to display four-dimensional data (time-space data) obtained from medical images, navigation systems, spatial linkages or digitalizers, and can also generate printable reports and multiple graphs as well as ASCII files that can be imported to spreadsheet programs such as Microsoft Excel.

Algorithms↗

Detection of T-wave alternans using an implantable cardioverter-defibrillator.

BACKGROUND: Microvolt T-wave alternans (TWA) increases acutely prior to ventricular tachycardia (VT) or ventricular fibrillation (VF) in computer simulations and animal models, suggesting that TWA may provide a warning for VT/VF in patients with an implantable cardioverter-defibrillator (ICD). OBJECTIVES: The purposes of this study were to develop a method for analyzing TWA recorded from ICD electrograms (EGMs) and to evaluate the degree of concordance between EGM TWA and TWA recorded from the surface ECG. METHODS: We developed a software program to measure EGM TWA in the frequency domain and then used simulated EGMs to determine the effects of ICD signal processing, electrical noise, and variation in the EGM fiducial point on the recorded amplitude and K score (signal-to-noise ratio) of TWA. We then applied this method to analyze TWA simultaneously using both surface ECGs and ICD EGMs during incremental pacing in 25 ICD patients. Pacing modes and EGM sources were varied in repeated trials. EGMs with dynamic range adjusted to achieve a large T wave were telemetered to a digital Holter recorder and measured offline. ECG TWA was analyzed using a commercial system. A positive (+) ECG test had sustained alternans >or=1.9 microV with K score >or=3. Stored EGMs were reviewed for VT/VF during a 6-month follow-up period. RESULTS: Simulations demonstrated that the EGM method accurately identified TWA >or=10 microV. Overall, 10 (40%) patients had at least one ECG TWA+ test and 15 patients (60%) had no ECG TWA+ tests. The maximum value of TWA was greater in EGMs than in ECGs (median 64 microV vs 2.2 microV, P <.0001). EGM TWA was greater in ECG TWA+ tests than in ECG TWA- tests (169 +/- 175 microV vs 71 +/- 61 microV, P <.001). Using a sustained EGM TWA threshold of 30 microV, EGM TWA was concordant with ECG TWA in 63 (84%) of 75 analyzed tests (P <.0001) and predicted ECG TWA results with 85% sensitivity and 84% specificity. Both ECG and EGM TWA predicted VT/VF during follow-up (ECG: P = .006; EGM: P = .035). CONCLUSION: The amplitude of TWA is at least 10 times greater on ICD EGMs than on surface ECGs. EGM and ECG TWA have substantial concordance and comparable predictive value for spontaneous VT/VF. These observations support the hypothesis that ECG and EGM TWA detect the same electrical alternans phenomenon.

Aged↗

Cardio: a web-based knowledge resource of genes and proteins related to cardiovascular disease.

BACKGROUND: Cardiovascular disease (CVD) is the leading killer for human. In order to understand the linkage between cardiovascular diseases and genes or proteins, it is essential to construct a database to organize the body of knowledge. While the existing molecular biological databases focus on the sequence and structural aspects of biological macromolecules, i.e. DNAs, RNAs and proteins, Cardio is the web-based system we built to provide a knowledge environment with visual interface to integrate information about major cardiovascular diseases in relation to genes and proteins. METHODS: We collected the information from the web by using a group of software we developed and used a relational database management system to manage the information of these data. RESULTS: Cardio consists of six sections: GENE, PROTEIN, DISEASE, DRUG, LINKS, and REFERENCE. Each section contains relevant information about the topic. Using a phenotype-driven approach, we can identify genetic mechanisms underlying the physiology and pathophysiology of specific cardiovascular disease, such as atherosclerosis, hypertension, heart failure, and stroke. CONCLUSION: The website titled "Database of Genes and Proteins Related to Cardiovascular Disease (Cardio)" is available at along with additional information on cardiovascular disease, supplementary materials and related figures.

Cardiovascular Diseases↗

Implications of radiation dosimetry of the mandible in patients with carcinomas of the oral cavity and nasopharynx treated with intensity modulated radiation therapy.

Intensity modulated radiation therapy (IMRT) is a newer method of delivering highly conformal, salivary gland sparing radiation treatment that is finding increasing applications in head and neck malignancies. However, the radiation dose distribution to the mandible is rarely considered with IMRT, and the potential risks of osteoradionecrosis or osseointegrated implant failure are not well characterized for this modality. In a series of 10 patients with oral cavity and nasopharyngeal cancers who previously underwent IMRT, examination of the three-dimensional mandibular dose distribution was undertaken. The findings indicate a modest potential risk of osteoradionecrosis and osseointegrated implant failure in cases where IMRT optimization constraints are not specifically aimed at sparing the mandibular bone. Significantly higher mandibular doses (P < 0.04) were received in cases of oral cavity as opposed to nasopharyngeal cancers with IMRT. Efforts to optimize IMRT to further reduce doses to the mandible should be considered, and development of software tools to integrate three-dimensional dose distributions into planning of post-radiotherapy osseointegration would be beneficial.

Carcinoma↗