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Fast systematic approach for the determination of drugs in biological fluids by fully automated high-performance liquid chromatography with on-line solid-phase extraction and automated cartridge exchange. Application to cebaracetam in human urine.

A fast stepwise systematic approach for the conversion of conventional reversed-phase high-performance liquid chromatographic (HPLC) assays involving liquid-liquid extraction of biological fluids into fully automated HPLC assays using solid-phase extraction and cartridge exchange is described. The suitability of this procedure is demonstrated for the determination of cebaracetam in human urine.

Chromatography, High Pressure Liquid

The automation of cytochemical methods for automated cytophotometers.

The development of an automated differential white blood cell counter is reviewed. After the red cells have been lysed, the white cells are counted by staining and passing through an electro-optical chamber in liquid suspension, surrounded by a laminar, or sheath, stream. Staining procedures were made specific for each type of leukocyte, and separate channels were used for counting each type. Staining intensity and characteristics of the various types of blood cells are discussed. They relate to enzyme levels and the effect on differentiation and identification of the cells. Since reasons for some of the design features are not obvious, discussion of the relevant problems is included. Several applications that go beyond routine differential counting are described.

Basophils

[Mathematical bases for automated automated equipment for mass medical screening and diagnosis].

Mathematical methods and the programmes for the computer choice of informative diagnostic signs and constructing resolving rules to formulate groups of risk for certain affections in automating large-scale medical examinations are described. The use of a method for linear discriminant functions is shown. The applicability of the programme on examples of early identification of mammary cancer and rheumatic affections is demonstrated.

Adult

Automation of a patient medical profile from insurance claims data: a possible first step in automating ambulatory medical records on a national scale.

This report describes how a detailed patient medical profile can be produced by the systematic collection and linkage of claims data in a state-wide Medicaid program. Extension of this system nationally could provide automated medical profiles for more than 20,000,000 people at a small increment in cost. The possibility that this cost could be offset by reduction of duplicated services currently provided deserves serious consideration by health care planners and administrators. The ability of the profile to portray a patient's clinical status accurately hinges on both the determination of health care administrators to adopt sensitive and precise diagnostic codes and on the adoption of improved data acquisition techniques. The deficiencies of the database are described, and methods of overcoming these problems are suggested.

Alabama

Automated site-directed drug design: the generation of a basic set of fragments to be used for automated structure assembly.

If a method is to be developed to assemble putative ligand structures in site-directed drug design, from molecular graphs generated in the site, then basic building blocks are needed. Structure assembly is a combinatoric process that needs to be optimised if it is to be tractable. What has to be determined is whether small molecular fragments can have transferable properties from one molecule to another. In this paper we determine all possible combinations of 3-, 4- and 5-atom aliphatic fragments from a small set of atoms H, C, N, O, F or Cl. The frequency of occurrence of these candidate fragments is searched for in the Cambridge Structural Database. A similar analysis is performed on charged fragments. A more restricted search is carried out for P and S and aromatic structures. A basic set of fragments can be derived that have a significant frequency in known crystal structures. The transferability of fragment properties is discussed in subsequent papers.

Computer-Aided Design

Automated blood pressure determination during exercise test. Clinical evaluation of a new automated device.

The accuracy and reproducibility of a new automatic device (P) specially designed for noninvasive blood pressure monitoring during the exercise stress test were evaluated in 50 consecutive subjects (34 normotensives and 16 hypertensives). Automatic measurements were compared with those taken by a sphygmomanometer (RR). A good agreement between systolic pressure values obtained by the two methods was found (RR 159 +/- 30 mmHg, P 158 +/- 28 mmHg, mean difference = -1.53 +/- 13 mmHg, p = 0.166, ns). On the contrary the new device significantly underestimated diastolic pressure values (RR 89.3 +/- 13 mmHg; P 84 +/- 13 mmHg, mean difference -5.37 +/- 9.3, p < 0.001). In conclusion the new device seems able to measure systolic but underestimates diastolic blood pressure both in hypertensives and in normotensives during the effort test.

Adult

Evaluation of automated large-scale screening tests for syphilis.

Two methods of performing serological screening tests for syphilis are compared. One consisted of the Venereal Diseases Reference Laboratory (VDRL) slide test, the cardiolipin Wassermann reaction (CWR), and the Reiter protein complement fixation test (RPCFT) performed manually; the other was a fully automated system using two Technicon AutoAnalyzers (AAII), one for the automated reagin test (ART) and the other for automated complement fixation tests. The absorbed fluorescent treponemal antibody test (FTA-ABS) was used as a final arbiter in all cases found to be seropositive by either method. A pooled antigen consisting of a mixture of cardiolipin and Reiter protein was used for the automated complement fixation test, thus increasing the scope and capacity of the system. The AutoAnalyzer was shown to be capable of performing 400 cardiolipin and Reiter complement fixation tests and 700 automated reagin tests in an 8-hour day. Modification of the complement fixation test method to take advantage of the highly sensitive colorimeter resulted in a significant increase in sensitivity and a corresponding saving in reagents. Of the 7843 sera tested, 258 gave a positive result in one or more of the screening tests. The automated test detected many more Reiter positive sera (127) than the manual test (83). Conversely, fewer CWR positive sera were detected by the automated test (60) than by the manual test (82). There was little difference between the number of positive sera detected by the ART (73) and the VDRL slide test (71). In 19 instances the automated tests detected positive sera which registered as completely negative in the manual tests, and four seropositive cases which the automated tests had failed to detect were detected by the manual tests, and four seropositive cases which the automated tests had failed to detect were detected by the manual tests. It was concluded that a combination of the ART and automated Reiter protein complement fixation test (ARPCFT) would be ideal for use in a large-scale screening programme for the detection of syphilis.

Autoanalysis

Laboratory automation systems. An introduction to concepts and terminology.

The concept of laboratory automation has existed for years; such automation has been used primarily in nonclinical and industrial settings. The next step is to implement automation systems in the clinical laboratory. A laboratory automation system consists of robots, conveyor systems, machine vision, and computer hardware and software. Specimen movement and result reporting are based on the identification of specimens using bar coded specimens and bar coded specimen carriers. The implementation of a laboratory automation system is dependent on the presence of a laboratory information system. An interface between the laboratory information system and the laboratory automation system provides the information required to move the specimen through the laboratory. The reporting of results is dependent on the laboratory information system or manual input, depending on the type of work cell in which the results are produced. The greatest hurdle to overcome in developing and implementing a laboratory automation system is the integration of systems, including commercial laboratory instrumentation and user-defined work cells. The barriers to implementation primarily are proprietary in nature: instrument software and instrument hardware. When the instrument manufacturers realize the necessity for development of electronic and physical integration, the proliferation of laboratory automation systems will occur. Several opportunities exist for the reduction in laboratory expenses and the development of new positions, such as "robotechnologist," a staff member who would function in a manner similar to the current laboratory information systems manager. This article describes the author's concepts of laboratory automation.

Automation