Computers and psychiatry. Promises to keep.

The potential of computer-based psychiatric information systems is still largely undeveloped. Conceptual, technical, cost, and procedural problems have limited the impact of computers, but there are programs that have been successful or that show promise. While changes in the philosophy of psychiatric computer applications are on-going, a cost-effective, widely available clinical computer system has been developed.

A computer-based data analysis system for enzyme-linked immunosorbent assays.

A computerized system is presented for automating the data collection, processing, and displaying tasks involved in enzyme-linked immunosorbent assays. This system uses a through-the-well absorbance reader of microtiter plates interfaced to a minicomputer running the UNIX operating system. Optical density in each well of a 96-well microtiter plate is recorded as a function of time for up to 10 time points. These data are automatically transmitted to the remote computer. The rate of product formation is then calculated for each well, and a battery of analysis, display, and comparison programs can then be used by the researcher for data presentation. Using the initial rate of reaction as the basis for quantifying enzyme-linked immunosorbent assays focuses on the catalytic property of the enzyme and allows a large dynamic range of the assay on any plate. These programs can be adapted to virtually any mini- or microcomputer with a graphics display or a plotting device. Assuming moderately powerful computing hardware, throughputs of 50 plates per day are easily achieved. The programs work equally well with peroxidase, beta-galactosidase, or alkaline phosphatase conjugated second antibodies, and with whole cell or soluble antigens.

A program system for interactive measurements on digitized cell images.

Using a high precision image scanner and a PDP-8/F minicomputer, we have developed a program system for interactive measurements on microscopic images. By giving simple keyboard commands, the operator can run the image scanner and manipulate the digitized images. The interface between the operator and the microscope-computer system is a Tektronix 4010 graphic terminal. The system allows objects to be isolated and parameters to be calculated from each object, e.g., parameters characterizing shape of the object, irregularity in light transmission over the object, area, integrated light transmission, etc. Objects are isolated and parameters are calculated under complete operator control using interactive computer graphics technique. Calculated parameters may be stored in dedicated data records, which are stored in files for later statistical analysis. The system also includes a statistical evaluation part. Technically, the system consists of a command scanner, which translates commands into internal representation, a parser, which checks the syntax of the commands, and an interpreter, which executes the commands. The system is designed so that new commands can be added easily.

Quality-control statistical interpretation by microcomputer.

A comprehensive summary report of quality-control data is of great value in monitoring the accuracy and precision of the clinical chemistry laboratory. This report allows a retrospective appraisal alerting laboratory personnel to possible test control material degradation or instrument malfunction. A microcomputer-based program package is described, designed to reduce the errors and lengthy preparation inherent in the manual generation of such a report. Quality-control summary data is automatically compared with a predefined set of statistical criteria, and any aberrant values are flagged, thus eliminating subjective and nonuniform data interpretation. Statistical comparisons include: number of control points, delta mean, delta standard deviation, standard deviation index, and F-ratio. The summary report is well accepted by the laboratory staff, and its incorporation into the decision-making process allows for an efficient, critical, and uniformly rigorous examination of analytic proficiency.

Computer card morphometry of jejunal biopsies in childhood coeliac disease.

The histological changes in 95 jejunal biopsy specimens from children have been analyzed by a new mporphometric technique. The microscope image of the specimen is traced directly onto computer data cards. A simple sketch records accurate quantitative data in a matrix of 840 points, retaining the spatial arrangement of the tissue components. The data are fed via an optical mark data card reader, into a mini-computer. FORTRAN IV programs allow calculation of surface area, villous heights, and component volumes in metric units, and of volume proportions, volume-to-volume ratios, and surface-to-volume ratios. Pictorial and numerical printouts are produced, which are suitable for inclusion in the patient's notes. Jejunal biopsies from 37 controls and 26 untreated coeliac patients were clearly distinguished morphometrically. Sixteen pairs of biopsies from coeliac patients on long-term gluten-free diets before, and 12 weeks after, the reintroduction of dietary gluten significantly reflected the effects of gluten challenge. Comparison of control and abnormal biopsies showed a spatial redistribution of the components, more than a change in their absolute amounts. There was no significant differences in the total epithelial volumes in controls, treated or untreated patients, suggesting that the mucosal lesion in coeliac disease is not a true atrophy.

Treatment planning with a graphics tablet.

A graphics-tablet treatment planning system is described. The cost effectiveness of this approach is especially attractive where time-sharing use of a central computer facility is available.

Digital image management: networking, display, and archiving.

The requirements for implementing a radiology imaging network are similar to those for local area networks now being designed for other purposes to manage large data films. A radiology department serving a 500-bed hospital generates about 927 megabytes of digitally formatted data per working day. These data are expected to be on line for the patient's hospitalization period. The retrieval rate of these data among the interactive diagnosis display stations requires data throughput rates of between 2 and 5 megabits per second. This throughput rate requires signaling rates of between 20 and 50 megabits per second. Analog hard-copy generation of the images on the network is required by the referring physician for selected images that support the consultation report. Digital laser recorders using paper may be quite satisfactory. Long-term archiving must be low in cost and requires a database scheme capable of managing more than a terabyte of image data. Radiology networks must be required to bridge with other hospital information systems.

Control of the rat's sniffing behavior by response-independent and dependent schedules of reinforcing brain stimulation.

The rat's sniffing response occurs in continuous bursts, at approximately 5-11 Hz. In the present experiments, the analog signal from a thermo-couple probe in the nasal cavity was digitized to provide a discrete logic pulse, defining a sniff, and permitting on-line presentations of reinforcing brain stimulation contingent on momentary sniffing patterns. Schedules of reinforcer presentation included response-independent fixed interval (temporal conditioning), continuous reinforcement (CRF), and differential reinforcement of low rates (DRL 10 sec). Under temporal conditioning, bursts of sniffing were observed immediately after stimulation, and an acceleration in sniffing developed preceding stimulation. Under CFR, operant rate-intensity functions were found to be similar to traditional bar-press data. Under DRL, sniffs were effectively paced by the criterion interval, and interresponse time analyses revealed evidence of temporal discrimination. The behavioral patterns were interpreted in terms of the interplay of operant and respondent functions.

[The determination of the left ventrical volume curve without background correction and its validation by direct intercomparison with the ejection fractions as determined by biplane laevocardiography (author's transl)]. / Nuklearmedizinische Bestimmung linksventrikulärer Volumenkurven ohne Untergrundkorrektur und ihre Validisierung durch direkten Vergleich mit biplan laevokardiographisch ermittelten Auswurffraktionen.

Background corrections applied on the left ventricular volume curve determined by the "gated blood pool"--method are based on an estimated rather than on a directly measured background. This imposes an uncertainty on the values determined from the volume curve, especially on the ejection fraction. A method which does not require background correction may be applied if all available measurement and evaluation facilities are utilized fully. High temporal and spatial resolution is of fundamental importance, permitting the exact determination of the time-dependent scintigraphic contour variations of the left ventricle during the mechanical action of the heart. A good criterion of the validity of the volume curves with respect to interfering background radiation is the ejection fraction calculated from these curves. The direct intercomparison of 10 ejection fractions obtained by an expanded "gated blood pool"-method, employing cardiac catheterization, immediately before a biplane laevocardiography demonstrated very good agreement. A small systematic underestimation of the ejection fraction by the nuclear method was observed. This understimulation shows that the influence of the true background is small if other interfering count rate contributions or methodical uncertainties are excluded systematically.

Evaluation of a computerised image analyser for studying alterations in radiographic bone density in the rat.

A computerised image analyser has been used experimentally to determine its possible usefulness in quantifying bone density. Rats were prepared for this purpose and ash weight/volume readings were obtained on femora which had been radiographed and studied to estimate radiographic density by means of the image analyser. The findings indicated that rats can be prepared by administering oestradiol or by allowing an additional week's growth, both of which give a statistically significant increase of bone density. The computerised image analyser was able to detect these differences but the correlations, although real and linear, between ash weight/volume and radiographic density were not large. Further refinements in techniques will be needed before the system is applied clinically.

Computer utilization for intravenous nutrition in surgical neonates preliminary report.

A program was developed to store important numerical clinical data such as daily weights, intravenous caloric intake, and laboratory test results on surgical neonates who required total intravenous nutrition. Preliminary experience with the data from the first 5 surgical neonates requiring intravenous nutrition indicated that this data processing is easily achieved. Data retrieval by the development of output programs provided rapid access to stored records, rapid data tabulation, and graphic print-out of parameters, such as intravenous calories per kilogram per day and weight gain, that can be placed in the patient's record.

Design and feasibility of a flexible computerized system for the clinical laboratory, based on the IEEE 488 standardized interface.

Our target is to build a flexible computerized system based on an informational study of the clinical laboratory, which would leave the laboratory staff free to use equipment or modules from different manufacturers interchangeably. This applies to hardware and software. To fulfil this objective, it is necessary that automatic analyzers, microcomputers and minicomputers, have built-in standardized hardware and software interfaces. Technical specifications of the IEEE 488 standardized interface, recommended by the authors, are presented here; this interface is already widely used in instrument interfacing with low-cost microcomputers are minicomputers but has not yet been used for clinical laboratory automatic analyzers. A design for a flexible laboratory based on this interface is presented, with a discussion of the feasibility of such a project.

Computer generation of surface distribution maps of measures of brain activity.

A laboratory computer system in described which will rapidly generate gray-scale maps showing the distribution of measures derived from the electrical activity of the brain, such as the electroencephalogram (EEG) or other biological measures. The system allows flexible description of electrode number and placement, mapping onto any shaped space and rapid generation of maps by integration with the data collection software.

Semi-automatic medical image processing.

During the last few years a number of systems for graphics generation and image processing have been developed by the authors. Depending on the application, one can consider many kinds of systems; for example for simple analysis of cellular images, a system that realizes the video mixing between a camera and graphics data from a microcomputer would be adequate. For a more elaborate analysis, such as angiographic and echographic images requiring a high level of interactivity, a semi-automatic acquisition system linked to a host computer would be necessary. Limits in precision and execution time of these semi-automatic systems leads to independent work-stations that realize digital acquisition, processing, and display of images.

Design philosophy of air quality surveillance systems.

This paper discusses the design philosophy of the air quality surveillance systems which Kennecott is installing in the vicinity of its copper smelters in Arizona, Nevada, New Mexico, and Utah. These monitoring systems are part of supplementary control systems (SCS) that are utilized to ensure that short-term ambient air quality standards are met. These systems utilize minicomputers as remote terminals. The interface between a terminal and the primary sensors is via specially designed input/output circuitry. The system is controlled by a centralized host minicomputer, which is connected to each of the remote stations via a telephone line communication network. Real time data is displayed on cathode ray tubes located at strategic locations in the plants. This paper will discuss the system design philosophy from both a hardware and software point of view. The actual experience in design, development, and installation of the system will also be discussed.

[Methods of input into a digital computer of low-frequency physiological data]. / Metodika vvoda v ETsVM nizkochastotnoi fiziologicheskoi informatsii

A procedure employed for input of low-frequency physiological information coming via several channels in a digital computer, model M-220A has been worked out. The operations are effected through the application of standard equipment with the use of routine communication channels to the computer. Particular attention is attached to the storage of the input information in the permanent memory of the machine for further synchronous analysis of physiological indices. The procedure may find use in analyzing materials covering a wide range of medico-biological experiments.

[Automated unit complex for analyzing biomedical signals in a mass population screening system]. / Avtomatizirovannyi kompleks dlia analiza biomeditsinskikh signalov v sisteme massovykh obsledovanii naseleniia.

Some features of automating processes of biomedical signal analysis are considered. An actual complex of algorithms and programs realized on the homemade hardware is taken as an example. Practical recommendations to improve similar complexes being in current use in outpatient clinics are given.

[Control computers in nuclear medicine]. / Upravliaiushchie EVM v iadernoi meditsine.

Problems concerned with the use of desk computers in the nuclear medicine are considered, viz. the structure of technical components in the radiodiagnostic systems and mathematical logistics, an analysis into comparative characteristics of some systems, as well as the experience gained by the authors in elaborating specialized mathematical logistics. This experience and a pertinent analysis prompted the authors to conclude that the use of a computer at each stage of a radioisotope investigation is a matter of necessity and of top importance, without, however, being of cardinal aid in establishing a diagnosis. An effective instrument that will be capable of rendering good service to medicine at the present level of its development should be complex diagnostic systems, whose creation will be the aim of further research work.