Computer-based Tools Research Articles

Strengths and weaknesses of computerized clinical decision support systems: insights from a digital control center (C3 COVID-19) for early and personalized treatment for COVID-19.

Clinical Decision Support Systems (CDSS) are computer-based tools that leverage the analysis of large volumes of health data to assist healthcare professionals in making clinical decisions, whether preventive, diagnostic, or therapeutic. This review examines the impact of CDSS on clinical practice, highlighting both their potential benefits and their limitations and challenges. We detail the experience of clinical medical professionals in the development of a virtual control center for COVID-19 patients (C3 COVID-19) in Spain during the SARS-CoV-2 pandemic. This tool enabled real-time monitoring of clinical data for hospitalized COVID-19 patients, optimizing personalized and informed medical decision-making. CDSS can offer significant advantages, such as improving the quality of inpatient care, promoting evidence-based clinical and therapeutic decision-making, facilitating treatment personalization, and enhancing healthcare system efficiency and productivity. However, the implementation of CDSS presents challenges, including the need for physicians to become familiar with the systems and software, and the necessity for ongoing updates and technical support of the systems.

The Camden and Islington Viral Hepatitis Identification Tool (CIVHIT): Use of a Clinical Database Case-Finding Tool for Hepatitis B, Hepatitis C and HIV in Primary Care.

Despite the availability of effective treatment and vaccines for hepatitis B virus (HBV) and C virus (HCV), many people are still infected and remain unaware of their infection. The Camden and Islington Viral Hepatitis Identification Tool (CIVHIT), a computer-based search tool, was introduced in 60 general practices (GPs) in April 2014 to support identification, testing and treatment of individuals at high risk for blood-borne viruses (BBVs). CIVHIT searched electronic medical records (EMRs), flagging all those with codes linked to risk factors or medical conditions associated with BBVs. CIVHIT was associated with a 78.5% increase in BBV tests in primary care in both boroughs. This translated to a 55.8% rise in new diagnoses. HBV testing saw the largest increase resulting in twice as many people diagnosed. Only 23.2% of HBV and 14.9% of HCV-positive tests were referred to secondary care. In an index practice, the most common flag was a history of STIs (477/719, 66.3%). Individuals with previous or current drug use and those with a known hepatitis contact were more likely to be offered a test compared to those flagged due to a history of STI. HIV and HBV testing was lower in males following a test offer. There was an increased likelihood of testing for HBV and HCV with increasing age. Additionally, individuals with previous or current drug use and individuals with a known hepatitis contact were more likely to test for HCV compared to individuals flagged due to STI history. CIVHIT shows promise to assist with the elimination of BBVs.

Development of an Expert-Based Scoring System for Early Identification of Patients with Inborn Errors of Immunity in Primary Care Settings - the PIDCAP Project.

Early diagnosis of inborn errors of immunity (IEIs) has been shown to reduce mortality, morbidity, and healthcare costs. The need for early diagnosis has led to the development of computational tools that trigger earlier clinical suspicion by physicians. Primary care professionals serve as the first line for improving early diagnosis. To this end, a computer-based tool (based on extended Jeffrey Modell Foundation (JMF) Warning Signs) was developed to assist physicians with diagnosis decisions for IEIs in the primary care setting. Two expert-guided scoring systems (one pediatric, one adult) were developed. IEI warning signs were identified and a panel of 36 experts reached a consensus on which signs to include and how they should be weighted. The resulting scoring system was tested against a retrospective registry of patients with confirmed IEI using primary care EHRs. A pilot study to assess the feasibility of implementation in primary care was conducted. The scoring system includes 27 warning signs for pediatric patients and 24 for adults, adding additional clinically relevant criteria established by expert consensus to the JMF Warning Signs. Cytopenias, ≥ 2 systemic infections, recurrent fever and bronchiectasis were the leading warning signs in children, as bronchiectasis, autoimmune diseases, cytopenias, and > 3 pneumonias were in adults. The PIDCAP (Primary Immune Deficiency "Centre d'Atenció Primària" that stands for Primary Care Center in Catalan) tool was implemented in the primary care workstation in a pilot area. The expert-based approach has the potential to lessen under-reporting and minimize diagnostic delays of IEIs. It can be seamlessly integrated into clinical primary care workstations.

What causes Emergency Medical Services (EMS) delay? Unravel high-risk buildings using citywide ambulance trajectory data

Emergency Medical Services (EMS) delay poses a challenge to public health, especially in ultra-dense cities and aging societies. The potential relationship between the built environment and the ambulance response time (ART) has not been thoroughly investigated at the building-level. This impedes the unraveling of high-risk buildings for EMS delay, and thus the precise optimization of urban EMS systems. Our study develops a quantitative-qualitative approach to construct a building-level ART prediction model and then validated it with ambulance drivers' experiences. A comprehensive theoretical framework is tailored for ART prediction incorporating neglected built environment factors of land use and development intensity. Based on 73,129 ambulance trajectories, a machine learning model is constructed and then employed to predict the ART for each of the 253,475 buildings in central Shanghai under multiple combinations of traffic periods and weather conditions. The results show that the accuracy of high-risk buildings for EMS delay achieves 91%. Moreover, three of the neglected built environment factors, medical POIs density, business POIs density and floor area ratio, rank high in the factor importance. The ambulance drivers’ experiences validate the importance of these built environment factors and emphasize the value of bus priority lanes for ambulance to borrow for swift access. In addition, to illustrate potential applications, we simulated the effects of built environment interventions in case areas predicted to concentrate high-risk buildings. This work provides a new computer-based tool to pinpoint the service blind spots of such urban emergency systems and to develop built environment interventions.

USING DIGITAL SOFTWARE TOOLS FOR ASSESSING STUDENT KNOWLEDGE (The Example of MyTextX Software)

This article analyzes the advantages and possibilities of using computer-based test software tools to assess students' knowledge in the education system. The MyTextX software is recommended for creating non-standard, interactive electronic tests. Additionally, the installation of the MyTextX software and the stages of preparing tests of various types are described in detail.

Novel color vision assessment tool: AIM Color Detection and Discrimination.

Color vision assessment is essential in clinical practice, yet different tests exhibit distinct strengths and limitations. Here we apply a psychophysical paradigm, Angular Indication Measurement (AIM) for color detection and discrimination. AIM is designed to address some of the shortcomings of existing tests, such as prolonged testing time, limited accuracy and sensitivity, and the necessity for clinician oversight. AIM presents adaptively generated charts, each a N×M (here 4×4) grid of stimuli, and participants are instructed to indicate either the orientation of the gap in a cone-isolating Landolt C optotype or the orientation of the edge between two colors in an equiluminant color space. The contrasts or color differences of the stimuli are adaptively selected for each chart based on performance of prior AIM charts. In a group of 23 color-normal and 15 people with color vision deficiency (CVD), we validate AIM color against Hardy-Rand-Rittler (HRR), Farnsworth-Munsell 100 hue test (FM100), and anomaloscope color matching diagnosis and use machine learning techniques to classify the type and severity of CVD. The results show that AIM has classification accuracies comparable to that of the anomaloscope, and while HRR and FM100 are less accurate than AIM and an anomaloscope, HRR is very rapid. We conclude that AIM is a computer-based, self-administered, response-adaptive and rapid tool with high test-retest repeatability that has the potential to be suitable for both clinical and research applications.

Assessing benefits of computer-based video training and tools on learning outcomes and motivation in mechanical engineering education: digitalized intervention and approach

Traditionally, laboratory work has been a common approach to facilitate the acquisition of practical skills and familiarize the undergraduate students, particularly engineering students, with specialized tools and equipment. However, the conventional in-person labs often experience challenges such as limited resources and space, instructor availability, and inflexible schedules. The emergence of digital tools and the recent COVID-19 pandemic have prompted educators to reconsider their teaching methods. To this effect, this paper introduces an innovative approach and teaching methodology to address the challenges in traditional engineering education within the laboratory. It presents a methodology that combines cost-effective instructional videos and portable kits to promote autonomous development of practical skills in undergraduate engineering students. The proposed teaching methodology was grounded on the Descriptive Decision theory and Learning-Oriented Assessment (LOA), which are theoretical framework and type of students’ learning outcome (SLO) model that studies the rationality behind the decisions that the users are disposed to make, as well as level of outcome of the students’ learning process or performance. Motivation among the students was assessed using the Model of Academic Motivation Inventory (MUSIC Inventory) to evaluate the impact of the proposed teaching method and learning intervention on the interest of the students. The method was implemented in four independent courses at two different campuses of Tecnologico de Monterrey. The results show that the proposed learning approach was effective in helping students develop hard skills with reduced instructor intervention. Moreover, high levels of motivation was reported through the MUSIC methodology and test administered to the participating students at the end of the courses. The outcome of this study can be used to inform and support the curriculum design by the educators, promote effective policy and decision making by the university leaders, and encourage wide adoption of the digitalized-education.

MolPlay: Democratizing Interactive Molecular Simulations and Analyses with a Portable, Turnkey Platform.

Computer-based tools for visualizing and manipulating molecular structures in real-time hold immense potential for accelerating research and improving education, but are only used to a limited extent. This paper explores the possibilities of these powerful techniques and presents a classification of common interactive modeling tasks, such as assembly, deformation, sampling of rare events, along with relevant use cases, especially for the study of membranes and membrane proteins. I introduce MolPlay─a platform that provides a ready-to-use software environment with a curated set of hands-on examples to democratize access to interactive molecular simulations and analyses (IMSA). These research tools allow researchers to visualize, manipulate, and study digital models of molecules in real-time and can be started directly from a small, portable storage device. The portable, self-contained nature of MolPlay enables versatile deployment scenarios ranging from outreach to teaching in computer laboratories to facilitating the distribution of research software. Initial tests at an international workshop have shown that MolPlay appeals to different target groups and lowers the access barriers to IMSA. By consolidating more than a decade of expertise into one accessible platform, MolPlay represents a significant step toward broader adoption of these underutilized but powerful computational techniques in education and research.

Development of a computer-based tool to obtain a family health history in Vietnam.

Background: Family health history (FHH) is central to human genomic profiling construction; however, there is no protocol for documenting FHH in a pedigree format in Vietnam.Aim: A "Gia Su Suc Khoe" (GSSK) tool was developed to create a user-friendly interface for collecting FHH and offering diseases' risk assessment.Results: A tool was described (https://giasusuckhoe.vn/) with good feedback from genetic counselors and family-medicine doctors. Among 20 surveys, 100% of respondents noted that the report accurately reflected their FHH and were satisfied with the tool's display. About 74% of familial conditions were covered. Overall, all constructive feedback has been adapted into the updated version.Conclusion: Gia Su Suc Khoe has the potential to significantly improve healthcare delivery and outcomes in Vietnam.

Visual tests, touch responses: Computer-based neuropsychological tools

Objective: Investigate three new computer tests of visual abilities relative to traditional paper-and-pencil (P&P) tests on groups with and without cerebral neurological impairment (CNI, Non-CNI) based on MRI and EEG criteria. The new tests employ an intuitive interface with audio instructions, touch responses, non-response prompts, and videography of test behavior. The Presidents Test was designed as an achievement-related measure of visual knowledge; the Railroad Test – visual perception and delayed recognition; and the Swamp Test – visual attention. Attitudes toward testing were assessed with an original Testing Experience Questionnaire (TEQ). Method: Of the 129 participants, 84 were women, 73 identified as non-White, average age 45.5 and education 14.3 years. Procedures included the new computer tests and a selection of standard neuropsychological measures including performance validity tests (PVT). Participants who failed two or three PVTs or had missing PVT data were excluded from main analyses, resulting in N = 115. Results: The new computer tests demonstrated adequate reliability. Correlations and factor analyses confirmed the computer tests as functioning in accordance with design. The Presidents Test was associated with academic achievement. The Railroad and Swamp Tests were linked to visual perception and visual attention. Correlations between computer total test duration time and traditional speed of processing tasks were modest. Computer and traditional tests demonstrated similar discriminability between CNI and Non-CNI groups. TEQ indicated positive attitudes toward testing in general, and computer testing in particular. Conclusions: The new computer tests evaluated in this study were found to be reliable, functioned to assess the designed cognitive domains, and discriminated between CNI and Non-CNI participants similarly to the traditional neuropsychological measures. Attitudes toward computer testing were favorable.

Canonical Correlations on Positive and Negative Attitudes of Computer-Based Statistics among Business Students

This study aims to investigate the canonical relationship between positive and negative attitudes of economics and business students when using computer-based analytical tools. The subjects of this study were students of the Faculty of Economics and Business in Medan. Samples were taken from two universities, including state universities and private universities. Using a random sampling technique, this study collected 247 responses, consisting of 47 male and 200 female respondents. The data in this study were collected using a questionnaire with a 5-Likert scale and analyzed by canonical correlation. The results of the canonical correlation analysis in this study revealed that Perceived Usefulness (PU) and Perceive Enjoyment (PE) were critical predictors of the construct set of positive attitudes. At the same time, Strain (ST) and Negative Affectivity (NA) were essential predictors of the formation of negative attitudes among users when using computer-based statistical tools. This study produces a new insight related to attitude toward Information Technology (IT) in a specific task, namely statistical analysis. This study also has practical recommendations for universities and lecturers to invest in and use statistical software that is easy and convenient for teaching statistics.

Automatic tablet-based monoplane quantification of stroke volume and left ventricular ejection fraction: A comparative assessment against computer-based biplane and monoplane tools.

Point-of-care cardiovascular left ventricle ejection fraction (LVEF) quantification is established, but automatic tablet-based stroke volume (SV) quantification with handheld ultrasound (HAND) devices is unexplored. We evaluated a tablet-based monoplane LVEF and LV volume quantification tool (AutoEF) against a computer-based tool (Tomtec) for LVEF and SV quantification. Patients underwent HAND scans, and LVEF and SV were quantified using AutoEF and computer-based software that utilized either apical four-chamber views (Auto Strain-monoplane [AS-mono]) or both apical four-chamber and apical two-chamber views (Auto Strain-biplane [AS-bi]). Correlation and Bland-Altman analysis were used to compare AutoEF with AS-mono and AS-bi. Out of 43 participants, eight were excluded. AutoEF showed a correlation of.83 [.69:.91] with AS-mono for LVEF and.68 [.44:.82] for SV. The correlation with AS-bi was.79 [.62:.89] for LVEF and.66 [.42:.81] for SV. The bias between AutoEF and AS-mono was 4.88% [3.15:6.61] for LVEF and 17.46mL [12.99:21.92] for SV. The limits of agreement (LOA) were [-5.50:15.26]% for LVEF and [-8.02:42.94] mL for SV. The bias between AutoEF and AS-bi was 6.63% [5.31:7.94] for LVEF and 20.62mL [16.18:25.05] for SV, with LOA of [-1.20:14.47]% for LVEF and [-4.71:45.94] mL for SV. LVEF quantification with AutoEF software was accurate and reliable, but SV quantification showed limitations, indicating non-interchangeability with neither AS-mono nor AS-bi. Further refinement of AutoEF is needed for reliable SV quantification at the point of care.

EFFECTS OF INSTRUCTIONAL MEDIA ON LEARNERS COMPETENCES IN MATHEMATICS IN PUBLIC SECONDARY SCHOOLS IN RWANDA A CASE OF RULINDO DISTRICT

This study explored the impact of instructional media on mathematics competencies in public secondary schools in Rulindo, Rwanda. Employing a descriptive and correlational design with a mixed approach, the study aimed to identify influential instructional media, assess mathematics competence levels, and determine their relationship. The target population included 616 teachers and 100 head teachers, totaling 716 individuals, with a sample size of 257 determined using the Yamane formula through purposive and random sampling. Data were collected via questionnaires, documentation research, and a pilot study, then analyzed using SPSS version 21.Key findings indicated strong agreement (85.5%-98.6%) on the effectiveness of computer-based tools, graphing calculators, mathematics textbooks, and dynamic geometry environments in teaching mathematics. Significant associations were found (p < 0.05) between competencies in numeracy, use of instructional media, and students comprehension of mathematical subjects. Recommendations included government scholarships to enhance teachers mathematics skills, optimized use of teaching resources, training by MINEDUC, and increased educational support for students. The study highlighted the need for further research to explore instructional materials broader impacts on secondary school students mathematics performance.

EGO to ECO: Tracing the History of Radioecology from the 1950's to the Present Day.

This paper starts with a brief history of the birth of the field of radioecology during the Cold War with a focus on US activity. We review the establishment of the international system for radiation protection and the science underlying the guidelines. We then discuss the famous ICRP 60 statement that if "Man" is protected, so is everything else and show how this led to a focus in radioecology on pathways to "Man" rather than concern about impacts on environments or ecosystems. We then review the contributions of Radiation Research Society members and papers published in Radiation Research which contributed to the knowledge base about effects on non-human species. These fed into international databases and computer-based tools such as ERICA and ResRad Biota to guide regulators. We then examine the origins of the concern that ICRP 60 is not sufficient to protect ecosystems and discuss the establishment of ICRP Committee 5 and its recommendations to establish reference animals and plants. The review finishes with current concerns that reference animals and plants (RAPs) are not sufficient to protect ecosystems, given the complexity of interacting factors such as the climate emergency and discusses the efforts of ICRP, the International Union of Radioecologists and other bodies to capture the concepts of ecosystem services and ecosystem complexity modelling in radioecology.

The Effects of Online Applications in English Vocabulary Learning: Quizlet Application

Purpose: The main purpose of this study is to analyze the impact of the Quizlet application, a computer-aided vocabulary learning tool widely recognized as an online flashcard application, on the development and retention of English vocabulary among students learning English as a foreign language. Design/Methodology/Approach: The data were obtained from 34 fifth-grade students studying English as a foreign language during 2019-2020 academic year at Yediiklim Secondary School in Karesi district of Balıkesir province. The research was conducted using a quantitative research method within quasi-experimental design without pre-test post-test control group. Quantitative data was collected through pre and post vocabulary achievement tests, retention test and scale. While word tests aim to measure students’ vocabulary acquisition, the retention test aims to measure students’ retention of vocabulary. The Quizlet Attitude Scale was also used to obtain opinions about Quizlet. Quantitative data were analyzed statistically in SPSS Statistics. Findings: As a result of the analysis, the findings show that there is a significant difference between Quizlet and test scores. According to the results of the survey, it is concluded that the students developed positive perceptions about the use of the Quizlet program. Highlights: In the light of these findings, it is recommended to use computer-based vocabulary learning tools as a student-centered and effective teaching technique in foreign language teaching and to expand their use.

Optimizing Building Form for Daylight Access in Dense Urban Areas in the Early Stages of Design

The urgency to address climate change, the energy crisis, and indoor air quality underscores the importance of utilizing daylight as a renewable energy source in urban environments. This study delves into passive design strategies to facilitate access to sunlight and daylight within urban contexts and architectural designs, aggregating essential parameters identified in the existing literature to improve building forms for daylight accessibility. The study then develops a multi-scale, multi-objective framework integrating these passive strategies to optimize building performance in densely populated areas. Suitable approaches for incorporating daylighting at both building and urban scales are identified by examining existing passive form-finding strategies and rules of thumb. Given the implications for dense urban areas, floor area is used as an evaluation criterion, with energy use intensity (EUI) and carbon footprint serving as additional criteria in the optimization process through manual analyses and computer-based tools. By adopting a workflow that considers multiple objectives and parameters, this study aims to guide designers in integrating optimal daylighting strategies during the initial design phases.

Combining Nontargeted Analysis with Computer-Based Hazard Comparison Approaches to Support Prioritization of Unregulated Organic Contaminants in Biosolids.

Biosolids are a byproduct of wastewater treatment that can be beneficially applied to agricultural land as a fertilizer. While U.S. regulations limit metals and pathogens in biosolids intended for land applications, no organic contaminants are currently regulated. Novel techniques can aid in detection, evaluation, and prioritization of biosolid-associated organic contaminants (BOCs). For example, nontargeted analysis (NTA) can detect a broad range of chemicals, producing data sets representing thousands of measured analytes that can be combined with computational toxicological tools to support human and ecological hazard assessment and prioritization. We combined NTA with a computer-based tool from the U.S. EPA, the Cheminformatics Hazard Comparison Module (HCM), to identify and prioritize BOCs present in U.S. and Canadian biosolids (n = 16). Four-hundred fifty-one features were detected in at least 80% of samples, with identities of 92 compounds confirmed or assigned probable structures. These compounds were primarily categorized as endogenous compounds, pharmaceuticals, industrial chemicals, and fragrances. Examples of top prioritized compounds were p-cresol and chlorophene, based on human health end points, and fludioxonil and triclocarban, based on ecological health end points. Combining NTA results with hazard comparison data allowed us to prioritize compounds to be included in future studies of the environmental fate and transport of BOCs.

Fostering systems thinking about socioscientific issues

ABSTRACT Systems thinking is essential for understanding wicked real-world problems and suggesting solutions. This is the case for addressing socioscientific issues (SSI) that involve inter-related personal, socio-political, cultural, scientific, economic and moral dimensions. It is challenging for teachers to support students in adopting and practising systems thinking when they explore SSI. In this study, we tested the extent to which causal loop diagramming (CLD) developed students’ systems thinking. We examined a 2-week teaching unit that used a computer-based CLD tool to foster students’ systems thinking about obesity in a first-year university general education course. Ninety-six students from a variety of majors/disciplines participated in this study. They worked in groups and engaged in reading news, proposing actions while creating causal loop diagrams about factors that contributed to obesity and approaches to tackle the issue. We analysed their pre-, mid-, and post-unit causal loop diagrams (3 × 26 groups) and weekly reflective memos. The data revealed their significant shift towards a systems approach of thinking. The reflective memos showed that the shift was afforded by cycles of construct–revise–use as they created the diagrams. The findings suggest the potential of causal loop diagramming to foster systems thinking in the sense-making and decision-making of SSI.

Automatic analysis of nuclear features reveals a non-tumoral predictor of tumor grade in bladder cancer

Background & objectivesTumor grade determines prognosis in urothelial carcinoma. The classification of low and high grade is based on nuclear morphological features that include nuclear size, hyperchromasia and pleomorphism. These features are subjectively assessed by the pathologists and are not numerically measured, which leads to high rates of interobserver variability. The purpose of this study is to assess the value of a computer-based image analysis tool for identifying predictors of tumor grade in bladder cancer.MethodsFour hundred images of urothelial tumors were graded by five pathologists and two expert genitourinary pathologists using a scale of 1 (lowest grade) to 5 (highest grade). A computer algorithm was used to automatically segment the nuclei and to provide morphometric parameters for each nucleus, which were used to establish the grading algorithm. Grading algorithm was compared to pathologists’ agreement.ResultsComparison of the grading scores of the five pathologists with the expert genitourinary pathologists score showed agreement rates between 88.5% and 97.5%.The agreement rate between the two expert genitourinary pathologists was 99.5%. The quantified algorithm based conventional parameters that determine the grade (nuclear size, pleomorphism and hyperchromasia) showed > 85% agreement with the expert genitourinary pathologists. Surprisingly, the parameter that was most associated with tumor grade was the 10th percentile of the nuclear area, and high grade was associated with lower 10th percentile nuclei, caused by the presence of more inflammatory cells in the high-grade tumors.ConclusionQuantitative nuclear features could be applied to determine urothelial carcinoma grade and explore new biologically explainable parameters with better correlation to grade than those currently used.

A computerized tool for the systematic visual quality assessment of infant multiple-breath washout measurements.

Multiple-breath washout (MBW) is a sensitive method for assessing lung volumes and ventilation inhomogeneity in infants, but remains prone to artefacts (e.g., sighs). There is a lack of tools for systematic retrospective analysis of existing datasets, and unlike N2-MBW in older children, there are few specific quality control (QC) criteria for artefacts in infant SF6-MBW. We aimed to develop a computer-based tool for systematic evaluation of visual QC criteria of SF6-MBW measurements and to investigate interrater agreement and effects on MBW outcomes among three independent examiners. We developed a software package for visualization of raw Spiroware (Eco Medics AG, Switzerland) and signal processed WBreath (ndd Medizintechnik AG, Switzerland) SF6-MBW signal traces. Interrater agreement among three independent examiners (two experienced, one novice) who systematically reviewed 400 MBW trials for visual artefacts and the decision to accept/reject the washin and washout were assessed. Our tool visualizes MBW signals and provides the user with (i) display options (e.g., zoom), (ii) options for a systematic QC assessment [e.g., decision to accept or reject, identification of artefacts (leak, sigh, irregular breathing pattern, breath hold), and comments], and (iii) additional information (e.g., automatic identification of sighs). Reviewer agreement was good using pre-defined QC criteria (κ 0.637-0.725). Differences in the decision to accept/reject had no substantial effect on MBW outcomes. Our visual quality control tool supports a systematic retrospective analysis of existing data sets. Based on predefined QC criteria, even inexperienced users can achieve comparable MBW results.