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[The significance of computed tomography in ophthalmologic diagnosis. I: The place of computed tomography, indications, study technics, anatomic representation, computed tomography of eyeball and orbital injuries].

CT is recognized today as method of choice for examining pathological conditions of eyeball and orbit. Several techniques of CT examination are needed to attain the most accurate and detailed information about orbital and eyeball lesions. The exact knowledge of the normal anatomic CT feature of orbital structures is necessary. In traumatic lesions of the globe and the orbit foreign bodies, haematomas and fractures of the orbital walls can be proved and localized and traumatic sequelae can be diagnosed.

Eye Foreign Bodies

Developing interactive computer-based simulations: an object-oriented development methodology enhances computer-assisted instruction.

The purpose of this research was to investigate the application of object-oriented technology and AI techniques to enhance development of computer-based training simulations. Towards that end, a comprehensive computer-assisted instructional unit was developed to teach the skills and concepts of window-based applications, the OS/2 desktop, and the use of a patient care information system. By taking advantage of sophisticated computer graphics for the visual representation of objects and the behavioral modeling capabilities of the object-oriented language, domain knowledge modeling and human-computer interactions were implemented without complex natural language processing techniques. The results of this research indicate that nurses and physicians are able to learn the basic skills and concepts of computer systems and how to query for patient information. The new methodology described for building these computer-assisted instructional simulations significantly eased the training and teaching of large numbers of nurses and physicians and simplified their transition to a complex, computer-based hospital information system environment.

Computer Graphics

Trends in measures of computer experience and computer anxiety for students in three successive medical school classes.

Computer-related variables, including measures of computer anxiety and computer experience, were evaluated for three successive classes of matriculating medical students. Across the three classes, average computer anxiety measures declined and differences in the levels of computer anxiety for males and females diminished. Average measures of computer experience rose over time and were comparable for males and females, although there was a trend toward increasing divergence in the range and distribution of students' computer experience scores. Implications of these findings for addressing computer literacy in the medical curricula are discussed.

Anxiety

A non-computer expert's experience with the computer.

In summary, I have tried to illustrate how the computer is rapidly becoming indispensable to the physician. This is true for both the physician in private practice as well as the physician involved in research. Computer technology has progressed to the point that a personal computer is readily affordable. Technologic advances and new software packages permit individuals who possess no computer skills to operate almost any system without limitations. There are no age limits to learn how to use the computer. I was introduced to the computer through my clinical research in malignant melanoma as a medical student. Its utility in research is undeniable. The uses of the computer have increased dramatically during the past few years. Today the computer aids not only in research but in the day-to-day care of patients and in medical education. Access to the information explosion is literally at the tips of the physician's fingers.

Appointments and Schedules

Laboratory computer availability: a College of American Pathologists Q-probes study of computer downtime in 422 institutions.

OBJECTIVE: To determine the frequency, duration, and impact of computer downtime on laboratory operations. METHODS: Four hundred twenty-two laboratories monitored the frequency of computer system downtime and other computer malfunctions over a period of 30 days. Participants classified each instance of unavailability according to its cause, duration, and consequences. In all, data from 11 967 instances were submitted for analysis. RESULTS: During the 30-day study period, the participating institutions experienced a median of eight episodes in which all or a primary computer function was unavailable. The cumulative median duration of downtime during these 30 days was 14.3 hours. The most unfortunate 10% of participants reported having 44 or more episodes in which all or a primary computer function was lost during the 30 days, for a cumulative duration of 77.7 or more hours of system unavailability. Computer installations that served two or more full-service laboratories were significantly more likely to experience unscheduled loss of all or a primary computer function than were sites that served only one laboratory, and unscheduled events were more likely to be of longer duration. Participants reported that 1.3% of downtime events required the use of staff overtime to perform required work. Overtime was more likely with longer-than-average periods of downtime and losses that had not been scheduled. Of all the downtime instances, 0.2% led to the release of inaccurate results, and 0.1% led to an adverse clinical outcome. These events were associated with software failure, unscheduled downtime, a site's overall frequency of downtime, particular software vendors, and not having installed a software patch in the previous 1000 days. CONCLUSIONS: The frequency of laboratory computer downtime varies widely among institutions and is occasionally associated with adverse clinical outcomes or additional staff expense.

Chi-Square Distribution

Influence of direct computer experience on older adults' attitudes toward computers.

This research examined whether older adults' attitudes toward computers became more positive as a function of computer experience. The sample comprised 101 community-dwelling older adults aged 57 to 87. The intervention involved a 2-week computer training program in which subjects learned to use a desktop publishing software program. A multidimensional computer attitude measure was used to assess differential attitude change and maintenance of change following training. The results indicated that older adults' computer attitudes are modifiable and that direct computer experience is an effective means of change. Attitude change as a function of training was found for the attitude dimensions targeted by the intervention program: computer comfort and efficacy. In addition, maintenance of attitude change was established for at least two weeks following training.

Aged

Evaluation of hydrocephalic periventricular radiolucency by dynamic computed tomography and xenon-computed tomography.

OBJECTIVE: A common finding of computed tomography in a case of normal-pressure hydrocephalus (NPH) is periventricular radiolucency (PVL). We analyzed PVL for patients with hydrocephalus, using dynamic computed tomographic and xenon-computed tomographic techniques to differentiate NPH from similar diseases. METHODS: Dynamic computed tomography was evaluated as a method of diagnosing NPH in 14 patients with computed tomographic findings of both PVL and ventricular dilatation. Of the 14 patients, varying degrees of clinical improvement after shunt surgery were observed in 10 (shunt-effective group) but not in the remaining 4 (shunt-ineffective group). The difference in arrival time between PVL and thalamus, the difference in peak time between PVL and anterior cerebral artery, and cerebral blood flow in PVL by xenon-computed tomographic study were analyzed. RESULTS: The difference in arrival time between PVL and thalamus was significantly longer in the effective group than among the remaining patients. There was no significant difference in PVL/cerebral blood flow and the difference in peak time between PVL and the anterior cerebral artery between the two groups. CONCLUSION: Dynamic computed tomographic analysis of the difference in arrival time between PVL and thalamus is useful for diagnosing NPH and predicting response to shunting.

Aged

Computer-based medical system for the computation of blood pressure excess in the diagnosis of hypertension.

A computer-based system for assessing hypertension was designed by combining hardware for automatic, long-term blood pressure (BP) measurement with a set of software modules for computing time-specified tolerance intervals and evaluating measures of BP excess. BP is so variable that the identification and proper definition of hypertension are highly ambiguous when based on single measurements. One first step in dealing with such variability is to replace the constant limits for BP frequently used in the assessment of hypertension by a time-specified reference interval. Once such a threshold is available, a hyperbaric index can be computed by numerical integration as the total area (within one cycle) of any given patient's BP above the threshold. In order to examine the extent of normal physiologic excess, a series of 266 systolic and diastolic BP and heart rate (HR) measurements were automatically monitored every 30 minutes for at least 48 hours from clinically healthy subjects, aged 19 to 25 years. Original data were used to obtain 90% tolerance intervals for each gender separately. The hyperbaric index was then computed for each individual BP profile. The distribution of the maximum hyperbaric index (maximum of the values computed for systolic, mean arterial, and diastolic BP levels shows a highest value of 14.839 mmHg x hr for the men and of 10.229 mmHg x hr for the women. These values represent a testable threshold for assessing hypertension based on the proposed approach. The tolerance intervals obtained from the reference population were also used to compute hyperbaric indices for a series of 175 BP measurements sampled from clinically healthy people, as well as a series of 60 measurements sampled from patients with mild hypertension. Sensitivity and specificity in the diagnosis of hypertension based on the hyperbaric index were both 100%, as opposed to values obtained from computing the BP load, the average of the BP series, or the circadian amplitude, all of which provided a much poorer diagnostic test. The software system developed for automatically establishing time-qualified tolerance limits from a reference population and assessing the extent and timing of BP elevation for a test subject may help to establish a prognosis and diagnosis, with a correspondingly better assessment of health status, to initiate treatment if needed, to time treatment when it is most desirable and least harmful in terms of undesired effects, and to gauge the patient's response to treatment.

Adult

An evaluation method of computer usability based on human-to-computer information transmission model.

This paper proposes a new evaluation and prediction method for computer usability. This method is based on our two previously proposed information transmission measures created from a human-to-computer information transmission model. The model has three information transmission levels: the device, software, and task content levels. Two measures, called the device independent information measure (DI) and the computer independent information measure (CI), defined on the software and task content levels respectively, are given as the amount of information transmitted. Two information transmission rates are defined as DI/T and CI/T, where T is the task completion time: the device independent information transmission rate (RDI), and the computer independent information transmission rate (RCI). The method utilizes the RDI and RCI rates to evaluate relatively the usability of software and device operations on different computer systems. Experiments using three different systems, in this case a graphical information input task, confirm that the method offers an efficient way of determining computer usability.

Computer Literacy

Medical affective computing: medical informatics meets affective computing.

"The need to cope with a changing and partly unpredictable world makes it very likely that any intelligent system with multiple motives and limited powers will have emotions." [1] From advisory systems that understand emotional attitudes toward medical outcomes, to wearable computers that compensate for communication disability, to computer simulations of emotions and their disorders, the research agendas of medical informatics and affective computing--how and why to create computers that detect, convey, and even have emotions--increasingly overlap. Some psychiatric and neurological researchers state their theories in terms of actual or hypothetical computer programs. Adaptive intelligent systems will increasingly rely on emotions to compensate for their own conflicting goals and limited resources--emotional reactions about which psychiatrists and neurologists have special insights. DEP2 (Depression Emulation Program 2) is a computer simulation of adaptive depression--learning from explainable patterns of failure in autobiographical memory--that simulates many depressive behaviors. In the terminology of fault-tolerant computing, adaptive depression involves fault detection (triggered by failure), fault location (strategic retreat and failure diagnosis), and fault recovery (return to on-line operation). DEP2 relies on subsystems whose structures and behaviors are based on popular hypotheses about left and right brain hemispheric function during depression and emotion. DEP2 and its predecessors, DEP and DEPlanner, are relevant to psychiatric and neurological informatics, and to the design of adaptive autonomous robots and software agents.

Adaptation, Psychological