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Computer-based learning in radiology: a hypermedia application in CT.

Multimedia is a form of computer data presentation that uses multiple formats (text, illustration, sound, and animation) to enhance attention to and retention of presented information. Hypermedia is a nonlinear, branched access version of this that allows the user to pursue information more freely and variably than a linear format does. We used the hypermedia format to create an interactive medical teaching program that we believe holds the user's interest and attention better than a straight-text style does.

Computer-Assisted Instruction↗

An interactive, computer-based atlas of neurologic positron emission tomographic studies for use in teaching.

Recent developments in personal computer hardware and software allow the manipulation of radiologic images. We developed an interactive, computer-based atlas of clinical neurologic positron emission tomographic studies for use as an educational resource. A personal computer and multimedia software were used to assemble the clinical case studies. For each clinical case, the user had available the clinical history, positron emission tomographic and correlative anatomic images, study interpretation, discussion, and references. The clinical cases were selected for their educational value, either as a representative example of an abnormality or for their ability to illustrate a common pitfall in positron emission tomographic imaging of the brain.

Central Nervous System Diseases↗

The Internet, World-Wide Web, and Mosaic: an overview.

Technology is revolutionizing education. Global networks, powerful personal computers, and user friendly, graphically oriented software are creating a new infrastructure that promotes rapid, efficient access to information. Images, text, audio, and video can be integrated into interactive multimedia presentations, providing a hierarchy of knowledge that can be traversed by the click of a mouse. The extensive use of images in our arena makes radiologic education a major beneficiary. Because the components (text, images) of educational presentations are stored electronically on a network rather than on the printed page, an individual component can be linked and bundled into as many different presentations as desired. Furthermore, components of information can exist on different computers throughout the world and yet be linked by software into a single presentation.

Computer Communication Networks↗

Using the photo CD in academic radiology.

Photo CD technology has expanded significantly since its introduction a few years ago. Because it is not strictly considered interactive multimedia, it has been largely overlooked in the medical field, but it has tremendous capabilities for image storage, retrieval, and transfer. Images can be used for both educator-assisted conferences and self teaching. Adding audio technology to the photo CD expands the self-teaching concept. The equipment needed is simple and relatively inexpensive. The time required to learn how to create photo CDs is short, and they can be produced at almost any institution.

CD-ROM↗

A remote conference system for image diagnosis on the World-Wide Web.

OBJECTIVE: The World-Wide Web on the Internet enables an exchange of multimedia information among remote desktop computers. Therefore, a teleradiology system using the Web would allow remote consultation with expert radiologists. Our objective was to establish a Web-based prototype system for image interpretation. CONCLUSION: Our system allows a physician to transmit clinically useful images to an expert radiologist at a different location, who can see them on a Web browser and discuss diagnoses with the physician.

Computer Communication Networks↗

A quantitative trait locus influencing type 2 diabetes susceptibility maps to a region on 5q in an extended French family.

Type 2 diabetes is a heterogeneous disorder of glucose metabolism characterized by insulin resistance, beta-cell dysfunction, and increased glucose production by the liver. Given the high degree of genetic heterogeneity, multiple genes with small to moderate effects may influence susceptibility to diabetes. To circumvent this limitation, we searched for quantitative trait loci (QTLs) that explain the variation in susceptibility of type 2 diabetes in a single extended family, as these individuals are likely to share polymorphisms. We collected genotypic and phenotypic data on 152 individuals ascertained through a multimedia campaign in France to find diabetes-prone families for genetic studies. The effects of genes and covariates (age and sex) on diabetes status were estimated using a threshold model and a maximum likelihood variance component approach. We obtained suggestive evidence of linkage (logarithm of odds [LOD] = 2.4) for diabetes status on chromosome 5q. Within the 1-LOD unit support interval, there are two strong candidates: PCSK1 and CAST. Furthermore, we have obtained a replication (LOD = 1.6) for a QTL for type 2 diabetes on chromosome 11 detected by Hanson and colleagues (1998).

Chromosome Mapping↗

Quantifying the qualitative: an empirical poetic approach.

Two studies are described which take a psychometric approach to a qualitative phenomenon. A computational analysis of poetry was conducted. Using a lexicon programme, patterns emerged generally supporting the idea of a poet's everchanging thematic preoccupations. Using a multimedia educational software package, presenting the poetical phrase accompanied by visual stimuli had a substantial effect on the appreciation of the poet's meaning. These novel methodological approaches might stimulate further work in this area.

Humans↗

Online data collection with special populations over the World Wide Web.

The quick ascendance of the World Wide Web as the dominant vehicle for internet communication has recently made experimentation in a multimedia environment feasible on the Internet. Although web sites containing online psychology demonstrations and experiments for non-handicapped individuals have appeared in recent years (especially in the areas of cognitive and social psychology), there appear to have been few attempts to conduct online experimentation with special populations. We recently completed two online pilot studies of families with Down syndrome or Williams syndrome members: a) A survey that asks (via Likert rating scales, adjective checklists, multiple-choice style questions, and text-entry boxes) about family background, computer use, and temperament of the special needs family member; and b) An experiment (completed by an individual with special needs) that includes auditory and visual digit span tasks and a memory-for-orientation task in which responses are entered via mouse clicks. Recruiting began with e-mail announcements to representative Down syndrome and Williams syndrome discussion groups, listserves, and bulletin boards, and submission of the project's URL (http://www.cofc.edu/~marcellm/testaw.htm) and key indexing terms to selected search engines. This paper reviews technical aspects of developing the online programmes as well as the strengths and weaknesses of online vs. traditional laboratory-based research in relation to issues such as experimental control, delivery of instructions, experimenter bias, participant recruitment, sample heterogeneity, generalization, attrition, privacy, financial costs, data integrity, and ethics. We conclude by offering our thoughts on two ways of implementing online experimentation with special populations: a) Using a remote parent 'helper' as a proxy to work with the target individual; and b) Collaborating with professional colleagues in Web-based projects conducted in traditional laboratory settings.

Child, Preschool↗

Internet and obstetrics and gynecology.

BACKGROUND: The Internet is an unrestricted, easily accessed source of information that has been greatly touted by the mass media. It represents a major advance in information acquisition and dissemination. It is estimated that between 3040 million North Americans alone have access to the Internet. This multimedia reservoir of information has developed into a significant resource for information gathering, especially for those who depend on comprehensive and contemporary information, including scientists and physicians. METHODS AND RESULTS: The purpose of this article is to describe some of the basic and practical services available on the Internet including e-mail, literature searches, interest groups, databases and on-line journals. Our focus is to describe these Internet resources with the physician in mind, and with particular emphasis on Internet applications for the obstetrician/gynecologist. CONCLUSION: The role of the Internet in medicine has not been defined, but continues to evolve. In the field of obstetrics and gynecology, the Internet has already become incorporated in various ways and it is safe to say that we are currently going through a revolution as fundamental to the human civilization as the eighteenth century industrial revolution--the information revolution.

Computer Communication Networks↗

Developments in the application of impact assessment methodologies for pollution prevention.

Pollution prevention requires the assessment of various multimedia environmental impacts to ensure that the alternative selected most closely represents the environmental goals and priorities of the facility. While some facility's environmental policies are easy to assess (e.g., reduce TRI emissions), others require a more sophisticated assessment methodology (e.g., select the most environmentally-friendly manufacturing process). Chemical environmental impact assessment for pollution prevention can be very effective, but can only provide a scientifically defensible decision point if the methodologies, analytical tools, and data quality are consistent with the environmental goals and priorities expressed. In many assessments completed in the past, the assessment methodologies have been overly simplistic when compared to the environmental goals projected. More sophisticated chemical impact assessment methodologies have not been used in the past for a variety of reasons, including: poor study design, poor data quality, inadequate funding, inadequate computer systems and databases, and practitioner's lack of understanding. This paper will describe a broad range of assessment methodologies, the steps involved in various evaluations, various resources available to conduct pollution prevention impact assessments, and on-going methodology development.

Ecology↗

Innovations in health care delivery for patients with end-stage renal disease (ESRD).

Increasing requirements for dialysis treatment, financial restraints, quality control and the need to increase the efficiency of professionals involved in the delivery and supervision of chronic dialysis services have stimulated the development of innovative techniques in dialysis health care delivery. The Regional Kidney Disease Program, located at Hennepin County Medical Center, has pioneered the development and application of several innovations to achieve more effective regional delivery of dialysis therapy. Three of the major innovations we have developed are described. They include a computerized automated medical information system, an unique multimedia modified programmed learning training program for allied health personnel and a dialysis nurse practitioner program. Several of these innovations have potential application as models for other developments in modern health care delivery.

Community Health Services↗

Community-based intervention to reduce demand for drugs in Northern Thai tribal villages.

This is an evaluation study of a community-based intervention model used in a project designed to reduce the demand for and use of opium, heroin, and other drugs among 85 tribal villages located in Northern Thailand. The Integrated Drug Abuse Prevention (IDAP) Project was conducted from 1995 to 1997 and used a community-based approach which included innovative methods such as multimedia awareness raising campaigns, networking between villages and local government agencies, and village-based drug detoxification and treatment to assist villages in solving their drug problems. The intervention model was successfully implemented in most villages and demonstrated very good results in improving awareness, decreasing the number of active drug users living in the villages, and preventing new cases of addiction. However, a follow-up study at 6 months after project termination indicated problems with sustainability of demand reduction activities and outcomes. These problems were attributed in part to a lack of empowerment among village leaders to continue activities without assistance from project staff. Also, village leaders expressed problems in resisting drug dealers who returned to the area, which suggested that support from law enforcement is critical to the viability of drug demand reduction programs.

Community Mental Health Services↗

Training of health care personnel towards the implementation and use of electronic health care records using integrated imaging technology.

The hospital of the future will be a place in which Health Care providers of various disciplines will have access to all information about a patient in a timely fashion, and where the communication system will be able to cope with all information representations ranging through data, text, images and voice. Multimedia systems offer the facilities to cope with the specific problems of the mainly manual approach for the effective and efficient organization of information related to facts and findings in medical care. In this article we outline the training needs for future users of such systems.

Computer User Training↗

Computer assisted process management for health care: the IBIS tool.

IBIS is a broad range informatics tool, which can provide essential assistance to users during quality development projects in the health care environment. It can be used to set up a preliminary process model and specify variable and their interrelationships; the system propagates various quality related effects through the process structure, in a bottom up fashion, by linking quality indices to outcomes, repetitively, until arriving at the final outcome, at the top. An incorporated interactive browser is used to simulate the running process, to test and evaluate it, though a cause--effect interaction on intermediate or final outcomes. The tool provides guided support throughout the quality development procedure and during the continuous improvement process. At the same time, it constitutes an effective training tool on the principles of quality work. Additionally, IBIS can be used for the quality system's documentation, by means of a multimedia presentation, incorporating descriptive text, images and graphical displays, video sequences and sound.

Decision Support Systems, Management↗

MARVIN, multi-agent softbot to retrieve multilingual medical information on the Web.

The World-Wide Web is an unstructured, multimedia and multilingual information network. While most efforts have addressed the structuring issue, very few attempts have been proposed to provide support for multilingual information retrieval. Yet, medical information is now available all over the world. The MARVIN (Multi-Agent Retrieval Vagabond on Information Network) softbot and its associated medical search engine MedHunt (Medical Hunter) are a solution for helping people, who only understand a few languages, to access multilingual information.

Information Storage and Retrieval↗

Stereoscopic imaging and its role in medical illustration.

Stereoscopic imaging is becoming more widespread as developments in computer software and hardware allow for rapid manipulation of electronically gathered medical data, and of computer-generated models. This paper examines the current three-dimensional multimedia scene, evaluates its place in training, and examines stereoscopic imaging and viewing techniques as well as the availability of stereoscopic equipment.

Depth Perception↗

Radiology as a part of a comprehensive telemedicine and eHealth network in Northern Finland.

Oulu University Hospital is the northernmost tertiary hospital in Finland and its responsibility area is the largest in the country, covering nearly half of the Finnish territory, also including the arctic regions. Because of vast distances and a sparse population, Oulu has been a forerunner in developing telemedicine and eHealth services in the country. The development started in 1990 and has resulted in the establishment of teleradiology and televideoconferencing services, distance education and a multimedia medical record with remote access capabilities. Wireless technology has been a special focus area, as has the development of an efficient communication between primary care and secondary care. This review highlights some of the key success elements.

Arctic Regions↗

Effects of pentoxifylline on the hepatic content of TGF-beta1 and collagen in Schistosomiasis japonica mice with liver fibrosis.

AIM: To study the effects of pentoxifylline (PTX) on the content of hepatic TGF-beta1, type I and type III collagen in schistosomiasis japonica mice with liver fibrosis and its mechanism of anti-fibrosis. METHODS: Forty mice with schistosomiasis were divided into four groups: one group as control without any treatment, other three were treated with Praziquantel 500 mg/(kg x d)for 2 d, high dose PTX 360 mg/(kg x d) for 8 wk, and low dose PTX 180 mg/(kg x d) for 8 wk respectively. Immunohistochemical technique and multimedia color pathographic analysis system were applied to observe the content change of hepatic TGF-beta1, type I and type III collagen in schistosomiasis japonica mice with liver fibrosis before and after PTX treatment. RESULTS: Effects of PTX on the content change of hepatic TGF-beta1, type I and type III collagen in schistosomiasis japonica mice with liver fibrosis were related to the dosage of PTX, high dose PTX treated group could significantly reduce the content of TGF-beta1 (0.709+/-0.111), type I (0.644+/-0.108) and type III (0.654+/-0.152) collagen compared with those of control group (0.883+/-0.140, 0.771+/-0.156, 0.822+/-0.129) with statistical significance (P<0.05). Low dose PTX could also reduce the hepatic content of TGF-beta1 (0.752+/-0.152), type I (0.733+/-0.117) and type III (0.788+/-0.147) collagen, but without statistical significance (P>0.05). Both high dose and low dose PTX groups have significant differences on the content of TGF-beta1, type I and type III collagen (P<0.05, P<0.05, P<0.01, respectively). CONCLUSION: High dose of PTX treatment could reduce the content of hepatic TGF-beta1, type I and type III collagen significantly in schistosomiasis japonica mice with liver fibrosis, and thus plays its role of antifibrosis.

Animals↗