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PubMedDate not supplied

Trends in students' knowledge, opinions, and experience regarding dental informatics and computer applications.

OBJECTIVE: This study investigated knowledge, opinions, and experience regarding dental informatics and computers among first-year dental students (D1s) and fourth-year dental students (D4s). DESIGN: First-year (N = 95) and fourth-year (N = 91) students in 1990 and first-year (N = 97) and fourth-year (N = 91) students in 1993 at a school of dentistry were surveyed. MEASUREMENTS: Demographic characteristics and computer ownership were assessed. Knowledge was measured using an 18-item scale (range 0-18). Opinions were measured using a 13-item scale (range 13-65; alpha = 0.81). Experience was measured using a 28-item scale (range 28-140). RESULTS: Response rates were all nearly 100%. Computer ownership by the D1s increased from 17.9% to 43.8% in the three years between surveys. Knowledge and opinions of the 1990 and 1993 D1s were similar, although the latter reported more experience with hardware and software. Experience with dental informatics applications was lacking in both groups. The 1993 D4s had completed more computer courses than had the 1990 D4s (2.3 vs 0.9), and demonstrated significantly more knowledge and experience. Opinion scores were nearly identical for these groups. The D4s in 1993 who had been D1s in 1990 had increased their knowledge of and experience with informatics applications during dental school. A difference in computer knowledge between the entering D1 males and females was observed in 1990, but was essentially gone by 1993 for the same individuals. CONCLUSIONS: Entering students had more computing knowledge and skill than their predecessors. Informatics knowledge and experience increased during dental school, and knowledge disparities between genders disappeared.

Adult↗
PubMed2001

Do computer generated ECG reports improve interpretation by accident and emergency senior house officers?

OBJECTIVES: To determine whether access to a computer generated electrocardiogram (ECG) report can reduce errors of interpretation by senior house officers (SHOs) in an accident and emergency department. METHODS: Ten SHOs were asked to interpret 50 ECGs each: 25 with computer generated reports, 25 without. Their answers, and the computer generated reports, were compared with a "gold standard" produced by two experienced clinicians. The primary outcome measure was the proportion of major errors of interpretation. RESULTS: The computer reading system made two major errors (4%, 95% confidence interval (CI) 1.1% to 13.5%) compared with the gold standard. Access to the computer report did not significantly reduce major errors among SHOs (46 (18.4%) with report v 56 (22.4%) without, odds ratio 0.64, 95% CI 0.36% to 1.14%, p=0.13) or improve the proportion completely correct (104 (41.6%) with report v 91 (36.4%) without, odds ratio 1.43, 95% CI 0.88 to 2.33, p=0.15). CONCLUSIONS: SHOs have a high error rate when interpreting ECGs, which is not significantly reduced by access to a computer generated report. Junior doctors should continue to seek expert senior help when they have to interpret a difficult ECG.

Clinical Competence↗
PubMed2006

On the computational power of threshold circuits with sparse activity.

Circuits composed of threshold gates (McCulloch-Pitts neurons, or perceptrons) are simplified models of neural circuits with the advantage that they are theoretically more tractable than their biological counterparts. However, when such threshold circuits are designed to perform a specific computational task, they usually differ in one important respect from computations in the brain: they require very high activity. On average every second threshold gate fires (sets a 1 as output) during a computation. By contrast, the activity of neurons in the brain is much sparser, with only about 1% of neurons firing. This mismatch between threshold and neuronal circuits is due to the particular complexity measures (circuit size and circuit depth) that have been minimized in previous threshold circuit constructions. In this letter, we investigate a new complexity measure for threshold circuits, energy complexity, whose minimization yields computations with sparse activity. We prove that all computations by threshold circuits of polynomial size with entropy O(log n) can be restructured so that their energy complexity is reduced to a level near the entropy of circuit states. This entropy of circuit states is a novel circuit complexity measure, which is of interest not only in the context of threshold circuits but for circuit complexity in general. As an example of how this measure can be applied, we show that any polynomial size threshold circuit with entropy O(log n) can be simulated by a polynomial size threshold circuit of depth 3. Our results demonstrate that the structure of circuits that result from a minimization of their energy complexity is quite different from the structure that results from a minimization of previously considered complexity measures, and potentially closer to the structure of neural circuits in the nervous system. In particular, different pathways are activated in these circuits for different classes of inputs. This letter shows that such circuits with sparse activity have a surprisingly large computational power.

Brain↗
PubMed2004

Prospective evaluation of an internet-linked handheld computer critical care knowledge access system.

INTRODUCTION: Critical care physicians may benefit from immediate access to medical reference material. We evaluated the feasibility and potential benefits of a handheld computer based knowledge access system linking a central academic intensive care unit (ICU) to multiple community-based ICUs. METHODS: Four community hospital ICUs with 17 physicians participated in this prospective interventional study. Following training in the use of an internet-linked, updateable handheld computer knowledge access system, the physicians used the handheld devices in their clinical environment for a 12-month intervention period. Feasibility of the system was evaluated by tracking use of the handheld computer and by conducting surveys and focus group discussions. Before and after the intervention period, participants underwent simulated patient care scenarios designed to evaluate the information sources they accessed, as well as the speed and quality of their decision making. Participants generated admission orders during each scenario, which were scored by blinded evaluators. RESULTS: Ten physicians (59%) used the system regularly, predominantly for nonmedical applications (median 32.8/month, interquartile range [IQR] 28.3-126.8), with medical software accessed less often (median 9/month, IQR 3.7-13.7). Eight out of 13 physicians (62%) who completed the final scenarios chose to use the handheld computer for information access. The median time to access information on the handheld handheld computer was 19 s (IQR 15-40 s). This group exhibited a significant improvement in admission order score as compared with those who used other resources (P = 0.018). Benefits and barriers to use of this technology were identified. CONCLUSION: An updateable handheld computer system is feasible as a means of point-of-care access to medical reference material and may improve clinical decision making. However, during the study, acceptance of the system was variable. Improved training and new technology may overcome some of the barriers we identified.

Academic Medical Centers↗
PubMed2006

Clinical computing in general dentistry.

OBJECTIVE: Measure the adoption and utilization of, opinions about, and attitudes toward clinical computing among general dentists in the United States. DESIGN: Telephone survey of a random sample of 256 general dentists in active practice in the United States. MEASUREMENTS: A 39-item telephone interview measuring practice characteristics and information technology infrastructure; clinical information storage; data entry and access; attitudes toward and opinions about clinical computing (features of practice management systems, barriers, advantages, disadvantages, and potential improvements); clinical Internet use; and attitudes toward the National Health Information Infrastructure. RESULTS: The authors successfully screened 1,039 of 1,159 randomly sampled U.S. general dentists in active practice (89.6% response rate). Two hundred fifty-six (24.6%) respondents had computers at chairside and thus were eligible for this study. The authors successfully interviewed 102 respondents (39.8%). Clinical information associated with administration and billing, such as appointments and treatment plans, was stored predominantly on the computer; other information, such as the medical history and progress notes, primarily resided on paper. Nineteen respondents, or 1.8% of all general dentists, were completely paperless. Auxiliary personnel, such as dental assistants and hygienists, entered most data. Respondents adopted clinical computing to improve office efficiency and operations, support diagnosis and treatment, and enhance patient communication and perception. Barriers included insufficient operational reliability, program limitations, a steep learning curve, cost, and infection control issues. CONCLUSION: Clinical computing is being increasingly adopted in general dentistry. However, future research must address usefulness and ease of use, workflow support, infection control, integration, and implementation issues.

Attitude to Computers↗
PubMed2004

Predicting stroke risk in pediatric moyamoya disease with xenon-enhanced computed tomography.

OBJECTIVE: To determine whether estimates of regional cerebral blood flow (rCBF) using xenon computed tomography (XeCT) in children with moyamoya disease can predict stroke risk before and after treatment. METHOD: Seven patients with moyamoya disease underwent 22 serial Xe computed tomographic scans. Estimates of rCBF were obtained at three computed tomographic levels by use of a 5-minute inhalation of 28% Xe. Acetazolamide challenge was performed in eight scans. For comparison of abnormal vessel distribution and areas of infarction, 17 intra-arterial digital subtraction angiograms, 47 computed tomographic scans, and 15 magnetic resonance imaging scans were available. Follow-up exceeded 36 months in all patients. Mean follow-up for the interventional group was 65.2 months (n = 5; range, 37-109 mo) and 38 months for the nonoperative patients (n = 2; 36 and 40 mo). RESULTS: Of six Xe computed tomographic scans obtained at diagnosis, four revealed regions of oligemia, augmented vertebrobasilar flow, and regions of carotid steal after acetazolamide. In the delay between diagnosis and treatment, three patients had strokes in ischemic areas identified by XeCT. Of the 10 posttreatment scans obtained from 4 patients, 2 revealed improved tissue perfusion with angiography confirming successful encephaloduroangiomyosynangiosis. In 2 others, XeCT performed 6 months posttreatment revealed improved perfusion without angiographic change, and angiography at 1 year revealed failed encephaloduroangiomyosynangiosis and new native collaterals. None of the patients with improved rCBF had new strokes. Eleven of 14 Xe computed tomographic scans were obtained within 30 days of angiography. Comparison of these studies demonstrates that regions of oligemia were confined to areas associated with vessel stenosis and little neovascularity or collateral pathways. CONCLUSION: XeCT, particularly with acetazolamide challenge, objectively quantifies rCBF. Our preliminary data suggest that it may permit assessment of stroke risk in children with moyamoya disease and may predict surgical outcome earlier than angiography.

Administration, Inhalation↗
PubMedDate not supplied

Meeting the computer technology needs of community faculty: building new models for faculty development.

OBJECTIVE: We aimed to identify the evolving computer technology needs and interests of community faculty in order to design an effective faculty development program focused on computer skills: the Teaching and Learning Through Educational Technology (TeLeTET) program. METHODOLOGY: Repeated surveys were conducted between 1994 and 2002 to assess computer resources and needs in a pool of over 800 primary care physician-educators in community practice in East Texas. Based on the results, we developed and evaluated several models to teach community preceptors about computer technologies that are useful for education. RESULTS: Before 1998, only half of our community faculty identified a strong interest in developing their technology skills. As the revolution in telecommunications advanced, however, preceptors' needs and interests changed, and the use of this technology to support community-based teaching became feasible. In 1998 and 1999, resource surveys showed that many of our community teaching sites had computers and Internet access. By 2001, the desire for teletechnology skills development was strong in a nucleus of community faculty, although lack of infrastructure, time, and skills were identified barriers. The TeLeTET project developed several innovative models for technology workshops and conferences, supplemented by online resources, that were well attended and positively evaluated by 181 community faculty over a 3-year period. CONCLUSIONS: We have identified the evolving needs of community faculty through iterative needs assessments, developed a flexible faculty development curriculum, and used open-ended, formative evaluation techniques to keep the TeLeTET program responsive to a rapidly changing environment for community-based education in computer technology.

Community Health Services↗
PubMed1997

Computational and numerical methods for bioelectric field problems.

Fundamental problems in electrophysiology can be studied by computationally modeling and simulating the associated microscopic and macroscopic bioelectric fields. To study such fields computationally, researchers have developed a variety of numerical and computational techniques. Advances in computer architectures have allowed researchers to model increasingly complex biophysical systems. Modeling such systems requires a researcher to apply a wide variety of computational and numerical methods to describe the underlying physics and physiology of the associated three-dimensional geometries. Issues naturally arise as to the accuracy and efficiency of such methods. In this paper we review computational and numerical methods of solving bioelectric field problems. The motivating applications represent a class of bioelectric field problems that arise in electrocardiography and electroencephalography.

Cardiology↗
PubMedDate not supplied

Helping hospital educators and clinical nurse specialists learn to use and develop computer-assisted instruction.

The impact of computers on healthcare delivery and management is both significant and increasing. Coupled with its potential educational benefits, computer-assisted instruction (CAI) has much to offer healthcare professionals. However, the individuals directly responsible for training nurses and other personnel typically have little knowledge about how computers can be used for training purposes. A series of workshops was designed for hospital educators and clinical nurse specialists to help them become computer literate and to provide them with the skills to evaluate, develop, and appropriately implement instructional software was emphasized during a series of formal seminars, guided individual instruction, and guided independent practice laboratory sessions. This approach resulted in a significant increase in participants' knowledge about computers while maintaining their positive attitudes toward the instructional uses of computers. A well-designed staff development program can provide these crucial individuals with the skills and knowledge required to use microcomputers and CAI as effective teaching and learning tools.

Computer User Training↗
PubMed1990

[The effects of impolite computer messages on workers].

The purpose of this study was to clarify the effects of computer messages of varying degrees of politeness on subjects' task performance, mental state, and attitude toward computers. The task of subjects in the experiment was to type characters into the computer. When subjects made an input mistake or exceeded the time-limit, or required aid (used the HELP key), a message was given by the computer to which subjects had to reply by pressing either the "Shut up!" button or the "I am sorry" button. Before and after the experiment subjects were required to answer a questionnaire concerned with their image and attitude toward computers and the degree to which the task of typing is unpleasant. The main results were: 1) Subjects who received impolite messages felt that the message was unfriendly, but felt less unpleasantness in typing than subjects who received no message. Subjects became aggressive when impolite message were given repeatedly. 2) Subjects who received impolite messages showed positive attitude change toward computers despite the impolite messages.

Adult↗
PubMedDate not supplied

Nurse practitioner use of computer technologies in practice.

A study was undertaken to determine computer use by nurse practitioners in public clinics, private practice, health maintenance organizations, and other settings in the greater San Francisco Bay Area. The descriptive research used a survey design. Subjects were 200 nurse practitioners. The survey instrument was developed by the researcher. Of the 104 respondents, 86 (83%) used computers at work. "Obtaining client records from other agencies or departments" was rated the most useful computer application for improving client care. "Internet searches" was rated the next most useful computer application; "entering client record information" was rated the third most useful. Use of computer applications varied by practice setting. Only 7 (25%) nurse practitioners in private practice accessed client records from other agencies, as did 17 (57%) in public clinics, and nearly all, 29 (94%), in HMOs. The research demonstrated that nurse practitioners underused computer applications that would improve client care in their practice.

Adult↗
PubMedDate not supplied

Use of computer technology to help students with special needs.

Millions of students across the United States cannot benefit fully from a traditional educational program because they have a disability that impairs their ability to participate in a typical classroom environment. For these students, computer-based technologies can play an especially important role. Not only can computer technology facilitate a broader range of educational activities to meet a variety of needs for students with mild learning disorders, but adaptive technology now exists than can enable even those students with severe disabilities to become active learners in the classroom alongside their peers who do not have disabilities. This article provides an overview of the role computer technology can play in promoting the education of children with special needs within the regular classroom. For example, use of computer technology for word processing, communication, research, and multimedia projects can help the three million students with specific learning and emotional disorders keep up with their nondisabled peers. Computer technology has also enhanced the development of sophisticated devices that can assist the two million students with more severe disabilities in overcoming a wide range of limitations that hinder classroom participation--from speech and hearing impairments to blindness and severe physical disabilities. However, many teachers are not adequately trained on how to use technology effectively in their classrooms, and the cost of the technology is a serious consideration for all schools. Thus, although computer technology has the potential to act as an equalizer by freeing many students from their disabilities, the barriers of inadequate training and cost must first be overcome before more widespread use can become a reality.

Adolescent↗
PubMed1999

Computer copings for partial coverage.

Partial coverage posterior tooth preparations are very complex surfaces for computer surface digitization, computer design, and manufacture of ceramic copings. The aim of this study was therefore to determine whether the Computer Integrated Crown Reconstruction (Cicero) system was compatible with a proposed partial coverage preparation design and capable of producing ceramic copings. Posterior teeth were prepared for partial coverage copings with deep gingival chamfers in the proximal boxes and around the functional cusps (buccal of mandibular and lingual of maxillary posterior teeth). The nonfunctional cusps (lingual of mandibular and buccal of maxillary posterior teeth) were prepared with broad bevels following the inclined occlusal plane pattern. Optical impressions were taken of stone dies by means of a fast laser-line scanning method that measured the three-dimensional geometry of the partial coverage preparation. Computers digitized the images, and designed and produced the ceramic copings. The Cicero system digitized the partial coverage preparation surfaces precisely with a minor coefficient of variance of 0.2%. The accuracy of the surface digitization, the design, and the computer aided milling showed that the system was capable of producing partial coverage copings with a mean marginal gap of 74 microns. This value was obtained before optimizing the marginal fit by means of porcelain veneering. In summary, Cicero computer technology, i.e., surface digitization, coping design, and manufacture, was compatible with the described partial coverage preparations for posterior teeth.

Bicuspid↗
PubMed1998

[The method and development of computer-assisted surgery].

The methodology and the state of the art of Computer-Assisted Surgery (CAS) are introduced in this paper. Computer-assisted surgery is a new high technology which uses computer science, biomedical engineering, mechanism, mathematics, surgery, and so on. Its objective is to help surgeons use multimodal data, such as CT, MRI, DSA, PET, et al. in a rational and quantitative way in order to plan and perform medical intervention. Stereotactic localization method and registration are two cruxes in computer-assisted surgery. There are several methods for localization and registration. In recent ten years, computer-assisted surgery has been a cynosure of scientists. Some computer-assisted surgery systems have been used in clinical practice.

General Surgery↗
PubMed1992

[Comparison of fingerprints using a personal computer and graphic software sold on market].

We compared the fingerprint images using a personal computer and a graphic software sold on market. The fingerprints of thumb of left hand recorded by pressing and rolling on paper were input in computer using image scanner. These two fingerprint images were overlapped by moving and rotation on the computer screen, and were fitted well. This result showed that the fingerprints recorded by any way from one person were fitted. Latent and accused's fingerprints were also input in computer using image scanner. These images were analyzed by the same procedure. These two fingerprints were part by unfitting. It was decided these two fingerprints were not derived from one person. We also considered the possibility that the latent fingerprint was the reversed one. Then, the image was reversed of its color on the screen of computer (black to white and white to black) and compared by the same procedure. In this experiment, two fingerprint images were not fitted in a part. This showed that the reversed fingerprint was also able to be analyzed by this procedure. For the comparison of fingerprints, this report showed the ability of the personal computer and software which can be obtained easily from market. Following the improvement of the hardware and software used in this examination in near future, the computerized identification of fingerprints like this study will become more accurate and convenient.

Computer Graphics↗
PubMedDate not supplied

Percutaneous drainage under real-time computed tomography-fluoroscopy guidance.

BACKGROUND/AIMS: The goal of our study was to assess the use of real-time computed tomography-fluoroscopy guidance for percutaneous drainage of abnormal thoracic, abdominal, and pelvic fluid collections. METHODOLOGY: The subjects were 32 patients who underwent 36 percutaneous computed tomography-fluoroscopy guided thoracic, abdominal, and pelvic drainage procedures to drain abscess (n=29), fluid collection after pancreatitis (n=3), lymphocyst after gynecological surgery (n=3), and the gallbladder transhepatically (n=1) between September 1997 and August 2003. The patient population was 28-86 years old and consisted of 19 men and 13 women. The drainage methods included a Seldinger's technique with a guidewire and serial dilators in every case. The procedures were guided by using a helical computed tomography scanner that provided real-time fluoroscopy reconstruction. RESULTS: Percutaneous drainage under real-time computed tomography-fluoroscopy guidance was successfully performed in every procedure. Real-time computed tomography-fluoroscopy allowed rapid assessment of needle, guidewire, dilator, and catheter placement. The only drainage-induced complication encountered was a subcutaneous hematoma after one procedure (2.8%). No patients had serious complications. The average procedure time was 32 minutes. CONCLUSIONS: Computed tomography-fluoroscopy is a useful method for guiding the accurate and safe drainage of abnormal thoracic, abdominal, and pelvic fluid collections.

Abscess↗
PubMed1991

[Changes in the rate and accuracy of information processing in the computer training of middle-grade pupils].

The computer enters more and more quickly the new school. Therefore an important problem is the influence of computer training on the velocity and accuracy of information processing. For this purpose were examined 28 school-children from VI-VII class, participating in computer training, computer plays and traditional lesion. This activity was carried out in the computer study of the Pioneer Palace, Sofia. An electronic determinator with test programme, containing preliminary arranged succession of 50 visual stimulants on red, blue, green, yellow and white colours, at vas used at 1,2 s. speed. The changes in the correct, delayed and wrong reactions were traced. The results as a whole point out, that the computer training, on the one hand, has no unfavourable effect on the velocity and accuracy of information processing, and on the other hand--forms positive psychoemotional adjustment to work.

Bulgaria↗
PubMed1991

Computers and cephalometrics.

Computers have been adapted to cephalometric data acquisition and analysis. Traditional cephalometric radiographs provide images that are entered into computers by converting them to digital data. Other non-ionizing radiation forms of energy, such as sound, light and magnetism, are now used to create images. Newer methods of data acquisition are emerging that convert objects directly to digital data for computer entry without going through intermediate analogue forms. The analysis of cephalometric data for diagnostic use is aided by computers, but the automated treatment planning application of computers is limited. This limitation is not a function of the computer, but a function of our inability to reliably predict absolute biologic changes in the face of biologic variability.

Cephalometry↗