distributed processing
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Ciba Foundation symposium ; 184
[1st ed.] VIII, 347 s. : obr., tab. ; 23 cm
- MeSH
- neurofyziologie MeSH
- oči - fyziologické jevy MeSH
- zrak fyziologie MeSH
- Publikační typ
- kongresy MeSH
- Konspekt
- Lékařské vědy. Lékařství
- NLK Obory
- fyziologie
- neurovědy
- oftalmologie
elektronický časopis
- Konspekt
- Fyziologie člověka a srovnávací fyziologie
- NLK Obory
- neurovědy
- technika
- NLK Publikační typ
- elektronické časopisy
Această lucrare descrie conceptele, metodele şi instrumentele utilizate în proiectarea unui sistem informatic de monitorizare a glaucomului, practic şi având un cost potenţial scăzut, distribuit, cu capabilităţi de acces web (Internet). Experienţa noastră cu sistemele informaţionale existente acum în spitale (eng. Hospital Information System - HIS) a arătat că acestea sunt inadecvate pentru procese clinice cum este şi acela foarte important al monitorizării pacienţilor cu glaucom. Actualele scheme de înregistrare electronică a pacienţilor (eng. Electronic Patient Record - EPR) sunt mai adecvate aspectelor simple de management şi programare a consultaţiilor decât proceselor clinice şi de luare a deciziilor. Într-o relaţie şi mai strânsă cu specificul unei afecţiuni, bazele de date demografice pentru pacienţi, denumite uzual ca sisteme de administrare a pacienţilor (Patient Administration System - PAS), nu au fost proiectate pentru exploatarea partajată sau concurentă de către programe diferite sau chiar replici diferite ale aceluiaşi program. Multe dintre deficienţele timpurii în procesul de urmărire a pacienţilor cu glaucom de către zeci de oftalmologi diferiţi, în cabinete independente din clinici diferite (cu sisteme eterogene de înregistrare a informaţiilor, nu foarte bine administrate prin capabilităţile de birotică), pot fi rezolvate doar prin specificarea, proiectarea şi implementarea unor noi scheme EPR în medii distribuite mixte, bazate pe o bază de date distribuită ca un nucleu demografic (PAS) al pacienţilor cu glaucom. Un asemenea sistem specializat de management al înregistrărilor medicale, cu funcţionalitate centrată pe monitorizarea glaucomului, şi datele din nucleu organizate într-un sistem cu baze de date distribuite, a fost proiectat într-o manieră bottom-up pentru a răspunde unor necesităţi imediate. Implementarea pilot a sa a fost intenţionat menţinută flexibilă şi ţine cont de standardele în dezvoltare cu scopul acomodării oricăror cerinţe viitoare, anticipate. Printre multe alte beneficii, aceste noi scheme EPR permit oftalmologilor vizualizarea şi modificarea informaţiilor despre pacienţi şi a înregistrărilor într-o manieră deopotrivă sigură, flexibilă şi eficientă.
This paper describes, from a practitioner's point of view, the concepts, methods and tools involved in the design of a practical and potentially low cost distributed information system, with web-based capabilities, for monitoring glaucoma. Our experience with existing Hospital Information Systems (HISs) found them unsuitable in the very important monitoring process of patients with glaucoma. Actual Electronic Patient Record (EPR) schemes are more to do with management and appointment simple aspects than with clinical and decision-making processes. In a closer relationship to the specific of the affection, we found that demographic patient databases, usually known as Patient Administration Systems (PASs), have not been designed for being shared or concurrently exploited by different programs or even several replicas of the same program. Many of the early deficiencies in the process of following-up glaucoma patients by dozens of different ophthalmologists in many independent offices from different clinics (with heterogeneous information recording, not very well managed by the existing office capabilities) could only be solved by specifying, designing and implementing a new EPR scheme in a mixed distributed environment, based on a distributed database as a demographic core (or PAS) of patients with glaucoma. A specialized health record management system, with core functionality in monitoring glaucoma, and core data organized as a distributed database system, has been designed in a bottom-up manner to meet the immediate needs. Its pilot implementation was intentionally kept flexible, taking in account developing standards, to accommodate any anticipated future requirements. Among many other benefits, the new EPR allowed medical doctors (ophthalmologists) to view and modify patient information and records in a safe, flexible and efficient manner. Improvements in all the managerial and decisional aspects (regarding costs and time delays) could also be remarked rapidly.
- MeSH
- lidé MeSH
- magnetická rezonanční tomografie využití MeSH
- počítačové komunikační sítě přístrojové vybavení využití MeSH
- počítačové zpracování obrazu metody přístrojové vybavení využití MeSH
- radiografie trendy využití MeSH
- software trendy MeSH
- telemedicína metody přístrojové vybavení využití MeSH
- vylepšení obrazu normy přístrojové vybavení MeSH
- zobrazování trojrozměrné metody přístrojové vybavení využití MeSH
- Check Tag
- lidé MeSH
Processing of memory is supported by coordinated activity in a network of sensory, association, and motor brain regions. It remains a major challenge to determine where memory is encoded for later retrieval. Here, we used direct intracranial brain recordings from epilepsy patients performing free recall tasks to determine the temporal pattern and anatomical distribution of verbal memory encoding across the entire human cortex. High γ frequency activity (65-115 Hz) showed consistent power responses during encoding of subsequently recalled and forgotten words on a subset of electrodes localized in 16 distinct cortical areas activated in the tasks. More of the high γ power during word encoding, and less power before and after the word presentation, was characteristic of successful recall and observed across multiple brain regions. Latencies of the induced power changes and this subsequent memory effect (SME) between the recalled and forgotten words followed an anatomical sequence from visual to prefrontal cortical areas. Finally, the magnitude of the memory effect was unexpectedly found to be the largest in selected brain regions both at the top and at the bottom of the processing stream. These included the language processing areas of the prefrontal cortex and the early visual areas at the junction of the occipital and temporal lobes. Our results provide evidence for distributed encoding of verbal memory organized along a hierarchical posterior-to-anterior processing stream.
- MeSH
- časové faktory MeSH
- elektrokortikografie MeSH
- gama rytmus EEG fyziologie MeSH
- lidé MeSH
- mapování mozku MeSH
- mozková kůra fyziologie patofyziologie MeSH
- percepce řeči fyziologie MeSH
- refrakterní epilepsie patofyziologie psychologie MeSH
- rozpomínání fyziologie MeSH
- slovní zásoba MeSH
- zraková percepce fyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- Research Support, U.S. Gov't, Non-P.H.S. MeSH
