Patricia Goede

Uniqueness of the S-cone pedicle in the human retina and consequences for color processing

The purpose of this study was to investigate more fully the shape and content of ribbons and synapses to second‐order neurons in the short‐wavelength cone (S‐cone, blue cone) pedicle and to learn more concerning the uniqueness of the S‐cone system in the primate retina.

A Methodology and Implementation for Annotating Digital Images for Context-appropriate Use in an Academic Health Care Environment

Use of digital medical images has become common over the last several years, coincident with the release of inexpensive, mega-pixel quality digital cameras and the transition to digital radiology operation by hospitals. One problem that clinicians, medical educators, and basic scientists encounter when handling images is the difficulty of using business and graphic arts commercial-off-the-shelf (COTS) software in multicontext authoring and interactive teaching environments. The authors investigated and developed software-supported methodologies to help clinicians, medical educators, and basic scientists become more efficient and effective in their digital imaging environments. The software that the authors developed provides the ability to annotate images based on a multispecialty methodology for annotation and visual knowledge representation. This annotation methodology is designed by consensus, with contributions from the authors and physicians, medical educators, and basic scientists in the Departments of Radiology, Neurobiology and Anatomy, Dermatology, and Ophthalmology at the University of Utah. The annotation methodology functions as a foundation for creating, using, reusing, and extending dynamic annotations in a context-appropriate, interactive digital environment. The annotation methodology supports the authoring process as well as output and presentation mechanisms. The annotation methodology is the foundation for a Windows implementation that allows annotated elements to be represented as structured eXtensible Markup Language and stored separate from the image(s).

The use of TeleCAM as a remote Web-based application for child maltreatment assessment, peer review, and case documentation.

Approximately 1 million children are physically or sexually abused each year in the United States. Accurate diagnosis of these children and subsequent extensive legal intervention requires a thorough clinical assessment as well as legal documentation. A Web-based application developed for the remote sharing of child maltreatment assessment among multiple child protection providers is presented. Usability data was collected from medical personnel at three remote Utah Childrens Advocacy Centers (CACs) and one urban tertiary childrens hospital. Qualitative findings are summarized and satisfaction differences are reported between remote sites and their referral tertiary center.

Development of Standardized Clinical Training Cases for Diagnosis of Sexual Abuse using a Secure Telehealth Application.

OBJECTIVES The training of physicians, nurse examiners, social workers and other health professional on the evidentiary findings of sexual abuse in children is challenging. Our objective was to develop peer reviewed training cases for medical examiners of child sexual abuse, using a secure web based telehealth application (TeleCAM). METHODS Sixty de-identified cases developed by 2 child abuse pediatricians, were stratified by availability of information (minimal, moderate, comprehensive) for both positive and negative child sexual abuse findings. These cases were narrowed to a set of 30 cases through an expert peer review process using pediatricians with extensive expertise in the evaluation of child sexual abuse. A previously studied secure web-based telehealth application TeleCAM which contains a child abuse workflow, was used to develop, disseminate and review cases. A series of Free Margin agreement statistics are used to select those cases with the highest rates of agreement. A final set of 30 cases are stratified equally by availability of information and for both positive and negative findings. Mantel Haenszel Chi-square was used for trend analysis of the ordered categorical variables. RESULTS The highest degrees of inter-rater reliability was found in cases with moderate to comprehensive information. Cases with minimal data had poor kappa agreement indicating that availability of differing levels and types of information contribute to variability in diagnostic findings. CONCLUSION These final cases will be further studied with medical examiners in various settings utilizing TeleCAM as the application for dissemination.

An Image-Centric, Web-Based, Telehealth Information System for Multidisciplinary Clinical Collaboration

Web-based technologies are changing the face of traditional telehealth applications by providing cost-effective clinical data capture and sharing solutions. Access to medical images in coordination with clinical workflow and face-to-face technologies can integrate clinical service delivery, diagnosis, and treatment across geographic, disciplinary, and organizational boundaries. For example, medical images are used for a variety of purposes and range in their complexity from a simple digital photograph of a physical mass taken by a primary care provider to a magnetic resonance image (MRI) reviewed by a radiologist that might describe the details of the mass; to a histopathology slide that a pathologist might use to diagnose the malignancy of the mass. Each of these images is managed by separate domain-specific information systems which are often located in technology silos and are constrained by disciplinary, organizational, and geographic barriers.

A simple mechanism for sharing and transporting medical digital case information across disparate computer language and data storage environments.

It is challenging to remotely share generic medical case information without an agreed upon definition of a medical digital teaching file (DTF). By utilizing an application of the extensible markup language (XML) called web-distributed data exchange (WDDX) along with an agreed upon WDDX structure, it is technically easy to share or syndicate medical case DTFs across computing environments that use different information models and computer languages. Thus, this easily implemented technology offers us an immediately available means to share and increase the value of scientific knowledge.

Three-dimensional reconstruction and surface rendering of the five different spectral types of cone pedicle in the turtle retina

Pseudo-3-dimensional models and surface renderings of a small group of neighboring cone pedicles in the turtle retina, in which the 5 different spectral types are represented, have been made from scanned serial electron micrographs using a Macintosh personal computer, Autocad and Studio Pro software. The resultant computer generated images clarify the morphological differences between the spectral types and show how they are related to each other via telodendrial connections and different levels of ending in the neuropil of the outer plexiform layer (OPL). The double cone pedicles end highest in the neuropil and the single red and green pedicles lie slightly lower into the OPL with the single blue and ultraviolent (UV)-sensitive cone pedicles coming in from obliquely angled axons to assume positions between the others much more vitread in the OPL. Telodendria interconnect the double and single red and green cones but not the blue and UV-sensitive cones.

“WWW.MDTF.ORG”: A world wide web forum for developing open-architecture, freely distributed, digital teaching file software by participant consensus

Purpose: To foster a community supported evaluation processes for open-source digital teaching file (DTF) development and maintenance. The mechanisms used to support this process will include standard web browsers, web servers, forum software, and custom additions to the forum software to potentially enable a mediated voting protocol. The web server will also serve as a focal point for beta and release software distribution, which is the desired end-goal of this process.Conclusions: We foresee thatwww.mdtf.org will provide for widespread distribution of open source DTF software that will include function and interface design decisions from community participation on the website forums.