Computer networking for scientists

Ten-year experience of remote medical education in Asia

BACKGROUND

Moving images are often essential in medical education, to learn new procedures and advanced skills, but, in the past, high-quality movie transmission was technically much more challenging than transmitting still pictures because of technological limitations and cost.

MATERIALS AND METHODS

We established a new system, taking advantage of two advanced technologies, the digital video transport system (DVTS) and the research and education network (REN), which enabled satisfactory telemedicine on a routine basis.

RESULTS

Between 2003 and 2013, we organized 360 programs connecting 221 hospitals or facilities in 34 countries in Asia and beyond. The two main areas were endoscopy and surgery, with 113 (31%) and 106 (29%) events, respectively. Teleconferences made up 76% of the total events, with the remaining 24% being live demonstrations. Multiple connections were more popular (63%) than one-to-one connections (37%). With continuous technological development, new high-definition H.323 and Vidyo(®) (Hackensack, NJ) systems were used in 47% and 39% of events in 2011 and 2012, respectively. The evaluation by questionnaires was favorable on image and sound quality as well as programs.

CONCLUSIONS

Remote medical education with moving images was well accepted in Asia with changing needs and developing technologies.

Neurosurgery and the Internet: a critical analysis and a review of available resources

Thanks to the development of computers and telecommunication, the concept of communication is undergoing radical changes. Scientific collaboration among medical professionals has evolved rapidly in the last few years toward the use of Internet, a new tool which will change the world of health. It is impossible to predict at present where this new type of scientific collaboration will lead us, but what is certain is that in the next decade, the so-called electronic communities will be created and will develop at an extraordinary rate. The increase in the capacity of image processing in computers and in the rate of transmission of data over the net will make possible applications such as the remote medical visit, video conferences, surgical simulation or even remote virtual surgery. However, while some medical professionals are dreaming of this type of electronic communication in the future, others are using it right now, taking advantage of all of its benefits. In fact, electronic communities are already a reality, being accessible today, and not a future goal. Being inside or outside these communities will make the difference between health professionals. It is well worth therefore being in contact with these new fields so as not to miss the boat of technological development. We present a comprehensive listing of neurosurgical resources available on the Internet, and some ideas on the present and future applications of the Internet in the world of Health Care.

The origins of informatics

This article summarizes the origins of informatics, which is based on the science, engineering, and technology of computer hardware, software, and communications. In just four decades, from the 1950s to the 1990s, computer technology has progressed from slow, first-generation vacuum tubes, through the invention of the transistor and its incorporation into microprocessor chips, and ultimately, to fast, fourth-generation very-large-scale-integrated silicon chips. Programming has undergone a parallel transformation, from cumbersome, first-generation, machine languages to efficient, fourth-generation application-oriented languages. Communication has evolved from simple copper wires to complex fiberoptic cables in computer-linked networks. The digital computer has profound implications for the development and practice of clinical medicine.

Some tools for the diffusion of biomedical information using research networks

Research and academic computer networks provide e-mail and other services to all members of participating institutions. Their usage by biomedical researchers and clinicians is still limited because of several reasons, including limited awareness of the available network resources. An increased use of these networks within the biomedical community would allow fast, effective communications and convenient remote access to information sources. As an example and pilot study, we prepared two network tools to make some information services maintained by our institution also accessible through e-mail. Both tools were implemented using PMDF e-mail software on a DEC MicroVAX connected to the Italian academic and research network (GARR), which is linked to the U.S. Internet. A network server takes care of automatic distribution of documents (files) reporting results of an oncology research/education project. An information server provides for semiautomated support of a consulting service on use of drugs. The feasibility of implementing these tools, based on existing software, further illustrates the potential usefulness of research computer networks for the dissemination of biomedical information.

DecisionNET: database/network support for clinical decision analysts

DecisionNET is a proposed remote database/wide-area computer network that should cultivate quantitative approaches to medicine by providing rapid access to medical facts, literature citations, decision models, and commentary of specific use to those involved with quantitative clinical decision making. Increasing accessibility to data and providing a forum for exchange of ideas should prove to be a significant asset to clinicians, either as modelers or as clients. Further work will address specific database implementation, development of a query engine, and coordination of the communications infrastructure. DecisionNET provides a unique model for the growth and maintenance of other medical knowledge bases.

Internet routing

Comprising an estimated 60,000 hosts, the DARPA Internet is the largest existing internet. This paper traces the routing information protocols used by Internet gateways to build routing tables that define the paths datagrams traverse as they travel between end systems. We articulate the weaknesses and limitations of the most commonly used routing protocols, including RIP, GGP, and HELLO and examine how the protocols interact with each other and with EGP. Finally, we trace the evolution of routing as the Internet has grown from a single backbone (ARPANET) to its present inclusion of the ARPANET, Milnet, and NSFnet cross-country networks.

Use of a satellite-assisted computer link for long-distance research collaboration

Research collaboration between investigators located at some distance from each other is not only possible but also feasible. By using satellite-assisted computer-to-computer links, researchers across the United States and overseas work with the staff and facilities of the Cardiovascular Research and Training Center (CVRTC) in the University of Washington, Seattle. This report presents the mechanics, advantages, and results of using such an approach to collaborate with distant colleagues.