bluuebunny/crossref_metadata_2025 huggingface dataset:
Diffusion Tensor Imaging for Dementia
Authors: Yamada Kei , Akazawa Kentaro , Nishimura Tsunehiko
Published: May 2011

Magnetic resonance MR tractography based on diffusion tensor imaging (DTI) was first introduced to the medical imaging community a decade ago. Since then, it has been successfully applied to a number of neurological conditions. It has been most commonly applied to the pre-operative planning of brain tumors. The other areas with active research additionally include stroke, multiple sclerosis and dementia, providing valuable information that would not be available through other imaging techniques. Tractography was first introduced with the deterministic streamline technique and has evolved to use more sophisticated probabilistic approaches. In this chapter, the authors will describe the clinical application of this tractographic technique to patients with dementia.
Development of Tactile Display Devices Using fMRI under High Magnetic Fields
Authors: Kitazawa Masayuki
Published: May 2011

Recently, the physiological function of the human brain has become the subject of several investigations. Several methods have been developed to measure neural functioning. One such method is functional magnetic resonance imaging (fMRI). This approach is utilized under a high magnetic field with an average strength of 1.5T. As a result, special devices are needed to serve as stimuli for subjects in an fMRI study. In particular, devices for the investigation of tactile sense are rare. In this work, the authors report the development of novel tactile display devices. These devices can be used to stimulate the skin of the subject’s hand to produces both pressure and movement stimulation. The devices are manipulated with ultrasonic motors that do not have coils and are constructed with non-magnetic materials, such as stainless steel and acrylic acid resin. Therefore, these devices can be used without disturbing the high magnetic field. To quantify the influence of the devices to the magnetic field, signal to noise ratios (SNR) for images generated by MRI were measured. These experiments confirmed that the SNR was altered by 5% when the devices were present; however, this change is within the acceptable range for the quality of an MRI image. From this work, the authors conclude that the developed devices have sufficient performance under high magnetic field conditions.
The Use of Mesh Glove Neurostimulation for Motor Recovery in Chronic Stroke
Authors: Nishino Katsuhiro , Yamaguchi Suguru , Matsuzono Kousuke , Yamamoto Hiroyuki
Published: May 2011

The results showed that the range of motion (ROM) was improved in 6 out of 7 cases, while fine movement of the hand was also improved in 4 cases. These improvements were observed a few days after the initiation of whole-hand electrical neural stimulation. In one chronic stroke case, the treatment resulted in an almost full recovery of hand control during the first 30 minutes of sub-threshold sensory stimulation, including pinching and grasping. This dramatic recovery led the authors to hypothesize that the responder would show no lesioning of the motor cortex on CT or MRI images. While more cases are needed to test the limitations of this modality and to determine the relationship between the level of recovery and the topology of CNS lesioning, this work illustrates the utility of this approach for improving motor control of the hand in chronic stroke patients.
A Novel Length Display Device for Cognitive Experiments and Rehabilitation
Authors: Kitayama Naotsugu , Wang Haibo , Takahashi Satoshi , Wu Jinglong
Published: May 2011

The purpose of this study was to develop a finger display device that has a four-degree-of-freedom (4DOF) length. This device was designed for rehabilitation and cognitive experimentation. The device can change the finger span between the thumb and four fingers, and the distance between digits is controlled by four motors. The positions of each unit, including the motor, are self-adjusted. Adjustments are made after recording the motion of the individual’s hand and analyzing fingertip movement. Each finger is controlled independently, and rehabilitation is performed on each individual finger. The device can be used for not only rehabilitation but also basic tactile studies. In particular, this device provides a valid method to measure length.
A Log-linearized Viscoelastic Model for Measuring Changes in Vascular Impedance
Authors: Kutluk Abdugheni , Nakamura Ryuji , Tsuji Toshio , Ukawa Teiji , Saeki Noboru , Yoshizumi Masao , Kawamoto Masashi
Published: May 2011

This chapter proposes a new nonlinear model, called a log-linearized viscoelastic model, to estimate the dynamic characteristics of human arterial walls. The model employs mechanical impedance factors, including stiffness and viscosity, in beat-to-beat measured from biological signals such as arterial blood pressure and photoplethysmograms. The validity of the proposed method is determined by demonstrating how arterial wall impedance properties change during arm position testing in the vertical direction. The estimated stiffness indices are compared with those of the conventional linear model. Estimated impedance parameters with contribution ratios exceeding 0.97 were used for comparison. The results indicated that stiffness and viscosity decrease when the arm is raised and increase when it is lowered, in the same pattern as mean blood pressure. However, the changes seen in the proposed nonlinear viscoelastic parameter are smaller (P < 0.05) than those of the linear model. This result suggests that the proposed nonlinear arterial viscoelastic model is less affected by changes in mean intravascular pressure during arm position changes.
Surface EMG and Upper-Limb Rehabilitation
Authors: Funada Kazuya , Wu Jinglong , Takahashi Satoshi
Published: May 2011

In rehabilitating hemiplegic patients, purposeful movements such as the opening and closing of hands are reported to be more effective than passive movement with an instrument. The authors of this chapter used surface electromyogram (surface EMG) signals as a way to convey the patient’s conscious ability to open and close their hands. The muscles in the forearm contract when the hand is closed or opened, which creates a simple signal that is comparatively easy to measure with surface EMG, a simple measuring device. The action potentials of the muscles involved in the opening-and-closing motions of hands were measured from several points in the forearm when those muscles contracted, and their distribution was analyzed. The purpose of this study is to develop a simple system to recognize the movement of a patient’s hand using measurements of EMG signals from only the most characteristic points on the forearm to replace similar, but more complex, research such as multi-channel measurement and wave analysis by FFT. The authors specified the optimum measuring points on the palm and dorsal sides of the forearm for the recognition of hand motion by the experimental system. This system successfully recognized hand motion through the analysis of the surface EMG signals measured from only two optimum points to allow arbitrary control of the rehabilitation device based on the recognition results.
E-Health as the Realm of Healthcare Quality
Authors: Moumtzoglou Anastasius
Published: May 2011

E-health has widely revolutionized medicine, creating subspecialties that include medical image technology, computer aided surgery, and minimal invasive interventions. New diagnostic approaches, treatment, prevention of diseases, and rehabilitation seem to speed up the continual pattern of innovation, clinical implementation and evaluation up to industrial commercialization. The advancement of e-health in healthcare derives large quality and patient safety benefits. Advances in genomics, proteomics, and pharmaceuticals introduce new methods for unraveling the complex biochemical processes inside cells. Data mining detects patterns in data samples, and molecular imaging unites molecular biology and in vivo imaging. At the same time, the field of microminiaturization enables biotechnologists to start packing their bulky sensing tools and medical simulation bridges the learning divide by representing certain key characteristics of a physical system.
Adoption of Electronic Health Records
Authors: Ahmad Yousuf J. , Raghavan Vijay V. , Martz Jr. William Benjamin
Published: May 2011

Adoption of Electronic Health Records (EHR) can provide an impetus to a greater degree of overall adoption of Information Technology (IT) in many healthcare organizations. In this study, using a Delphi technique, input from 40 CIO responses is analyzed to provide an insight into acceptance and adoption of EHRs at an enterprise level. Many useful findings emerged from the study. First, a majority of the participants believed that about 40-49 percent of the providers will be using EHRs by the year 2014, thus highlighting the need for studying EHR diffusion in hospitals. As predictors of successful implementations, physicians’ leadership and attitude was ranked as the most important factor. Another significant determinant of success was the business model of the physicians—whether they are affiliated with hospitals or working independently. This factor highlights the need to employ different strategies to encourage adoption of EHRs among these distinct groups. All findings are discussed, including their implications for IT diffusion in healthcare.
A Framework for Information Processing in the Diagnosis of Sleep Apnea
Authors: Abeyratne Udantha R.
Published: May 2011

Obstructive sleep apnea (OSA) is one of the most common sleep disorders. It is characterized by repetitive obstruction of the upper airways during sleep. The frequency of such events can range up to hundreds of events per sleep-hour. Full closure of the airways is termed apnea, and a partial closure is known as hypopnea. The number of apnea/hypopnea events per hour is known as the AHI-index, and is used by clinical community as a measure of the severity of OSA. OSA, when untreated, presents as a major public health concern throughout the world. OSA patients use health facilities at twice the average rate (Delaive, Roos, Manfreda, & Kryger, 1998), causing huge pressures on national healthcare systems. OSA is associated with serious complications such as cardiovascular disease, stroke, (Barber & Quan, 2002; Kryger, 2000,), and sexual impotence. It also causes cognitive deficiencies, low IQ in children, fatigue, and accidents. Australian Sleep Association reported (ASA, 1999) that in the state of New South Wales alone 11,000–43,000 traffic accidents per year were attributable to untreated-OSA.
Computer Aided Risk Estimation of Breast Cancer
Authors: Spyrou George M. , Ligomenides Panos A.
Published: May 2011

In this chapter the authors report about their experiences in designing, implementing, prototyping and evaluating a system for computer aided risk estimation of breast cancer. The strategy and architecture of “Hippocrates-mst” along with its functionalities are going to be presented. Also, the evaluation results in the clinical practice concerning the performance of “Hippocrates-mst” in the “Ippokrateio” University Hospital of Athens will be presented. The feedback from medical experts along with the new features of the system that are under development will be discussed.
Segmentation Methods in Ultrasound Images
Authors: Sahba Farhang
Published: May 2011

Ultrasound imaging now has widespread clinical use. It involves exposing a part of the body to highfrequency sound waves in order to generate images of the inside of the body. Because it is a real-time procedure, the ultrasound images show the movement of the body’s internal structure as well. It is usually a painless medical test and its procedures seem to be safe. Despite recent improvement in the quality of information from an ultrasound device, these images are still a challenging case for segmentation. Thus, there is much interest in understanding how to apply an image segmentation task to ultrasound data and any improvements in this regard are desirable. Many methods have been introduced in existing literature to facilitate more accurate automatic or semi-automatic segmentation of ultrasound images. This chapter is a basic review of the works on ultrasound image segmentation classified by application areas, including segmentation of prostate transrectal ultrasound (TRUS), breast ultrasound, and intravascular ultrasound (IVUS) images.
Socio-Technical Structures, 4Ps and Hodges’ Model
Authors: Jones Peter
Published: May 2011

This chapter explores the potential of a conceptual framework – Hodges’ model – both as a socio-technical structure and means to explore such structures of relevance to nursing informatics theory and practice. The model can be applied universally by virtue of its structure and the content which it can encompass. In apprehending this chapter, readers will be able to draw, describe and explain the scope of Hodges’ model within contemporary healthcare contexts and the wider global issues presented by the 21st Century that influence and shape nursing informatics. Critically, the reader will also gain insight into how socio-technical structures can facilitate cross fertilization of clinical and informatics theory and practice; drawing attention to information as a concept that provides a bridge between socio-technical, clinical, and informatics disciplines. This chapter will review the socio-technical literature and venture definitions of socio-technical structures related to Hodges’ model and advocate the need for sociopolitical-technical structures. The chapter also proposes the 4Ps as a tool to facilitate reflection upon and the construction of socio-technical structures. The adoption and significance of the hyphenated form as per “socio-technical” will also be explained.
The European Perspective of E-Health and a Framework for its Economic Evaluation
Authors: Di Giacomo Paola
Published: May 2011

E-health is a priority of the European i2010 initiative, which aims to provide safe and interoperable information systems for patients and health professionals throughout Europe. Moreover, the use of electronic storing and transmission of data to patients is increasing while through the deployment of e-health applications, health care is improved in terms of waiting time for patients. The concentration results from the cumulative incidence of chronic-degenerative pathologies, the greater utilization of biomedical technologies, and the increased health services demand. Finally, the interest towards electromechanical systems means the realization of tools of small dimensions, which have tremendous advantages thanks to their invasivity and greater diagnostic-therapeutic effectiveness. Therefore, an economic analysis has to take into consideration the use of biomedical technology, the analysis of alternatives, the selection of the economic evaluation technique, and the identification and quantification of the costs and benefits.
Sensing of Vital Signs and Transmission Using Wireless Networks
Authors: Jasemian Yousef
Published: May 2011

People living with chronic medical conditions, or with conditions requiring short term monitoring, need regular and individualized care to maintain their normal lifestyles. Mobile healthcare is a solution for providing patients’ mobility while their health is being monitored. Existing studies show that mobile healthcare can bring significant economic savings, improve the quality of care, and consequently the patient’s quality of life. However, despite all progresses in advanced information and telecommunication technologies, there are still very few functioning commercial wireless mobile monitoring devices present on the market, which most work off-line, are not proper for m-health services and there are still many issues to be dealt with. This chapter deals with a comprehensive investigation of feasibility of wireless and cellular telecommunication technologies and services in a real-time m-health system. The chapter bases its investigation, results, discussion and argumentation on an already developed remote patient monitoring system by the author. The implemented m-health system has been evaluated and validated by a number of well defined tests and experiments. The designed and implemented system fulfils the requirements. The suggested system is reliable, functions with a clinically acceptable performance, and transfers medical data with a reasonable quality, even though the system was tested under totally uncontrolled circumstances during the patients’ daily activities. Both the patients and the involved healthcare personnel expressed their confidence in using it. It is concluded that the system is applicable in clinical setup, and might be generalized in clinical practice. Finally, the chapter suggests improvement approaches for more reliable, more secure, more user-friendly and higher performance of an m-health system in future.
Neural Networks in Medicine
Authors: Logeswaran Rajasvaran
Published: May 2011

Automatic detection of tumors in the bile ducts of the liver is very difficult as often, in the defacto noninvasive diagnostic images using magnetic resonance cholangiopancreatography (MRCP), tumors are not clearly visible. Specialists use their experience in anatomy to diagnose a tumor by absence of expected structures in the images. Naturally, undertaking such diagnosis is very difficult for an automated system. This chapter proposes an algorithm that is based on a combination of the manual diagnosis principles along with nature-inspired image processing techniques and artificial neural networks (ANN) to assist in the preliminary diagnosis of tumors affecting the bile ducts in the liver. The results obtained show over 88% success rate of the system developed using an ANN with the multi-layer perceptron (MLP) architecture, in performing the difficult automated preliminary detection of the tumors, even in the robust clinical test images with other biliary diseases present.
Modeling of Porphyrin Metabolism with PyBioS
Authors: Daskalaki Andriani
Published: May 2011

Photodynamic Therapy (PDT) involves administration of a photosensitizer (PS) either systemically or locally, followed by illumination of the lesion with visible light. PDT of cancer is now evolving from experimental treatment to a therapeutic alternative. Clinical results have shown that PDT is at least as efficacious as standard treatments of malignancies of the skin and Barrett’s esophagus. Hemes and heme proteins are vital components of essentially every cell in virtually all eukaryote organisms. Protoporphyrin IX (PpIX) is produced in cells via the heme synthesis pathway from the substrate aminolevulinic acid (ALA). Exogenous administration of ALA induces accumulation of (PpIX), which can be used as a photosensitiser for tumor detection or photodynamic therapy. Although the basis of the selectivity of ALA-based PDT or photodiagnosis is not fully understood, it has sometimes been correlated with the metabolic rate of the cells, or with the differential enzyme expressions along the heme biosynthetic pathway in cancer cells. An in silico analysis by modeling may be performed in order to determine the functional roles of genes coding enzymes of the heme biosynthetic pathway like ferrochelatase. Modeling and simulation systems are a valuable tool for the understanding of complex biological systems. With PyBioS, an object-oriented modelling software for biological processes, we can analyse porphyrin metabolism pathways.
Ultrasound Guided Noninvasive Measurement of Central Venous Pressure
Authors: Aggarwal Vikram , Cho Yoonju , Chatterjee Aniruddha , Cheung Dickson
Published: May 2011

Central venous pressure (CVP) is a measure of the mean pressure within the thoracic vena cava, which is the largest vein in the body and responsible for returning blood from the systemic circulation to the heart. CVP is a major determinant of the filling pressure and cardiac preload, and like any fluid pump, the heart depends on an adequate preload to function effectively. Low venous return translates into a lower preload and a drop in overall cardiac output, a relationship described by the Frank-Starling Mechanism. CVP is an important physiological parameter, the correct measure of which is a clinically relevant diagnostic tool for heart failure patients. In addition to other vitals such as heart rate and mean arterial pressure, accurate measures of central venous pressure through simple diagnostic instrumentation would provide physicians with a clear picture of cardiac functionality, and allow for more targeted treatment. Recent literature has also shown that measuring CVP can be an important hemodynamic indicator for the early identification and treatment of more widespread conditions, such as sepsis (Rivers, Nguyen, Havstad, & Ressler, 2001). With over five million patients (American Heart Association, http://www.americanheart.org/presenter. jhtml) in the U.S. presenting with heart failure-like symptoms annually, a current challenge for physicians is to obtain a quick and accurate measure of a patient’s central venous pressure in a manner that poses minimum discomfort.
The Use and Evaluations of IT in Chronic Disease Management
Authors: Adler-Milstein Julia , Linden Ariel
Published: May 2011

This chapter describes the broad array of information technologies currently used in programs that manage individuals with chronic diseases and discusses evaluation strategies to assess the impact of implementing programs that incorporate such technologies. More specifically, it describes the three components of a chronic disease management program and then details the technologies commonly used in each component. Three evaluation designs well-suited to measure DM program effectiveness are also discussed. The intent of this chapter is to educate readers on the range of approaches to incorporating information technology into chronic disease management and the most appropriate evaluation designs that will strengthen the understanding of which approaches are most successful.
The MOBEL Project
Authors: Dybdahl Sorby Inger , Melby Line , Dahl Yngve , Seland Gry
Published: May 2011

This chapter presents results and experiences from the MOBEL (MOBile ELectronic patient record) project at the Norwegian University of Science and Technology (NTNU) in Trondheim, Norway. MOBEL was a multidisciplinary research project established in 2000. The problem area of the project was communication and information needs in hospital wards, and the aim of the project was to develop and explore methods and prototypes for point of care clinical information systems (PoCCS) that support clinicians in their patient-centered activities. The chapter summarizes four sub studies performed during the project. Each study presents different approaches to user-centered design of PoCCS. Findings from these studies confirm the need for mobile information and communication technology (ICT) in hospitals. Furthermore, the studies demonstrate how more user involvement and complementary approaches to traditional requirements engineering (RE) and system development methods can be useful when developing mobile information and communication systems for clinicians.
Clinical Decision Support System To Prevent Toxicity In Patients Treated With Digoxin
Authors: Albert Asunción , Serrano Antonio J. , Soria Emilio , Jiménez Nicolás Victor
Published: May 2011

In this chapter, authors develop a system for prevention and detection of congestive heart failure and fibrillation. Due to its narrow therapeutic range more than 10% of the patients treated with DGX can suffer toxic effects, but it is estimated that half of the cases of digitalis toxicity could be prevented. Two multivariate models were developed to prevent digitalis toxicity.
Reporting Clinical Gait Analysis Data
Authors: White Raymond , Noble Robert
Published: May 2011

Gait analysis is a special investigation that can assist clinical staff in the decision making process regarding treatment options for patients with walking difficulties. Interpretation of gait analysis data recorded from 3D motion capture systems is a time consuming and complex process. This chapter describes techniques and a software program that can be used to simplify interpretation of gait data. It can be viewed with an interactive display and a gait report can be produced more quickly with the key results highlighted. This will allow referring clinicians to integrate the relevant gait measurements and observations and to formulate the patient treatment plan. Although an abbreviated analysis may be useful for clinicians, a full explanation with the key features highlighted is helpful for movement scientists. Visualization software has been developed that directs the clinician and scientist to the relevant parts of the data simplifying the analysis and increasing insight.
Verification of Uncurated Protein Annotations
Authors: Couto Francisco M. , Silva Mário J. , Lee Vivian , Dimmer Emily , Camon Evelyn , Apweiler Rolf
Published: May 2011

Molecular Biology research projects produced vast amounts of data, part of which has been preserved in a variety of public databases. However, a large portion of the data contains a significant number of errors and therefore requires careful verification by curators, a painful and costly task, before being reliable enough to derive valid conclusions from it. On the other hand, research in biomedical information retrieval and information extraction are nowadays delivering Text Mining solutions that can support curators to improve the efficiency of their work to deliver better data resources. Over the past decades, automatic text processing systems have successfully exploited biomedical scientific literature to reduce the researchers’ efforts to keep up to date, but many of these systems still rely on domain knowledge that is integrated manually leading to unnecessary overheads and restrictions in its use. A more efficient approach would acquire the domain knowledge automatically from publicly available biological sources, such as BioOntologies, rather than using manually inserted domain knowledge. An example of this approach is GOAnnotator, a tool that assists the verification of uncurated protein annotations. It provided correct evidence text at 93% precision to the curators and thus achieved promising results. GOAnnotator was implemented as a web tool that is freely available at http://xldb.di.fc.ul.pt/rebil/tools/goa/.
Relationship Between Shrinkage and Stress
Authors: Versluis Antheunis , Tantbirojn Daranee
Published: May 2011

Residual stress due to polymerization shrinkage of restorative dental materials has been associated with a number of clinical symptoms, ranging from post-operative sensitivity to secondary caries to fracture. Although the concept of shrinkage stress is intuitive, its assessment is complex. Shrinkage stress is the outcome of multiple factors. To study how they interact requires an integrating model. Finite element models have been invaluable for shrinkage stress research because they provide an integration environment to study shrinkage concepts. By retracing the advancements in shrinkage stress concepts, this chapter illustrates the vital role that finite element modeling plays in evaluating the essence of shrinkage stress and its controlling factors. The shrinkage concepts discussed in this chapter will improve clinical understanding for management of shrinkage stress, and help design and assess polymerization shrinkage research.
Primary Care through a Public-Private Partnership
Authors: Bergkvist Sofi , Pernefeldt Hanna
Published: May 2011

The primary care delivery model developed by the Health Management and Research Institute (HMRI) in India, integrates innovative technical solutions and process-oriented operations for the provision of healthcare services, while supporting the public health system. Through a public-private partnership with the state government of Andhra Pradesh, HMRI has a unique base to pilot large scale health interventions. The HMRI Model includes components such as a medical helpline, rural outreach health services, a disease surveillance program, a blood bank application, and telemedicine projects. Both clinical and non-clinical procedures are strengthened by technology that enables research, tailored and evidence-based interventions, as well as improves efficiency and quality of healthcare delivery. Health management and decision-making is assisted by the organization’s large database of electronic medical records. Challenges to implementation include implications of large government contracts, funding issues, as well as technical constraints and human resources issues. This chapter describes the Model’s various components and its contextual framework with enabling and constraining factors. HMRI has developed a unique system for preventive and primary care that can serve as a model for low, middle, and high income countries, though external evaluations are critically needed for further assessment of best practices.
Strategic Fit in the Healtcare IDS
Authors: Thrasher Evelyn H. , Byrd Terry A.
Published: May 2011

Interorganizational networks are defined as “clusters of organizations that make decisions jointly and integrate their efforts to produce a product or service” (Alter & Hage, 1993, p.2) and “advanced organizational structures perceived to improve efficiency, flexibility, and innovativeness and described as decoupled units developed because of rapid growth or knowledge and technology” (Schumaker, 2002). The healthcare integrated delivery system (IDS) is a distinct example of an interorganizational network. Defined as networks of healthcare organizations linked for the goals of clinical integration and an effective patient care continuum (Zucherman, Kaluzny, & Ricketts, 1995; Kilbridge, 1998; Young & McCarthy, 1999; Deluca & Enmark, 2002), IDSs may assume various organizational forms, namely strategic alliances, contracted networks, or joint ventures and may be comprised of multiple forms within a single network (Page, 2003). Also of interest is the distinction of the IDS as a lateral network of stakeholders, all directly serving the patient. This study uses the healthcare IDS to test a model of strategic fit and to examine differences in the nature and strength of the strategic fit to performance relationship across two distinct levels of IDS development.
Synthetic Speech Perception in Individuals with Intellectual and Communicative Disabilities
Authors: Koul Rajinder , Dembowski James
Published: May 2011

The purpose of this chapter is to review research conducted over the past two decades on the perception of synthetic speech by individuals with intellectual, language, and hearing impairments. Many individuals with little or no functional speech as a result of intellectual, language, physical, or multiple disabilities rely on non-speech communication systems to augment or replace natural speech. These systems include Speech Generating Devices (SGDs) that produce synthetic speech upon activation. Based on this review, the two main conclusions are evident. The first is that persons with intellectual and/or language impairment demonstrate greater difficulties in processing synthetic speech than their typical matched peers. The second conclusion is that repeated exposure to synthetic speech allows individuals with intellectual and/or language disabilities to identify synthetic speech with increased accuracy and speed. This finding is of clinical significance as it indicates that individuals who use SGDs become more proficient at understanding synthetic speech over a period of time.
Systems Engineering and Health Informatics
Authors: Pasupathy Kalyan Sunder
Published: May 2011

Healthcare organizations are struggling to provide safe and high quality care while reducing costs. Abundant data on various aspects of the care delivery process (both clinical and non-clinical) are collected and stored in large databases in different parts of the organization. Informatics, as an area of study with roots in computer science and information science, has grown and evolved to enable collection, storage, retrieval, and analysis of data, and reporting of useful information. Health informatics (HI) ranges from bioinformatics to public health informatics depending on the level of focus and applications. At the same time, systems engineering (SE), as an interdisciplinary field of engineering, has grown to encompass the design, analysis, and management of complex health systems to improve their quality and performance. HI and SE are complementary in their approach to identification of problems, methodology, and solution procedure for improvement. This combination brings forth implications for industry and education to address pressing issues of today’s health care delivery.
A Distributed Approach of a Clinical Decision Support System Based on Cooperation
Authors: Ruiz-Fernandez Daniel , Soriano-Paya Antonio
Published: May 2011

The incorporation of computer engineering into medicine has meant significant improvements in the diagnosis-related tasks. This chapter presents an architecture for diagnosis support based on the collaboration among different diagnosis-support artificial entities and the physicians themselves; the authors try to imitate the clinical meetings in hospitals in which the members of a medical team share their opinions in order to analyze complicated diagnoses. A system that combines availability, cooperation and harmonization of all contributions in a diagnosis process will bring more confidence in healthcare for the physicians. They have tested the architecture proposed in two different diagnosis, melanoma, and urological dysfunctions.
Diagnostic Cost Reduction Using Artificial Neural Networks
Authors: Walczak Steven , Brimhall Bradley B. , Lefkowitz Jerry B.
Published: May 2011

Patients face a multitude of diseases, trauma, and related medical problems that are difficult and costly to diagnose with respect to direct costs, including pulmonary embolism (PE). Advanced decision-making tools such as artificial neural networks (ANNs) improve diagnostic capabilities for these problematic medical conditions. The research in this chapter develops a backpropagation trained ANN diagnostic model to predict the occurrence of PE. Laboratory database values for 292 patients who were determined to be at risk for a PE, with 15% suffering a confirmed PE, are collected and used to evaluate various ANN models’ performance. Results indicate that using ANN diagnostic models enables the leveraging of knowledge gained from standard clinical laboratory tests, significantly improving both overall positive predictive and negative predictive performance.
The Regulation of Genetic Testing and the Protection of Genetic and Medical Information in Singapore
Authors: Kaan Terry
Published: May 2011

In the decades since its independence in 1965, the transformation of Singapore’s economy and its transition to a relatively developed economy has also in like manner transformed its health care system, and of the demands made of it. The emergence and availability of new medical technologies has put into sharp focus many novel legal, ethical as well as social issues. This chapter looks at how Singapore has attempted to respond to issues thrown up by genetic testing and screening technologies. A particular focus of this chapter will be the tension between privacy concerns, and the imperatives of access for biomedical research, given that biomedical research has been championed by the Singapore government as one of the future leading sectors of the economy of Singapore. This chapter also examines Singapore’s approach to the question of “genetic exceptionalism:” Does genetic information possess special qualities or attributes that remove it from the realm of ordinary personal information, and which thereby demands special treatment and protection? In this context, the impact of the doctrine of genetic exceptionalism on industry (in this case the insurance industry) is examined.
Data Security in Electronic Health Records
Authors: Kabene Stefane M , Leduc Raymond W. , Gibson Candace J
Published: May 2011

Traditionally, patient information has been recorded on paper and stored in file folders at healthcare facilities and within physicians’ offices. The implementation of electronic health records (EHRs), the lifetime record of an individual’s health and health services delivered, allows for information to be stored on computers and offers the opportunity to store considerably more data, in much less space, with new efficiencies and value added as information is easier to access, legible, timely, non-redundant and readily available. However, there are many issues to consider with the implementation of a fully shared EHR. The protection of the information contained in the record is of the utmost importance as individuals stand to become quite vulnerable if that personal health information is compromised or accessed by unauthorized users. Therefore, one of the goals of this chapter is to uncover ways in which personal health information is being protected in EHR systems. The second objective, a broader one, examines what regulations, legislation and policies are in place that remove some of the uncertainty and risk and make the use of shared information safe and secure. Many of the techniques and technologies used so far are adopted from the corporate world, where data security has been an issue for some time. Current legislation in the United States and Canada at both the federal and state/provincial levels has addressed the general principles of data security and privacy but are still lacking in specifics with regard to cross-jurisdictional sharing of health information and the implementation and use of EHRs. Many of the researchers and studies on the subject find this to be one of the most important areas of concern moving forward. The opportunities for EHR implementation and use are exciting as they have the strong potential to improve both individual health care and population health, but without proper regulation and policies in place it is possible that the risks may outweigh the benefits.
Legal Issues in Health Information and Electronic Health Records
Authors: Ries Nola M.
Published: May 2011

This chapter discusses key legal issues raised by the contemporary trend to managing and sharing patient information via electronic health records (EHR). Concepts of privacy, confidentiality, consent, and security are defined and considered in the context of EHR initiatives in Canada, the United Kingdom, and Australia. This chapter explores whether patients have the right to withhold consent to the collection and sharing of their personal information via EHRs. It discusses opt-in and opt-out models for participation in EHRs and concludes that presumed consent for EHR participation will ensure more rapid and complete implementation, but at the cost of some personal choice for patients. The reduction in patient control over personal information ought to be augmented with strong security protections to minimize risks of unauthorized access to EHRs and fulfill legal and ethical obligations to safeguard patient information.
New Technologies in Hospital Information Systems
Authors: Petroudi Dimitra , Giannakakis Nikolaos
Published: May 2011

A hospital information system (HIS), variously also called clinical information system (CIS), is a comprehensive, integrated information system designed to manage the administrative, financial, and clinical aspects of a hospital. This encompasses paper-based information processing as well as data processing machines. As an area of medical informatics, the aim of an HIS is to achieve the best possible support of patient care and administration by electronic data processing. It can be composed of one or few software components with specialty specific extensions, as well as of a large variety of subsystems in medical specialties (e.g., laboratory information system, radiology information system). CISs are sometimes separated from HISs in that the former concentrate on patient and clinical state-related data (electronic patient record), whereas the latter keeps track of administrative issues. The distinction is not always clear, and there is contradictory evidence against a consistent use of both terms.
Emerging Technologies for Aging in Place
Authors: Becker Shirley Ann , Webbe Frank
Published: May 2011

Similar to other nations, the United States faces a critical challenge in dealing with an aging population that has unprecedented life expectancies. Emerging technologies offer the hope of allowing older adults to remain in their homes longer by empowering individuals to manage daily activities while dealing with chronic health conditions and age-related diseases. These technologies increasingly target a home environment whereby on a regular basis an individual can obtain assistance in performing daily living activities, stay connected to family and friends, manage medication, and be monitored for health-related changes. As important as these assistive technologies are for individuals and families, their potential for positively impacting the United States economy by changing the model of healthcare delivery is equally huge.
New Developments in Intracoronary Ultrasound Processing
Authors: Bourantas Christos V. , Naka Katerina , Fotiadis Dimitrios , Michalis Lampros
Published: May 2011

Intracoronary Ultrasound (ICUS) imaging is an intravascular catheter-based technique which provides real-time, high resolution, cross-sectional images of coronary arteries. In these images the lumen, the media-adventitia border, the plaque burden and the composition of the plaque can be identified. Conventionally, ICUS border detection is performed manually. However, this process is laborious and time consuming. To enhance the clinical applicability of ICUS, several automated algorithms have been developed for fast ICUS segmentation and characterisation of the type of the plaque. In this chapter the authors present an overview on the developments in ICUS processing and they describe advanced methodologies which fuse ICUS and X-ray angiographic data in order to overcome indigenous limitations of ICUS imaging and provide complete and geometrically correct coronary reconstruction.
Buffer Management in Cellular IP Network using PSO
Authors: Anbar Mohammad , Vidyarthi Deo Prakash
Published: May 2011

Cellular IP networks deal with the concepts of micro-mobility. Buffer management in Cellular IP networks is very crucial as its proper usage not only increases the throughput of the network but also results in the reduction of the call drops. This article proposes a model for buffer management in Cellular IP network using Particle Swarm Optimization (PSO), an evolutionary computational method often used to solve hard problems. The model considers two kinds of buffers; Gateway buffer and Base Station buffer. In the proposed two-tier model, the first tier applies a prioritization algorithm for prioritizing real-time packets in the buffer. In the second tier PSO algorithm is used on a swarm of cells in the network. PSO is applied for a given time slot, called window. In each window period the swarm can store number of packets depending on the window size and the total number of packets. The effect of various parameters e.g. number of packets, size of packets, window size, and a threshold value on buffer utilization has been studied by conducting the simulation experiments.
The Accuracy of Location Prediction Algorithms Based on Markovian Mobility Models
Authors: Fülöp Péter , Imre Sándor , Szabó Sándor , Szálka Tamás
Published: May 2011

The efficient dimensioning of cellular wireless access networks depends highly on the accuracy of the underlying mathematical models of user distribution and traffic estimations. The optimal placement/deployment of e.g. UMTS, IEEE 802.16 WiMAX base stations or IEEE 802.11 WLAN access points is based on user distribution and traffic characteristics in the service area. In this paper we focus on the tradeoff between the accuracy and the complexity of the mathematical models used to describe user movements in the network. We propose a novel Markov chain based model capable of utilizing user’s movement history thus providing more accurate results than other models in the literature. The new model is applicable in real-life scenarios, because it relies on information effectively available in cellular networks (e.g. handover history). The complexity of the proposed model is analyzed, and the accuracy is justified by means of simulation.
Frequency Domain Equalization and Adaptive OFDM vs. Single Carrier Modulation
Authors: Kaur Inderjeet
Published: May 2011

In the present article an attempt is made to compare multi-carrier and single carrier modulation schemes for wireless communication systems with the utilization of fast Fourier transform (FFT) and its inverse in both cases. With the assumption that in OFDM (orthogonal frequency division multiplexing), the inverse FFT transforms the complex amplitudes of the individual sub-carriers at the transmitter into time domain, the inverse operation is carried out at the receiver. In case of single carrier modulation, the FFT and its inverse are used at the input and output of the frequency domain equalizer in the receiver. Different single carrier and multi-carrier transmission systems are simulated with time-variant transfer functions measured with a wideband channel sounder. In case of OFDM, the individual sub-carriers are modulated with fixed and adaptive signal alphabets. Furthermore, a frequency-independent as well as the optimum power distribution are used. Single carrier modulation uses a single carrier, instead of the hundreds or thousands typically used in OFDM, so the peak-to-average transmitted power ratio for single carrier modulated signals is smaller. This in turn means that a SC system requires a smaller linear range to support a given average power. This enables the use of cheaper power amplifier as compared to OFDM system.[Article copies are available for purchase from InfoSci-on-Demand.com]
Mobile Video Streaming Over Heterogeneous Networks
Authors: Al-Suhail Ghaida A. , Fleury Martin , Al-Majeed Salah M. Saleh
Published: May 2011

All-IP networks are under development with multimedia services in mind. Video multicast is an efficient way to deliver one video simultaneously to many users over such heterogeneous wired-to-wireless networks, such as in wireless IP applications where a mobile terminal communicates with an IP server through a wired IP network in tandem with a wireless network. Unicast video streaming is also an attractive way to deliver time-shifted TV to mobile devices. This Chapter presents a simple cross-layer model that leads to the optimal throughput to multiple users for multicasting video over a heterogeneous network. An adaptive forward-error-correction scheme is applied at the byte-level as well as at the packet-level to reduce channel errors. The results show that a server can significantly adapt to the bandwidth and FEC codes to maximize the video quality of service. For unicast streaming, the Chapter presents a single negative acknowledgment scheme in which a video stream is transmitted over a heterogeneous network from a streaming server to a mobile device in a WiMAX network. The broadband streaming system is compared to several candidate solutions based on originally wired network congestion controllers. Multi-connection streaming is also investigated.
Automatic Talker Identification Using Optimal Spectral Resolution
Authors: Ouamour Siham , Sayoud Halim , Guerti Mhania
Published: May 2011

Results show the importance of the high spectral resolution in noisy environment and telephonic bandwidth, while the current research works have always favoured the low resolution of 24 coefficients in such tasks. For example, the authors notice an improvement of about 11% on the identification score, since they increase the resolution from 24 to 48 MFSC, in the telephonic bandwidth.