Search results for: Medical Surgical
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 652

Search results for: Medical Surgical

502 An Empirical Study of Taiwan-s Hospital Foundation Investment in Corporate Social Responsibility and Financial Performance

Authors: Hsiu-Pi Lin, Wen-Chen Huang, Hui-Fang Chen, Yan-Pin Ke

Abstract:

Corporate Social Responsibility (CSR) has become a new trend of business governance. Few research studies on CSR published in Taiwanese academia, especially for medical settings, we were interested in probing the relationship of CSR and financial performance in medical settings in Taiwan. The results illustrate that: (1) a time delay effect exists with a lag between CSR effort and its performance in the hospital foundation, (2) input into the internal domains of CSR will be helpful to improve employee productivity in the hospital foundation, and (3) input into the external domains of CSR will be helpful in improving financial performance in the hospital foundation. This study overviews CSR in the medical industry in Taiwan and the relationship of CSR and financial performance. Discussions of possible implications from the study results are applied to consult the CSR concept that will be transferred into a business strategy for the organization manager.

Keywords: Corporate Social Responsibility (CSR), financialperformance, hospital foundation,

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501 Exploring the Application of Knowledge Management Factors in Esfahan University's Medical College

Authors: Alireza Shirvani, Shadi Ebrahimi Mehrabani

Abstract:

In this competitive age, one of the key tools of most successful organizations is knowledge management. Today some organizations measure their current knowledge and use it as an indicator for rating the organization on their reports. Noting that the universities and colleges of medical science have a great role in public health of societies, their access to newest scientific research and the establishment of organizational knowledge management systems is very important. In order to explore the Application of Knowledge Management Factors, a national study was undertaken. The main purpose of this study was to find the rate of the application of knowledge management factors and some ways to establish more application of knowledge management system in Esfahan University-s Medical College (EUMC). Esfahan is the second largest city after Tehran, the capital city of Iran, and the EUMC is the biggest medical college in Esfahan. To rate the application of knowledge management, this study uses a quantitative research methodology based on Probst, Raub and Romhardt model of knowledge management. A group of 267 faculty members and staff of the EUMC were asked via questionnaire. Finding showed that the rate of the application of knowledge management factors in EUMC have been lower than average. As a result, an interview with ten faculty members conducted to find the guidelines to establish more applications of knowledge management system in EUMC.

Keywords: Knowledge, knowledge management, knowledge management factors.

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500 Intelligent Heart Disease Prediction System Using CANFIS and Genetic Algorithm

Authors: Latha Parthiban, R. Subramanian

Abstract:

Heart disease (HD) is a major cause of morbidity and mortality in the modern society. Medical diagnosis is an important but complicated task that should be performed accurately and efficiently and its automation would be very useful. All doctors are unfortunately not equally skilled in every sub specialty and they are in many places a scarce resource. A system for automated medical diagnosis would enhance medical care and reduce costs. In this paper, a new approach based on coactive neuro-fuzzy inference system (CANFIS) was presented for prediction of heart disease. The proposed CANFIS model combined the neural network adaptive capabilities and the fuzzy logic qualitative approach which is then integrated with genetic algorithm to diagnose the presence of the disease. The performances of the CANFIS model were evaluated in terms of training performances and classification accuracies and the results showed that the proposed CANFIS model has great potential in predicting the heart disease.

Keywords: CANFIS, genetic algorithms, heart disease, membership function.

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499 The Biomechanical Properties of the Different Modalities of Surgically Corrected Coarctation of the Aorta in Neonates and Infants

Authors: Elina Ligere, Valts Ozolins, Lauris Smits, Normunds Sikora, Ivars Melderis, Laila Feldmane, Aris Lacis, Vladimir Kasyanov

Abstract:

Biomechanical properties of infantile aorta in vitro in cases of different standard anastomoses: end-to-end (ETE), extended anastomosis end-to-end (EETE) and subclavian flap aortoplasty (SFA) used for surgical correction of coarctation were analyzed to detect the influence of the method on the biomechanics of infantile aorta and possible changes in haemodinamics. 10 specimens of native aorta, 3 specimens with ETE, 4 EEET and 3 SFA were investigated. The experiments showed a non-linear relationship between stress and strain in the infantile aorta, the modulus of elasticity of the aortic wall increased with the increase of inner pressure. In the case of anastomosis end-to-end the modulus was almost constant, relevant to the modulus of elasticity of the aorta with the inner pressure 100-120 mmHg. The anastomoses EETE and SFA showed elastic properties closer to native aorta, the stiffness of ETE did not change with the changes in inner pressure.

Keywords: biomechanics, coarctation, mechanical properties, neonatal aorta

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498 Incorporating Lexical-Semantic Knowledge into Convolutional Neural Network Framework for Pediatric Disease Diagnosis

Authors: Xiaocong Liu, Huazhen Wang, Ting He, Xiaozheng Li, Weihan Zhang, Jian Chen

Abstract:

The utilization of electronic medical record (EMR) data to establish the disease diagnosis model has become an important research content of biomedical informatics. Deep learning can automatically extract features from the massive data, which brings about breakthroughs in the study of EMR data. The challenge is that deep learning lacks semantic knowledge, which leads to impracticability in medical science. This research proposes a method of incorporating lexical-semantic knowledge from abundant entities into a convolutional neural network (CNN) framework for pediatric disease diagnosis. Firstly, medical terms are vectorized into Lexical Semantic Vectors (LSV), which are concatenated with the embedded word vectors of word2vec to enrich the feature representation. Secondly, the semantic distribution of medical terms serves as Semantic Decision Guide (SDG) for the optimization of deep learning models. The study evaluates the performance of LSV-SDG-CNN model on four kinds of Chinese EMR datasets. Additionally, CNN, LSV-CNN, and SDG-CNN are designed as baseline models for comparison. The experimental results show that LSV-SDG-CNN model outperforms baseline models on four kinds of Chinese EMR datasets. The best configuration of the model yielded an F1 score of 86.20%. The results clearly demonstrate that CNN has been effectively guided and optimized by lexical-semantic knowledge, and LSV-SDG-CNN model improves the disease classification accuracy with a clear margin.

Keywords: lexical semantics, feature representation, semantic decision, convolutional neural network, electronic medical record

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497 A Study of Gaps in CBMIR Using Different Methods and Prospective

Authors: Pradeep Singh, Sukhwinder Singh, Gurjinder Kaur

Abstract:

In recent years, rapid advances in software and hardware in the field of information technology along with a digital imaging revolution in the medical domain facilitate the generation and storage of large collections of images by hospitals and clinics. To search these large image collections effectively and efficiently poses significant technical challenges, and it raises the necessity of constructing intelligent retrieval systems. Content-based Image Retrieval (CBIR) consists of retrieving the most visually similar images to a given query image from a database of images[5]. Medical CBIR (content-based image retrieval) applications pose unique challenges but at the same time offer many new opportunities. On one hand, while one can easily understand news or sports videos, a medical image is often completely incomprehensible to untrained eyes.

Keywords: Classification, clustering, content-based image retrieval (CBIR), relevance feedback (RF), statistical similarity matching, support vector machine (SVM).

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496 Computer-aided Lenke Classification of Scoliotic Spines

Authors: Neila Mezghani, Philippe Phan, Hubert Labelle, Carl Eric Aubin, Jacques de Guise

Abstract:

The identification and classification of the spine deformity play an important role when considering surgical planning for adolescent patients with idiopathic scoliosis. The subject of this article is the Lenke classification of scoliotic spines using Cobb angle measurements. The purpose is two-fold: (1) design a rulebased diagram to assist clinicians in the classification process and (2) investigate a computer classifier which improves the classification time and accuracy. The rule-based diagram efficiency was evaluated in a series of scoliotic classifications by 10 clinicians. The computer classifier was tested on a radiographic measurement database of 603 patients. Classification accuracy was 93% using the rule-based diagram and 99% for the computer classifier. Both the computer classifier and the rule based diagram can efficiently assist clinicians in their Lenke classification of spine scoliosis.

Keywords: Scoliosis, Lenke model, decision-rules, computer aided classifier.

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495 Virtual Reality Learning Environment in Embryology Education

Authors: Salsabeel F. M. Alfalah, Jannat F. Falah, Nadia Muhaidat, Amjad Hudaib, Diana Koshebye, Sawsan AlHourani

Abstract:

Educational technology is changing the way how students engage and interact with learning materials. This improved the learning process amongst various subjects. Virtual Reality (VR) applications are considered one of the evolving methods that have contributed to enhancing medical education. This paper utilizes VR to provide a solution to improve the delivery of the subject of Embryology to medical students, and facilitate the teaching process by providing a useful aid to lecturers, whilst proving the effectiveness of this new technology in this particular area. After evaluating the current teaching methods and identifying students ‘needs, a VR system was designed that demonstrates in an interactive fashion the development of the human embryo from fertilization to week ten of intrauterine development. This system aims to overcome some of the problems faced by the students’ in the current educational methods, and to increase the efficacy of the learning process.

Keywords: Virtual reality, student assessment, medical education, 3D, embryology.

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494 Development of a Microsensor to Minimize Post Cataract Surgery Complications

Authors: M. Mottaghi, F. Ghalichi, H. Badri Ghavifekr, H. Niroomand Oskui

Abstract:

This paper presents design and characterization of a microaccelerometer designated for integration into cataract surgical probe to detect hardness of different eye tissues during cataract surgery. Soft posterior lens capsule of eye can be easily damaged in comparison with hard opaque lens since the surgeon can not see directly behind cutting needle during the surgery. Presence of microsensor helps the surgeon to avoid rupturing posterior lens capsule which if occurs leads to severe complications such as glaucoma, infection, or even blindness. The microsensor having overall dimensions of 480 μm x 395 μm is able to deliver significant capacitance variations during encountered vibration situations which makes it capable to distinguish between different types of tissue. Integration of electronic components on chip ensures high level of reliability and noise immunity while minimizes space and power requirements. Physical characteristics and results on performance testing, proves integration of microsensor as an effective tool to aid the surgeon during this procedure.

Keywords: Cataract surgery, MEMS, Microsensor, Phacoemulsification.

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493 Neural Network based Texture Analysis of Liver Tumor from Computed Tomography Images

Authors: K.Mala, V.Sadasivam, S.Alagappan

Abstract:

Advances in clinical medical imaging have brought about the routine production of vast numbers of medical images that need to be analyzed. As a result an enormous amount of computer vision research effort has been targeted at achieving automated medical image analysis. Computed Tomography (CT) is highly accurate for diagnosing liver tumors. This study aimed to evaluate the potential role of the wavelet and the neural network in the differential diagnosis of liver tumors in CT images. The tumors considered in this study are hepatocellular carcinoma, cholangio carcinoma, hemangeoma and hepatoadenoma. Each suspicious tumor region was automatically extracted from the CT abdominal images and the textural information obtained was used to train the Probabilistic Neural Network (PNN) to classify the tumors. Results obtained were evaluated with the help of radiologists. The system differentiates the tumor with relatively high accuracy and is therefore clinically useful.

Keywords: Fuzzy c means clustering, texture analysis, probabilistic neural network, LVQ neural network.

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492 Comparison of Compression Ability Using DCT and Fractal Technique on Different Imaging Modalities

Authors: Sumathi Poobal, G. Ravindran

Abstract:

Image compression is one of the most important applications Digital Image Processing. Advanced medical imaging requires storage of large quantities of digitized clinical data. Due to the constrained bandwidth and storage capacity, however, a medical image must be compressed before transmission and storage. There are two types of compression methods, lossless and lossy. In Lossless compression method the original image is retrieved without any distortion. In lossy compression method, the reconstructed images contain some distortion. Direct Cosine Transform (DCT) and Fractal Image Compression (FIC) are types of lossy compression methods. This work shows that lossy compression methods can be chosen for medical image compression without significant degradation of the image quality. In this work DCT and Fractal Compression using Partitioned Iterated Function Systems (PIFS) are applied on different modalities of images like CT Scan, Ultrasound, Angiogram, X-ray and mammogram. Approximately 20 images are considered in each modality and the average values of compression ratio and Peak Signal to Noise Ratio (PSNR) are computed and studied. The quality of the reconstructed image is arrived by the PSNR values. Based on the results it can be concluded that the DCT has higher PSNR values and FIC has higher compression ratio. Hence in medical image compression, DCT can be used wherever picture quality is preferred and FIC is used wherever compression of images for storage and transmission is the priority, without loosing picture quality diagnostically.

Keywords: DCT, FIC, PIFS, PSNR.

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491 Evaluation of Edge Configuration in Medical Echo Images Using Genetic Algorithms

Authors: Ching-Fen Jiang

Abstract:

Edge detection is usually the first step in medical image processing. However, the difficulty increases when a conventional kernel-based edge detector is applied to ultrasonic images with a textural pattern and speckle noise. We designed an adaptive diffusion filter to remove speckle noise while preserving the initial edges detected by using a Sobel edge detector. We also propose a genetic algorithm for edge selection to form complete boundaries of the detected entities. We designed two fitness functions to evaluate whether a criterion with a complex edge configuration can render a better result than a simple criterion such as the strength of gradient. The edges obtained by using a complex fitness function are thicker and more fragmented than those obtained by using a simple fitness function, suggesting that a complex edge selecting scheme is not necessary for good edge detection in medical ultrasonic images; instead, a proper noise-smoothing filter is the key.

Keywords: edge detection, ultrasonic images, speckle noise

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490 Effectiveness of Contourlet vs Wavelet Transform on Medical Image Compression: a Comparative Study

Authors: Negar Riazifar, Mehran Yazdi

Abstract:

Discrete Wavelet Transform (DWT) has demonstrated far superior to previous Discrete Cosine Transform (DCT) and standard JPEG in natural as well as medical image compression. Due to its localization properties both in special and transform domain, the quantization error introduced in DWT does not propagate globally as in DCT. Moreover, DWT is a global approach that avoids block artifacts as in the JPEG. However, recent reports on natural image compression have shown the superior performance of contourlet transform, a new extension to the wavelet transform in two dimensions using nonseparable and directional filter banks, compared to DWT. It is mostly due to the optimality of contourlet in representing the edges when they are smooth curves. In this work, we investigate this fact for medical images, especially for CT images, which has not been reported yet. To do that, we propose a compression scheme in transform domain and compare the performance of both DWT and contourlet transform in PSNR for different compression ratios (CR) using this scheme. The results obtained using different type of computed tomography images show that the DWT has still good performance at lower CR but contourlet transform performs better at higher CR.

Keywords: Computed Tomography (CT), DWT, Discrete Contourlet Transform, Image Compression.

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489 Steps towards the Development of National Health Data Standards in Developing Countries: An Exploratory Qualitative Study in Saudi Arabia

Authors: Abdullah I. Alkraiji, Thomas W. Jackson, Ian R. Murray

Abstract:

The proliferation of health data standards today is somewhat overlapping and conflicting, resulting in market confusion and leading to increasing proprietary interests. The government role and support in standardization for health data are thought to be crucial in order to establish credible standards for the next decade, to maximize interoperability across the health sector, and to decrease the risks associated with the implementation of non-standard systems. The normative literature missed out the exploration of the different steps required to be undertaken by the government towards the development of national health data standards. Based on the lessons learned from a qualitative study investigating the different issues to the adoption of health data standards in the major tertiary hospitals in Saudi Arabia and the opinions and feedback from different experts in the areas of data exchange and standards and medical informatics in Saudi Arabia and UK, a list of steps required towards the development of national health data standards was constructed. Main steps are the existence of: a national formal reference for health data standards, an agreed national strategic direction for medical data exchange, a national medical information management plan and a national accreditation body, and more important is the change management at the national and organizational level. The outcome of this study can be used by academics and practitioners to develop the planning of health data standards, and in particular those in developing countries.

Keywords: Interoperability, Case Study, Health Data Standards, Medical Data Exchange, Saudi Arabia.

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488 Quality Evaluation of Compressed MRI Medical Images for Telemedicine Applications

Authors: Seddeq E. Ghrare, Salahaddin M. Shreef

Abstract:

Medical image modalities such as computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), X-ray are adapted to diagnose disease. These modalities provide flexible means of reviewing anatomical cross-sections and physiological state in different parts of the human body. The raw medical images have a huge file size and need large storage requirements. So it should be such a way to reduce the size of those image files to be valid for telemedicine applications. Thus the image compression is a key factor to reduce the bit rate for transmission or storage while maintaining an acceptable reproduction quality, but it is natural to rise the question of how much an image can be compressed and still preserve sufficient information for a given clinical application. Many techniques for achieving data compression have been introduced. In this study, three different MRI modalities which are Brain, Spine and Knee have been compressed and reconstructed using wavelet transform. Subjective and objective evaluation has been done to investigate the clinical information quality of the compressed images. For the objective evaluation, the results show that the PSNR which indicates the quality of the reconstructed image is ranging from (21.95 dB to 30.80 dB, 27.25 dB to 35.75 dB, and 26.93 dB to 34.93 dB) for Brain, Spine, and Knee respectively. For the subjective evaluation test, the results show that the compression ratio of 40:1 was acceptable for brain image, whereas for spine and knee images 50:1 was acceptable.

Keywords: Medical Image, Magnetic Resonance Imaging, Image Compression, Discrete Wavelet Transform, Telemedicine.

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487 Software Architecture and Support for Patient Tracking Systems in Critical Scenarios

Authors: Gianluca Cornetta, Abdellah Touhafi, David J. Santos, Jose Manuel Vazquez

Abstract:

In this work a new platform for mobile-health systems is presented. System target application is providing decision support to rescue corps or military medical personnel in combat areas. Software architecture relies on a distributed client-server system that manages a wireless ad-hoc networks hierarchy in which several different types of client operate. Each client is characterized for different hardware and software requirements. Lower hierarchy levels rely in a network of completely custom devices that store clinical information and patient status and are designed to form an ad-hoc network operating in the 2.4 GHz ISM band and complying with the IEEE 802.15.4 standard (ZigBee). Medical personnel may interact with such devices, that are called MICs (Medical Information Carriers), by means of a PDA (Personal Digital Assistant) or a MDA (Medical Digital Assistant), and transmit the information stored in their local databases as well as issue a service request to the upper hierarchy levels by using IEEE 802.11 a/b/g standard (WiFi). The server acts as a repository that stores both medical evacuation forms and associated events (e.g., a teleconsulting request). All the actors participating in the diagnostic or evacuation process may access asynchronously to such repository and update its content or generate new events. The designed system pretends to optimise and improve information spreading and flow among all the system components with the aim of improving both diagnostic quality and evacuation process.

Keywords: IEEE 802.15.4 (ZigBee), IEEE 802.11 a/b/g (WiFi), distributed client-server systems, embedded databases, issue trackers, ad-hoc networks.

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486 Nuclear Medical Image Treatment System Based On FPGA in Real Time

Authors: B. Mahmoud, M.H. Bedoui, R. Raychev, H. Essabbah

Abstract:

We present in this paper an acquisition and treatment system designed for semi-analog Gamma-camera. It consists of a nuclear medical Image Acquisition, Treatment and Display chain(IATD) ensuring the acquisition, the treatment of the signals(resulting from the Gamma-camera detection head) and the scintigraphic image construction in real time. This chain is composed by an analog treatment board and a digital treatment board. We describe the designed systems and the digital treatment algorithms in which we have improved the performance and the flexibility. The digital treatment algorithms are implemented in a specific reprogrammable circuit FPGA (Field Programmable Gate Array).interface for semi-analog cameras of Sopha Medical Vision(SMVi) by taking as example SOPHY DS7. The developed system consists of an Image Acquisition, Treatment and Display (IATD) ensuring the acquisition and the treatment of the signals resulting from the DH. The developed chain is formed by a treatment analog board and a digital treatment board designed around a DSP [2]. In this paper we have presented the architecture of a new version of our chain IATD in which the integration of the treatment algorithms is executed on an FPGA (Field Programmable Gate Array)

Keywords: Nuclear medical image, scintigraphic image, digitaltreatment, linearity, spectrometry, FPGA.

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485 Fuzzy Logic Approach to Robust Regression Models of Uncertain Medical Categories

Authors: Arkady Bolotin

Abstract:

Dichotomization of the outcome by a single cut-off point is an important part of various medical studies. Usually the relationship between the resulted dichotomized dependent variable and explanatory variables is analyzed with linear regression, probit regression or logistic regression. However, in many real-life situations, a certain cut-off point dividing the outcome into two groups is unknown and can be specified only approximately, i.e. surrounded by some (small) uncertainty. It means that in order to have any practical meaning the regression model must be robust to this uncertainty. In this paper, we show that neither the beta in the linear regression model, nor its significance level is robust to the small variations in the dichotomization cut-off point. As an alternative robust approach to the problem of uncertain medical categories, we propose to use the linear regression model with the fuzzy membership function as a dependent variable. This fuzzy membership function denotes to what degree the value of the underlying (continuous) outcome falls below or above the dichotomization cut-off point. In the paper, we demonstrate that the linear regression model of the fuzzy dependent variable can be insensitive against the uncertainty in the cut-off point location. In the paper we present the modeling results from the real study of low hemoglobin levels in infants. We systematically test the robustness of the binomial regression model and the linear regression model with the fuzzy dependent variable by changing the boundary for the category Anemia and show that the behavior of the latter model persists over a quite wide interval.

Keywords: Categorization, Uncertain medical categories, Binomial regression model, Fuzzy dependent variable, Robustness.

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484 A New Rigid Fistulectomy Set for Minimally Invasive “Core-Out“ Excision of High Anal Fistulas

Authors: Siamak Najarian, Meysam Esmaeili, Mohsen Towliat Kashani

Abstract:

In this article, we propose a new surgical device for circumferentially excision of high anal fistulas in a minimally invasive manner. The new apparatus works on the basis of axially rotating and moving a tubular blade along a fistulous tract straightened using a rigid straight guidewire. As the blade moves along the tract, its sharp circular cutting edge circumferentially separates approximately 2.25 mm thickness of tract encircling the rigid guidewire. We used the new set to excise two anal fistulas in a 62-year-old male patient, an extrasphincteric type and a long tract with no internal opening. With regard to the results of this test, the new device can be considered as a sphincter preserving mechanism for treatment of high anal fistulas. Consequently, a major reduction in the risk of fecal incontinence, recurrence rate, convalescence period and patient morbidity may be achieved using the new device for treatment of fistula-in-ano.

Keywords: Fecal Incontinence, Fistulectomy, High Anal Fistula, Minimally Invasive.

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483 Data Mining in Oral Medicine Using Decision Trees

Authors: Fahad Shahbaz Khan, Rao Muhammad Anwer, Olof Torgersson, Göran Falkman

Abstract:

Data mining has been used very frequently to extract hidden information from large databases. This paper suggests the use of decision trees for continuously extracting the clinical reasoning in the form of medical expert-s actions that is inherent in large number of EMRs (Electronic Medical records). In this way the extracted data could be used to teach students of oral medicine a number of orderly processes for dealing with patients who represent with different problems within the practice context over time.

Keywords: Data mining, Oral Medicine, Decision Trees, WEKA.

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482 Survey of Epidemiology and Mechanisms of Badminton Injury Using Medical Check-Up and Questionnaire of School Age Badminton Players

Authors: Xiao Zhou, Kazuhiro Imai, Xiaoxuan Liu

Abstract:

Badminton is one type of racket sports that requires repetitive overhead motion, with the shoulder in abduction/external rotation and requires players to perform jumps, lunges, and quick directional changes. These characteristics could be stressful for body regions that may cause badminton injuries. Regarding racket players including badminton players, there have not been any studies that have utilized medical check-up to evaluate epidemiology and mechanism of injuries. In addition, epidemiology of badminton injury in school age badminton players is unknown. The first purpose of this study was to investigate the badminton injuries, physical fitness parameters, and intensity of shoulder pain using medical check-up so that the mechanisms of shoulder injuries might be revealed. The second purpose of this study was to survey the distribution of badminton injuries in elementary school age players so that injury prevention can be implemented as early as possible. The results of this study revealed that shoulder pain occurred in all players, and present shoulder pain players had smaller weight, greater shoulder external rotation (ER) gain, significantly thinner circumference of upper limbs and greater trunk extension. Identifying players with specific of these factors may enhance the prevention of badminton injury. This study also shows that there are high incidences of knee, ankle, plantar, and shoulder injury or pain in elementary school age badminton players. Injury prevention program might be implemented for elementary school age players.

Keywords: Badminton injury, epidemiology, medical check-up, school age players.

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481 A Chaotic Study on Tremor Behavior of Parkinsonian Patients under Deep Brain Stimulation

Authors: M. Sadeghi, A.H. Jafari, S.M.P. Firoozabadi

Abstract:

Deep Brain Stimulation or DBS is a surgical treatment for Parkinson-s Disease with three stimulation parameters: frequency, pulse width, and voltage. The parameters should be selected appropriately to achieve effective treatment. This selection now, performs clinically. The aim of this research is to study chaotic behavior of recorded tremor of patients under DBS in order to present a computational method to recognize stimulation optimum voltage. We obtained some chaotic features of tremor signal, and discovered embedding space of it has an attractor, and its largest Lyapunov exponent is positive, which show tremor signal has chaotic behavior, also we found out, in optimal voltage, entropy and embedding space variance of tremor signal have minimum values in comparison with other voltages. These differences can help neurologists recognize optimal voltage numerically, which leads to reduce patients' role and discomfort in optimizing stimulation parameters and to do treatment with high accuracy.

Keywords: Chaos, Deep Brain Stimulation, Parkinson's Disease, Stimulation Parameters, tremor.

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480 Virtual Reality for PostCOVID-19 Stroke: A Case Report

Authors: Kasra Afsahi, Maryam Soheilifar, Noureddin Nakhostin Ansari

Abstract:

COVID-19 has been associated with stroke and neurological complications. The patient was a 59-year-old male presented with sudden left hemiparesis and diplopia due to cavernous sinus thrombosis (CST) on 28/03/2020. The COVID-19 test was positive. Multislice computerized tomography (MSCT) showed ischemic infarction. He underwent surgical sinectomy 9 days after admission. Physiotherapy began for him on August 2020. Our game-based virtual reality (VR) technology developed for stroke patients was based on upper extremity exercises and function for stroke. After 6 weeks of VR therapy plus conventional physiotherapy exercises (18 sessions, three times per week, 60 minutes each session), there were significant improvements in Brunnstrom Motor Recovery Stage (from “4” to “5”), Fugl-Meyer Scale score of upper extremity section (from 49 to 54), and Modified Barthel Index (from 15 to 18). There were no adverse effects. This case with stroke post COVID-19 due to the CST showed the usefulness of VR therapy used as an adjunct to conventional physiotherapy in improving affected upper extremity.

Keywords: COVID-19, stroke, virtual reality, rehabilitation.

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479 Evaluating the Standards of Hospital Pharmacies in Therapeutic Centers Affiliated with Kermanshah University of Medical Sciences, Iran

Authors: Tahvilian R., Siahi Shadbad MR., Hamishehkar H., Aghababa Gharehbagh V.

Abstract:

Nowadays pharmaceutical care departments located in hospitals are amongst the important pillars of the healthcare system. The aim of this study was to evaluate quality of hospital drugstores affiliated with Kermanshah University of Medical Sciences. In this cross-sectional study a validated questionnaire was used. The questionnaire was filled in by the one of the researchers in all seventeen hospital drugstores located in the teaching and nonteaching hospitals affiliated with Kermanshah University of Medical Sciences. The results shows that in observed hospitals,24% of pharmacy environments, 25% of pharmacy store and storage conditions, 49% of storage procedure, 25% of ordering drugs and supplies, 73% of receiving supplies (proper procedure are fallowed for receiving supplies), 35% of receiving supplies (prompt action taken if deterioration of drugs received is suspected), 23.35% of drugs delivery to patients and finally 0% of stock cards are used for proper inventory control have full compliance with standards.

Keywords: Hospital pharmacy standards, Kermanshah, pharmacy management

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478 Creation of a Care Robot Impact Assessment

Authors: E. Fosch-Villaronga

Abstract:

This paper pioneers Care Robot Impact Assessment (CRIA), a methodology used to identify, analyze, mitigate and eliminate the risks posed by the insertion of non-medical personal care robots (PCR) in medical care facilities. Its precedent instruments [Privacy and Surveillance Impact Assessment (PIA and SIA)] fall behind in coping with robots. Indeed, personal care robots change dramatically how care is delivered. The paper presents a specific risk-sector methodology, identifies which robots are under its scope and presents some of the challenges introduced by these robots.

Keywords: Ethics, Impact Assessment, Law, Personal Care Robots.

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477 Study of Reporting System for Adverse Events Related to Common Medical Devices at a Tertiary Care Public Sector Hospital in India

Authors: S. Kurien, S. Satpathy, S. K. Gupta, S. K. Arya, D. K. Sharma

Abstract:

Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: Adverse events, health care technology, public sector hospital, reporting systems.

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476 Hybrid Knowledge Approach for Determining Health Care Provider Specialty from Patient Diagnoses

Authors: Erin Lynne Plettenberg, Jeremy Vickery

Abstract:

In an access-control situation, the role of a user determines whether a data request is appropriate. This paper combines vetted web mining and logic modeling to build a lightweight system for determining the role of a health care provider based only on their prior authorized requests. The model identifies provider roles with 100% recall from very little data. This shows the value of vetted web mining in AI systems, and suggests the impact of the ICD classification on medical practice.

Keywords: Ontology, logic modeling, electronic medical records, information extraction, vetted web mining.

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475 Design of Tracking Controllers for Medical Equipment Holders Using AHRS and MEMS Sensors

Authors: Seung You Na, Joo Hyun Jung, Jin Young Kim, Mohammad AhangarKiasari

Abstract:

There are various kinds of medical equipment which requires relatively accurate positional adjustments for successful treatment. However, patients tend to move without notice during a certain span of operations. Therefore, it is common practice that accompanying operators adjust the focus of the equipment. In this paper, tracking controllers for medical equipment are suggested to replace the operators. The tracking controllers use AHRS sensor information to recognize the movements of patients. Sensor fusion is applied to reducing the error magnitudes through linear Kalman filters. The image processing of optical markers is included to adjust the accumulation errors of gyroscope sensor data especially for yaw angles. The tracking controller reduces the positional errors between the current focus of a device and the target position on the body of a patient. Since the sensing frequencies of AHRS sensors are very high compared to the physical movements, the control performance is satisfactory. The typical applications are, for example, ESWT or rTMS, which have the error ranges of a few centimeters.

Keywords: AHRS, Sensor fusion, Tracking control, Position and posture.

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474 Segmentation of Lungs from CT Scan Images for Early Diagnosis of Lung Cancer

Authors: Nisar Ahmed Memon, Anwar Majid Mirza, S.A.M. Gilani

Abstract:

Segmentation is an important step in medical image analysis and classification for radiological evaluation or computer aided diagnosis. The CAD (Computer Aided Diagnosis ) of lung CT generally first segment the area of interest (lung) and then analyze the separately obtained area for nodule detection in order to diagnosis the disease. For normal lung, segmentation can be performed by making use of excellent contrast between air and surrounding tissues. However this approach fails when lung is affected by high density pathology. Dense pathologies are present in approximately a fifth of clinical scans, and for computer analysis such as detection and quantification of abnormal areas it is vital that the entire and perfectly lung part of the image is provided and no part, as present in the original image be eradicated. In this paper we have proposed a lung segmentation technique which accurately segment the lung parenchyma from lung CT Scan images. The algorithm was tested against the 25 datasets of different patients received from Ackron Univeristy, USA and AGA Khan Medical University, Karachi, Pakistan.

Keywords: Computer Aided Diagnosis, Medical ImageProcessing, Region Growing, Segmentation, Thresholding,

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473 Artemisia Species from Iran as Valuable Resources for Medicinal Uses

Authors: Mohammad Reza Naghavi, Farzad Alaeimoghadam, Hossein Ghafoori

Abstract:

Artemisia species, which are medically beneficial, are widespread in temperate regions of both Northern and Southern hemispheres among which Iran is located. About 35 species of Artemisia are indigenous in Iran among them some are widespread in all or most provinces, yet some are restricted to some specific regions. In this review paper, initially, GC-Mass results of some experiments done in different provinces of Iran are mentioned among them some compounds are common among species, some others are mostly restricted to other species; after that, medical advantages based on some researches on species of this genus are reviewed; different qualities such as anti-leishmania, anti-bacteria, antiviral as well as anti-proliferative could be mentioned.

Keywords: Artemisia, GC-Mass analysis, medical advantage.

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