Search results for: Medical Surgical

Authors: George Karkavitsas, Maria Rangoussi

Abstract:

We present a genetic algorithm application to the problem of object registration (i.e., object detection, localization and recognition) in a class of medical images containing various types of blood cells. The genetic algorithm approach taken here is seen to be most appropriate for this type of image, due to the characteristics of the objects. Successful cell registration results on real life microscope images of blood cells show the potential of the proposed approach.

Keywords: Genetic algorithms, object registration, pattern recognition, blood cell microscope images.

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Authors: Juan L. Castro, Maria I. NavarroVictor Lopez, Eduardo M. Eisman, Jose M. Zurita

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This paper describes the Multilingual Virtual Simulated Patient framework. It has been created to train the social skills and testing the knowledge of primary health care medical students. The framework generates conversational agents which perform in serveral languages as virtual simulated patients that help to improve the communication and diagnosis skills of the students complementing their training process.

Keywords: Medical training, conversational agents, patient modeling.

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Authors: Jeroen S. de Bruin, Karin Schindler, Christian Schuh

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With increasingly more mobile health applications appearing due to the popularity of smartphones, the possibility arises that these data can be used to improve the medical diagnostic process, as well as the overall quality of healthcare, while at the same time lowering costs. However, as of yet there have been no reports of a successful combination of patient-generated data from smartphones with data from clinical routine. In this paper we describe how these two types of data can be combined in a secure way without modification to hospital information systems, and how they can together be used in a medical expert system for automatic nutritional classification and triage.

Keywords: Data integration, disease-related malnutrition, expert systems, mobile health.

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Authors: Hariton N. Costin, Sorin Puscoci, Cristian Rotariu, Bogdan Dionisie, Marinela C. Cimpoesu

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TELMES project aims to develop a securized multimedia system devoted to medical consultation teleservices. It will be finalized with a pilot system for a regional telecenters network that connects local telecenters, having as support multimedia platforms. This network will enable the implementation of complex medical teleservices (teleconsulations, telemonitoring, homecare, urgency medicine, etc.) for a broader range of patients and medical professionals, mainly for family doctors and those people living in rural or isolated regions. Thus, a multimedia, scalable network, based on modern IT&C paradigms, will result. It will gather two inter-connected regional telecenters, in Iaşi and Piteşti, Romania, each of them also permitting local connections of hospitals, diagnostic and treatment centers, as well as local networks of family doctors, patients, even educational entities. As communications infrastructure, we aim to develop a combined fixmobile- internet (broadband) links. Other possible communication environments will be GSM/GPRS/3G and radio waves. The electrocardiogram (ECG) acquisition, internet transmission and local analysis, using embedded technologies, was already successfully done for patients- telemonitoring.

Keywords: Healthcare, telemedicine, telemonitoring, ECG analysis.

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Authors: Amir Moslemi, Amir Movafeghi, Shahab Moradi

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One of the most important challenging factors in medical images is nominated as noise. Image denoising refers to the improvement of a digital medical image that has been infected by Additive White Gaussian Noise (AWGN). The digital medical image or video can be affected by different types of noises. They are impulse noise, Poisson noise and AWGN. Computed tomography (CT) images are subjects to low quality due to the noise. Quality of CT images is dependent on absorbed dose to patients directly in such a way that increase in absorbed radiation, consequently absorbed dose to patients (ADP), enhances the CT images quality. In this manner, noise reduction techniques on purpose of images quality enhancement exposing no excess radiation to patients is one the challenging problems for CT images processing. In this work, noise reduction in CT images was performed using two different directional 2 dimensional (2D) transformations; i.e., Curvelet and Contourlet and Discrete Wavelet Transform (DWT) thresholding methods of BayesShrink and AdaptShrink, compared to each other and we proposed a new threshold in wavelet domain for not only noise reduction but also edge retaining, consequently the proposed method retains the modified coefficients significantly that result good visual quality. Data evaluations were accomplished by using two criterions; namely, peak signal to noise ratio (PSNR) and Structure similarity (Ssim).

Keywords: Computed Tomography (CT), noise reduction, curve-let, contour-let, Signal to Noise Peak-Peak Ratio (PSNR), Structure Similarity (Ssim), Absorbed Dose to Patient (ADP).

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Authors: Alexandru George Floares

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Chronic hepatitis B can evolve to cirrhosis and liver cancer. Interferon is the only effective treatment, for carefully selected patients, but it is very expensive. Some of the selection criteria are based on liver biopsy, an invasive, costly and painful medical procedure. Therefore, developing efficient non-invasive selection systems, could be in the patients benefit and also save money. We investigated the possibility to create intelligent systems to assist the Interferon therapeutical decision, mainly by predicting with acceptable accuracy the results of the biopsy. We used a knowledge discovery in integrated medical data - imaging, clinical, and laboratory data. The resulted intelligent systems, tested on 500 patients with chronic hepatitis B, based on C5.0 decision trees and boosting, predict with 100% accuracy the results of the liver biopsy. Also, by integrating the other patients selection criteria, they offer a non-invasive support for the correct Interferon therapeutic decision. To our best knowledge, these decision systems outperformed all similar systems published in the literature, and offer a realistic opportunity to replace liver biopsy in this medical context.

Keywords: Interferon, chronic hepatitis B, intelligent virtualbiopsy.

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Authors: Chang Soo Chon, Cheol Woong Ko, Han Sung Kim

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The aim of this study is to develop an anterior lumbar interbody fusion (ALIF) PEEK cage suitable for Korean people. In this study, CT images were obtained from Korean male (173cm, 71kg) and 3D Korean lumbar models were reconstructed based on the CT images to investigate anatomical characteristics. Major design parameters of anterior lumbar interbody fusion (ALIF) PEEK Cage were selected using the morphological measurement information of the Korean Lumbar models. Through finite element analysis and mechanical tests, the developed ALIFPEEK Cage prototype was compared with the Fidji Cage (Zimmer. Inc, USA) and it was found that the ALIF prototype showed similar and/or superior mechanical performance compared to the FidJi Cage. Also, clinical validation for the ALIF PEEK Cage prototype was carried out to check predictable troubles in surgical operations. Finally, it is considered that the convenience and stability of the prototype was clinically verified.

Keywords: Interbody fusion, PEEK, implant, finite element analysis, lumbar, spine.

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Authors: Chang, Chun-Lang, Liu, Chun-Kai

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This study, for its research subjects, uses patients who had undergone total knee replacement surgery from the database of the National Health Insurance Administration. Through the review of literatures and the interviews with physicians, important factors are selected after careful screening. Then using Cross Entropy Method, Genetic Algorithm Logistic Regression, and Particle Swarm Optimization, the weight of each factor is calculated and obtained. In the meantime, Excel VBA and Case Based Reasoning are combined and adopted to evaluate the system. Results show no significant difference found through Genetic Algorithm Logistic Regression and Particle Swarm Optimization with over 97% accuracy in both methods. Both ROC areas are above 0.87. This study can provide critical reference to medical personnel as clinical assessment to effectively enhance medical care quality and efficiency, prevent unnecessary waste, and provide practical advantages to resource allocation to medical institutes.

Keywords: Total knee replacement, Case Based Reasoning, Cross Entropy Method, Genetic Algorithm Logistic Regression, Particle Swarm Optimization.

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Authors: Ersin Kaya, Bulent Oran, Ahmet Arslan

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In this study, fuzzy rule-based classifier is used for the diagnosis of congenital heart disease. Congenital heart diseases are defined as structural or functional heart disease. Medical data sets were obtained from Pediatric Cardiology Department at Selcuk University, from years 2000 to 2003. Firstly, fuzzy rules were generated by using medical data. Then the weights of fuzzy rules were calculated. Two different reasoning methods as “weighted vote method" and “singles winner method" were used in this study. The results of fuzzy classifiers were compared.

Keywords: Congenital heart disease, Fuzzy rule-basedclassifiers, Classification

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Authors: Sheema Shuja Khattak, Gule Saman, Imran Khan, Abdus Salam

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Image segmentation plays an important role in medical imaging applications. Therefore, accurate methods are needed for the successful segmentation of medical images for diagnosis and detection of various diseases. In this paper, we have used maximum entropy to achieve image segmentation. Maximum entropy has been calculated using Shannon, Renyi and Tsallis entropies. This work has novelty based on the detection of skin lesion caused by the bite of a parasite called Sand Fly causing the disease is called Cutaneous Leishmaniasis.

Keywords: Shannon, Maximum entropy, Renyi, Tsallis entropy.

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Authors: Jian-hua Yeh, Shi-yi Kuo

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This paper discusses the classification process for medical data. In this paper, we use the data from ACM KDDCup 2008 to demonstrate our classification process based on latent topic discovery. In this data set, the target set and outliers are quite different in their nature: target set is only 0.6% size in total, while the outliers consist of 99.4% of the data set. We use this data set as an example to show how we dealt with this extremely biased data set with latent topic discovery and noise reduction techniques. Our experiment faces two major challenge: (1) extremely distributed outliers, and (2) positive samples are far smaller than negative ones. We try to propose a suitable process flow to deal with these issues and get a best AUC result of 0.98.

Keywords: classification, latent topics, outlier adjustment, feature scaling

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Authors: Shayan Rezvanigilkolaei, Shayesteh Vefaghnematollahi

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Electrical impedance tomography is a non-invasive medical imaging technique suitable for medical applications. This paper describes an electrical impedance tomography device with the ability to navigate a robotic arm to manipulate a target object. The design of the device includes various hardware and software sections to perform medical imaging and control the robotic arm. In its hardware section an image is formed by 16 electrodes which are located around a container. This image is used to navigate a 3DOF robotic arm to reach the exact location of the target object. The data set to form the impedance imaging is obtained by having repeated current injections and voltage measurements between all electrode pairs. After performing the necessary calculations to obtain the impedance, information is transmitted to the computer. This data is fed and then executed in MATLAB which is interfaced with EIDORS (Electrical Impedance Tomography Reconstruction Software) to reconstruct the image based on the acquired data. In the next step, the coordinates of the center of the target object are calculated by image processing toolbox of MATLAB (IPT). Finally, these coordinates are used to calculate the angles of each joint of the robotic arm. The robotic arm moves to the desired tissue with the user command.

Keywords: Electrical impedance tomography, EIT, Surgeon robot, image processing of Electrical impedance tomography.

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Authors: Chau-Kuang Chen, John Hughes, Jr., A. Dexter Samuels

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The prediction models for the United States Medical Licensure Examination (USMLE) Steps 1 and 2 performances were constructed by the Monte Carlo simulation modeling approach via linear regression. The purpose of this study was to build robust simulation models to accurately identify the most important predictors and yield the valid range estimations of the Steps 1 and 2 scores. The application of simulation modeling approach was deemed an effective way in predicting student performances on licensure examinations. Also, sensitivity analysis (a/k/a what-if analysis) in the simulation models was used to predict the magnitudes of Steps 1 and 2 affected by changes in the National Board of Medical Examiners (NBME) Basic Science Subject Board scores. In addition, the study results indicated that the Medical College Admission Test (MCAT) Verbal Reasoning score and Step 1 score were significant predictors of the Step 2 performance. Hence, institutions could screen qualified student applicants for interviews and document the effectiveness of basic science education program based on the simulation results.

Keywords: Prediction Model, Sensitivity Analysis, Simulation Method, USMLE.

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Authors: Miho Tsukamoto

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Beppu hot spring provides medical treatment as well as comfort visitors and mental easiness for many years. This paper studies hot spring in Beppu and Tōji, medical treatment in hot spring, and investigates how people’s visit to Beppu has changed with Tōji, and how Beppu Tourism Office tries to regain visitors in Beppu. In this paper, firstly, hot spring history in Beppu will be explained especially focusing on Beppu Hattou (eight major hot springs) and Jigoku Meguri (eight major hell hot spring tours). Secondly, Tōji, a long-residential hot spring with the purpose of medical treatment along with the information about chemical efficacy of hot springs will be analyzed. Then, finally, the change of the long-stay type to short-stay Onsen programs with the combination of multiplex tourism resources will be focused along with the decrease of Onsen or hot spring visitors. It is concluded that Tōji is not only physically and mentally cure people but also bring people mental easiness and release them from their stressful life. All in all, it can be concluded that because Onsen is involved in people’s life in Beppu and keep local people united in the community. Tōji’s attraction is shown when local people try to create the new type of Onsen program so as to keep their traditional way of Tōji.

Keywords: Hot spring, Tōji, Treatment.

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Authors: K. Amudha, C. Nelson Kennedy Babu, S. Balu

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The security of the medical images and its related data is the major research area which is to be concentrated in today’s era. Security in the medical image indicates that the physician may hide patients’ related data in the medical image and transfer it safely to a defined location using reversible watermarking. Many reversible watermarking methods had proposed over the decade. This paper enhances the security level in brain tumor images to hide the patient’s detail, which has to be conferred with other physician’s suggestions. The details or the information will be hidden in Non-ROI area of the image by using the block cipher algorithm. The block cipher uses different keys to extract the details that are difficult for the intruder to detect all the keys and to spot the details, which are the key advantage of this method. The ROI is the tumor area and Non-ROI is the area rest of ROI. The Non-ROI should not be spoiled in any cause and the details in the Non-ROI should be extracted correctly. The reversible watermarking method proposed in this paper performs well when compared to existing methods in the process of extraction of an original image and providing information security.

Keywords: Brain tumor images, Block Cipher, Reversible watermarking, ROI.

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Authors: Nahla Barakat, Joachim Diederich

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Support vector machines (SVMs) have shown superior performance compared to other machine learning techniques, especially in classification problems. Yet one limitation of SVMs is the lack of an explanation capability which is crucial in some applications, e.g. in the medical and security domains. In this paper, a novel approach for eclectic rule-extraction from support vector machines is presented. This approach utilizes the knowledge acquired by the SVM and represented in its support vectors as well as the parameters associated with them. The approach includes three stages; training, propositional rule-extraction and rule quality evaluation. Results from four different experiments have demonstrated the value of the approach for extracting comprehensible rules of high accuracy and fidelity.

Keywords: Data mining, hybrid rule-extraction algorithms, medical diagnosis, SVMs

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Authors: M R Asadi, G Torkaman, M Hedayati

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We evaluated the effect of sensory (direct current (DC), 600μA) and motor (monophasic current, pulse duration 300μs, 100 Hz, 2.5-3mA) intensities of cathodal electrical stimulation (ES) current to release VEGF and biomechanical properties of wound. 54 male Sprague-dawley rats were randomly assigned into one control and two experimental groups. A full thickness skin incision was made on animals- dorsal region. The experimental groups received ES for 1h/day and every other day. VEGF expression was measured in skin on the 7th day after surgical incision and tensile strength was measured on 21st day. On the 7th day, the values of skin VEGF in the sensory group were significantly greater than those of the other groups (p < 0.05). Sensory and Motor intensity stimulation, can not improve the biomechanical properties of the repaired wounds. It seems the mechanical environment induced by sensory and motor intensity of electrical stimulation, could not simulate the role of normal daily stress and strain to maturation of collagen fibers and their cross links. Further work is needed to determine the relationship between VEGF expression after ES and its effect on tensile strength of healed wound.

Keywords: Biomechanical properties Direct current, Monophasic current, Skin, VEGF

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Authors: Pardeep Singh, Sanjay Sharma

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Content-Based Image Retrieval (CBIR) has been one on the most vivid research areas in the field of computer vision over the last 10 years. Many programs and tools have been developed to formulate and execute queries based on the visual or audio content and to help browsing large multimedia repositories. Still, no general breakthrough has been achieved with respect to large varied databases with documents of difering sorts and with varying characteristics. Answers to many questions with respect to speed, semantic descriptors or objective image interpretations are still unanswered. In the medical field, images, and especially digital images, are produced in ever increasing quantities and used for diagnostics and therapy. In several articles, content based access to medical images for supporting clinical decision making has been proposed that would ease the management of clinical data and scenarios for the integration of content-based access methods into Picture Archiving and Communication Systems (PACS) have been created. This paper gives an overview of soft computing techniques. New research directions are being defined that can prove to be useful. Still, there are very few systems that seem to be used in clinical practice. It needs to be stated as well that the goal is not, in general, to replace text based retrieval methods as they exist at the moment.

Keywords: CBIR, GA, Rough sets, CBMIR

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Authors: Chanisada Choosuk, Napisporn Memongkol Runchana Sinthavalai, Fareeda Lambensah

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The objective of this research is to explore the role of actors at the local level in managing the Pre-hospital Emergency Medical Service (EMS) system in Thailand. The research method was done through documentary research, individual interviews, and one forum conducted in each province. This paper uses the case of three provinces located in three regions in Thailand including; Ubon Ratchathani (North-eastern region), Lampang (Northern Region), and Songkhla (Southern Region). The result shows that, recently, the role of the local government in being the service provider for their local people is increasingly concerned. In identifying the key success factors towards the EMS system, it includes; (i) the local executives- vision and influence that the decisions made by them, for both PAO (Provincial Administration Organisation (PAO) and TAO (Tambon Administration Organisation), is vital to address the overall challenges in EMS development, (ii) the administrative system through reforming their working style create the flexibility in running the EMS task, (iii) the network-based management among different agencies at the local level leads to the better EMS practices, and (iv) the development in human resource is very vital in delivering the effective services.

Keywords: Local governments, Management, Emergency Medical Services (EMS), Thailand

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Authors: Beibei Han, Yong-Jin Yoon, Muhammad Hamidullah, Angel Tsu-Hui Lin, Woo-Tae Park

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This paper presents the design of a ring-shaped tri-axial fore sensor that can be incorporated into the tip of a guidewire for use in minimally invasive surgery (MIS). The designed sensor comprises a ring-shaped structure located at the center of four cantilever beams. The ringdesign allows surgical tools to be easily passed through which largely simplified the integration process. Silicon nanowires (SiNWs) are used aspiezoresistive sensing elementsembeddedon the four cantilevers of the sensor to detect the resistance change caused by the applied load.An integration scheme with new designed guidewire tip structure having two coils at the distal end is presented. Finite element modeling has been employed in the sensor design to find the maximum stress location in order to put the SiNWs at the high stress regions to obtain maximum output. A maximum applicable force of 5 mN is found from modeling. The interaction mechanism between the designed sensor and a steel wire has been modeled by FEM. A linear relationship between the applied load on the steel wire and the induced stress on the SiNWs were observed.

Keywords: Triaxial MEMS force sensor, Ring shape, Silicon Nanowire, Minimally invasive surgery.

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Authors: Carlos L. Antunes, Tony R. Almeida, Nélia Raposeiro, Belarmino Gonçalves, Paulo Almeida, André Antunes

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In the last two decades radiofrequency ablation (RFA) has been considered a promising medical procedure for the treatment of primary and secondary malignancies. However, the needle-based electrodes so far developed for this kind of treatment are not suitable for the thermal ablation of tumors located in hollow organs like esophagus, colon or bile duct. In this work a tubular electrode solution is presented. Numerical and experimental analyses were performed to characterize the volume of the lesion induced. Results show that this kind of electrode is a feasible solution and numerical simulation might provide a tool for planning RFA procedure with some accuracy.

Keywords: 3D modeling, cancer, medical therapy, radiofrequency ablation.

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Authors: Aboamama Atahar Ahmed, Muhammad Shafie Abd Latiff, Kamalrulnizam Abu Bakar, Zainul AhmadRajion

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Distance visualization of large datasets often takes the direction of remote viewing and zooming techniques of stored static images. However, the continuous increase in the size of datasets and visualization operation causes insufficient performance with traditional desktop computers. Additionally, the visualization techniques such as Isosurface depend on the available resources of the running machine and the size of datasets. Moreover, the continuous demand for powerful computing powers and continuous increase in the size of datasets results an urgent need for a grid computing infrastructure. However, some issues arise in current grid such as resources availability at the client machines which are not sufficient enough to process large datasets. On top of that, different output devices and different network bandwidth between the visualization pipeline components often result output suitable for one machine and not suitable for another. In this paper we investigate how the grid services could be used to support remote visualization of large datasets and to break the constraint of physical co-location of the resources by applying the grid computing technologies. We show our grid enabled architecture to visualize large medical datasets (circa 5 million polygons) for remote interactive visualization on modest resources clients.

Keywords: Visualization, Grid computing, Medical datasets, visualization techniques, thin clients, Globus toolkit, VTK.

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Authors: G. Shruthi, Purohit Shrinivasacharya

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The biggest problem in cloud is securing an outsourcing data. A cloud environment cannot be considered to be trusted. It becomes more challenging when outsourced data sources are managed by multiple outsourcers with different access rights. Several methods have been proposed to protect data confidentiality against the cloud service provider to support fine-grained data access control. We propose a method with combined Cipher Text Policy Attribute-based Encryption (CP-ABE) and Timed-release encryption (TRE) secure method to control medical data storage in public cloud.

Keywords: Attribute, encryption, security, trapdoor.

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Authors: Madiajagan Muthaiyan, Neha Goel, Deepti Sunder Prakash

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This paper discusses about an intelligent system to be installed in ambulances providing professional support to the paramedics on board. A video conferencing device over mobile 4G services enables specialists virtually attending the patient being transferred to the hospital. The data centre holds detailed databases on the patients past medical history and hospitals with the specialists. It also hosts various software modules that compute the shortest traffic –less path to the closest hospital with the required facilities, on inputting the symptoms of the patient, on a real time basis.

Keywords: 4G mobile services, cloud computing, data centre, intelligent system, optimization, real time traffic reporting, SaaS, video conferencing.

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Authors: I. L. Ahmad, M. Mohamed, N. A. Ab. Ghani

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This paper presents the work of signal discrimination specifically for Electrocardiogram (ECG) waveform. ECG signal is comprised of P, QRS, and T waves in each normal heart beat to describe the pattern of heart rhythms corresponds to a specific individual. Further medical diagnosis could be done to determine any heart related disease using ECG information. The emphasis on QRS Complex classification is further discussed to illustrate the importance of it. Pan-Tompkins Algorithm, a widely known technique has been adapted to realize the QRS Complex classification process. There are eight steps involved namely sampling, normalization, low pass filter, high pass filter (build a band pass filter), derivation, squaring, averaging and lastly is the QRS detection. The simulation results obtained is represented in a Graphical User Interface (GUI) developed using MATLAB.

Keywords: ECG, Pan Tompkins Algorithm, QRS Complex, Simulation

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Authors: Napisporn Memongkol, Runchana Sinthavalai, Nattapong Seneeratanaprayune Weerawat Ounsaneha, Chanisada Choosuk

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The objective of this research is to develop the performance indicators (PIs) in operational level for the Pre-hospital Emergency Medical Service (EMS) system employing in Thailand. This research started with ascertaining the current pre-hospital care system. The team analyzed the strategies of Narerthorn, a government unit under the ministry of public health, and the existing PIs of the pre-hospital care. Afterwards, the current National Strategic Plan of EMS development (2008-2012) of the Emergency Medical Institute of Thailand (EMIT) was considered using strategic analysis to developed Strategy Map (SM) and identified the Success Factors (SFs). The analysis results from strategy map and SFs were used to develop the Performance Indicators (PIs). To verify the set of PIs, the team has interviewed with the relevant practitioners for the possibilities to implement the PIs. To this paper, it was to ascertain that all the developed PIs support the objectives of the strategic plan. Nevertheless, the results showed that the operational level PIs suited only with the first dimension of National Strategic Plan (infrastructure and information technology development). Besides, the SF was the infrastructure development (to contribute the EMS system to people throughout with standard and efficiency both in normally and disaster conditions). Finally, twenty-nine indicators were developed from the analysis results of SM and SFs.

Keywords: Emergency Medical Service, Performance Indicator, Success Factor, Thailand

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Authors: Nathan C. Lea, Tony Austin, Stephen Hailes, Dipak Kalra

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This paper introduces a tool that is being developed for the expression of information security policy controls that govern electronic healthcare records. By reference to published findings, the paper introduces the theory behind the use of knowledge management for automatic and consistent security policy assertion using the formalism called the Secutype; the development of the tool and functionality is discussed; some examples of Secutypes generated by the tool are provided; proposed integration with existing medical record systems is described. The paper is concluded with a section on further work and critique of the work achieved to date.

Keywords: Information Security Policy, Electronic Healthcare Records, Knowledge Management, Archetypes, Secutypes.

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Authors: Veni.S , K.A.Narayanankutty

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For about two decades scientists have been developing techniques for enhancing the quality of medical images using Fourier transform, DWT (Discrete wavelet transform),PDE model etc., Gabor wavelet on hexagonal sampled grid of the images is proposed in this work. This method has optimal approximation theoretic performances, for a good quality image. The computational cost is considerably low when compared to similar processing in the rectangular domain. As X-ray images contain light scattered pixels, instead of unique sigma, the parameter sigma of 0.5 to 3 is found to satisfy most of the image interpolation requirements in terms of high Peak Signal-to-Noise Ratio (PSNR) , lower Mean Squared Error (MSE) and better image quality by adopting windowing technique.

Keywords: Hexagonal lattices, Gabor filter, Interpolation, imageprocessing.

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Authors: Panos D. Kotsas

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This paper presents the application of a signal intensity independent registration criterion for 2D rigid body registration of medical images using 1D binary projections. The criterion is defined as the weighted ratio of two projections. The ratio is computed on a pixel per pixel basis and weighting is performed by setting the ratios between one and zero pixels to a standard high value. The mean squared value of the weighted ratio is computed over the union of the one areas of the two projections and it is minimized using the Chebyshev polynomial approximation using n=5 points. The sum of x and y projections is used for translational adjustment and a 45deg projection for rotational adjustment. 20 T1- T2 registration experiments were performed and gave mean errors 1.19deg and 1.78 pixels. The method is suitable for contour/surface matching. Further research is necessary to determine the robustness of the method with regards to threshold, shape and missing data.

Keywords: Medical image, projections, registration, rigid.

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Authors: Yu-Yu Wang, Shih-Hua Hsieh, Ru-Shian Hsieh

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Wishes and choices being respected, and the right to be supported rather than coerced, have been internationally recognized as the human rights of persons with mental illness. In Taiwan, ‘coerced hospitalization’ has become difficult since the revision of the mental health legislation in 2007. Despite trend towards human rights, the real problem families face when their family members are in mental health crisis is the lack of alternative services. This study aims to explore: 1) When is hospitalization seen as the only solution by family members? 2) What are the barriers for arranging hospitalization, and how are they managed? 3) What have family carers learned, in their experiences of caring for their family members with mental illness? To answer these questions, qualitative approach was adopted, and focus group interviews were taken to collect data. This study includes 24 family carers. The main findings of this research include: First, hospital is the last resort for carers in helplessness. Family carers tend to do everything they could to provide care at home for their family members with mental illness. Carers seek hospitalization only when a patient’s behavior is too violent, weird, and/or abnormal, and beyond their ability to manage. Hospitalization, nevertheless, is never an easy choice. Obstacles emanate from the attitudes of the medical doctors, the restricted areas of ambulance service, and insufficient information from the carers’ part. On the other hand, with some professionals’ proactive assistance, access to medical care while in crisis becomes possible. Some family carers obtained help from the medical doctor, nurse, therapist and social workers. Some experienced good help from policemen, taxi drivers, and security guards at the hospital. The difficulty in accessing medical care prompts carers to work harder on assisting their family members with mental illness to stay in stable states. Carers found different ways of helping the ‘person’ to get along with the ‘illness’ and have better quality of life. Taking back ‘the right to control’ in utilizing medication, from passiveness to negotiating with medical doctors and seeking alternative therapies, are seen in many carers’ efforts. Besides, trying to maintain regular activities in daily life and play normal family roles are also experienced as important. Furthermore, talking with the patient as a person is also important. The authors conclude that in order to protect the human rights of persons with mental illness, it is crucial to make the medical care system more flexible and to make the services more humane: sufficient information should be provided and communicated, and efforts should be made to maintain the person’s social roles and to support the family.

Keywords: Family carers, coercive treatment, independent living, mental health crisis, persons with mental illness.

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