Search results for: cardiac patient
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 434

Search results for: cardiac patient

194 A Novel Method for Blood Glucose Measurement by Noninvasive Technique Using Laser

Authors: V.Ashok, A.Nirmalkumar, N.Jeyashanthi

Abstract:

A method and apparatus for noninvasive measurement of blood glucose concentration based on transilluminated laser beam via the Index Finger has been reported in this paper. This method depends on atomic gas (He-Ne) laser operating at 632.8nm wavelength. During measurement, the index finger is inserted into the glucose sensing unit, the transilluminated optical signal is converted into an electrical signal, compared with the reference electrical signal, and the obtained difference signal is processed by signal processing unit which presents the results in the form of blood glucose concentration. This method would enable the monitoring blood glucose level of the diabetic patient continuously, safely and noninvasively.

Keywords: Anisotropy factor, Blood glucose, Diabetes Mellitus, Noninvasive method, Photo detectors.

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193 Tool for Helping Rural Woman Giving Birth

Authors: Bernadus Kristyanto, Luciana T Dewi, Rustamaji

Abstract:

Giving birth is a natural process and most women have to go through it. Gynecologist or Midwife usually uses the leg holder to position the cervix in the stitching process. In some part of rural areas in Indonesia, the labor process normally being done at homes by calling in a midwife or gynecologist. The facilities for this kind of labor process is not yet sufficient, as the use of leg holder supposedly on the obstetric bed. The reality is that it is impossible to bring in the obstetric bed to the patient-s house at the time they call for giving birth or the time when the stitching of the cervix need to be done. This research is redesigning the leg holder through Biomechanics and ergonomic approaches to obtain the optimal design which is suitable to the user of a developing country such as Indonesia.

Keywords: Giving birth, Leg holder, Re-design product, Biomechanics and ergonomic approaches

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192 Rapid Detection System of Airborne Pathogens

Authors: Shigenori Togashi, Kei Takenaka

Abstract:

We developed new processes which can collect and detect rapidly airborne pathogens such as the avian flu virus for the pandemic prevention. The fluorescence antibody technique is known as one of high-sensitive detection methods for viruses, but this needs up to a few hours to bind sufficient fluorescence dyes to viruses for detection. In this paper, we developed a mist-labeling can detect substitution viruses in a short time to improve the binding rate of fluorescent dyes and substitution viruses by the micro reaction process. Moreover, we developed the rapid detection system with the above “mist labeling”. The detection system set with a sampling bag collecting patient’s breath and a cartridge can detect automatically pathogens within 10 minutes.

Keywords: Viruses, Sampler, Mist, Detection, Fluorescent dyes, Microreaction.

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191 The Current Home Hemodialysis Practices and Patients’ Safety Related Factors: A Case Study from Germany

Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

Abstract:

The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: Home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis.

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190 HelpMeBreathe: A Web-Based System for Asthma Management

Authors: Alia Al Rayssi, Mahra Al Marar, Alyazia Alkhaili, Reem Al Dhaheri, Shayma Alkobaisi, Hoda Amer

Abstract:

We present in this paper a web-based system called “HelpMeBreathe” for managing asthma. The proposed system provides analytical tools, which allow better understanding of environmental triggers of asthma, hence better support of data-driven decision making. The developed system provides warning messages to a specific asthma patient if the weather in his/her area might cause any difficulty in breathing or could trigger an asthma attack. HelpMeBreathe collects, stores, and analyzes individuals’ moving trajectories and health conditions as well as environmental data. It then processes and displays the patients’ data through an analytical tool that leads to an effective decision making by physicians and other decision makers.

Keywords: Asthma, environmental triggers, map interface, peak flow, web-based system.

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189 Modeling the Human Cardiovascular System with Aspecial Focus on the Heart Using Dymola

Authors: Stefanie Heinke, Carina Pereira, Jan Spillner, Steffen Leonhardt

Abstract:

Severe heart failure is a common problem that has a significant effect on health expenditures in industrialized countries; moreover it reduces patient-s quality of life. However, current research usually focuses either on detailed modeling of the heart or on detailed modeling of the cardiovascular system. Thus, this paper aims to present a sophisticated model of the heart enhanced with an extensive model of the cardiovascular system. Special interest is on the pressure and flow values close to the heart since these values are critical to accurately diagnose causes of heart failure. The model is implemented in Dymola an object-oriented, physical modeling language. Results achieved with the novel model show overall feasibility of the approach. Moreover, results are illustrated and compared to other models. The novel model shows significant improvements.

Keywords: Cardiovascular system, heart, modeling.

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188 Survey of Cerebral Palsy Cases in Tripoli Children Hospital in the Period between (2009-2010)

Authors: W. Astiata, N. Elmesrati, N. Elmesrati, A. Abo Reyana

Abstract:

The aim of this study is to survey the incidence, prevalence, types and associated impairments of CP in children at the Tripoli children hospital (T.C.H). The study covered all the cases the hospital had diagnosed in the period between (1.1.2009) and (31.12.2010), during which 38 cases of ages between 2 months to 3 years were diagnosed in the mentioned period. The incidence of CP was (17.42 per one thousand) out of (2143) of different neurological cases and came with a result of 23 cases of spastic CP which represented about (60.53%) out of the total number of cases, and the most associated impairment is convulsion. Medical information was collected from the patients’ files at the registration department from the neurology department. The data has been collected by a questionnaire, which had been set to finely organize the patient’s files.

Keywords: Physiotherapy, Rehabilitation, Libya, Cerebral Palsy, hospital, survey.

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187 The Effect of Eight Weeks of Aerobic Training on Indices of Cardio-Respiratory and Exercise Tolerance in Overweight Women with Chronic Asthma

Authors: Somayeh Negahdari, Mohsen Ghanbarzadeh, Masoud Nikbakht, Heshmatolah Tavakol

Abstract:

Asthma, obesity and overweight are the main factors causing change within the heart and respiratory airways. Asthma symptoms are normally observed during exercising. Epidemiological studies have indicated asthma symptoms occurring due to certain lifestyle habits; for example, a sedentary lifestyle. In this study, eight weeks of aerobic exercises resulted in a positive effect overall in overweight women experiencing mild chronic asthma. The quasi-experimental applied research has been done based on experimental and control groups. The experimental group (seven patients) and control group (n = 7) were graded before and after the test. According to the Borg dyspnea and fatigue Perception Index, the training intensity has determined. Participants in the study performed a sub-maximal aerobic activity schedule (45% to 80% of maximum heart rate) for two months, while the control group (n = 7) stayed away from aerobic exercise. Data evaluation and analysis of covariance compared both the pre-test and post-test with paired t-test at significance level of P≤ 0.05. After eight weeks of exercise, the results of the experimental group show a significant decrease in resting heart rate, systolic blood pressure, minute ventilation, while a significant increase in maximal oxygen uptake and tolerance activity (P ≤ 0.05). In the control group, there was no significant difference in these parameters ((P ≤ 0.05). The results indicate the aerobic activity can strengthen the respiratory muscles, while other physiological factors could result in breathing and heart recovery. Aerobic activity also resulted in favorable changes in cardiovascular parameters, and exercise tolerance of overweight women with chronic asthma.

Keywords: Asthma, respiratory cardiac index, exercise tolerance, aerobic, overweight.

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186 Combination of Different Classifiers for Cardiac Arrhythmia Recognition

Authors: M. R. Homaeinezhad, E. Tavakkoli, M. Habibi, S. A. Atyabi, A. Ghaffari

Abstract:

This paper describes a new supervised fusion (hybrid) electrocardiogram (ECG) classification solution consisting of a new QRS complex geometrical feature extraction as well as a new version of the learning vector quantization (LVQ) classification algorithm aimed for overcoming the stability-plasticity dilemma. Toward this objective, after detection and delineation of the major events of ECG signal via an appropriate algorithm, each QRS region and also its corresponding discrete wavelet transform (DWT) are supposed as virtual images and each of them is divided into eight polar sectors. Then, the curve length of each excerpted segment is calculated and is used as the element of the feature space. To increase the robustness of the proposed classification algorithm versus noise, artifacts and arrhythmic outliers, a fusion structure consisting of five different classifiers namely as Support Vector Machine (SVM), Modified Learning Vector Quantization (MLVQ) and three Multi Layer Perceptron-Back Propagation (MLP–BP) neural networks with different topologies were designed and implemented. The new proposed algorithm was applied to all 48 MIT–BIH Arrhythmia Database records (within–record analysis) and the discrimination power of the classifier in isolation of different beat types of each record was assessed and as the result, the average accuracy value Acc=98.51% was obtained. Also, the proposed method was applied to 6 number of arrhythmias (Normal, LBBB, RBBB, PVC, APB, PB) belonging to 20 different records of the aforementioned database (between– record analysis) and the average value of Acc=95.6% was achieved. To evaluate performance quality of the new proposed hybrid learning machine, the obtained results were compared with similar peer– reviewed studies in this area.

Keywords: Feature Extraction, Curve Length Method, SupportVector Machine, Learning Vector Quantization, Multi Layer Perceptron, Fusion (Hybrid) Classification, Arrhythmia Classification, Supervised Learning Machine.

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185 CT Reconstruction from a Limited Number of X-Ray Projections

Authors: Tao Quang Bang, Insu Jeon

Abstract:

Most CT reconstruction system x-ray computed tomography (CT) is a well established visualization technique in medicine and nondestructive testing. However, since CT scanning requires sampling of radiographic projections from different viewing angles, common CT systems with mechanically moving parts are too slow for dynamic imaging, for instance of multiphase flows or live animals. A large number of X-ray projections are needed to reconstruct CT images, so the collection and calculation of the projection data consume too much time and harmful for patient. For the purpose of solving the problem, in this study, we proposed a method for tomographic reconstruction of a sample from a limited number of x-ray projections by using linear interpolation method. In simulation, we presented reconstruction from an experimental x-ray CT scan of a Aluminum phantom that follows to two steps: X-ray projections will be interpolated using linear interpolation method and using it for CT reconstruction based upon Ordered Subsets Expectation Maximization (OSEM) method.

Keywords: CT reconstruction, X-ray projections, Interpolation technique, OSEM

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184 Motor Imagery Based Brain-Computer Interface for Cerebellar Impaired Patients

Authors: Young-Seok Choi

Abstract:

Cerebellar ataxia is a steadily progressive neurodegenerative disease associated with loss of motor control, leaving patients unable to walk, talk, or perform activities of daily living. Direct motor instruction in cerebella ataxia patients has limited effectiveness, presumably because an inappropriate closed-loop cerebellar response to the inevitable observed error confounds motor learning mechanisms. Could the use of EEG based BCI provide advanced biofeedback to improve motor imagery and provide a “backdoor” to improving motor performance in ataxia patients? In order to determine the feasibility of using EEG-based BCI control in this population, we compare the ability to modulate mu-band power (8-12 Hz) by performing a cued motor imagery task in an ataxia patient and healthy control.

Keywords: Cerebellar ataxia, Electroencephalogram, brain-computer interface, motor imagery.

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183 The System Architecture of the Open European Nephrology Science Centre

Authors: G. Lindemann, D. Schmidt, T. Schrader, M. Beil, T. Schaaf, H.-D. Burkhard

Abstract:

The amount and heterogeneity of data in biomedical research, notably in interdisciplinary research, requires new methods for the collection, presentation and analysis of information. Important data from laboratory experiments as well as patient trials are available but come out of distributed resources. The Charite Medical School in Berlin has established together with the German Research Foundation (DFG) a new information service center for kidney diseases and transplantation (Open European Nephrology Science Centre - OpEN.SC). The system is based on a service-oriented architecture (SOA) with main and auxiliary modules arranged in four layers. To improve the reuse and efficient arrangement of the services the functionalities are described as business processes using the standardised Business Process Execution Language (BPEL).

Keywords: Software development management, Business dataprocessing, Knowledge based systems in medicine

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182 Exploiting Kinetic and Kinematic Data to Plot Cyclograms for Managing the Rehabilitation Process of BKAs by Applying Neural Networks

Authors: L. Parisi

Abstract:

Kinematic data wisely correlate vector quantities in space to scalar parameters in time to assess the degree of symmetry between the intact limb and the amputated limb with respect to a normal model derived from the gait of control group participants. Furthermore, these particular data allow a doctor to preliminarily evaluate the usefulness of a certain rehabilitation therapy. Kinetic curves allow the analysis of ground reaction forces (GRFs) to assess the appropriateness of human motion. Electromyography (EMG) allows the analysis of the fundamental lower limb force contributions to quantify the level of gait asymmetry. However, the use of this technological tool is expensive and requires patient’s hospitalization. This research work suggests overcoming the above limitations by applying artificial neural networks.

Keywords: Kinetics, kinematics, cyclograms, neural networks.

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181 Multiple Organ Manifestation in Neonatal Lupus Erythematous (Report of Two Cases)

Authors: Lubis A., Widayanti R., Hikmah Z., Endaryanto A., Harsono A., Harianto A., Etika R., Handayani D. K., Sampurna M.

Abstract:

Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.

Keywords: Neonatus lupus erythematous, maternal autoantibody, clinical characteristic.

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180 The Therapist's Self Disclosure in Cross- Cultural Treatment

Authors: Ruth Lijtmaer, Roy Moodley, Shafik Sunderani

Abstract:

The argument that self-disclosure will change the psychoanalytic process into a socio-cultural niche distorting the therapeutic alliance and compromise therapeutic effectiveness is still the widely held belief amongst many psychotherapists. This paper considers the issues surrounding culture, disclosure and concealment since they remain largely untheorized and clinically problematic. The first part of the paper will critically examine the theory and practice of psychoanalysis across cultures, and explore the reasons for culturally diverse patients to conceal rather than disclose their feelings and thoughts in the transference. This is followed by a discussion on how immigrant analysts- anonymity is difficult to maintain since diverse nationalities, language and accents provide clues to the therapist-s and patient-s origins. Through personal clinical examples of one the author-s (who is an immigrant) the paper analyses the transference-countertransference paradigm and how it reflects in the analyst-s self-revelation.

Keywords: Self-disclosure, cross-cultural, transferencecountertransference, immigrant therapist.

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179 Performance Analysis of Artificial Neural Network with Decision Tree in Prediction of Diabetes Mellitus

Authors: J. K. Alhassan, B. Attah, S. Misra

Abstract:

Human beings have the ability to make logical decisions. Although human decision - making is often optimal, it is insufficient when huge amount of data is to be classified. Medical dataset is a vital ingredient used in predicting patient’s health condition. In other to have the best prediction, there calls for most suitable machine learning algorithms. This work compared the performance of Artificial Neural Network (ANN) and Decision Tree Algorithms (DTA) as regards to some performance metrics using diabetes data. WEKA software was used for the implementation of the algorithms. Multilayer Perceptron (MLP) and Radial Basis Function (RBF) were the two algorithms used for ANN, while RegTree and LADTree algorithms were the DTA models used. From the results obtained, DTA performed better than ANN. The Root Mean Squared Error (RMSE) of MLP is 0.3913 that of RBF is 0.3625, that of RepTree is 0.3174 and that of LADTree is 0.3206 respectively.

Keywords: Artificial neural network, classification, decision tree, diabetes mellitus.

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178 Creating a Virtual Perception for Upper Limb Rehabilitation

Authors: Nina Robson, Kenneth John Faller II, Vishalkumar Ahir, Arthur Ricardo Deps Miguel Ferreira, John Buchanan, Amarnath Banerjee

Abstract:

This paper describes the development of a virtual-reality system ARWED, which will be used in physical rehabilitation of patients with reduced upper extremity mobility to increase limb Active Range of Motion (AROM). The ARWED system performs a symmetric reflection and real-time mapping of the patient’s healthy limb on to their most affected limb, tapping into the mirror neuron system and facilitating the initial learning phase. Using the ARWED, future experiments will test the extension of the action-observation priming effect linked to the mirror-neuron system on healthy subjects and then stroke patients.

Keywords: Physical rehabilitation, mirror neuron, virtual reality, stroke therapy.

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177 Process Optimization Regarding Geometrical Variation and Sensitivity Involving Dental Drill- and Implant-Guided Surgeries

Authors: T. Kero, R. Söderberg, M. Andersson, L. Lindkvist

Abstract:

Within dental-guided surgery, there has been a lack of analytical methods for optimizing the treatment of the rehabilitation concepts regarding geometrical variation. The purpose of this study is to find the source of the greatest geometrical variation contributor and sensitivity contributor with the help of virtual variation simulation of a dental drill- and implant-guided surgery process using a methodical approach. It is believed that lower geometrical variation will lead to better patient security and higher quality of dental drill- and implant-guided surgeries. It was found that the origin of the greatest contributor to the most variation, and hence where the foci should be set, in order to minimize geometrical variation was in the assembly category (surgery). This was also the category that was the most sensitive for geometrical variation.

Keywords: Variation Simulation, Process Optimization, Guided Surgeries, Dental Prosthesis.

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176 Machine Vision for the Inspection of Surgical Tasks: Applications to Robotic Surgery Systems

Authors: M. Ovinis, D. Kerr, K. Bouazza-Marouf, M. Vloeberghs

Abstract:

The use of machine vision to inspect the outcome of surgical tasks is investigated, with the aim of incorporating this approach in robotic surgery systems. Machine vision is a non-contact form of inspection i.e. no part of the vision system is in direct contact with the patient, and is therefore well suited for surgery where sterility is an important consideration,. As a proof-of-concept, three primary surgical tasks for a common neurosurgical procedure were inspected using machine vision. Experiments were performed on cadaveric pig heads to simulate the two possible outcomes i.e. satisfactory or unsatisfactory, for tasks involved in making a burr hole, namely incision, retraction, and drilling. We identify low level image features to distinguish the two outcomes, as well as report on results that validate our proposed approach. The potential of using machine vision in a surgical environment, and the challenges that must be addressed, are identified and discussed.

Keywords: Visual inspection, machine vision, robotic surgery.

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175 Pervasive Computing in Healthcare Systems

Authors: Elham Rastegari, Amirmasood Rahmani, Saeed Setayeshi

Abstract:

The hospital and the health-care center of a community, as a place for people-s life-care and health-care settings, must provide more and better services for patients or residents. After Establishing Electronic Medical Record (EMR) system -which is a necessity- in the hospital, providing pervasive services is a further step. Our objective in this paper is to use pervasive computing in a case study of healthcare, based on EMR database that coordinates application services over network to form a service environment for medical and health-care. Our method also categorizes the hospital spaces into 3 spaces: Public spaces, Private spaces and Isolated spaces. Although, there are many projects about using pervasive computing in healthcare, but all of them concentrate on the disease recognition, designing smart cloths, or provide services only for patient. The proposed method is implemented in a hospital. The obtained results show that it is suitable for our purpose.

Keywords: Pervasive computing, RFID, Health-care.

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174 Investigation of Genetic Epidemiology of Metabolic Compromises in ß Thalassemia Minor Mutation: Phenotypic Pleiotropy

Authors: Surajit Debnath, Soma Addya

Abstract:

Human genome is not only the evolutionary summation of all advantageous events, but also houses lesions of deleterious foot prints. A single gene mutation sometimes may express multiple consequences in numerous tissues and a linear relationship of the genotype and the phenotype may often be obscure. ß Thalassemia minor, a transfusion independent mild anaemia, coupled with environment among other factors may articulate into phenotypic pleotropy with Hypocholesterolemia, Vitamin D deficiency, Tissue hypoxia, Hyper-parathyroidism and Psychological alterations. Occurrence of Pancreatic insufficiency, resultant steatorrhoea, Vitamin-D (25-OH) deficiency (13.86 ngm/ml) with Hypocholesterolemia (85mg/dl) in a 30 years old male ß Thal-minor patient (Hemoglobin 11mg/dl with Fetal Hemoglobin 2.10%, Hb A2 4.60% and Hb Adult 84.80% and altered Hemogram) with increased Para thyroid hormone (62 pg/ml) & moderate Serum Ca+2 (9.5mg/ml) indicate towards a cascade of phenotypic pleotropy where the ß Thalassemia mutation ,be it in the 5’ cap site of the mRNA , differential splicing etc in heterozygous state is effecting several metabolic pathways. Compensatory extramedulary hematopoiesis may not coped up well with the stressful life style of the young individual and increased erythropoietic stress with high demand for cholesterol for RBC membrane synthesis may have resulted in Hypocholesterolemia.Oxidative stress and tissue hypoxia may have caused the pancreatic insufficiency, leading to Vitamin D deficiency. This may in turn have caused the secondary hyperparathyroidism to sustain serum Calcium level. Irritability and stress intolerance of the patient was a cumulative effect of the vicious cycle of metabolic compromises. From these findings we propose that the metabolic deficiencies in the ß Thalassemia mutations may be considered as the phenotypic display of the pleotropy to explain the genetic epidemiology. According to the recommendations from the NIH Workshop on Gene-Environment Interplay in Common Complex Diseases: Forging an Integrative Model, study design of observations should be informed by gene-environment hypotheses and results of a study (genetic diseases) should be published to inform future hypotheses. Variety of approaches is needed to capture data on all possible aspects, each of which is likely to contribute to the etiology of disease. Speakers also agreed that there is a need for development of new statistical methods and measurement tools to appraise information that may be missed out by conventional method where large sample size is needed to segregate considerable effect. A meta analytic cohort study in future may bring about significant insight on to the title comment.

Keywords: Genetic disease, Genetic epidemiology, Heterozygous, Phenotype, Pleotropy, ß Thalassemia minor, Metabolic compromises.

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173 Family Carers' Experiences in Striving for Medical Care and Finding Their Solutions for Family Members with Mental Illnesses

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

Abstract:

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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172 The Effect of Press Fit on Osseointegration of Acetabular Cup

Authors: Nor Azali Azmir, Iskhrizat Taib, Mohammed Rafiq Abdul Kadir

Abstract:

The primary cause of Total Hip Replacement (THR) failure for younger patients is aseptic loosening. This complication is twice more likely to happen in acetabular cup than in femoral stem. Excessive micromotion between bone and implant will cause loosening and it depends in patient activities, age and bone. In this project, the effects of different metal back design of press fit on osseointegration of the acetabular cup are carried out. Commercial acetabular cup designs, namely Spiked, Superfix and Quadrafix are modelled and analyzed using commercial finite element software. The diameter of acetabular cup is based on the diameter of acetabular rim to make sure the component fit to the acetabular cavity. A new design of acetabular cup are proposed and analyzed to get better osseointegration between the bones and implant interface. Results shows that the proposed acetabular cup designs are more stable compared to other designs with respect to stress and displacement aspects.

Keywords: Finite element analysis, total hip replacement, acetabular cup, loosening.

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171 Telehealth Ecosystem: Challenge and Opportunity

Authors: R. Poonsuph

Abstract:

Technological innovation plays a crucial role in virtual healthcare services. A growing number of telehealth platforms are concentrating on using digital tools to improve the quality and availability of care. As a result, telehealth represents an opportunity to redesign the way health services are delivered. The research objective is to discover a new business model for digital health services and related industries to participate with telehealth solutions. The business opportunity is valuable for healthcare investors as a startup company to further investigations or implement the telehealth platform. The paper presents a digital healthcare business model and business opportunities to related industries. These include digital healthcare services extending from a traditional business model and use cases of business opportunities to related industries. Although there are enormous business opportunities, telehealth is still challenging due to the patient adaption and digital transformation process within a healthcare organization.

Keywords: telehealth, Internet hospital, HealthTech, InsurTech

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170 Analytics Model in a Telehealth Center Based on Cloud Computing and Local Storage

Authors: L. Ramirez, E. Guillén, J. Sánchez

Abstract:

Some of the main goals about telecare such as monitoring, treatment, telediagnostic are deployed with the integration of applications with specific appliances. In order to achieve a coherent model to integrate software, hardware, and healthcare systems, different telehealth models with Internet of Things (IoT), cloud computing, artificial intelligence, etc. have been implemented, and their advantages are still under analysis. In this paper, we propose an integrated model based on IoT architecture and cloud computing telehealth center. Analytics module is presented as a solution to control an ideal diagnostic about some diseases. Specific features are then compared with the recently deployed conventional models in telemedicine. The main advantage of this model is the availability of controlling the security and privacy about patient information and the optimization on processing and acquiring clinical parameters according to technical characteristics.

Keywords: Analytics, telemedicine, internet of things, cloud computing.

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169 EPR Hiding in Medical Images for Telemedicine

Authors: K. A. Navas, S. Archana Thampy, M. Sasikumar

Abstract:

Medical image data hiding has strict constrains such as high imperceptibility, high capacity and high robustness. Achieving these three requirements simultaneously is highly cumbersome. Some works have been reported in the literature on data hiding, watermarking and stegnography which are suitable for telemedicine applications. None is reliable in all aspects. Electronic Patient Report (EPR) data hiding for telemedicine demand it blind and reversible. This paper proposes a novel approach to blind reversible data hiding based on integer wavelet transform. Experimental results shows that this scheme outperforms the prior arts in terms of zero BER (Bit Error Rate), higher PSNR (Peak Signal to Noise Ratio), and large EPR data embedding capacity with WPSNR (Weighted Peak Signal to Noise Ratio) around 53 dB, compared with the existing reversible data hiding schemes.

Keywords: Biomedical imaging, Data security, Datacommunication, Teleconferencing.

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168 Fractal Analysis on Human Colonic Pressure Activities based on the Box-counting Method

Authors: Rongguo Yan, Guozheng Yan, Banghua Yang

Abstract:

The colonic tissue is a complicated dynamic system and the colonic activities it generates are composed of irregular segmental waves, which are referred to as erratic fluctuations or spikes. They are also highly irregular with subunit fractal structure. The traditional time-frequency domain statistics like the averaged amplitude, the motility index and the power spectrum, etc. are insufficient to describe such fluctuations. Thus the fractal box-counting dimension is proposed and the fractal scaling behaviors of the human colonic pressure activities under the physiological conditions are studied. It is shown that the dimension of the resting activity is smaller than that of the normal one, whereas the clipped version, which corresponds to the activity of the constipation patient, shows with higher fractal dimension. It may indicate a practical application to assess the colonic motility, which is often indicated by the colonic pressure activity.

Keywords: Colonic pressure activity, erratic fluctuations, fractal dimension and spikes.

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167 Cardiovascular Modeling Software Tools in Medicine

Authors: J. Fernandez, R. Fernandez de Canete, J. Perea-Paizal, J. C. Ramos-Diaz

Abstract:

The high prevalence of cardiovascular diseases has provoked a raising interest in the development of mathematical models in order to evaluate the cardiovascular function both under physiological and pathological conditions. In this paper, a physical model of the cardiovascular system with intrinsic regulation is presented and implemented by using the object-oriented Modelica simulation software tools.  For this task, a multi-compartmental system previously validated with physiological data has been built, based on the interconnection of cardiovascular elements such as resistances, capacitances and pumping among others, by following an electrohydraulic analogy. The results obtained under both physiological and pathological scenarios provide an easy interpretative key to analyze the hemodynamic behavior of the patient. The described approach represents a valuable tool in the teaching of physiology for graduate medical and nursing students among others.

Keywords: Cardiovascular system, Modelica simulation software, physical modeling, teaching tool.

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166 Development of Position Changing System for Obstructive Sleep Apnea Patient using HRV

Authors: Soo- Young Ye, Dong-Hyun Kim

Abstract:

Obstructive sleep apnea in patients, between 70 and 80 percent, can be cured with just a posture correcting. The most import thing to do this is detection of obstructive sleep apnea. Detection of obstructive sleep apnea can be performed through heart rate variability analysis using power spectrum density analysis. After HRV analysis we needed to know the current position information for correcting the position. The pressure sensors of the array type were used to obtain position information. These sensors can obtain information from the experimenter about position. In addition, air cylinder corrected the position of the experimenter by lifting the bed. The experimenter can be changed position without breaking during sleep by the system. Polysomnograph recording were obtained from 10 patients. The results of HRV analysis were that NLF and LF/HF ratio increased, while NHF decreased during OSA. Position change had to be done the periods.

Keywords: Obstructive sleep apnea, Heart rate variability, Air cylinder, PSD, RR interval, ANS

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165 Design and Development of a 3D Printed Myoelectric-Controlled Prosthesis Hand Using sEMG Sensor

Authors: Sher Shermin Azmiri Khan, Syeda Jannatul Ferdous, Sushmita Chakraborty

Abstract:

Over the last decades, biomedical engineering prosthetics become one of the most essential grounds. Prosthetic hands are rapidly evolving. Therefore, for designing prosthetic components, it is essential to improve quality such as make it affordable and improve patient comfort and mobility by making them lightweight and easy to wear. In this paper, we proposed a myoelectric controlled prosthesis hand. We can fabricate and manufacture customized cost-effective, small volumes of 3D printed hand which is interesting. The total weight of an adult hand is about 1000 gm including a battery. The prosthetic hand is built up with low-cost materials and techniques, the cost of manufacturing will be approximately US$145. The hand can grip objects of different shapes and sizes. The 3D printed hand can rotate its wrist like a human hand. The prosthetic hand is capable of showing some types of human gestures.

Keywords: Prosthetic Hand, sEMG, 3D printing, Arduino.

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