Search results for: medical decisions

Authors: Stephan Printz, Kristina Lahl, René Vossen, Sabina Jeschke

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Strategic investment decisions are characterized by high innovation potential and long-term effects on the competitiveness of enterprises. Due to the uncertainty and risks involved in this complex decision making process, the need arises for well-structured support activities. A method that considers cost and the long-term added value is the cost-benefit effectiveness estimation. One of those methods is the “profitability estimation focused on benefits – PEFB”-method developed at the Institute of Management Cybernetics at RWTH Aachen University. The method copes with the challenges associated with strategic investment decisions by integrating long-term non-monetary aspects whilst also mapping the chronological sequence of an investment within the organization’s target system. Thus, this method is characterized as a holistic approach for the evaluation of costs and benefits of an investment. This participation-oriented method was applied to business environments in many workshops. The results of the workshops are a library of more than 96 cost aspects, as well as 122 benefit aspects. These aspects are preprocessed and comparatively analyzed with regards to their alignment to a series of risk levels. For the first time, an accumulation and a distribution of cost and benefit aspects regarding their impact and probability of occurrence are given. The results give evidence that the PEFB-method combines precise measures of financial accounting with the incorporation of benefits. Finally, the results constitute the basics for using information technology and data science for decision support when applying within the PEFB-method.

Keywords: Cost-benefit analysis, multi-criteria decision, profitability estimation focused on benefits, risk and uncertainty analysis.

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Authors: Aryana Collins Jackson, Elisabetta Bevacqua, Pierre De Loor, Ronan Querrec

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This paper presents a taxonomy of non-technical skills, communicative intentions, and behavior for an individual acting as a medical coordinator. In medical emergency situations, a leader among the group is imperative to both patient health and team emotional and mental health. Situational Leadership is used to make clear and easy-to-follow guidelines for behavior depending on circumstantial factors. Low-level leadership behaviors belonging to two different styles, directive and supporting, are identified from literature and are included in the proposed taxonomy. The high-level information in the taxonomy consists of the necessary non-technical skills belonging to a medical coordinator: situation awareness, decision making, task management, and teamwork. Finally, communicative intentions, dimensions, and functions are included. Thus this work brings high-level and low-level information - medical non-technical skills, communication capabilities, and leadership behavior - into a single versatile taxonomy of behavior.

Keywords: Medical, leadership styles, taxonomy, human behavior.

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Authors: Fahad Shahbaz Khan, Fahad Maqbool, Saad Razzaq, Kashif Irfan, Tehseen Zia

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Expert systems are used extensively in many domains. This paper discusses the use of medical expert systems in Pakistan. Countries all over the world pay special attention on health facilities. A country like Pakistan faces a lot of trouble in health sector. Several attempts have been made in Pakistan to improve the health conditions of the people but the situation is still not encouraging. There is a shortage of doctors and other trained personnel in Pakistan. Expert systems can play a vital role in such cases where the medical expert is not readily available. The purpose of this paper is to analyze the role that such systems can play in improving the health conditions of the people in Pakistan.

Keywords: Medical Diagnostics, Expert Systems, Pakistan.

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Authors: Puteri Nemie Jahn Kassim, Khadijah Mohd Najid

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Medical negligence disputes in Malaysia are mainly resolved through litigation by using the tort system. The tort system, being adversarial in nature has subjected parties to litigation hazards such as delay, excessive costs and uncertainty of outcome. The dissatisfaction of the tort system in compensating medically injured victims has created various alternatives to litigation. Amongst them is the implementation of a no-fault compensation system which would allow compensation to be given without the need of proving fault on the medical personnel. Instead, the community now bears the burden of compensating and at the end, promotes collective responsibility. For Malaysia, introducing a no-fault system would provide a tempting solution and may ultimately, achieve justice for the medical injured victims. Nevertheless, such drastic change requires a great deal of consideration to determine the suitability of the system and whether or not it will eventually cater for the needs of the Malaysian population

Keywords: Medical Disputes, Litigation, Malaysia, No-Fault Compensation.

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Authors: Lara Dutil-Fafard, Caroline Rhéaume, Patrick Archambault, Daniel Lafond, Neal W. Pollock

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Improving resources for medical autonomy of astronauts in prolonged space missions, such as a Mars mission, requires not only technology development, but also decision-making support systems. The Advanced Crew Medical System - Medical Condition Requirements study, funded by the Canadian Space Agency, aimed to create knowledge content and a scenario-based query capability to support medical autonomy of astronauts. The key objective of this study was to create a prototype tool for identifying medical infrastructure requirements in terms of medical knowledge, skills and materials. A multicriteria decision-making method was used to prioritize the highest risk medical events anticipated in a long-term space mission. Starting with those medical conditions, event sequence diagrams (ESDs) were created in the form of decision trees where the entry point is the diagnosis and the end points are the predicted outcomes (full recovery, partial recovery, or death/severe incapacitation). The ESD formalism was adapted to characterize and compare possible outcomes of medical conditions as a function of available medical knowledge, skills, and supplies in a given mission scenario. An extensive literature review was performed and summarized in a medical condition database. A PostgreSQL relational database was created to allow query-based evaluation of health outcome metrics with different medical infrastructure scenarios. Critical decision points, skill and medical supply requirements, and probable health outcomes were compared across chosen scenarios. The three medical conditions with the highest risk rank were acute coronary syndrome, sepsis, and stroke. Our efforts demonstrate the utility of this approach and provide insight into the effort required to develop appropriate content for the range of medical conditions that may arise.

Keywords: Decision support system, event sequence diagram, exploration mission, medical autonomy, scenario-based queries, space medicine.

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Authors: Mehmet Altınöz

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This study focuses on bureau management technologies and information systems in developing countries. Developing countries use such systems which facilitate executive and organizational functions through the utilization of bureau management technologies and provide the executive staff with necessary information. The concepts of data and information differ from each other in developing countries, and thus the concepts of data processing and information processing are different. Symbols represent ideas, objects, figures, letters and numbers. Data processing system is an integrated system which deals with the processing of the data related to the internal and external environment of the organization in order to make decisions, create plans and develop strategies; it goes without saying that this system is composed of both human beings and machines. Information is obtained through the acquisition and the processing of data. On the other hand, data are raw communicative messages. Within this framework, data processing equals to producing plausible information out of raw data. Organizations in developing countries need to obtain information relevant to them because rapid changes in the organizational arena require rapid access to accurate information. The most significant role of the directors and managers who work in the organizational arena is to make decisions. Making a correct decision is possible only when the directors and managers are equipped with sound ideas and appropriate information. Therefore, acquisition, organization and distribution of information gain significance. Today-s organizations make use of computer-assisted “Management Information Systems" in order to obtain and distribute information. Decision Support System which is closely related to practice is an information system that facilitates the director-s task of making decisions. Decision Support System integrates human intelligence, information technology and software in order to solve the complex problems. With the support of the computer technology and software systems, Decision Support System produces information relevant to the decision to be made by the director and provides the executive staff with supportive ideas about the decision. Artificial Intelligence programs which transfer the studies and experiences of the people to the computer are called expert systems. An expert system stores expert information in a limited area and can solve problems by deriving rational consequences. Bureau management technologies and information systems in developing countries create a kind of information society and information economy which make those countries have their places in the global socio-economic structure and which enable them to play a reasonable and fruitful role; therefore it is of crucial importance to make use of information and management technologies in order to work together with innovative and enterprising individuals and it is also significant to create “scientific policies" based on information and technology in the fields of economy, politics, law and culture.

Keywords: Bureau Management, Information Systems.

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Authors: A. Rubiano F, N. Olarte, D. Lara

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This paper presents the design, implementation and results related to the storage system of medical information associated to the ECG (Electrocardiography) signal. The system includes the signal acquisition modules, the preprocessing and signal processing, followed by a module of transmission and reception of the signal, along with the storage and web display system of the medical platform. The tests were initially performed with this signal, with the purpose to include more biosignal under the same system in the future.

Keywords: Acquisition, ECG Signal, Storage, Web Platform

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Authors: Aki Sugano, Mika Ohta, Mineko Ikegami, Kenji Miura, Sayo Tsukamoto, Akihiro Ichinose, Toshiko Ohshima, Eiichi Maeda, Masako Matsuura, Yutaka Takao

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Along with the advances in medicine, providing medical information to individual patient is becoming more important. In Japan such information via Braille is hardly provided to blind and partially sighted people. Thus we are researching and developing a Web-based automatic translation program “eBraille" to translate Japanese text into Japanese Braille. First we analyzed the Japanese transcription rules to implement them on our program. We then added medical words to the dictionary of the program to improve its translation accuracy for medical text. Finally we examined the efficacy of statistical learning models (SLMs) for further increase of word segmentation accuracy in braille translation. As a result, eBraille had the highest translation accuracy in the comparison with other translation programs, improved the accuracy for medical text and is utilized to make hospital brochures in braille for outpatients and inpatients.

Keywords: Automatic Braille translation, Medical text, Partially sighted people.

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Authors: Dhurgham Al-Karawi, Nisreen Polus, Shakir Al-Zaidi, Sabah Jassim

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The management of COVID-19 patients based on chest imaging is emerging as an essential tool for evaluating the spread of the pandemic which has gripped the global community. It has already been used to monitor the situation of COVID-19 patients who have issues in respiratory status. There has been increase to use chest imaging for medical triage of patients who are showing moderate-severe clinical COVID-19 features, this is due to the fast dispersal of the pandemic to all continents and communities. This article demonstrates the development of machine learning techniques for the test of COVID-19 patients using Chest X-Ray (CXR) images in nearly real-time, to distinguish the COVID-19 infection with a significantly high level of accuracy. The testing performance has covered a combination of different datasets of CXR images of positive COVID-19 patients, patients with viral and bacterial infections, also, people with a clear chest. The proposed AI scheme successfully distinguishes CXR scans of COVID-19 infected patients from CXR scans of viral and bacterial based pneumonia as well as normal cases with an average accuracy of 94.43%, sensitivity 95%, and specificity 93.86%. Predicted decisions would be supported by visual evidence to help clinicians speed up the initial assessment process of new suspected cases, especially in a resource-constrained environment.

Keywords: COVID-19, chest x-ray scan, artificial intelligence, texture analysis, local binary pattern transform, Gabor filter.

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Authors: Kasim Terzic, Bernd Neumann

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Scene interpretation systems need to match (often ambiguous) low-level input data to concepts from a high-level ontology. In many domains, these decisions are uncertain and benefit greatly from proper context. This paper demonstrates the use of decision trees for estimating class probabilities for regions described by feature vectors, and shows how context can be introduced in order to improve the matching performance.

Keywords: Classification, Decision Trees, Interpretation, Vision

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Authors: Amit Chhabra, Gurvinder Singh, Sandeep Singh Waraich, Bhavneet Sidhu, Gaurav Kumar

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Decrease in hardware costs and advances in computer networking technologies have led to increased interest in the use of large-scale parallel and distributed computing systems. One of the biggest issues in such systems is the development of effective techniques/algorithms for the distribution of the processes/load of a parallel program on multiple hosts to achieve goal(s) such as minimizing execution time, minimizing communication delays, maximizing resource utilization and maximizing throughput. Substantive research using queuing analysis and assuming job arrivals following a Poisson pattern, have shown that in a multi-host system the probability of one of the hosts being idle while other host has multiple jobs queued up can be very high. Such imbalances in system load suggest that performance can be improved by either transferring jobs from the currently heavily loaded hosts to the lightly loaded ones or distributing load evenly/fairly among the hosts .The algorithms known as load balancing algorithms, helps to achieve the above said goal(s). These algorithms come into two basic categories - static and dynamic. Whereas static load balancing algorithms (SLB) take decisions regarding assignment of tasks to processors based on the average estimated values of process execution times and communication delays at compile time, Dynamic load balancing algorithms (DLB) are adaptive to changing situations and take decisions at run time. The objective of this paper work is to identify qualitative parameters for the comparison of above said algorithms. In future this work can be extended to develop an experimental environment to study these Load balancing algorithms based on comparative parameters quantitatively.

Keywords: SLB, DLB, Host, Algorithm and Load.

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Authors: Ismail Baniadam, Nafisa Tadayyon, Javid Fereidoni

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This study aimed to investigate medical students’ attitudes toward some teachers’ talking features regarding their gender in the Iranian context. To do so, 60 male and 60 female medical students of Urmia University of Medical Sciences (UMSU) participated in the research. A researcher made Likert-type questionnaire which was initially piloted and was used to gather the data. Comparing the four different factors regarding the features of teacher talk, it was revealed that visual and extra-linguistic information factor, Lexical and syntactic familiarity, Speed of speech, and the use of Persian language had the highest to the lowest mean score, respectively. It was also indicated that female students rather than male students were significantly more in favor of speed of speech and lexical and syntactic familiarity.

Keywords: Attitude, gender, medical student, teacher talk.

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Authors: Mai Miyabe, Taku Fukushima, Takashi Yoshino, Aguri Shigeno

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The need for multilingual communication in Japan has increased due to an increase in the number of foreigners in the country. When people communicate in their nonnative language, the differences in language prevent mutual understanding among the communicating individuals. In the medical field, communication between the hospital staff and patients is a serious problem. Currently, medical translators accompany patients to medical care facilities, and the demand for medical translators is increasing. However, medical translators cannot necessarily provide support, especially in cases in which round-the-clock support is required or in case of emergencies. The medical field has high expectations from information technology. Hence, a system that supports accurate multilingual communication is required. Despite recent advances in machine translation technology, it is very difficult to obtain highly accurate translations. We have developed a support system called M3 for multilingual medical reception. M3 provides support functions that aid foreign patients in the following respects: conversation, questionnaires, reception procedures, and hospital navigation; it also has a Q&A function. Users can operate M3 using a touch screen and receive text-based support. In addition, M3 uses accurate translation tools called parallel texts to facilitate reliable communication through conversations between the hospital staff and the patients. However, if there is no parallel text that expresses what users want to communicate, the users cannot communicate. In this study, we have developed a circulating support environment for multilingual medical communication using parallel texts. The proposed environment can circulate necessary parallel texts through the following procedure: (1) a user provides feedback about the necessary parallel texts, following which (2) these parallel texts are created and evaluated.

Keywords: multilingual medical communication, parallel texts.

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Authors: Trevor Kroeger, Hayden Williams, Edward Holzinger, David Coleman, Brian Haberman

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The network connectivity of medical devices is increasing at a rapid rate. Many medical devices, such as vital sign monitors, share information via wireless or wired connections. However, these connectivity options suffer from a variety of well-known limitations. Wireless connectivity, especially in the unlicensed radio frequency bands, can be disrupted. Such disruption could be due to benign reasons, such as a crowded spectrum, or to malicious intent. While wired connections are less susceptible to interference, they inhibit the mobility of the medical devices, which could be critical in a variety of scenarios. This work explores the application of Light Fidelity (Li-Fi) communication to enhance the security, performance, and mobility of medical devices in connected healthcare scenarios. A simple bridge for connected devices serves as an avenue to connect traditional medical devices to the Li-Fi network. This bridge was utilized to conduct bandwidth tests on a small Li-Fi network installed into a Mock-ICU setting with a backend enterprise network similar to that of a hospital. Mobile and stationary tests were conducted to replicate various different situations that might occur within a hospital setting. Results show that in room Li-Fi connectivity provides reasonable bandwidth and latency within a hospital like setting.

Keywords: Hospital, light fidelity, Li-Fi, medical devices, security.

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Authors: W. Maddison

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This paper describes an Action Research project which was undertaken to inform professional practice in order to develop a newly created Centre for Student Success in the specific context of transnational medical and nursing education in the Middle East. The objectives were to enhance the academic performance, persistence, integration and personal and professional development of a multinational study body, in particular in relation to pre-clinical medical students, and to establish a comfortable, friendly and student-driven environment within an Irish medical university recently established in Bahrain. The outcomes of the project resulted in the development of a specific student success ‘signature’ for this particular transnational higher education context.

Keywords: Global-Local, pre-clinical medical students, student success, transnational higher education, Middle East.

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Authors: Y. N. Phang, E. F. Loh

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Many researchers have suggested the use of zero inflated Poisson (ZIP) and zero inflated negative binomial (ZINB) models in modeling overdispersed medical count data with extra variations caused by extra zeros and unobserved heterogeneity. The studies indicate that ZIP and ZINB always provide better fit than using the normal Poisson and negative binomial models in modeling overdispersed medical count data. In this study, we proposed the use of Zero Inflated Inverse Trinomial (ZIIT), Zero Inflated Poisson Inverse Gaussian (ZIPIG) and zero inflated strict arcsine models in modeling overdispered medical count data. These proposed models are not widely used by many researchers especially in the medical field. The results show that these three suggested models can serve as alternative models in modeling overdispersed medical count data. This is supported by the application of these suggested models to a real life medical data set. Inverse trinomial, Poisson inverse Gaussian and strict arcsine are discrete distributions with cubic variance function of mean. Therefore, ZIIT, ZIPIG and ZISA are able to accommodate data with excess zeros and very heavy tailed. They are recommended to be used in modeling overdispersed medical count data when ZIP and ZINB are inadequate.

Keywords: Zero inflated, inverse trinomial distribution, Poisson inverse Gaussian distribution, strict arcsine distribution, Pearson’s goodness of fit.

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Authors: Vladimíra Čavojová, Eva Ballová Mikušková

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In this study we tried to replicate the unconscious thought advantage (UTA), which states that complex decisions are better handled by unconscious thinking. We designed an experiment in e-prime using similar material as the original study (choosing between four different apartments, each described by 12 attributes). A total of 73 participants (52 women (71.2%); 18 to 62 age: M=24.63; SD=8.7) took part in the experiment. We did not replicate the results suggested by UTT. However, from the present study we cannot conclude whether this was the case of flaws in the theory or flaws in our experiment and we discuss several ways in which the issue of UTA could be examined further.

Keywords: Decision making, unconscious thoughts, UTT.

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

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Segmentation is an important step in medical image analysis and classification for radiological evaluation or computer aided diagnosis. This paper presents the problem of inaccurate lung segmentation as observed in algorithms presented by researchers working in the area of medical image analysis. The different lung segmentation techniques have been tested using the dataset of 19 patients consisting of a total of 917 images. We obtained datasets of 11 patients from Ackron University, USA and of 8 patients from AGA Khan Medical University, Pakistan. After testing the algorithms against datasets, the deficiencies of each algorithm have been highlighted.

Keywords: Computer Aided Diagnosis (CAD), MathematicalMorphology, Medical Image Analysis, Region Growing, Segmentation, Thresholding,

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Authors: Jagadish H. Pujar, Pallavi S. Gurjal, Shambhavi D. S, Kiran S. Kunnur

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Medical image segmentation based on image smoothing followed by edge detection assumes a great degree of importance in the field of Image Processing. In this regard, this paper proposes a novel algorithm for medical image segmentation based on vigorous smoothening by identifying the type of noise and edge diction ideology which seems to be a boom in medical image diagnosis. The main objective of this algorithm is to consider a particular medical image as input and make the preprocessing to remove the noise content by employing suitable filter after identifying the type of noise and finally carrying out edge detection for image segmentation. The algorithm consists of three parts. First, identifying the type of noise present in the medical image as additive, multiplicative or impulsive by analysis of local histograms and denoising it by employing Median, Gaussian or Frost filter. Second, edge detection of the filtered medical image is carried out using Canny edge detection technique. And third part is about the segmentation of edge detected medical image by the method of Normalized Cut Eigen Vectors. The method is validated through experiments on real images. The proposed algorithm has been simulated on MATLAB platform. The results obtained by the simulation shows that the proposed algorithm is very effective which can deal with low quality or marginal vague images which has high spatial redundancy, low contrast and biggish noise, and has a potential of certain practical use of medical image diagnosis.

Keywords: Image Segmentation, Image smoothing, Edge Detection, Impulsive noise, Gaussian noise, Median filter, Canny edge, Eigen values, Eigen vector.

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Authors: Peter U. Eze, P. Udaya, Robin J. Evans

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Data hiding can be achieved by Steganography or invisible digital watermarking. For digital watermarking, both accurate retrieval of the embedded watermark and the integrity of the cover image are important. Medical image security in Teleradiology is one of the applications where the embedded patient record needs to be extracted with accuracy as well as the medical image integrity verified. In this research paper, the Constant Correlation Spread Spectrum digital watermarking for medical image tamper detection and accurate embedded watermark retrieval is introduced. In the proposed method, a watermark bit from a patient record is spread in a medical image sub-block such that the correlation of all watermarked sub-blocks with a spreading code, W, would have a constant value, p. The constant correlation p, spreading code, W and the size of the sub-blocks constitute the secret key. Tamper detection is achieved by flagging any sub-block whose correlation value deviates by more than a small value, ℇ, from p. The major features of our new scheme include: (1) Improving watermark detection accuracy for high-pixel depth medical images by reducing the Bit Error Rate (BER) to Zero and (2) block-level tamper detection in a single computational process with simultaneous watermark detection, thereby increasing utility with the same computational cost.

Keywords: Constant correlation, medical image, spread spectrum, tamper detection, watermarking.

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Authors: Md Shohidul Islam, Jongmyon Kim, Ui-pil Chong

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Medical image is an integral part of e-health care and e-diagnosis system. Medical image watermarking is widely used to protect patients’ information from malicious alteration and manipulation. The watermarked medical images are transmitted over the internet among patients, primary and referred physicians. The images are highly prone to corruption in the wireless transmission medium due to various noises, deflection, and refractions. Distortion in the received images leads to faulty watermark detection and inappropriate disease diagnosis. To address the issue, this paper utilizes error correction code (ECC) with (8, 4) Hamming code in an existing watermarking system. In addition, we implement the high complex ECC on a graphics processing units (GPU) to accelerate and support real-time requirement. Experimental results show that GPU achieves considerable speedup over the sequential CPU implementation, while maintaining 100% ECC efficiency.

Keywords: Medical Image Watermarking (MIW), e-health system, error correction, Hamming code, GPU.

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Authors: Mou-Yuan Liao, Chien-Wei Wu, Chien-Hua Lin

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Process capability index Cpk is the most widely used index in making managerial decisions since it provides bounds on the process yield for normally distributed processes. However, existent methods for assessing process performance which constructed by statistical inference may unfortunately lead to fine results, because uncertainties exist in most real-world applications. Thus, this study adopts fuzzy inference to deal with testing of Cpk . A brief score is obtained for assessing a supplier’s process instead of a severe evaluation.

Keywords: Process capability analysis, quality control.

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Authors: Nahla Ibraheem Jabbar, Monica Mehrotra

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This paper used a fuzzy kohonen neural network for medical image segmentation. Image segmentation plays a important role in the many of medical imaging applications by automating or facilitating the diagnostic. The paper analyses the tumor by extraction of the features of (area, entropy, means and standard deviation).These measurements gives a description for a tumor.

Keywords: FCM, features extraction, medical image processing, neural network, segmentation.

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Authors: Mannan Mridha, Mohammad S. Islam

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Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: Accidents reporting system, patient car and safety, safe medical devices.

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Authors: J. Mehena, M. C. Adhikary

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In this paper, a spatial multiple-kernel fuzzy C-means (SMKFCM) algorithm is introduced for segmentation problem. A linear combination of multiples kernels with spatial information is used in the kernel FCM (KFCM) and the updating rules for the linear coefficients of the composite kernels are derived as well. Fuzzy cmeans (FCM) based techniques have been widely used in medical image segmentation problem due to their simplicity and fast convergence. The proposed SMKFCM algorithm provides us a new flexible vehicle to fuse different pixel information in medical image segmentation and detection of MR images. To evaluate the robustness of the proposed segmentation algorithm in noisy environment, we add noise in medical brain tumor MR images and calculated the success rate and segmentation accuracy. From the experimental results it is clear that the proposed algorithm has better performance than those of other FCM based techniques for noisy medical MR images.

Keywords: Clustering, fuzzy C-means, image segmentation, MR images, multiple kernels.

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Authors: B. Stroetmann, A. Aisenbrey

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The Siemens Healthcare Sector is one of the world's largest suppliers to the healthcare industry and a trendsetter in medical imaging and therapy, laboratory diagnostics, medical information technology, and hearing aids. Siemens offers its customers products and solutions for the entire range of patient care from a single source – from prevention and early detection to diagnosis, and on to treatment and aftercare. By optimizing clinical workflows for the most common diseases, Siemens also makes healthcare faster, better, and more cost effective. The optimization of clinical workflows requires a multidisciplinary focus and a collaborative approach of e.g. medical advisors, researchers and scientists as well as healthcare economists. This new form of collaboration brings together experts with deep technical experience, physicians with specialized medical knowledge as well as people with comprehensive knowledge about health economics. As Charles Darwin is often quoted as saying, “It is neither the strongest of the species that survive, nor the most intelligent, but the one most responsive to change," We believe that those who can successfully manage this change will emerge as winners, with valuable competitive advantage. Current medical information and knowledge are some of the core assets in the healthcare industry. The main issue is to connect knowledge holders and knowledge recipients from various disciplines efficiently in order to spread and distribute knowledge.

Keywords: Business Excellence, Clinical Knowledge, Knowledge Management, Knowledge Services, Learning Organizations, Trust.

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Authors: Edith Esparza-Young, Ángel M. Matos, Yaritza Gonzalez, Kirthana Sugunathevan

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Introduction: This research describes the existing medical school program which supports a multicultural setting and bilingualism. The rise of Spanish speakers in the United States has led to the recruitment of bilingual medical students who can serve the evolving demographics. This paper includes anecdotal evidence, narratives and the latest research on the outcomes of supporting a multilingual academic experience in medical school and beyond. People in the United States will continue to need health care from physicians who have experience with multicultural competence. Physicians who are bilingual and possess effective communication skills will be in high demand. Methodologies: This research is descriptive. Through this descriptive research, the researcher will describe the qualities and characteristics of the existing medical school programs, curriculum, and student services. Additionally, the researcher will shed light on the existing curriculum in the medical school and also describe specific programs which help to serve as safety nets to support diverse populations. The method included observations of the existing program and the implementation of the medical school program, specifically the Accelerated Review Program, the Language Education and Professional Communication Program, student organizations and the Global Health Institute. Concluding Statement: This research identified and described characteristics of the medical school’s program. The research explained and described the current and present phenomenon of this medical program, which has focused on increasing the graduation of bilingual and minority physicians. The findings are based on observations of the curriculum, programs and student organizations which evolves and remains innovative to stay current with student enrollment.

Keywords: Bilingual, English, medicine, doctor.

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Authors: T. Gotoh, T. Takayama, M. Ishiki, T. Ikeda

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Recently, majors of doctors are divided into terribly lots of detailed areas. However, it is actually not a rare case that a doctor has a patient who is not in his/her major. He/She must judge an assessment and make a medical treatment plan for this patient. According to our investigation, conventional approaches such as image diagnosis cooperation are insufficient. This paper proposes an 'Assessment / Medical Treatment Plan Consulting System'. We have implemented a pilot system based on our proposition. Its effectiveness is clarified by an evaluation.

Keywords: Application, computational intelligence and telecommunications, medicine, intelligent systems.

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Authors: M. McHugh, D. Lillis

Abstract:

Mobile applications are being used to perform a wide variety of tasks in day-to-day life, ranging from checking email to controlling your home heating. Application developers have recognized the potential to transform a smart device into a medical device, by using a mobile medical application i.e. a mobile phone or a tablet. When initially conceived these mobile medical applications performed basic functions e.g. BMI calculator, accessing reference material etc.; however, increasing complexity offers clinicians and patients a range of functionality. As this complexity and functionality increases, so too does the potential risk associated with using such an application. Examples include any applications that provide the ability to inflate and deflate blood pressure cuffs, as well as applications that use patient-specific parameters and calculate dosage or create a dosage plan for radiation therapy. If an unapproved mobile medical application is marketed by a medical device organization, then they face significant penalties such as receiving an FDA warning letter to cease the prohibited activity, fines and possibility of facing a criminal conviction. Regulatory bodies have finalized guidance intended for mobile application developers to establish if their applications are subject to regulatory scrutiny. However, regulatory controls appear contradictory with the approaches taken by mobile application developers who generally work with short development cycles and very little documentation and as such, there is the potential to stifle further improvements due to these regulations. The research presented as part of this paper details how by adopting development techniques, such as agile software development, mobile medical application developers can meet regulatory requirements whilst still fostering innovation.

Keywords: Medical, mobile, applications, software Engineering, FDA, standards, regulations, agile.

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Authors: Manar AlJazzazi, Mohammed Rawashdeh, Tariq Alshawaheen, Aktham Malkawi

Abstract:

This paper is a part of research, in which the way the biomedical engineers follow in their work is analyzed. The goal of this paper is to present a method for specification of user requirements in the medical devices maintenance process. Data Gathering Methods, Research Model Phases and Descriptive Analysis is presented. These technology and verification rules can be implemented in Medical devices maintenance management process to the maintenance process.

Keywords: Quality Function Deployment (QFD), User - requirements approach.

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