Search results for: medical ultrasound.
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 687

Search results for: medical ultrasound.

567 Medical Negligence Disputes in Malaysia: Resolving through Hazards of Litigation or through Community Responsibilities?

Authors: Puteri Nemie Jahn Kassim, Khadijah Mohd Najid

Abstract:

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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566 Development of Requirements Analysis Tool for Medical Autonomy in Long-Duration Space Exploration Missions

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

Abstract:

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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565 Design of Medical Information Storage System – ECG Signal

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

Abstract:

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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564 Providing Medical Information in Braille: Research and Development of Automatic Braille Translation Program for Japanese “eBraille“

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

Abstract:

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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563 Investigating Medical Students’ Perspectives toward University Teachers’ Talking Features in an English as a Foreign Language Context in Urmia, Iran

Authors: Ismail Baniadam, Nafisa Tadayyon, Javid Fereidoni

Abstract:

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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562 Development of Circulating Support Environment of Multilingual Medical Communication using Parallel Texts for Foreign Patients

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

Abstract:

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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561 A FE-Based Scheme for Computing Wave Interaction with Nonlinear Damage and Generation of Harmonics in Layered Composite Structures

Authors: R. K. Apalowo, D. Chronopoulos

Abstract:

A Finite Element (FE) based scheme is presented for quantifying guided wave interaction with Localised Nonlinear Structural Damage (LNSD) within structures of arbitrary layering and geometric complexity. The through-thickness mode-shape of the structure is obtained through a wave and finite element method. This is applied in a time domain FE simulation in order to generate time harmonic excitation for a specific wave mode. Interaction of the wave with LNSD within the system is computed through an element activation and deactivation iteration. The scheme is validated against experimental measurements and a WFE-FE methodology for calculating wave interaction with damage. Case studies for guided wave interaction with crack and delamination are presented to verify the robustness of the proposed method in classifying and identifying damage.

Keywords: Layered Structures, nonlinear ultrasound, wave interaction with nonlinear damage, wave finite element, finite element.

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560 Leveraging Li-Fi to Enhance Security and Performance of Medical Devices

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

Abstract:

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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559 Transnational Higher Education: Developing a Transnational Student Success 'Signature' for Pre-Clinical Medical Students – An Action Research Project

Authors: W. Maddison

Abstract:

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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558 Extraction of Natural Colorant from the Flowers of Flame of Forest Using Ultrasound

Authors: Sunny Arora, Meghal A. Desai

Abstract:

An impetus towards green consumerism and implementation of sustainable techniques, consumption of natural products and utilization of environment friendly techniques have gained accelerated acceptance. Butein, a natural colorant, has many medicinal properties apart from its use in dyeing industries. Extraction of butein from the flowers of flame of forest was carried out using ultrasonication bath. Solid loading (2-6 g), extraction time (30-50 min), volume of solvent (30-50 mL) and types of solvent (methanol, ethanol and water) have been studied to maximize the yield of butein using the Taguchi method. The highest yield of butein 4.67% (w/w) was obtained using 4 g of plant material, 40 min of extraction time and 30 mL volume of methanol as a solvent. The present method provided a greater reduction in extraction time compared to the conventional method of extraction. Hence, the outcome of the present investigation could further be utilized to develop the method at a higher scale.

Keywords: Butein, flowers of flame of forest, Taguchi method, ultrasonic bath.

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557 Statistical Analysis for Overdispersed Medical Count Data

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

Abstract:

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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556 Evaluation of Carbon Dioxide Pressure through Radial Velocity Difference in Arterial Blood Modeled by Drift Flux Model

Authors: Aicha Rima Cheniti, Hatem Besbes, Joseph Haggege, Christophe Sintes

Abstract:

In this paper, we are interested to determine the carbon dioxide pressure in the arterial blood through radial velocity difference. The blood was modeled as a two phase mixture (an aqueous carbon dioxide solution with carbon dioxide gas) by Drift flux model and the Young-Laplace equation. The distributions of mixture velocities determined from the considered model permitted the calculation of the radial velocity distributions with different values of mean mixture pressure and the calculation of the mean carbon dioxide pressure knowing the mean mixture pressure. The radial velocity distributions are used to deduce a calculation method of the mean mixture pressure through the radial velocity difference between two positions which is measured by ultrasound. The mean carbon dioxide pressure is then deduced from the mean mixture pressure.

Keywords: Mean carbon dioxide pressure, mean mixture pressure, mixture velocity, radial velocity difference.

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555 Deficiencies of Lung Segmentation Techniques using CT Scan Images for CAD

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

Abstract:

Segmentation is an important step in medical image analysis and classification for radiological evaluation or computer aided diagnosis. 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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554 Medical Image Segmentation Based On Vigorous Smoothing and Edge Detection Ideology

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

Abstract:

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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553 Ultrasound Assisted Method to Increase the Aluminum Dissolve Rate from Acidified Water

Authors: Wen Po Cheng, Chi Hua Fu, Ping Hung Chen, Ruey Fang Yu

Abstract:

Aluminum salt that is generally presents as a solid phase in the water purification sludge (WPS) can be dissolved, recovering a liquid phase, by adding strong acid to the sludge solution. According to the reaction kinetics, when reactant is in the form of small particles with a large specific surface area, or when the reaction temperature is high, the quantity of dissolved aluminum salt or reaction rate, respectively are high. Therefore, in this investigation, water purification sludge (WPS) solution was treated with ultrasonic waves to break down the sludge, and different acids (1 N HCl and 1 N H2SO4) were used to acidify it. Acid dosages that yielded the solution pH of less than two were used. The results thus obtained indicate that the quantity of dissolved aluminum in H2SO4-acidified solution exceeded that in HCl-acidified solution. Additionally, ultrasonic treatment increased the rate of dissolution of aluminum and the amount dissolved. The quantity of aluminum dissolved at 60℃ was 1.5 to 2.0 times higher than that at 25℃.

Keywords: Coagulant, Aluminum, Ultrasonic, Acidification, Temperature, Sludge.

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552 Screening of Congenital Heart Diseases with Fetal Phonocardiography

Authors: F. Kovács, K. Kádár, G. Hosszú, Á. T. Balogh, T. Zsedrovits, N. Kersner, A. Nagy, Gy. Jeney

Abstract:

The paper presents a novel screening method to indicate congenital heart diseases (CHD), which otherwise could remain undetected because of their low level. Therefore, not belonging to the high-risk population, the pregnancies are not subject to the regular fetal monitoring with ultrasound echocardiography. Based on the fact that CHD is a morphological defect of the heart causing turbulent blood flow, the turbulence appears as a murmur, which can be detected by fetal phonocardiography (fPCG). The proposed method applies measurements on the maternal abdomen and from the recorded sound signal a sophisticated processing determines the fetal heart murmur. The paper describes the problems and the additional advantages of the fPCG method including the possibility of measurements at home and its combination with the prescribed regular cardiotocographic (CTG) monitoring. The proposed screening process implemented on a telemedicine system provides an enhanced safety against hidden cardiac diseases.

Keywords: Cardiac murmurs, fetal phonocardiography, screening of CHDs, telemedicine system.

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551 Medical Image Watermark and Tamper Detection Using Constant Correlation Spread Spectrum Watermarking

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

Abstract:

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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550 GPU Based High Speed Error Protection for Watermarked Medical Image Transmission

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

Abstract:

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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549 Development of a Non-invasive System to Measure the Thickness of the Subcutaneous Adipose Tissue Layer for Human

Authors: Hyuck Ki Hong, Young Chang Jo, Yeon Shik Choi, Beom Joon Kim, Hyo Derk Park

Abstract:

To measure the thickness of the subcutaneous adipose tissue layer, a non-invasive optical measurement system (λ=1300 nm) is introduced. Animal and human subjects are used for the experiments. The results of human subjects are compared with the data of ultrasound device measurements, and a high correlation (r=0.94 for n=11) is observed. There are two modes in the corresponding signals measured by the optical system, which can be explained by two-layered and three-layered tissue models. If the target tissue is thinner than the critical thickness, detected data using diffuse reflectance method follow the three-layered tissue model, so the data increase as the thickness increases. On the other hand, if the target tissue is thicker than the critical thickness, the data follow the two-layered tissue model, so they decrease as the thickness increases.

Keywords: Subcutaneous adipose tissue layer, non-invasive measurement system, two-layered and three-layered tissue models.

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548 FZP Design Considering Spherical Wave Incidence

Authors: Sergio Pérez-López, Daniel Tarrazó-Serrano, José M. Fuster, Pilar Candelas, Constanza Rubio

Abstract:

Fresnel Zone Plates (FZPs) are widely used in many areas, such as optics, microwaves or acoustics. On the design of FZPs, plane wave incidence is typically considered, but that is not usually the case in ultrasounds, especially in applications where a piston emitter is placed at a certain distance from the lens. In these cases, having control of the focal distance is very important, and with the usual Fresnel equation a focal displacement from the theoretical distance is observed due to the plane wave supposition. In this work, a comparison between FZP with plane wave incidence design and FZP with point source design in the case of piston emitter is presented. Influence of the main parameters of the piston in the final focalization profile has been studied. Numerical models and experimental results are shown, and they prove that when spherical wave incidence is considered for the piston case, it is possible to have a fine control of the focal distance in comparison with the classical design method.

Keywords: Focusing, Fresnel zone plate, ultrasound, spherical wave incidence, piston emitter.

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547 Application of Fuzzy Neural Network for Image Tumor Description

Authors: Nahla Ibraheem Jabbar, Monica Mehrotra

Abstract:

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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546 A Preliminary Study of Drug Perfusion Enhancement by Microstreaming Induced by an Oscillating Microbubble

Authors: Jin Sun Oh, Kyung Ho Lee, S ang Gug Chung, Kyehan Rhee

Abstract:

Microbubbbles incorporating ultrasound have been used to increase the efficacy of targeted drug delivery, because microstreaming induced by cavitating bubbles affects the drug perfusion into the target cells and tissues. In order to clarify the physical effects of microstreaming on drug perfusion into tissues, a preliminary experimental study of perfusion enhancement by a stably oscillating microbubble was performed. Microstreaming was induced by an oscillating bubble at 15 kHz, and perfusion of dye into an agar phantom was optically measured by histology on agar phantom. Surface color intensity and the penetration length of dye in the agar phantom were increased more than 70% and 30%, respectively, due to the microstreaming induced by an oscillating bubble. The mass of dye perfused into a tissue phantom for 30 s was increased about 80% in the phantom with an oscillating bubble. This preliminary experiment shows the physical effects of steady streaming by an oscillating bubble can enhance the drug perfusion into the tissues while minimizing the biological effects.

Keywords: Bubble, Mass Transfer, Microstreaming, Drug Delivery, Acoustic Wave.

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545 A 3-Year Evaluation Study on Fine Needle Aspiration Cytology and Corresponding Histology

Authors: Amjad Al Shammari, Ashraf Ibrahim, Laila Seada

Abstract:

Background and Objectives: Incidence of thyroid carcinoma has been increasing world-wide. In the present study, we evaluated diagnostic accuracy of Fine needle aspiration (FNA) and its efficiency in early detecting neoplastic lesions of thyroid gland over a 3-year period. Methods: Data have been retrieved from pathology files in King Khalid Hospital. For each patient, age, gender, FNA, site & size of nodule and final histopathologic diagnosis were recorded. Results: Study included 490 cases where 419 of them were female and 71 male. Male to female ratio was 1:6. Mean age was 43 years for males and 38 for females. Cases with confirmed histopathology were 131. In 101/131 (77.1%), concordance was found between FNA and histology. In 30/131 (22.9%), there was discrepancy in diagnosis. Total malignant cases were 43, out of which 14 (32.5%) were true positive and 29 (67.44%) were false negative. No false positive cases could be found in our series. Conclusion: FNA could diagnose benign nodules in all cases, however, in malignant cases, ultrasound findings have to be taken into consideration to avoid missing of a microcarcinoma in the contralateral lobe.

Keywords: FNA, hail, histopathology, thyroid.

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544 Improving Health Care and Patient Safety at the ICU by Using Innovative Medical Devices and ICT Tools: Examples from Bangladesh

Authors: Mannan Mridha, Mohammad S. Islam

Abstract:

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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543 Medical Image Segmentation and Detection of MR Images Based on Spatial Multiple-Kernel Fuzzy C-Means Algorithm

Authors: J. Mehena, M. C. Adhikary

Abstract:

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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542 Medical Knowledge Management in Healthcare Industry

Authors: B. Stroetmann, A. Aisenbrey

Abstract:

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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541 Making Waves: Preparing the Next Generation of Bilingual Medical Doctors

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

Abstract:

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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540 A Support System to Consult Remote another Doctor on Assessment and/or Medical Treatment Plan when a Doctor has a Patient not in His/Her Major

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

Abstract:

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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539 The Impact of Regulatory Changes on the Development of Mobile Medical Apps

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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538 Quadratic Pulse Inversion Ultrasonic Imaging(QPI): A Two-Step Procedure for Optimization of Contrast Sensitivity and Specificity

Authors: Mamoun F. Al-Mistarihi

Abstract:

We have previously introduced an ultrasonic imaging approach that combines harmonic-sensitive pulse sequences with a post-beamforming quadratic kernel derived from a second-order Volterra filter (SOVF). This approach is designed to produce images with high sensitivity to nonlinear oscillations from microbubble ultrasound contrast agents (UCA) while maintaining high levels of noise rejection. In this paper, a two-step algorithm for computing the coefficients of the quadratic kernel leading to reduction of tissue component introduced by motion, maximizing the noise rejection and increases the specificity while optimizing the sensitivity to the UCA is presented. In the first step, quadratic kernels from individual singular modes of the PI data matrix are compared in terms of their ability of maximize the contrast to tissue ratio (CTR). In the second step, quadratic kernels resulting in the highest CTR values are convolved. The imaging results indicate that a signal processing approach to this clinical challenge is feasible.

Keywords: Volterra Filter, Pulse Inversion, Ultrasonic Imaging, Contrast Agent.

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