Abstract: Environment today is featured with aging population,
increasing prevalence of chronic disease and complex of medical
treatment. Safe use of pharmaceutics relied very much on the efforts
made by both the health- related organizations and as well as the
government agencies. As far as the specialization concern in providing
health services to the patients, the government actively issued and
implemented the divisions of medical treatment and pharmaceutical to
improve the quality of care and to reduce medication errors and ensure
public health. Pharmaceutical sub-sector policy has been implemented
for 13 years. This study attempts to explore the factors that affect the
patients- behavior intention of refilling a prescription from a NHIB
pharmacy. Samples were those patients refilling their prescriptions
with the case NHIB pharmacies. A self-administered questionnaire
was used to collect respondents- information while the patients or
family members visit the pharmacy for the refilling. 1,200
questionnaires were dispatched in 37 pharmacies that randomly
selected from Pingtung City, Dongkang, Chaozhou, Hengchun areas.
732 responses were gained with 604 valid samples for further analyses.
Results of data analyses indicated that respondents- attitude,
subjective norm, perceived behavior control and behavior intentions
toward refilling behavior varied from some demographic variables to
another. This research also suggested adding actual behavior, either by
a self-report or observed, into the research.
Abstract: Privacy issues commonly discussed among
researchers, practitioners, and end-users in pervasive healthcare.
Pervasive healthcare systems are applications that can support
patient-s need anytime and anywhere. However, pervasive healthcare
raises privacy concerns since it can lead to situations where patients
may not be aware that their private information is being shared and
becomes vulnerable to threat. We have systematically analyzed the
privacy issues and present a summary in tabular form to show the
relationship among the issues. The six issues identified are medical
information misuse, prescription leakage, medical information
eavesdropping, social implications for the patient, patient difficulties
in managing privacy settings, and lack of support in designing
privacy-sensitive applications. We narrow down the issues and chose
to focus on the issue of 'lack of support in designing privacysensitive
applications' by proposing a privacy-sensitive architecture
specifically designed for pervasive healthcare monitoring systems.
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.
Abstract: Data Mining aims at discovering knowledge out of
data and presenting it in a form that is easily comprehensible to
humans. One of the useful applications in Egypt is the Cancer
management, especially the management of Acute Lymphoblastic
Leukemia or ALL, which is the most common type of cancer in
children.
This paper discusses the process of designing a prototype that can
help in the management of childhood ALL, which has a great
significance in the health care field. Besides, it has a social impact
on decreasing the rate of infection in children in Egypt. It also
provides valubale information about the distribution and
segmentation of ALL in Egypt, which may be linked to the possible
risk factors.
Undirected Knowledge Discovery is used since, in the case of this
research project, there is no target field as the data provided is
mainly subjective. This is done in order to quantify the subjective
variables. Therefore, the computer will be asked to identify
significant patterns in the provided medical data about ALL. This
may be achieved through collecting the data necessary for the
system, determimng the data mining technique to be used for the
system, and choosing the most suitable implementation tool for the
domain.
The research makes use of a data mining tool, Clementine, so as to
apply Decision Trees technique. We feed it with data extracted from
real-life cases taken from specialized Cancer Institutes. Relevant
medical cases details such as patient medical history and diagnosis
are analyzed, classified, and clustered in order to improve the disease
management.
Abstract: The identification and classification of the spine deformity play an important role when considering surgical planning for adolescent patients with idiopathic scoliosis. The subject of this article is the Lenke classification of scoliotic spines using Cobb angle measurements. The purpose is two-fold: (1) design a rulebased diagram to assist clinicians in the classification process and (2) investigate a computer classifier which improves the classification time and accuracy. The rule-based diagram efficiency was evaluated in a series of scoliotic classifications by 10 clinicians. The computer classifier was tested on a radiographic measurement database of 603 patients. Classification accuracy was 93% using the rule-based diagram and 99% for the computer classifier. Both the computer classifier and the rule based diagram can efficiently assist clinicians in their Lenke classification of spine scoliosis.
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.
Abstract: Hemodialysis patients might suffer from unhealthy
care behaviors or long-term dialysis treatments. Ultimately they need
to be hospitalized. If the hospitalization rate of a hemodialysis center
is high, its quality of service would be low. Therefore, how to decrease
hospitalization rate is a crucial problem for health care. In this study
we combined temporal abstraction with data mining techniques for
analyzing the dialysis patients' biochemical data to develop a decision
support system. The mined temporal patterns are helpful for clinicians
to predict hospitalization of hemodialysis patients and to suggest them
some treatments immediately to avoid hospitalization.
Abstract: TELMES project aims to develop a securized
multimedia system devoted to medical consultation teleservices. It
will be finalized with a pilot system for a regional telecenters
network that connects local telecenters, having as support
multimedia platforms. This network will enable the implementation
of complex medical teleservices (teleconsulations, telemonitoring,
homecare, urgency medicine, etc.) for a broader range of patients
and medical professionals, mainly for family doctors and those
people living in rural or isolated regions. Thus, a multimedia,
scalable network, based on modern IT&C paradigms, will result. It
will gather two inter-connected regional telecenters, in Iaşi and
Piteşti, Romania, each of them also permitting local connections of
hospitals, diagnostic and treatment centers, as well as local networks
of family doctors, patients, even educational entities. As
communications infrastructure, we aim to develop a combined fixmobile-
internet (broadband) links. Other possible communication
environments will be GSM/GPRS/3G and radio waves. The
electrocardiogram (ECG) acquisition, internet transmission and
local analysis, using embedded technologies, was already
successfully done for patients- telemonitoring.
Abstract: Diabetes mellitus (DM) is frequently characterized by
autonomic nervous dysfunction. Analysis of heart rate variability
(HRV) has become a popular noninvasive tool for assessing the
activities of autonomic nervous system (ANS). In this paper, changes
in ANS activity are quantified by means of frequency and time
domain analysis of R-R interval variability. Electrocardiograms
(ECG) of 16 patients suffering from DM and of 16 healthy volunteers
were recorded. Frequency domain analysis of extracted normal to
normal interval (NN interval) data indicates significant difference in
very low frequency (VLF) power, low frequency (LF) power and
high frequency (HF) power, between the DM patients and control
group. Time domain measures, standard deviation of NN interval
(SDNN), root mean square of successive NN interval differences
(RMSSD), successive NN intervals differing more than 50 ms (NN50
Count), percentage value of NN50 count (pNN50), HRV triangular
index and triangular interpolation of NN intervals (TINN) also show
significant difference between the DM patients and control group.
Abstract: The purpose of this study is to derive parameters
estimating for the Lyman–Kutcher–Burman (LKB) normal tissue
complication probability (NTCP) model using analysis of scintigraphy
assessments and quality of life (QoL) measurement questionnaires for
the parotid gland (xerostomia). In total, 31 patients with
head-and-neck (HN) cancer were enrolled. Salivary excretion factor
(SEF) and EORTC QLQ-H&N35 questionnaires datasets are used for
the NTCP modeling to describe the incidence of grade 4 xerostomia.
Assuming that n= 1, NTCP fitted parameters are given as TD50= 43.6
Gy, m= 0.18 in SEF analysis, and as TD50= 44.1 Gy, m= 0.11 in QoL
measurements, respectively. SEF and QoL datasets can validate the
Quantitative Analyses of Normal Tissue Effects in the Clinic
(QUANTEC) guidelines well, resulting in NPV-s of 100% for the both
datasets and suggests that the QUANTEC 25/20Gy gland-spared
guidelines are suitable for clinical used for the HN cohort to
effectively avoid xerostomia.
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.
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.
Abstract: In this article, we propose a new surgical device for
circumferentially excision of high anal fistulas in a minimally
invasive manner. The new apparatus works on the basis of axially
rotating and moving a tubular blade along a fistulous tract
straightened using a rigid straight guidewire. As the blade moves
along the tract, its sharp circular cutting edge circumferentially
separates approximately 2.25 mm thickness of tract encircling the
rigid guidewire. We used the new set to excise two anal fistulas in a
62-year-old male patient, an extrasphincteric type and a long tract
with no internal opening. With regard to the results of this test, the
new device can be considered as a sphincter preserving mechanism
for treatment of high anal fistulas. Consequently, a major reduction
in the risk of fecal incontinence, recurrence rate, convalescence
period and patient morbidity may be achieved using the new device
for treatment of fistula-in-ano.
Abstract: A Positron Emission Tomography (PET) is a radioisotope imaging technique that illustrates the organs and the metabolisms of the human body. This technique is based on the simultaneous detection of 511 keV annihilation photons, annihilated as a result of electrons annihilating positrons that radiate from positron-emitting radioisotopes that enter biological active molecules in the body. This study was conducted on ten patients in an effort to conduct patient-related experimental studies. Dosage monitoring for the bladder, which was the organ that received the highest dose during PET applications, was conducted for 24 hours. Assessment based on measuring urination activities after injecting patients was also a part of this study. The MIRD method was used to conduct dosage calculations for results obtained from experimental studies. Results obtained experimentally and theoretically were assessed comparatively.
Abstract: The study of the variability of the postural strategies
in low back pain patients, as a criterion in evaluation of the
adaptability of this system to the environmental demands is the
purpose of this study. A cross-sectional case-control study was
performed on 21 recurrent non-specific low back pain patients and 21
healthy volunteers. The electromyography activity of Deltoid,
External Oblique (EO), Transverse Abdominis/Internal Oblique
(TrA/IO) and Erector Spine (ES) muscles of each person was
recorded in 75 rapid arm flexion with maximum acceleration.
Standard deviation of trunk muscles onset relative to deltoid muscle
onset were statistically analyzed by MANOVA . The results show
that chronic low back pain patients exhibit less variability in their
anticipatory postural adjustments (APAs) in comparison with the
control group. There is a decrease in variability of postural control
system of recurrent non-specific low back pain patients that can
result in the persistence of pain and chronicity by decreasing the
adaptability to environmental demands.
Abstract: This paper proposes a novel architecture for At-
Home medical care which enables senior citizens, patients
with chronic ailments and patients requiring post- operative
care to be remotely monitored in the comfort of their homes.
This architecture is implemented using sensors and wireless
networking for transmitting patient data to the hospitals,
health- care centers for monitoring by medical professionals.
Patients are equipped with sensors to measure their
physiological parameters, like blood pressure, pulse rate etc.
and a Wearable Data Acquisition Unit is used to transmit the
patient sensor data. Medical professionals can be alerted to
any abnormal variations in these values for diagnosis and
suitable treatment. Security threats and challenges inherent to
wireless communication and sensor network have been
discussed and a security mechanism to ensure data
confidentiality and source authentication has been proposed.
Symmetric key algorithm AES has been used for encrypting
the data and a patent-free, two-pass block cipher mode CCFB
has been used for implementing semantic security.
Abstract: Sense-antisense gene pair (SAGP) is a pair of two oppositely transcribed genes sharing a common region on a chromosome. In the mammalian genomes, SAGPs can be organized in more complex sense-antisense gene architectures (CSAGA) in which at least one gene could share loci with two or more antisense partners. Many dozens of CSAGAs can be found in the human genome. However, CSAGAs have not been systematically identified and characterized in context of their role in human diseases including cancers. In this work we characterize the structural-functional properties of a cluster of 5 genes –TMEM97, IFT20, TNFAIP1, POLDIP2 and TMEM199, termed TNFAIP1 / POLDIP2 module. This cluster is organized as CSAGA in cytoband 17q11.2. Affymetrix U133A&B expression data of two large cohorts (410 atients, in total) of breast cancer patients and patient survival data were used. For the both studied cohorts, we demonstrate (i) strong and reproducible transcriptional co-regulatory patterns of genes of TNFAIP1/POLDIP2 module in breast cancer cell subtypes and (ii) significant associations of TNFAIP1/POLDIP2 CSAGA with amplification of the CSAGA region in breast cancer, (ii) cancer aggressiveness (e.g. genetic grades) and (iv) disease free patient-s survival. Moreover, gene pairs of this module demonstrate strong synergetic effect in the prognosis of time of breast cancer relapse. We suggest that TNFAIP1/ POLDIP2 cluster can be considered as a novel type of structural-functional gene modules in the human genome.
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.
Abstract: Background: Widespread use of chemotherapeutic
drugs in the treatment of cancer has lead to higher health hazards
among employee who handle and administer such drugs, so nurses
should know how to protect themselves, their patients and their work
environment against toxic effects of chemotherapy. Aim of this study
was carried out to examine the effect of chemotherapy safety protocol
for oncology nurses on their protective measure practices. Design: A
quasi experimental research design was utilized. Setting: The study
was carried out in oncology department of Menoufia university
hospital and Tanta oncology treatment center. Sample: A
convenience sample of forty five nurses in Tanta oncology treatment
center and eighteen nurses in Menoufiya oncology department.
Tools: 1. an interviewing questionnaire that covering sociodemographic
data, assessment of unit and nurses' knowledge about
chemotherapy. II: Obeservational check list to assess nurses' actual
practices of handling and adminestration of chemotherapy. A base
line data were assessed before implementing Chemotherapy Safety
protocol, then Chemotherapy Safety protocol was implemented, and
after 2 monthes they were assessed again. Results: reveled that 88.9%
of study group I and 55.6% of study group II improved to good total
knowledge scores after educating on the safety protocol, also 95.6%
of study group I and 88.9% of study group II had good total practice
score after educating on the safety protocol. Moreover less than half
of group I (44.4%) reported that heavy workload is the most barriers
for them, while the majority of group II (94.4%) had many barriers
for adhering to the safety protocol such as they didn’t know the
protocol, the heavy work load and inadequate equipment.
Conclusions: Safety protocol for Oncology Nurses seemed to have
positive effect on improving nurses' knowledge and practice.
Recommendation: chemotherapy safety protocol should be instituted
for all oncology nurses who are working in any oncology unit and/ or
center to enhance compliance, and this protocol should be done at
frequent intervals.