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: 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: Chronic diseases prevailed along with economic
growth as well as life style changed in recent years in Taiwan.
According to the governmental statistics, hypertension related disease
is the tenth of death causes with 1,816 died directly from hypertension
in 2010. There were more death causes amongst the top ten had been
proofed that having strong association with the hypertension, such as
heart diseases, cardiovascular diseases, and diabetes. Hypertension or
High blood pressure is one of the major indicators for chronic diseases,
and was generally perceived as the major causes of mortality. The
literature generally suggested that regular physical exercise was
helpful to prevent the occurrence or to ease the progress of a
hypertension. This paper reported the process and outcomes in
detailed of an improvement project of physical exercise intervention
specific for hypertension patients. Physical information were
measured before and after the project to obtain information such as
weight, waistline, cholesterol (HD & LD), blood examination, as well
as self-perceived health status. The intervention project involved a
six-week exercise program, of which contained three times a week, 30
minutes of tutored physical exercise intervention. The project had
achieved several gains in changing the subjects- behavior in terms of
many important biophysical indexes. Around 20% of the participants
had significantly improved their cholesterols, BMI, and changed
unhealthy behaviors. Results from the project were encouraging, and
would be good reference for other samples.
Abstract: Background noise is particularly damaging to speech
intelligibility for people with hearing loss especially for sensorineural
loss patients. Several investigations on speech intelligibility have
demonstrated sensorineural loss patients need 5-15 dB higher SNR
than the normal hearing subjects. This paper describes Discrete
Cosine Transform Power Normalized Least Mean Square algorithm
to improve the SNR and to reduce the convergence rate of the LMS
for Sensory neural loss patients. Since it requires only real arithmetic,
it establishes the faster convergence rate as compare to time domain
LMS and also this transformation improves the eigenvalue
distribution of the input autocorrelation matrix of the LMS filter.
The DCT has good ortho-normal, separable, and energy compaction
property. Although the DCT does not separate frequencies, it is a
powerful signal decorrelator. It is a real valued function and thus
can be effectively used in real-time operation. The advantages of
DCT-LMS as compared to standard LMS algorithm are shown via
SNR and eigenvalue ratio computations. . Exploiting the symmetry
of the basis functions, the DCT transform matrix [AN] can be
factored into a series of ±1 butterflies and rotation angles. This
factorization results in one of the fastest DCT implementation. There
are different ways to obtain factorizations. This work uses the fast
factored DCT algorithm developed by Chen and company. The
computer simulations results show superior convergence
characteristics of the proposed algorithm by improving the SNR at
least 10 dB for input SNR less than and equal to 0 dB, faster
convergence speed and better time and frequency characteristics.
Abstract: Sensory nerves in the foot play an important part in the diagnosis of various neuropathydisorders, especially in diabetes mellitus.However, a detailed description of the anatomical distribution of the nerves is currently lacking. A computationalmodel of the afferent nerves inthe foot may bea useful tool for the study of diabetic neuropathy. In this study, we present the development of an anatomically-based model of various major sensory nerves of the sole and dorsal sidesof the foot. In addition, we presentan algorithm for generating synthetic somatosensory nerve networks in the big-toe region of a right foot model. The algorithm was based on a modified version of the Monte Carlo algorithm, with the capability of being able to vary the intra-epidermal nerve fiber density in differentregionsof the foot model. Preliminary results from the combinedmodel show the realistic anatomical structure of the major nerves as well as the smaller somatosensory nerves of the foot. The model may now be developed to investigate the functional outcomes of structural neuropathyindiabetic patients.
Abstract: It is necessary to incorporate technological advances
achieved in the field of engineering into dentistry in order to enhance
the process of diagnosis, treatment planning and enable the doctors to
render better treatment to their patients. To achieve this ultimate goal
long distance collaborations are often necessary. This paper discusses
the various collaborative tools and their applications to solve a few
burning problems confronted by the dentists. Customization is often
the solution to most of the problems. But rapid designing,
development and cost effective manufacturing is a difficult task to
achieve. This problem can be solved using the technique of digital
manufacturing. Cases from 6 major branches of dentistry have been
discussed and possible solutions with the help of state of art
technology using rapid digital manufacturing have been proposed in
the present paper. The paper also entails the usage of existing tools in
collaborative and digital manufacturing area.
Abstract: Automatic tube current modulation (ATCM) systems are available for all CT manufacturers and are used for the majority of patients. Understanding how the systems work and their influence on patient dose and image quality is important for CT users, in order to gain the most effective use of the systems. In the present study, a new phantom was used for evaluating dose distribution and image quality under the ATCM operation for the Toshiba Aquilion 64 CT scanner using different ATCM options and a fixed mAs technique. A routine chest, abdomen and pelvis (CAP) protocol was selected for study and Gafchromic film was used to measure entrance surface dose (ESD), peripheral dose and central axis dose in the phantom. The results show the dose reductions achievable with various ATCM options, in relation with the target noise. The doses and image noise distribution were more uniform when the ATCM system was implemented compared with the fixed mAs technique. The lower limit set for the tube current will affect the modulations especially for the lower dose option. This limit prevented the tube current being reduced further and therefore the lower dose ATCM setting resembled a fixed mAs technique. Selection of a lower tube current limit is likely to reduce doses for smaller patients in scans of chest and neck regions.
Abstract: Bone growth factors, such as Bone Morphogenic
Protein-2 (BMP-2) have been approved by the FDA to replace grafting for some surgical interventions, but the high dose requirement limits its use in patients. Noggin, an extracellular protein, blocks the effect of BMP-2 by binding to BMP. Preventing
the BMP-2/noggin interaction will help increase the free
concentration of BMP-2 and therefore should enhance its efficacy to
induce bone formation. The work presented here involves
computational design of novel small molecule inhibitory agents of BMP-2/noggin interaction, based on our current understanding of
BMP-2, and its known putative ligands (receptors and antagonists). A
successful acquisition of such an inhibitory agent of BMP-2/noggin interaction would allow clinicians to reduce the dose required of
BMP-2 protein in clinical applications to promote osteogenesis. The
available crystal structures of the BMPs, its receptors, and the binding partner noggin were analyzed to identify the critical residues
involved in their interaction. In presenting this study, LUDI de novo design method was utilized to perform virtual screening of a large
number of compounds from a commercially available library against the binding sites of noggin to identify the lead chemical compounds
that could potentially block BMP-noggin interaction with a high specificity.
Abstract: The Zung self-depression scale and Beck Anxiety Inventory were used to study the depression and anxiety levels of Armenian Crohn's disease patients, as well as to reveal the relation between emotional status and placebo effect of these patients. Despite of registered high levels of depression and anxiety, the high placebo rate during investigations was described. The importance of use of psychotherapies for optimal outcomes during treatments of Crohn's disease is obvious.
Abstract: Stevia rebaudiana Bertoni (natural sweetener) belongs
to Asteraceae family and can be used as substitute of artificial
sweeteners for diabetic patients. Conventionally, it is cultivated by
seeds or stem cutting, but seed viability rate is poor. A protocol for
callus induction and multiplication was developed to produce large
no. of calli in short period. Surface sterilized nodal, leaf and root
explants were cultured on Murashige and Skoog (MS) medium with
different concentrations of plant hormone like, IBA, kinetin, NAA,
2,4-D, and NAA in combination with 2,4-D. 100% callusing was
observed from leaf explants cultured on combination of NAA and
2,4-D after three weeks while with 2,4-D, only 10% callusing was
observed. Calli obtained from leaf and root explants were shiny green
while with nodal explants it was hard and brown. The present
findings deal with induction of callusing in Stevia to achieve the
rapid callus multiplication for study of steviol glycosides in callus
culture.
Abstract: The objective of the present research manuscript is to
perform parametric, nonparametric, and decision tree analysis to
evaluate two treatments that are being used for breast cancer patients.
Our study is based on utilizing real data which was initially used in
“Tamoxifen with or without breast irradiation in women of 50 years
of age or older with early breast cancer" [1], and the data is supplied
to us by N.A. Ibrahim “Decision tree for competing risks survival
probability in breast cancer study" [2]. We agree upon certain aspects
of our findings with the published results. However, in this
manuscript, we focus on relapse time of breast cancer patients instead
of survival time and parametric analysis instead of semi-parametric
decision tree analysis is applied to provide more precise
recommendations of effectiveness of the two treatments with respect
to reoccurrence of breast cancer.
Abstract: With the rapid growth in business size, today-s businesses orient Throughout thirty years local, national and international experience in medicine as a medical student, junior doctor and eventually Consultant and Professor in Anaesthesia, Intensive Care and Pain Management, I note significant generalised dissatisfaction among medical students and doctors regarding their medical education and practice. We repeatedly hear complaints from patients about the dysfunctional health care system they are dealing with and subsequently the poor medical service that they are receiving. Medical students are bombarded with lectures, tutorials, clinical rounds and various exams. Clinicians are weighed down with a never-ending array of competing duties. Patients are extremely unhappy about the long waiting lists, loss of their records and the continuous deterioration of the health care service. This problem has been reported in different countries by several authors [1,2,3]. In a trial to solve this dilemma, a genuine idea has been suggested implementing computer technology in medicine [2,3]. Computers in medicine are a medium of international communication of the revolutionary advances being made in the application of the computer to the fields of bioscience and medicine [4,5]. The awareness about using computers in medicine has recently increased all over the world. In Misr University for Science & Technology (MUST), Egypt, medical students are now given hand-held computers (Laptop) with Internet facility making their medical education accessible, convenient and up to date. However, this trial still needs to be validated. Helping the readers to catch up with the on going fast development in this interesting field, the author has decided to continue reviewing the literature, exploring the state-of-art in computer based medicine and up dating the medical professionals especially the local trainee Doctors in Egypt. In part I of this review article we will give a general background discussing the potential use of computer technology in the various aspects of the medical field including education, research, clinical practice and the health care service given to patients. Hope this will help starting changing the culture, promoting the awareness about the importance of implementing information technology (IT) in medicine, which is a field in which such help is needed. An international collaboration is recommended supporting the emerging countries achieving this target.
Abstract: As a part of routine oesophageal HDR Brachytherapy procedure, treatment planning takes about 45 minutes while patients are under light sedation. Some patients may suffer gagging and/or spasms before the 90-minute brachytherapy procedure complete, and the treatment may need to be aborted. A pre-prepared plan generated before patient’s sedation may reduce the brachytherapy procedure time by 40 minutes. This paper reports rationality and evidence of pre-prepared treatment plans. A retrospective study of 28 patients confirms that pre-prepared plans would be acceptable for all reviewed patients. The rationality is further confirmed by a systemic study with a wide range of applicator curvature and treatment volume. Detailed comparison between CT based treatment plans and pre-prepared plans are discussed. The argument holds for endobronchial HDR brachytherapy too. With the above evidence, pre-prepared plans have been used for all oesophageal and endobronchial HDR brachytherapy cases in our clinic.
Abstract: The last decade has seen an early majority of people
The last decade, the role of the of the information communication
technologies has increased in improving the social and business life
of people. Today, it is recognized that game could contribute to
enhance virtual rehabilitation by better engaging patients. Our
research study aims to develop a game based system enhancing
cognitive and physical capabilities of elderly people. To this end, the
project aims to develop a low cost hand held system based on
existing game such as Wii, PSP, or Xbox. This paper discusses the
concepts and requirements for developing such game for elderly
people. Based on the requirement elicitation, we intend to develop a
prototype related to sport and dance activities.
Abstract: Multidrug resistant organisms have been taunting the
medical world for the last few decades. Even with new antibiotics
developed, resistant strains have emerged soon after. With the
advancement of nanotechnology, we investigated colloidal silver
nanoparticles for its antimicrobial activity against Pseudomonas
aeruginosa. This organism is a multidrug resistant which contributes
to the high morbidity and mortality in immunocompromised patients.
Five multidrug resistant strains were used in this study. The
antimicrobial effect was studied using the disc diffusion and broth
dilution techniques. An inhibition zone of 11 mm was observed with
10 μg dose of the nanoparticles. The nanoparticles exhibited MIC of
50 μg/ml when added at the lag phase and the subinhibitory
concentration was measured as 100 μg/ml. The MIC50 value showed
to be 15 μg/ml. This study suggests that silver nanoparticles can be
further developed as an antimicrobial agent, hence decreasing the
burden of the multidrug resistance phenomena.
Abstract: In this paper we used data mining techniques to
identify outlier patients who are using large amount of drugs over a
long period of time. Any healthcare or health insurance system
should deal with the quantities of drugs utilized by chronic diseases
patients. In Kingdom of Bahrain, about 20% of health budget is spent
on medications. For the managers of healthcare systems, there is no
enough information about the ways of drug utilization by chronic
diseases patients, is there any misuse or is there outliers patients. In
this work, which has been done in cooperation with information
department in the Bahrain Defence Force hospital; we select the data
for Cardiac patients in the period starting from 1/1/2008 to
December 31/12/2008 to be the data for the model in this paper. We
used three techniques for finding the drug utilization for cardiac
patients. First we applied a clustering technique, followed by
measuring of clustering validity, and finally we applied a decision
tree as classification algorithm. The clustering results is divided into
three clusters according to the drug utilization, for 1603 patients, who
received 15,806 prescriptions during this period can be partitioned
into three groups, where 23 patients (2.59%) who received 1316
prescriptions (8.32%) are classified to be outliers. The classification
algorithm shows that the use of average drug utilization and the age,
and the gender of the patient can be considered to be the main
predictive factors in the induced model.
Abstract: With getting older in the whole population, the
prevalence of stroke and its residual disability is getting higher and
higher recently in Taiwan. The functional electrical stimulation
cycling system (FESCS) is useful for hemiplegic patients. Because
that the muscle of stroke patients is under hybrid activation. The raw
electromyography (EMG) represents the residual muscle force of
stroke subject whereas the peak-to-peak of stimulus EMG indicates the
force enhancement benefiting from ES. It seems that EMG signals
could be used for a parameter of feedback control mechanism. So, we
design the feedback control protocol of FESCS, it includes
physiological signal recorder, FPGA biomedical module, DAC and
electrical stimulation circuit. Using the intensity of real-time EMG
signal obtained from patients, as a feedback control method for the
output voltage of FES-cycling system.
Abstract: Diffuse viral encephalitis may lack fever and other cardinal signs of infection and hence its distinction from other acute encephalopathic illnesses is challenging. Often, the EEG changes seen routinely are nonspecific and reflect diffuse encephalopathic changes only. The aim of this study was to use nonlinear dynamic mathematical techniques for analyzing the EEG data in order to look for any characteristic diagnostic patterns in diffuse forms of encephalitis.It was diagnosed on clinical, imaging and cerebrospinal fluid criteria in three young male patients. Metabolic and toxic encephalopathies were ruled out through appropriate investigations. Digital EEGs were done on the 3rd to 5th day of onset. The digital EEGs of 5 male and 5 female age and sex matched healthy volunteers served as controls.Two sample t-test indicated that there was no statistically significant difference between the average values in amplitude between the two groups. However, the standard deviation (or variance) of the EEG signals at FP1-F7 and FP2-F8 are significantly higher for the patients than the normal subjects. The regularisation dimension is significantly less for the patients (average between 1.24-1.43) when compared to the normal persons (average between 1.41-1.63) for the EEG signals from all locations except for the Fz-Cz signal. Similarly the wavelet dimension is significantly less (P = 0.05*) for the patients (1.122) when compared to the normal person (1.458). EEGs are subdued in the case of the patients with presence of uniform patterns, manifested in the values of regularisation and wavelet dimensions, when compared to the normal person, indicating a decrease in chaotic nature.
Abstract: A cross sectional survey design was used to collect
data from 370 diabetic patients. Two instruments were used in
obtaining data; in-depth interview guide and researchers- developed
questionnaire. Fisher's exact test was used to investigate association
between the identified factors and nonadherence. Factors identified
were: socio-demographic factors such as: gender, age, marital status,
educational level and occupation; psychosocial obstacles such as:
non-affordability of prescribed diet, frustration due to the restriction,
limited spousal support, feelings of deprivation, feeling that
temptation is inevitable, difficulty in adhering in social gatherings
and difficulty in revealing to host that one is diabetic; health care
providers obstacles were: poor attitude of health workers, irregular
diabetes education in clinics , limited number of nutrition education
sessions/ inability of the patients to estimate the desired quantity of
food, no reminder post cards or phone calls about upcoming patient
appointments and delayed start of appointment / time wasting in
clinics.
Abstract: Cancer classification to their corresponding cohorts has been key area of research in bioinformatics aiming better prognosis of the disease. High dimensionality of gene data has been makes it a complex task and requires significance data identification technique in order to reducing the dimensionality and identification of significant information. In this paper, we have proposed a novel approach for classification of oral cancer into metastasis positive and negative patients. We have used significance analysis of microarrays (SAM) for identifying significant genes which constitutes gene signature. 3 different gene signatures were identified using SAM from 3 different combination of training datasets and their classification accuracy was calculated on corresponding testing datasets using k-Nearest Neighbour (kNN), Fuzzy C-Means Clustering (FCM), Support Vector Machine (SVM) and Backpropagation Neural Network (BPNN). A final gene signature of only 9 genes was obtained from above 3 individual gene signatures. 9 gene signature-s classification capability was compared using same classifiers on same testing datasets. Results obtained from experimentation shows that 9 gene signature classified all samples in testing dataset accurately while individual genes could not classify all accurately.