Biometric Quantization through Detection Rate Optimized Bit Allocation

Directory of Open Access Journals (Sweden)

C. Chen

2009-01-01

Full Text Available Extracting binary strings from real-valued biometric templates is a fundamental step in many biometric template protection systems, such as fuzzy commitment, fuzzy extractor, secure sketch, and helper data systems. Previous work has been focusing on the design of optimal quantization and coding for each single feature component, yet the binary string—concatenation of all coded feature components—is not optimal. In this paper, we present a detection rate optimized bit allocation (DROBA principle, which assigns more bits to discriminative features and fewer bits to nondiscriminative features. We further propose a dynamic programming (DP approach and a greedy search (GS approach to achieve DROBA. Experiments of DROBA on the FVC2000 fingerprint database and the FRGC face database show good performances. As a universal method, DROBA is applicable to arbitrary biometric modalities, such as fingerprint texture, iris, signature, and face. DROBA will bring significant benefits not only to the template protection systems but also to the systems with fast matching requirements or constrained storage capability.

Rate Control for MPEG-4 Bit Stream

Institute of Scientific and Technical Information of China (English)

王振洲; 李桂苓

2003-01-01

For a very long time video processing dealt exclusively with fixed-rate sequences of rectangular shaped images. However, interest has been recently moving toward a more flexible concept in which the subject of the processing and encoding operations is a set of visual elements organized in both time and space in a flexible and arbitrarily complex way. The moving picture experts group (MPEG-4) standard supports this concept and its verification model (VM) encoder has adopted scalable rate control (SRC) as the rate control scheme, which is based on the spatial domain and compatible with constant bit rate (CBR) and variable bit rate (VBR). In this paper,a new rate control algorithm based on the DCT domain instead of the pixel domain is presented. More-over, macroblock level rate control scheme to compute the quantization step for each macroblock has been adopted. The experimental results show that the new algorithm can achieve a much better result than the original one in both peak signal-to-noise ratio (PSNR) and the coding bits, and that the new algorithm is more flexible than test model 5 (TM5) rate control algorithm.

Shuttle bit rate synchronizer. [signal to noise ratios and error analysis

Science.gov (United States)

Huey, D. C.; Fultz, G. L.

1974-01-01

A shuttle bit rate synchronizer brassboard unit was designed, fabricated, and tested, which meets or exceeds the contractual specifications. The bit rate synchronizer operates at signal-to-noise ratios (in a bit rate bandwidth) down to -5 dB while exhibiting less than 0.6 dB bit error rate degradation. The mean acquisition time was measured to be less than 2 seconds. The synchronizer is designed around a digital data transition tracking loop whose phase and data detectors are integrate-and-dump filters matched to the Manchester encoded bits specified. It meets the reliability (no adjustments or tweaking) and versatility (multiple bit rates) of the shuttle S-band communication system through an implementation which is all digital after the initial stage of analog AGC and A/D conversion.

Reversible and Embedded Watermarking of Medical Images for Telemedicine

Directory of Open Access Journals (Sweden)

Chung-Yen Su

2015-08-01

Full Text Available In this paper, we propose a new reversible watermarking of medical images for the applications in telemedicine. By using a bit-stream insertion scheme, the patient’s information can be treated as a watermark and can be embedded into the bit-stream of a cover image for remote transmission. The proposed method simplifies the design of traditional image coding after a reversible watermarking. Experimental results show that the compression ratio can be achieved up to 3.025. The watermarking capacity can be obtained over 0.75 bpp for some common images. In addition, the watermark can be extracted exactly and the cover image can be reconstructed either in a lossless way or a lossy way. The obtained results also show the improvement with respect to previous works.

Online collaboration environments in telemedicine applications of speech therapy.

Science.gov (United States)

Pierrakeas, C; Georgopoulos, V; Malandraki, G

2005-01-01

The use of telemedicine in speech and language pathology provides patients in rural and remote areas with access to quality rehabilitation services that are sufficient, accessible, and user-friendly leading to new possibilities in comprehensive and long-term, cost-effective diagnosis and therapy. This paper discusses the use of online collaboration environments for various telemedicine applications of speech therapy which include online group speech therapy scenarios, multidisciplinary clinical consulting team, and online mentoring and continuing education.

Telemedicine for Developing Countries

Science.gov (United States)

Combi, Carlo; Pozzani, Gabriele

2016-01-01

Summary Background Developing countries need telemedicine applications that help in many situations, when physicians are a small number with respect to the population, when specialized physicians are not available, when patients and physicians in rural villages need assistance in the delivery of health care. Moreover, the requirements of telemedicine applications for developing countries are somewhat more demanding than for developed countries. Indeed, further social, organizational, and technical aspects need to be considered for successful telemedicine applications in developing countries. Objective We consider all the major projects in telemedicine, devoted to developing countries, as described by the proper scientific literature. On the basis of such literature, we want to define a specific taxonomy that allows a proper classification and a fast overview of telemedicine projects in developing countries. Moreover, by considering both the literature and some recent direct experiences, we want to complete such overview by discussing some design issues to be taken into consideration when developing telemedicine software systems. Methods We considered and reviewed the major conferences and journals in depth, and looked for reports on the telemedicine projects. Results We provide the reader with a survey of the main projects and systems, from which we derived a taxonomy of features of telemedicine systems for developing countries. We also propose and discuss some classification criteria for design issues, based on the lessons learned in this research area. Conclusions We highlight some challenges and recommendations to be considered when designing a telemedicine system for developing countries. PMID:27803948

Wireless and mobile systems in telemedicine

Directory of Open Access Journals (Sweden)

Reza Safdari

2012-12-01

Full Text Available Background: It is necessary to deploy mobile and wireless systems in healthcare, because they have many benefits for healthcare systems. The objectives of this article were introducing various systems, applications, and standards of the wireless and mobile telemedicine. Material and Methods: This review study was conducted in 2010. To conduct the study, published articles in the years 2005 to 2012, in English with an emphasis on wireless and mobile technologies in health were studied. Search was done with key words include telemedicine, wireless health systems, health and telecommunications technology in databases including Pubmed, Science Direct, Google Scholar, Web of Sciences, Proquest. The collected data were analyzed. Results: Telemedicine system in the ambulance, telemedicine systems in space, telecardiology systems, EEG system, ultrasound system are some types of wireless and mobile systems in telemedicine. PDA-based mobile and wireless telemedicine application, based PDA drug application, and patient tracking application are some of wireless and mobile applications of telemedicine. The most important standards of wireless and mobile telemedicine are HL7, DICOM, SNOMed, and ICD-9-CM. Conclusion: There are many challenges in the wireless and mobile systems in telemedicine, despite the many benefits. Slow speed in sending pictures and video, lack of attention to the privacy in the design of these systems, environmental variables and the number of users during the day are some of these challenges. It is recommended to consider these challenges during the planning and designing of wireless and mobile systems in telemedicine.

Nine human factors contributing to the user acceptance of telemedicine applications: a cognitive-emotional approach.

Science.gov (United States)

Buck, Susanne

2009-01-01

Much attention is paid to the technical aspects of telemedicine in the development of new applications, but the enthusiasm about what is technically possible very often leads to the user acceptance of such products being neglected. The number of successful and sustainable telemedicine applications would be much higher if developers concentrated more on matters related to the cognitive-emotional situation of the users involved in telemedicine. The users include the care and cure providers, as well as the care and cure receivers. Based on an informal literature search and discussions with telemedicine implementation staff, nine factors have been identified which are essential for the user acceptance of telemedicine applications. All of them are connected more to the cognitive-emotional than to the cognitive-rational side of information processing. This suggests that in the future the cognitive-emotional side will need more attention. This in turn implies that the nine points mentioned above have to find their way into requirements engineering, development processes and product life cycles.

Optical Switching and Bit Rates of 40 Gbit/s and above

DEFF Research Database (Denmark)

Ackaert, A.; Demester, P.; O'Mahony, M.

2003-01-01

Optical switching in WDM networks introduces additional aspects to the choice of single channel bit rates compared to WDM transmission systems. The mutual impact of optical switching and bit rates of 40 Gbps and above is discussed....

Bit Error Rate Minimizing Channel Shortening Equalizers for Single Carrier Cyclic Prefixed Systems

National Research Council Canada - National Science Library

Martin, Richard K; Vanbleu, Koen; Ysebaert, Geert

2007-01-01

.... Previous work on channel shortening has largely been in the context of digital subscriber lines, a wireline system that allows bit allocation, thus it has focused on maximizing the bit rate for a given bit error rate (BER...

Internet technologies and requirements for telemedicine

Science.gov (United States)

Lamaster, H.; Meylor, J.; Meylor, F.

1997-01-01

Internet technologies are briefly introduced and those applicable for telemedicine are reviewed. Multicast internet technologies are described. The National Aeronautics and Space Administration (NASA) 'Telemedicine Space-bridge to Russia' project is described and used to derive requirements for internet telemedicine. Telemedicine privacy and Quality of Service (QoS) requirements are described.

Use of Telemedicine in Addiction Treatment: Current Practices and Organizational Implementation Characteristics

Directory of Open Access Journals (Sweden)

Todd Molfenter

2018-01-01

Full Text Available Telemedicine applications offer innovative approaches for treating and reducing the effects of substance use disorders (SUDs. This analysis assessed the interest in and use of 11 telemedicine applications in a sample of 363 SUD organizations in the United States of America. Fifty percent of the organizations expressed high rates of interest in seven of the telemedicine applications, demonstrating the appeal of telemedicine within this field. The top three self-reported telemedicine applications being used were (1 computerized screening/assessments (44.6%, (2 telephone-based recovery supports (29.5%, and (3 telephone-based therapy (28.37%. The greatest gaps between interest and use were for (1 texting appointment reminders (55.2% differential, (2 mobile apps for posttreatment recovery (46.6% differential, and (3 recovery support chats (46.6% differential. A Latent Class Analysis (LCA of the organizations’ telemedicine use behavior identified three groupings: “Innovators” that were using a range of technologies (n=27, 7.4%; “Technology Traditionalists” that limited their use to telephone, video, and web portal technologies (n=101, 27.8%; and “Low Tech” that had low overall technology use (n=235, 64.7%. Future studies should build on how telemedicine could be applied in SUD settings, organizational behaviors towards its adoption, and telemedicine’s effect on treatment adherence and clinical outcomes.

Adoption of telemedicine: from pilot stage to routine delivery

Directory of Open Access Journals (Sweden)

Zanaboni Paolo

2012-01-01

Full Text Available Abstract Background Today there is much debate about why telemedicine has stalled. Teleradiology is the only widespread telemedicine application. Other telemedicine applications appear to be promising candidates for widespread use, but they remain in the early adoption stage. The objective of this debate paper is to achieve a better understanding of the adoption of telemedicine, to assist those trying to move applications from pilot stage to routine delivery. Discussion We have investigated the reasons why telemedicine has stalled by focusing on two, high-level topics: 1 the process of adoption of telemedicine in comparison with other technologies; and 2 the factors involved in the widespread adoption of telemedicine. For each topic, we have formulated hypotheses. First, the advantages for users are the crucial determinant of the speed of adoption of technology in healthcare. Second, the adoption of telemedicine is similar to that of other health technologies and follows an S-shaped logistic growth curve. Third, evidence of cost-effectiveness is a necessary but not sufficient condition for the widespread adoption of telemedicine. Fourth, personal incentives for the health professionals involved in service provision are needed before the widespread adoption of telemedicine will occur. Summary The widespread adoption of telemedicine is a major -- and still underdeveloped -- challenge that needs to be strengthened through new research directions. We have formulated four hypotheses, which are all susceptible to experimental verification. In particular, we believe that data about the adoption of telemedicine should be collected from applications implemented on a large-scale, to test the assumption that the adoption of telemedicine follows an S-shaped growth curve. This will lead to a better understanding of the process, which will in turn accelerate the adoption of new telemedicine applications in future. Research is also required to identify

Adoption of telemedicine: from pilot stage to routine delivery

Science.gov (United States)

2012-01-01

Background Today there is much debate about why telemedicine has stalled. Teleradiology is the only widespread telemedicine application. Other telemedicine applications appear to be promising candidates for widespread use, but they remain in the early adoption stage. The objective of this debate paper is to achieve a better understanding of the adoption of telemedicine, to assist those trying to move applications from pilot stage to routine delivery. Discussion We have investigated the reasons why telemedicine has stalled by focusing on two, high-level topics: 1) the process of adoption of telemedicine in comparison with other technologies; and 2) the factors involved in the widespread adoption of telemedicine. For each topic, we have formulated hypotheses. First, the advantages for users are the crucial determinant of the speed of adoption of technology in healthcare. Second, the adoption of telemedicine is similar to that of other health technologies and follows an S-shaped logistic growth curve. Third, evidence of cost-effectiveness is a necessary but not sufficient condition for the widespread adoption of telemedicine. Fourth, personal incentives for the health professionals involved in service provision are needed before the widespread adoption of telemedicine will occur. Summary The widespread adoption of telemedicine is a major -- and still underdeveloped -- challenge that needs to be strengthened through new research directions. We have formulated four hypotheses, which are all susceptible to experimental verification. In particular, we believe that data about the adoption of telemedicine should be collected from applications implemented on a large-scale, to test the assumption that the adoption of telemedicine follows an S-shaped growth curve. This will lead to a better understanding of the process, which will in turn accelerate the adoption of new telemedicine applications in future. Research is also required to identify suitable financial and

Characterizing New England Emergency Departments by Telemedicine Use

Directory of Open Access Journals (Sweden)

Kori S. Zachrison

2017-09-01

Full Text Available Introduction: Telemedicine connects emergency departments (ED with resources necessary for patient care; its use has not been characterized nationally, or even regionally. Our primary objective was to describe the prevalence of telemedicine use in New England EDs and the clinical applications of use. Secondarily, we aimed to determine if telemedicine use was associated with consultant availability and to identify ED characteristics associated with telemedicine use. Methods: We analyzed data from the National Emergency Department Inventory-New England survey, which assessed basic ED characteristics in 2014. The survey queried directors of every ED (n=195 in the six New England states (excluding federal hospitals and college infirmaries. Descriptive statistics characterized ED telemedicine use; multivariable logistic regression identified independent predictors of use. Results: Of the 169 responding EDs (87% response rate, 82 (49% reported using telemedicine. Telemedicine EDs were more likely to be rural (18% of users vs. 7% of non-users, p=0.03; less likely to be academic (1% of users vs. 11% of non-users, p=0.01; and less likely to have 24/7 access to neurology (p<0.001, neurosurgery (p<0.001, orthopedics (p=0.01, plastic surgery (p=0.01, psychiatry (p<0.001, and hand surgery (p<0.001 consultants. Neuro/stroke (68%, pediatrics (11%, psychiatry (11%, and trauma (10% were the most commonly reported applications. On multivariable analysis, telemedicine was more likely in rural EDs (odds ratio [OR] 4.39, 95% confidence interval [CI] 1.30–14.86, and less likely in EDs with 24/7 neurologist availability (OR 0.21, 95% CI [0.09–0.49], and annual volume <20,000 (OR 0.24, 95% CI [0.08–0.68]. Conclusion: Telemedicine is commonly used in New England EDs. In 2014, use was more common among rural EDs and EDs with limited neurology consultant availability. In contrast, telemedicine use was less common among very low-volume EDs.

Telemedicine expanding the scope of health care information.

Science.gov (United States)

Balch, D C; Tichenor, J M

1997-01-01

The definition of health information is growing to include multimedia audio, video, and high-resolution still images. This article describes the telemedicine program at East Carolina University School of Medicine, including the telemedicine applications presently in use and the virtual reality applications currently under development' Included are the major design criteria that shape the telemedicine network some of the lessons learned in developing the network, and a discussion of the future of telemedicine, including efforts to incorporate telemedicine within a fully integrated health information system.

Performance of the JPEG Estimated Spectrum Adaptive Postfilter (JPEG-ESAP) for Low Bit Rates

Science.gov (United States)

Linares, Irving (Inventor)

2016-01-01

Frequency-based, pixel-adaptive filtering using the JPEG-ESAP algorithm for low bit rate JPEG formatted color images may allow for more compressed images while maintaining equivalent quality at a smaller file size or bitrate. For RGB, an image is decomposed into three color bands--red, green, and blue. The JPEG-ESAP algorithm is then applied to each band (e.g., once for red, once for green, and once for blue) and the output of each application of the algorithm is rebuilt as a single color image. The ESAP algorithm may be repeatedly applied to MPEG-2 video frames to reduce their bit rate by a factor of 2 or 3, while maintaining equivalent video quality, both perceptually, and objectively, as recorded in the computed PSNR values.

Effectiveness and future prospects of telemedicine/remote health care management applications in Pakistan

International Nuclear Information System (INIS)

Iqbal, S.; Khan, N.

2017-01-01

Medical/Health care system is spraining in Pakistan because of innovative technology, activities and services as per their financial cost (position) which is increasing day by day. This research is intended for the assessment of Telemedicine/Remote Health Care Management practices (system), which encompasses usability, acceptance and impact in public/private hospitals. To improve the existing remote health care/telemedicine practices in Pakistan by using EM (Engineering Management) based approach. It has been widely and successfully implemented and is considered as a strategic and operational tool. In the 21st century due to the Technological advancements the mode of operation of service and business sector have been changed drastically. In the same way the health sectors activities also have been altered, new methods and techniques have also been devised for the treatment of the patients that were never even thought before. In the health sector Telemedicine/Remote Health Care Management is one of the development which was experienced lately. Telemedicine/Remote Health Careistaken exactly "medicine at a distance". Therefore, hypothetically, some procedures performed with medication which does not take place "face-to-face"and"in person"which can be considered as Telemedicine/Remote Health Care. In the industrialized world telemedicine is being used in full capacity to provide the health care services to remote and un-accessible areas. But Telemedicine/Remote Health Care Management is not very popular and admired in Pakistan; few applications are being functional presently. (author)

Up to 20 Gbit/s bit-rate transparent integrated interferometric wavelength converter

DEFF Research Database (Denmark)

Jørgensen, Carsten; Danielsen, Søren Lykke; Hansen, Peter Bukhave

1996-01-01

We present a compact and optimised multiquantum-well based, integrated all-active Michelson interferometer for 26 Gbit/s optical wavelength conversion. Bit-rate transparent operation is demonstrated with a conversion penalty well below 0.5 dB at bit-rates ranging from 622 Mbit/s to 20 Gbit/s....

Characterizing New England Emergency Departments by Telemedicine Use.

Science.gov (United States)

Zachrison, Kori S; Hayden, Emily M; Schwamm, Lee H; Espinola, Janice A; Sullivan, Ashley F; Boggs, Krislyn M; Raja, Ali S; Camargo, Carlos A

2017-10-01

Telemedicine connects emergency departments (ED) with resources necessary for patient care; its use has not been characterized nationally, or even regionally. Our primary objective was to describe the prevalence of telemedicine use in New England EDs and the clinical applications of use. Secondarily, we aimed to determine if telemedicine use was associated with consultant availability and to identify ED characteristics associated with telemedicine use. We analyzed data from the National Emergency Department Inventory-New England survey, which assessed basic ED characteristics in 2014. The survey queried directors of every ED (n=195) in the six New England states (excluding federal hospitals and college infirmaries). Descriptive statistics characterized ED telemedicine use; multivariable logistic regression identified independent predictors of use. Of the 169 responding EDs (87% response rate), 82 (49%) reported using telemedicine. Telemedicine EDs were more likely to be rural (18% of users vs. 7% of non-users, p=0.03); less likely to be academic (1% of users vs. 11% of non-users, p=0.01); and less likely to have 24/7 access to neurology (ptelemedicine was more likely in rural EDs (odds ratio [OR] 4.39, 95% confidence interval [CI] 1.30-14.86), and less likely in EDs with 24/7 neurologist availability (OR 0.21, 95% CI [0.09-0.49]), and annual volume Telemedicine is commonly used in New England EDs. In 2014, use was more common among rural EDs and EDs with limited neurology consultant availability. In contrast, telemedicine use was less common among very low-volume EDs.

Design of pseudo-symmetric high bit rate, bend insensitive optical fiber applicable for high speed FTTH

Science.gov (United States)

Makouei, Somayeh; Koozekanani, Z. D.

2014-12-01

In this paper, with sophisticated modification on modal-field distribution and introducing new design procedure, the single-mode fiber with ultra-low bending-loss and pseudo-symmetric high bit-rate of uplink and downlink, appropriate for fiber-to-the-home (FTTH) operation is presented. The bending-loss reduction and dispersion management are done by the means of Genetic Algorithm. The remarkable feature of this methodology is designing a bend-insensitive fiber without reduction of core radius and MFD. Simulation results show bending loss of 1.27×10-2 dB/turn at 1.55 μm for 5 mm curvature radius. The MFD and Aeff are 9.03 μm and 59.11 μm2. Moreover, the upstream and downstream bit-rates are approximately 2.38 Gbit/s-km and 3.05 Gbit/s-km.

Enhanced bit rate-distance product impulse radio ultra-wideband over fiber link

DEFF Research Database (Denmark)

Rodes Lopez, Roberto; Jensen, Jesper Bevensee; Caballero Jambrina, Antonio

2010-01-01

We report on a record distance and bit rate-wireless impulse radio (IR) ultra-wideband (UWB) link with combined transmission over a 20 km long fiber link. We are able to improve the compliance with the regulated frequency emission mask and achieve bit rate-distance products as high as 16 Gbit/s·m....

Urban Telemedicine: The Applicability of Teleburns in the Rehabilitative Phase.

Science.gov (United States)

Liu, Yuk Ming; Mathews, Katie; Vardanian, Andrew; Bozkurt, Taylan; Schneider, Jeffrey C; Hefner, Jaye; Schulz, John T; Fagan, Shawn P; Goverman, Jeremy

Telemedicine has been successfully used in many areas of medicine, including triage and evaluation of the acute burn patient. The utility of telemedicine during the rehabilitative phase of burn care has yet to be evaluated; therefore, we expanded our telemedicine program to link our burn center with a rehabilitation facility. The goal of this project was to demonstrate cost-effective improvements in the transition and quality of care. A retrospective review was performed on all patients enrolled in our telemedicine/rehabilitation program between March 2013 and March 2014. Data collected included total number of encounters, visits, type of visit, physician time, and readmissions. Transportation costs were based on local ambulance rates between the two facilities. The impact of telemedicine was evaluated with respect to the time saved for the physician, burn center, and burn clinic, as well as rehabilitative days saved. A patient satisfaction survey was also administered. A total of 29 patients participated in 73 virtual visits through the telemedicine project. Virtual visits included new consults, preoperative evaluations, and postoperative follow-ups. A total of 146 ambulance transports were averted during the study period, totaling $101,110. Virtual visits saved 6.8 outpatient burn clinic days, or 73 clinic appointments of 30-min duration. The ability to perform more outpatient surgery resulted in 80 inpatient bed days saved at the burn hospital. The rehabilitation hospital saved an average of 2 to 3 patient days secondary to unnecessary travel. Satisfaction surveys demonstrated patient satisfaction with the encounters, primarily related to time saved. The decrease in travel time for the patient from the rehabilitation hospital to outpatient burn clinic improved adherence to the rehabilitation care plan and resulted in increased throughput at the rehabilitation facility. Videoconferencing between a burn center and rehabilitation hospital streamlined patient care

Video Synchronization With Bit-Rate Signals and Correntropy Function

Directory of Open Access Journals (Sweden)

Igor Pereira

2017-09-01

Full Text Available We propose an approach for the synchronization of video streams using correntropy. Essentially, the time offset is calculated on the basis of the instantaneous transfer rates of the video streams that are extracted in the form of a univariate signal known as variable bit-rate (VBR. The state-of-the-art approach uses a window segmentation strategy that is based on consensual zero-mean normalized cross-correlation (ZNCC. This strategy has an elevated computational complexity, making its application to synchronizing online data streaming difficult. Hence, our proposal uses a different window strategy that, together with the correntropy function, allows the synchronization to be performed for online applications. This provides equivalent synchronization scores with a rapid offset determination as the streams come into the system. The efficiency of our approach has been verified through experiments that demonstrate its viability with values that are as precise as those obtained by ZNCC. The proposed approach scored 81 % in time reference classification against the equivalent 81 % of the state-of-the-art approach, requiring much less computational power.

A Web-based Architecture Enabling Multichannel Telemedicine Applications

Directory of Open Access Journals (Sweden)

Fabrizio Lamberti

2003-02-01

Full Text Available Telemedicine scenarios include today in-hospital care management, remote teleconsulting, collaborative diagnosis and emergency situations handling. Different types of information need to be accessed by means of etherogeneous client devices in different communication environments in order to enable high quality continuous sanitary assistance delivery wherever and whenever needed. In this paper, a Web-based telemedicine architecture based on Java, XML and XSL technologies is presented. By providing dynamic content delivery services and Java based client applications for medical data consultation and modification, the system enables effective access to an Electronic Patient Record based standard database by means of any device equipped with a Web browser, such as traditional Personal Computers and workstation as well as modern Personal Digital Assistants. The effectiveness of the proposed architecture has been evaluated in different scenarios, experiencing fixed and mobile clinical data transmissions over Local Area Networks, wireless LANs and wide coverage telecommunication network including GSM and GPRS.

[Telemedicine in dermatological practice: teledermatology].

Science.gov (United States)

Danis, Judit; Forczek, Erzsébet; Bari, Ferenc

2016-03-06

Technological advances in the fields of information and telecommunication technologies have affected the health care system in the last decades, and lead to the emergence of a new discipline: telemedicine. The appearance and rise of internet and smart phones induced a rapid progression in telemedicine. Several new applications and mobile devices are published every hour even for medical purposes. Parallel to these changes in the technical fields, medical literature about telemedicine has grown rapidly. Due to its visual nature, dermatology is ideally suited to benefit from this new technology and teledermatology became one of the most dynamically evolving fields of telemedicine by now. Teledermatology is not routinely practiced in Hungary yet, however, it promises the health care system to become better, cheaper and faster, but we have to take notice on the experience and problems faced in teledermatologic applications so far, summarized in this review.

Least reliable bits coding (LRBC) for high data rate satellite communications

Science.gov (United States)

Vanderaar, Mark; Budinger, James; Wagner, Paul

1992-01-01

LRBC, a bandwidth efficient multilevel/multistage block-coded modulation technique, is analyzed. LRBC uses simple multilevel component codes that provide increased error protection on increasingly unreliable modulated bits in order to maintain an overall high code rate that increases spectral efficiency. Soft-decision multistage decoding is used to make decisions on unprotected bits through corrections made on more protected bits. Analytical expressions and tight performance bounds are used to show that LRBC can achieve increased spectral efficiency and maintain equivalent or better power efficiency compared to that of BPSK. The relative simplicity of Galois field algebra vs the Viterbi algorithm and the availability of high-speed commercial VLSI for block codes indicates that LRBC using block codes is a desirable method for high data rate implementations.

International Telemedicine/Disaster Medicine Conference: Papers and Presentations

Science.gov (United States)

1991-01-01

The first International Telemedicine/Disaster Medicine Conference was held in Dec. 1991. The overall purpose was to convene an international, multidisciplinary gathering of experts to discuss the emerging field of telemedicine and assess its future directions; principally the application of space technology to disaster response and management, but also to clinical medicine, remote health care, public health, and other needs. This collection is intended to acquaint the reader with recent landmark efforts in telemedicine as applied to disaster management and remote health care, the technical requirements of telemedicine systems, the application of telemedicine and telehealth in the U.S. space program, and the social and humanitarian dimensions of this area of medicine.

Comodulation masking release in bit-rate reduction systems

DEFF Research Database (Denmark)

Vestergaard, Martin David; Rasmussen, Karsten Bo; Poulsen, Torben

1999-01-01

It has been suggested that the level dependence of the upper masking slope be utilized in perceptual models in bit-rate reduction systems. However, comodulation masking release (CMR) phenomena lead to a reduction of the masking effect when a masker and a probe signal are amplitude modulated...... with the same frequency. In bit-rate reduction systems the masker would be the audio signal and the probe signal would represent the quantization noise. Masking curves have been determined for sinusoids and 1-Bark-wide noise maskers in order to investigate the risk of CMR, when quantizing depths are fixed...... in accordance with psycho-acoustical principles. Masker frequencies of 500 Hz, 1 kHz, and 2 kHz have been investigated, and the masking of pure tone probes has been determined in the first four 1/3 octaves above the masker. Modulation frequencies between 6 and 20 Hz were used with a modulation depth of 0...

Application of Ethics for Providing Telemedicine Services and Information Technology.

Science.gov (United States)

Langarizadeh, Mostafa; Moghbeli, Fatemeh; Aliabadi, Ali

2017-10-01

Advanced technology has increased the use of telemedicine and Information Technology (IT) in treating or rehabilitating diseases. An increased use of technology increases the importance of the ethical issues involved. The need for keeping patients' information confidential and secure, controlling a number of therapists' inefficiency as well as raising the quality of healthcare services necessitates adequate heed to ethical issues in telemedicine provision. The goal of this review is gathering all articles that are published through 5 years until now (2012-2017) for detecting ethical issues for providing telemedicine services and Information technology. The reason of this time is improvement of telemedicine and technology through these years. This article is important for clinical practice and also to world, because of knowing ethical issues in telemedicine and technology are always important factors for physician and health providers. the required data in this research were derived from published electronic sources and credible academic articles published in such databases as PubMed, Scopus and Science Direct. The following key words were searched for in separation and combination: tele-health, telemedicine, ethical issues in telemedicine. A total of 503 articles were found. After excluding the duplicates (n= 93), the titles and abstracts of 410 articles were skimmed according to the inclusion criteria. Finally, 64 articles remained. They were reviewed in full text and 36 articles were excluded. At the end, 28 articles were chosen which met our eligibility criteria and were included in this study. Ethics has been of a great significance in IT and telemedicine especially the Internet since there are more chances provided for accessing information. It is, however, accompanied by a threat to patients' personal information. Therefore, suggestions are made to investigate ethics in technology, to offer standards and guidelines to therapists. Due to the advancement in

Bit Error Rate Performance of a MIMO-CDMA System Employing Parity-Bit-Selected Spreading in Frequency Nonselective Rayleigh Fading

Directory of Open Access Journals (Sweden)

Claude D'Amours

2011-01-01

Full Text Available We analytically derive the upper bound for the bit error rate (BER performance of a single user multiple input multiple output code division multiple access (MIMO-CDMA system employing parity-bit-selected spreading in slowly varying, flat Rayleigh fading. The analysis is done for spatially uncorrelated links. The analysis presented demonstrates that parity-bit-selected spreading provides an asymptotic gain of 10log(Nt dB over conventional MIMO-CDMA when the receiver has perfect channel estimates. This analytical result concurs with previous works where the (BER is determined by simulation methods and provides insight into why the different techniques provide improvement over conventional MIMO-CDMA systems.

Towards the generation of random bits at terahertz rates based on a chaotic semiconductor laser

International Nuclear Information System (INIS)

Kanter, Ido; Aviad, Yaara; Reidler, Igor; Cohen, Elad; Rosenbluh, Michael

2010-01-01

Random bit generators (RBGs) are important in many aspects of statistical physics and crucial in Monte-Carlo simulations, stochastic modeling and quantum cryptography. The quality of a RBG is measured by the unpredictability of the bit string it produces and the speed at which the truly random bits can be generated. Deterministic algorithms generate pseudo-random numbers at high data rates as they are only limited by electronic hardware speed, but their unpredictability is limited by the very nature of their deterministic origin. It is widely accepted that the core of any true RBG must be an intrinsically non-deterministic physical process, e.g. measuring thermal noise from a resistor. Owing to low signal levels, such systems are highly susceptible to bias, introduced by amplification, and to small nonrandom external perturbations resulting in a limited generation rate, typically less than 100M bit/s. We present a physical random bit generator, based on a chaotic semiconductor laser, having delayed optical feedback, which operates reliably at rates up to 300Gbit/s. The method uses a high derivative of the digitized chaotic laser intensity and generates the random sequence by retaining a number of the least significant bits of the high derivative value. The method is insensitive to laser operational parameters and eliminates the necessity for all external constraints such as incommensurate sampling rates and laser external cavity round trip time. The randomness of long bit strings is verified by standard statistical tests.

Towards the generation of random bits at terahertz rates based on a chaotic semiconductor laser

Science.gov (United States)

Kanter, Ido; Aviad, Yaara; Reidler, Igor; Cohen, Elad; Rosenbluh, Michael

2010-06-01

Random bit generators (RBGs) are important in many aspects of statistical physics and crucial in Monte-Carlo simulations, stochastic modeling and quantum cryptography. The quality of a RBG is measured by the unpredictability of the bit string it produces and the speed at which the truly random bits can be generated. Deterministic algorithms generate pseudo-random numbers at high data rates as they are only limited by electronic hardware speed, but their unpredictability is limited by the very nature of their deterministic origin. It is widely accepted that the core of any true RBG must be an intrinsically non-deterministic physical process, e.g. measuring thermal noise from a resistor. Owing to low signal levels, such systems are highly susceptible to bias, introduced by amplification, and to small nonrandom external perturbations resulting in a limited generation rate, typically less than 100M bit/s. We present a physical random bit generator, based on a chaotic semiconductor laser, having delayed optical feedback, which operates reliably at rates up to 300Gbit/s. The method uses a high derivative of the digitized chaotic laser intensity and generates the random sequence by retaining a number of the least significant bits of the high derivative value. The method is insensitive to laser operational parameters and eliminates the necessity for all external constraints such as incommensurate sampling rates and laser external cavity round trip time. The randomness of long bit strings is verified by standard statistical tests.

New roller cone bits with unique nozzle designs reduce drilling costs

International Nuclear Information System (INIS)

Moffitt, S.R.; Pearce, D.E.; Ivie, C.R.

1992-01-01

This paper reports that selection of the optimum rock bit design to achieve the lowest drilling cost in a given application is often difficult due to a large number of rock bit performance considerations. However, in a majority of applications increased penetration rate is the key consideration in reducing drilling costs. Discovery of a new bit design concept has led to the development of roller cone bits that achieve significant penetration rate increases using superior hydraulic nozzle designs. Prototype designs have achieved 20 to 40% increases in penetration rate with comparable footage drilled when tested in 6 1/2, 8 1/2, 8-3/4, 9-7/8 and 12 1/4 IADC 437, 517 and 537 type bits in the U.S., North Sea, Italy, and Oman. Second-generation designs tested in a full-scale drilling laboratory have delivered 70% increases in penetration rates

Increasing the bit rate in OCDMA systems using pulse position modulation techniques.

Science.gov (United States)

Arbab, Vahid R; Saghari, Poorya; Haghi, Mahta; Ebrahimi, Paniz; Willner, Alan E

2007-09-17

We have experimentally demonstrated two novel pulse position modulation techniques, namely Double Pulse Position Modulation (2-PPM) and Differential Pulse Position Modulation (DPPM) in Time-Wavelength OCDMA systems that will operate at a higher bit rate compared to traditional OOK-OCDMA systems with the same bandwidth. With 2-PPM technique, the number of active users will be more than DPPM while their bit rate is almost the same. Both techniques provide variable quality of service in OCDMA networks.

A pilot study for the integration of cytometry reports in digital cytology telemedicine applications.

Science.gov (United States)

Giansanti, Daniele; Cerroni, Fabio; Amodeo, Rachele; Filoni, Marco; Giovagnoli, Maria Rosaria

2010-01-01

Up to date, tele-pathology in the three different forms of application, "dynamic", "static" and "virtual microscopy" has been mainly based on tele-hystology remote consulting. Today the diffusion of specialized WAN connections is guiding the research of new applications of tele-pathology. A specific analysis has been conducted, focused on digital cytology, in the biomedical laboratory of Sant'Andrea Hospital to investigate the technologies potentially useful to integrate in the LAN/WAN for telemedicine applications. Among the possible tools useful to be integrated in the LAN/WAN for telemedicine applications, the cytometry equipment available in the technical unity of cytometry has been considered important. The study finally provides a proposal for a tele-consulting architecture for the integration of cytometry reports both in the hospital LAN and the WAN for possible cooperative diagnosis and second opinion support.

A pilot study for the integration of cytometry reports in digital cytology telemedicine applications

Directory of Open Access Journals (Sweden)

Daniele Giansanti

2010-06-01

Full Text Available Up to date, tele-pathology in the three different forms of application, "dynamic", "static" and "virtual microscopy" has been mainly based on tele-hystology remote consulting. Today the diffusion of specialized WAN connections is guiding the research of new applications of tele-pathology. A specific analysis has been conducted, focused on digital cytology, in the biomedical laboratory of Sant'Andrea Hospital to investigate the technologies potentially useful to integrate in the LAN/WAN for telemedicine applications. Among the possible tools useful to be integrated in the LAN/WAN for telemedicine applications, the cytometry equipment available in the technical unity of cytometry has been considered important. The study finally provides a proposal for a tele-consulting architecture for the integration of cytometry reports both in the hospital LAN and the WAN for possible cooperative diagnosis and second opinion support.

Stinger Enhanced Drill Bits For EGS

Energy Technology Data Exchange (ETDEWEB)

Durrand, Christopher J. [Novatek International, Inc., Provo, UT (United States); Skeem, Marcus R. [Novatek International, Inc., Provo, UT (United States); Crockett, Ron B. [Novatek International, Inc., Provo, UT (United States); Hall, David R. [Novatek International, Inc., Provo, UT (United States)

2013-04-29

The project objectives were to design, engineer, test, and commercialize a drill bit suitable for drilling in hard rock and high temperature environments (10,000 meters) likely to be encountered in drilling enhanced geothermal wells. The goal is provide a drill bit that can aid in the increased penetration rate of three times over conventional drilling. Novatek has sought to leverage its polycrystalline diamond technology and a new conical cutter shape, known as the Stinger®, for this purpose. Novatek has developed a fixed bladed bit, known as the JackBit®, populated with both shear cutter and Stingers that is currently being tested by major drilling companies for geothermal and oil and gas applications. The JackBit concept comprises a fixed bladed bit with a center indenter, referred to as the Jack. The JackBit has been extensively tested in the lab and in the field. The JackBit has been transferred to a major bit manufacturer and oil service company. Except for the attached published reports all other information is confidential.

Accurate Bit Error Rate Calculation for Asynchronous Chaos-Based DS-CDMA over Multipath Channel

Science.gov (United States)

Kaddoum, Georges; Roviras, Daniel; Chargé, Pascal; Fournier-Prunaret, Daniele

2009-12-01

An accurate approach to compute the bit error rate expression for multiuser chaosbased DS-CDMA system is presented in this paper. For more realistic communication system a slow fading multipath channel is considered. A simple RAKE receiver structure is considered. Based on the bit energy distribution, this approach compared to others computation methods existing in literature gives accurate results with low computation charge. Perfect estimation of the channel coefficients with the associated delays and chaos synchronization is assumed. The bit error rate is derived in terms of the bit energy distribution, the number of paths, the noise variance, and the number of users. Results are illustrated by theoretical calculations and numerical simulations which point out the accuracy of our approach.

Analytical expression for the bit error rate of cascaded all-optical regenerators

DEFF Research Database (Denmark)

Mørk, Jesper; Öhman, Filip; Bischoff, S.

2003-01-01

We derive an approximate analytical expression for the bit error rate of cascaded fiber links containing all-optical 2R-regenerators. A general analysis of the interplay between noise due to amplification and the degree of reshaping (nonlinearity) of the regenerator is performed.......We derive an approximate analytical expression for the bit error rate of cascaded fiber links containing all-optical 2R-regenerators. A general analysis of the interplay between noise due to amplification and the degree of reshaping (nonlinearity) of the regenerator is performed....

5G, an approach towards future telemedicine

DEFF Research Database (Denmark)

Anwar, Sadia; Prasad, Ramjee; Kumar, Ambuj

for telemedicine application. Telemedicine’s applications and high data medical information generally require high definition visuals and lower latency connection, in addition mobility and reliability. The next generation of wireless communication standard, known as 5G, will provide data speed in (Gigabit per...... second) Gb/s with lower latency and higher reliability connection, and can be better approach for future telemedicine. In this paper we survey the current state of telemedicine along with examining the characteristics of 5G technology. We also present research challenges concerning 5G and telemedicine.......The use of smartphones has been increasing rapidly and it is expected that in future most people will have a smartphone capable of high speed Internet connection. The capability of smartphones with high definition display, computation power and multitude of sensors made it an excellent candidate...

Telemedicine in radiotherapy treatment planning: requirements and applications

International Nuclear Information System (INIS)

Olsen, D.R.; Bruland, O.S.; Davis, B.J.

2000-01-01

Telemedicine facilitates decentralized radiotherapy services by allowing remote treatment planning and quality assurance of treatment delivery. A prerequisite is digital storage of relevant data and an efficient and reliable telecommunication system between satellite units and the main radiotherapy clinic. The requirements of a telemedicine system in radiotherapy is influenced by the level of support needed. In this paper we differentiate between three categories of telemedicine support in radiotherapy. Level 1 features video conferencing and display of radiotherapy images and dose plans. Level 2 involves replication of selected data from the radiotherapy database - facilitating remote treatment planning and evaluation. Level 3 includes real-time, remote operations, e.g. target volume delineation and treatment planning performed by the team at the satellite unit under supervision and guidance from more experienced colleagues at the main clinic. (author)

The bit's the thing : PDC bits are the sparkly new best friend of drillers everywhere

Energy Technology Data Exchange (ETDEWEB)

Cook, D.

2008-09-15

Polycrystalline diamond compact (PDC) cutters were introduced to the oil and gas industry in 1972. The drill bit technology has made significant advances since its introduction, and the PDC bits are now more widely used than conventional roller cone bits. This article discussed new PDC drill bits designed to have rates of penetration (ROP) of over 1000 feet an hour, run distances of up to 22,000 feet, and have cumulative depths of 180,000 feet. A diamond volume management (DVM) system is used to place the diamond where it is needed for specific applications. Designed by Precise Drilling Component Ltd, the bits are accompanied by thermo stable cutters developed to increase the stability of the PDC bits. Precise Drilling Component is now supplying the drilling equipment to major international oil companies. The company has also developed new abrasion-resistant cutters and improved hydraulics that have increased durability and stability, as well as lower drilling costs. The PDC cutters are able to remove rock more efficiently than the grinding and gouging actions of roller bits, which translates into faster penetration rates and longer bit lives. PDC bits are increasingly being used in steam assisted gravity drainage (SAGD) operations as the tungsten carbide matrix used for the PDC bits is able to withstand the abrasive sands encountered in oil sands wellbores. It was concluded that the PDC drill bits will continue to be optimized for use in harsh oil sands conditions. New optimization features and analytical models for improving drilling efficiency were also outlined. 4 figs.

Influence of transmission bit rate on performance of optical fibre communication systems with direct modulation of laser diodes

International Nuclear Information System (INIS)

Ahmed, Moustafa F

2009-01-01

This paper reports on the influence of the transmission bit rate on the performance of optical fibre communication systems employing laser diodes subjected to high-speed direct modulation. The performance is evaluated in terms of the bit error rate (BER) and power penalty associated with increasing the transmission bit rate while keeping the transmission distance. The study is based on numerical analysis of the stochastic rate equations of the laser diode and takes into account noise mechanisms in the receiver. Correlation between BER and the Q-parameter of the received signal is presented. The relative contributions of the transmitter noise and the circuit and shot noises of the receiver to BER are quantified as functions of the transmission bit rate. The results show that the power penalty at BER = 10 -9 required to keep the transmission distance increases moderately with the increase in the bit rate near 1 Gbps and at high bias currents. In this regime, the shot noise is the main contributor to BER. At higher bit rates and lower bias currents, the power penalty increases remarkably, which comes mainly from laser noise induced by the pseudorandom bit-pattern effect.

Telemedicine for Developing Countries. A Survey and Some Design Issues.

Science.gov (United States)

Combi, Carlo; Pozzani, Gabriele; Pozzi, Giuseppe

2016-11-02

Developing countries need telemedicine applications that help in many situations, when physicians are a small number with respect to the population, when specialized physicians are not available, when patients and physicians in rural villages need assistance in the delivery of health care. Moreover, the requirements of telemedicine applications for developing countries are somewhat more demanding than for developed countries. Indeed, further social, organizational, and technical aspects need to be considered for successful telemedicine applications in developing countries. We consider all the major projects in telemedicine, devoted to developing countries, as described by the proper scientific literature. On the basis of such literature, we want to define a specific taxonomy that allows a proper classification and a fast overview of telemedicine projects in developing countries. Moreover, by considering both the literature and some recent direct experiences, we want to complete such overview by discussing some design issues to be taken into consideration when developing telemedicine software systems. We considered and reviewed the major conferences and journals in depth, and looked for reports on the telemedicine projects. We provide the reader with a survey of the main projects and systems, from which we derived a taxonomy of features of telemedicine systems for developing countries. We also propose and discuss some classification criteria for design issues, based on the lessons learned in this research area. We highlight some challenges and recommendations to be considered when designing a telemedicine system for developing countries.

The Impact of Telemedicine on Pediatric Critical Care Triage.

Science.gov (United States)

Harvey, Jillian B; Yeager, Brooke E; Cramer, Christina; Wheeler, David; McSwain, S David

2017-11-01

To examine the relationship between pediatric critical care telemedicine consultation to rural emergency departments and triage decisions. We compare the triage location and provider rating of the accuracy of remote assessment for a cohort of patients who receive critical care telemedicine consultations and a similar group of patients receiving telephone consultations. Retrospective evaluation of consultations occurring between April 2012 and March 2016. Pediatric critical care telemedicine and telephone consultations in 52 rural healthcare settings in South Carolina. Pediatric patients receiving critical care telemedicine or telephone consultations. Telemedicine consultations. Data were collected from the consulting provider for 484 total consultations by telephone or telemedicine. We examined the providers' self-reported assessments about the consultation, decision-making, and triage outcomes. We estimate a logit model to predict triage location as a function of telemedicine consult age and sex. For telemedicine patients, the odds of triage to a non-ICU level of care are 2.55 times larger than the odds for patients receiving telephone consultations (p = 0.0005). Providers rated the accuracy of their assessments higher when consultations were provided via telemedicine. When patients were transferred to a non-ICU location following a telemedicine consultation, providers indicated that the use of telemedicine influenced the triage decision in 95.7% of cases (p telemedicine consultation to community hospitals is feasible and results in a reduction in PICU admissions. This study demonstrates an improvement in provider-reported accuracy of patient assessment via telemedicine compared with telephone, which may produce a higher comfort level with transporting patients to a lower level of care. Pediatric critical care telemedicine consultations represent a promising means of improving care and reducing costs for critically ill children in rural areas.

Telemedicine in otolaryngology.

Science.gov (United States)

Holtel, Michael R; Burgess, Lawrence P A

2002-12-01

More research is needed in otolaryngology telemedicine, but it would be a mistake to stop at only determining if telemedicine is as good as an in-person exam. The digital image recorded in a telemedicine encounter can be manipulated to increase diagnostic information not currently available. Radiologists currently take a chest radiograph in which a chest mass or the tip of an nasogastric tube is difficult to visualize, and by inverting the gray scale or viewing other digital manipulations of that image, the mass or tube tip becomes obvious. Examples in otolaryngology might include images of the larynx manipulated to better demonstrate the inflamed tissue of reflux, or images of the tympanic membrane manipulated to better demonstrate early retraction. Despite dramatic and likely continued decreases, equipment cost is still an issue. Current research points to good consumer acceptance, and certainly with each new generation the technology is more readily accepted. As Nesbitt [4] points out, it is certainly not difficult to look to the future and see ubiquitous broadband with video as common as telephone, or even extreme broadband enabling robotics and virtual reality TV with three-dimensional touch. Robotics and genomics will eventually play a greater role in telemedicine and our lives in general. Applications for remote diagnosis in biologic warfare defense and homeland security are currently raising interest in telemedicine. Telemedicine will be combined with new technological advances such as virtual "fly-through" computerized axial tomography examinations. Instead of performing an exploratory tympanotomy, surgeons will use computer programs to "fly through" and examine all aspects of a patient's middle or even inner ear. Spectral imaging of the eardrum, larynx, or oropharynx will immediately identify bacteria without cultures, or gram stain, and potential malignancy without biopsy. By measuring fluorescence emitted from an oropharynx illuminated with a specific

Traffic management mechanism for intranets with available-bit-rate access to the Internet

Science.gov (United States)

Hassan, Mahbub; Sirisena, Harsha R.; Atiquzzaman, Mohammed

1997-10-01

The design of a traffic management mechanism for intranets connected to the Internet via an available bit rate access- link is presented. Selection of control parameters for this mechanism for optimum performance is shown through analysis. An estimate for packet loss probability at the access- gateway is derived for random fluctuation of available bit rate of the access-link. Some implementation strategies of this mechanism in the standard intranet protocol stack are also suggested.

Telemedicine in Greenland

DEFF Research Database (Denmark)

Nielsen, Lasse Overballe; Krebs, Hans Jørgen; Albert, Nancy M.

2017-01-01

BACKGROUND: Telemedicine may have the possibility to provide better access to healthcare delivery for the citizens. Telemedicine in arctic remote areas must be tailored according to the needs of the local population. Therefore, we need more knowledge about their needs and their view of telemedicine......: Data collected on citizens' views about the possibilities of using telemedicine in Greenland revealed the following findings: Greenlandic citizens are positive toward telemedicine, and telemedicine can help facilitate improved access to healthcare for residents in these Greenlandic settlements...

Case histories of roller cone core bit application in crystalline rock

International Nuclear Information System (INIS)

Dahlem, J.S.

1988-01-01

The increased interest in deep crystalline rock drilling projects has resulted in a requirement for premium coring bits which are effective in such a harsh and abrasive environment. Hard formation roller cone insert bits have traditionally and constantly performed well in crystalline rock. As a result, the application of state of the art roller cone rock bit technology to the design and development of core bits has made crystalline coring projects more viable than ever before. This paper follows the development of roller cone core bits by examining their use on project such as HDR (Hot Dry Rock, Los Alamos); NAGRA (Nuclear Waste Disposal Wells in Switzerland); Camborne School of Mines Geothermal Project in Cornwall, UK; Deep Gas Project in Sweden; and the KTB Deep Drilling Project in West Germany

AplikasiTelemedicine dalam Merujuk Pasien dari Daerah Rural

Directory of Open Access Journals (Sweden)

Lidwina Anissa

2016-03-01

Full Text Available Kusta adalah penyakit menular yang disebabkan oleh basil lepra. Penderita kusta tersebar di seluruh Indonesia. Dalam Standar Kompetensi Dokter Indonesia, penanganan kusta tanpa komplikasi merupakankompetensi tingkat 4A, sedangkan penanganan reaksi kusta merupakan kompetensi tingkat 3A. Penanganankasus reaksi kusta dengan proses rujukan konvensional ke layanan kesehatan yang memilliki tenaga ahliterkendala oleh berbagai macam penyulit. Pemanfaatan teknologi smartphone berupa aplikasi Whatsapp,dengan menerapkan konsep telemedicine, diharapkan dapat menjadi solusi untuk meretas hambatanjarak, waktu dan finansial dalam proses rujukan pasien secara konvensional. Demi memberikan pelayanan kesehatan yang bersifat paripurna, sebaiknya konsep telemedicine dipelajari lebih lanjut dan diterapkan dalam pelayanan kesehatan. Kata Kunci: kusta, reaksi kusta, rujukan, smartphone, telemedicine, Whatsapp   Telemedicine Application for Rural Patients’ Referral Abstract Leprosy is a communicable disease caused by leprosy bacillus. People with leprosy are distributed in all areas of Indonesia. In Indonesian Doctor Competence Standards, leprosy management is at level 4Acompetence; meanwhile leprosy reaction management is at level 3A competence. Management of leprosyreaction that needs a conventional referral to higher level of health centre has faced many obstacles.Smartphone instant messaging application (eg. Whatsapp utilizes the concept of telemedicine, which will bea solution in solving distance, time and financial problems in conventional referral process. In order to provideholistic health service, telemedicine should be learnt further and applied. Keywords: leprosy, leprosy reaction, referral, smartphone, telemedicine, Whatsapp

The Design of a Single-Bit CMOS Image Sensor for Iris Recognition Applications

Directory of Open Access Journals (Sweden)

Keunyeol Park

2018-02-01

Full Text Available This paper presents a single-bit CMOS image sensor (CIS that uses a data processing technique with an edge detection block for simple iris segmentation. In order to recognize the iris image, the image sensor conventionally captures high-resolution image data in digital code, extracts the iris data, and then compares it with a reference image through a recognition algorithm. However, in this case, the frame rate decreases by the time required for digital signal conversion of multi-bit digital data through the analog-to-digital converter (ADC in the CIS. In order to reduce the overall processing time as well as the power consumption, we propose a data processing technique with an exclusive OR (XOR logic gate to obtain single-bit and edge detection image data instead of multi-bit image data through the ADC. In addition, we propose a logarithmic counter to efficiently measure single-bit image data that can be applied to the iris recognition algorithm. The effective area of the proposed single-bit image sensor (174 × 144 pixel is 2.84 mm2 with a 0.18 μm 1-poly 4-metal CMOS image sensor process. The power consumption of the proposed single-bit CIS is 2.8 mW with a 3.3 V of supply voltage and 520 frame/s of the maximum frame rates. The error rate of the ADC is 0.24 least significant bit (LSB on an 8-bit ADC basis at a 50 MHz sampling frequency.

The Design of a Single-Bit CMOS Image Sensor for Iris Recognition Applications.

Science.gov (United States)

Park, Keunyeol; Song, Minkyu; Kim, Soo Youn

2018-02-24

This paper presents a single-bit CMOS image sensor (CIS) that uses a data processing technique with an edge detection block for simple iris segmentation. In order to recognize the iris image, the image sensor conventionally captures high-resolution image data in digital code, extracts the iris data, and then compares it with a reference image through a recognition algorithm. However, in this case, the frame rate decreases by the time required for digital signal conversion of multi-bit digital data through the analog-to-digital converter (ADC) in the CIS. In order to reduce the overall processing time as well as the power consumption, we propose a data processing technique with an exclusive OR (XOR) logic gate to obtain single-bit and edge detection image data instead of multi-bit image data through the ADC. In addition, we propose a logarithmic counter to efficiently measure single-bit image data that can be applied to the iris recognition algorithm. The effective area of the proposed single-bit image sensor (174 × 144 pixel) is 2.84 mm² with a 0.18 μm 1-poly 4-metal CMOS image sensor process. The power consumption of the proposed single-bit CIS is 2.8 mW with a 3.3 V of supply voltage and 520 frame/s of the maximum frame rates. The error rate of the ADC is 0.24 least significant bit (LSB) on an 8-bit ADC basis at a 50 MHz sampling frequency.

Telemedicine: the slow revolution.

Science.gov (United States)

Moncrief, Jack W

2014-01-01

The use of interactive video has been recognized as a means of delivering medical support to isolated areas since the 1950s. The Department of Defense recognized early the capacity of telemedicine to deliver medical care and support to front-line military personnel. In 1989, the Texas Telemedicine Project received grants and support from the then American Telephone and Telegraph Company (now AT&T) and the Meadows Foundation of Dallas, Texas, to establish and evaluate telemedicine delivery in central Texas. That project had 6 connected telemedicine sites: 3 in Austin, Texas, and 3 in Giddings, Texas (a small community 55 miles to the southeast of Austin). The sites in Giddings included a chronic outpatient dialysis facility, an inpatient psychiatric hospital, and the emergency department at Giddings Hospital. Patient contact began in April 1991 and continued through March 1993. During that period, data on the 1500 patient contacts made were recorded. After termination of the Texas Telemedicine Project, AT&T continued to provide the transmission lines, and between 1993 and 1996, another 12,000 patient contacts were made. Approximately 80% were dialysis evaluations and 20% were non-dialysis primary care contacts. The original cost of materials and equipment in the Texas Telemedicine Project exceeded $50,000 per site. Today, a secure Internet connection with full-motion video and wireless data transfer to almost any location in the world is achievable with an iPad. Multiple inexpensive applications with connections for electrocardiogram, otoscope, and stethoscope, among others, make this technology extremely inexpensive and user-friendly. The revolution now is rapidly moving forward, with Medicare reimbursing telemedicine contacts in medically underserved areas. Multiple bills are before Congress to expand Medicare and therefore private insurance payment for this service.

Telemedicine Program

Science.gov (United States)

1996-01-01

Since the 1970s, NASA has been involved in the research and demonstration of telemedicine for its potential in the care of astronauts in flight and Earth-bound applications. A combination of NASA funding, expertise and off-the-shelf computer and networking systems made telemedicine possible for a medically underserved hospital in Texas. Through two-way audio/video relay, the program links pediatric oncology specialists at the University of Texas Health Science Center in San Antonio to South Texas Hospital in Harlingen, providing easier access and better care to children with cancer. Additionally, the hospital is receiving teleclinics on pediatric oncology nursing, family counseling and tuberculosis treatment. VTEL Corporation, Sprint, and the Healthcare Open Systems and Trials Consortium also contributed staff and hardware.

The Use of Telemedicine in Oral and Maxillofacial Surgery.

Science.gov (United States)

Wood, Eric W; Strauss, Robert A; Janus, Charles; Carrico, Caroline K

2016-04-01

To determine the perceived utility and demand for the application of telemedicine for improved patient care between nonsurgical dental practitioners (GPs) and oral and maxillofacial surgeons (OMS). Two distinct questionnaires were made, one for GPs and one for OMSs. The GP questionnaire was sent to practicing Virginia Dental Association members on an e-mail list (approximately 2,200). The OMS questionnaire was sent by the Virginia Society of Oral Maxillofacial Surgery to members on an e-mail list (approximately 213). Questionnaires included questions about access to care, benefits of telemedicine consultations, reliability of telemedicine consultations, and perceived barriers against and opportunities for the implementation of telemedicine. The questionnaire was completed by 226 GP and 41 OMS respondents. There was a significant difference among responses of GPs based on practice location: rural patients had a longer average time from referral to OMS consultation (P = .003), rural patients traveled longer distances (P telemedicine, whereas OMS respondents were more neutral. GPs responded they would refer more patients (4.4) if consultations could be performed by telemedicine. OMSs agreed that more referrals would influence their decision to provide telemedicine consultations (51%). Practitioners had neutral perceptions about the reliability of telemedicine. OMS respondents agreed they would implement telemedicine in their practice if it provided equally good consultations as in-office visits. According to the present findings, telemedicine could be an important step in the right direction for overcoming current issues with patient access to care and increasing health care costs. The benefits of telemedicine technology have been documented and will continue to be seen with wider application of its use in other areas of health care such as oral and maxillofacial surgery. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier

Clinicians' Knowledge and Perception of Telemedicine Technology.

Science.gov (United States)

Ayatollahi, Haleh; Sarabi, Fatemeh Zahra Pourfard; Langarizadeh, Mostafa

2015-01-01

Telemedicine is an application of information and communication technology in the healthcare environment. This study aimed to compare knowledge and perceptions of telemedicine technology among different groups of clinicians. This survey study was conducted in 2013. The potential participants included 532 clinicians who worked in two hospitals and three clinics in a northern province of Iran. Data were collected using a five-point Likert-scale questionnaire. The content validity of the questionnaire was checked, and the reliability was calculated using Cronbach's alpha coefficient (α = 0.73). The results showed that most of the clinicians (96.1 percent) had little knowledge about telemedicine. They perceived the advantages of telemedicine at a moderate level and its disadvantages at a low level. The knowledge of dentists about this technology was less than that of other groups, and as a result they were less positive about the advantages of telemedicine compared to nurses, general physicians, and specialists. The limited knowledge of clinicians about telemedicine seems to have influenced their perceptions of the technology. Therefore, providing healthcare professionals with more information about new technologies in healthcare, such as telemedicine, can help to gain a more realistic picture of their perceptions.

QoE for telemedicine: challenges and trends

Science.gov (United States)

Cavaro-Ménard, Christine; Lu, Zhang Ge; Le Callet, Patrick

2013-09-01

Telemedicine that involves sharing of digital data (i.e. physiological signals, 2D/3D images and videos) should meet the same standards of traditional healthcare in terms of usability, accessibility, efficiency, effectiveness and quality of clinical processes. All these requirements can be seen as elementary components that participate to the quality of experience (QoE) in an ad hoc medical application scenario. Although, the quality of service (QoS) in telemedicine has been quite investigated, QoE is still lacking clear definition in this context. This later should not be assimilated to QoS as it refers clearly to the experience by the user while QoS focuses mostly on the system. QoE has a potential relevancy to optimize and understand the technical transmission chain from the final task point viewpoint which one of the most important factor for adoption of telemedicine. Towards this goal, QoE studies should be conducted with an appropriate methodology incorporating user involvement and digital data and their relation with QoS. As one of the first effort in this field, this paper proposes a survey of some key issues and solutions associated to QoE in telemedicine. We first present the services offered by telemedicine and underline the significance of QoE for tele-diagnosis and tele-surgery. Next, we identify and analyze the influencing factors such as application area, application purpose (emergency care, acquisition assistance, second opinion, education...), content type (data specificities depending on acquisition modality), context of use (offline/real time, interactivity...), and user's state (stress, expertise...), that have to be considered for a relevant QoE assessment in telemedicine.

Invariance of the bit error rate in the ancilla-assisted homodyne detection

International Nuclear Information System (INIS)

Yoshida, Yuhsuke; Takeoka, Masahiro; Sasaki, Masahide

2010-01-01

We investigate the minimum achievable bit error rate of the discrimination of binary coherent states with the help of arbitrary ancillary states. We adopt homodyne measurement with a common phase of the local oscillator and classical feedforward control. After one ancillary state is measured, its outcome is referred to the preparation of the next ancillary state and the tuning of the next mixing with the signal. It is shown that the minimum bit error rate of the system is invariant under the following operations: feedforward control, deformations, and introduction of any ancillary state. We also discuss the possible generalization of the homodyne detection scheme.

Digital Signal Processing For Low Bit Rate TV Image Codecs

Science.gov (United States)

Rao, K. R.

1987-06-01

In view of the 56 KBPS digital switched network services and the ISDN, low bit rate codecs for providing real time full motion color video are under various stages of development. Some companies have already brought the codecs into the market. They are being used by industry and some Federal Agencies for video teleconferencing. In general, these codecs have various features such as multiplexing audio and data, high resolution graphics, encryption, error detection and correction, self diagnostics, freezeframe, split video, text overlay etc. To transmit the original color video on a 56 KBPS network requires bit rate reduction of the order of 1400:1. Such a large scale bandwidth compression can be realized only by implementing a number of sophisticated,digital signal processing techniques. This paper provides an overview of such techniques and outlines the newer concepts that are being investigated. Before resorting to the data compression techniques, various preprocessing operations such as noise filtering, composite-component transformation and horizontal and vertical blanking interval removal are to be implemented. Invariably spatio-temporal subsampling is achieved by appropriate filtering. Transform and/or prediction coupled with motion estimation and strengthened by adaptive features are some of the tools in the arsenal of the data reduction methods. Other essential blocks in the system are quantizer, bit allocation, buffer, multiplexer, channel coding etc.

Telemedicine for wound management

Directory of Open Access Journals (Sweden)

Ravi K Chittoria

2012-01-01

Full Text Available The escalating physiological, psychological, social and financial burdens of wounds and wound care on patients, families and society demand the immediate attention of the health care sector. Many forces are affecting the changes in health care provision for patients with chronic wounds, including managed care, the limited number of wound care therapists, an increasingly ageing and disabled population, regulatory and malpractice issues, and compromised care. The physician is also faced with a number of difficult issues when caring for chronic wound patients because their conditions are time consuming and high risk, represent an unprofitable part of care practice and raise issues of liability. Telemedicine enhances communication with the surgical wound care specialist. Digital image for skin lesions is a safe, accurate and cost-effective referral pathway. The two basic modes of telemedicine applications, store and forward (asynchronous transfer and real-time transmission (synchronous transfer, e.g. video conference, are utilized in the wound care setting. Telemedicine technology in the hands of an experienced physician can streamline management of a problem wound. Although there is always an element of anxiety related to technical change, the evolution of wound care telemedicine technology has demonstrated a predictable maturation process.

A PDA-based flexible telecommunication system for telemedicine applications.

Science.gov (United States)

Nazeran, Homer; Setty, Sunil; Haltiwanger, Emily; Gonzalez, Virgilio

2004-01-01

Technology has been used to deliver health care at a distance for many years. Telemedicine is a rapidly growing area and recently there are studies devoted to prehospital care of patients in emergency cases. In this work we have developed a compact, reliable, and low cost PDA-based telecommunication device for telemedicine applications to transmit audio, still images, and vital signs from a remote site to a fixed station such as a clinic or a hospital in real time. This was achieved based on a client-server architecture. A Pocket PC, a miniature camera, and a hands-free microphone were used at the client site and a desktop computer running the Windows XP operating system was used as a server. The server was located at a fixed station. The system was implemented on TCP/IP and HTTP protocol. Field tests have shown that the system can reliably transmit still images, audio, and sample vital signs from a simulated remote site to a fixed station either via a wired or wireless network in real time. The Pocket PC was used at the client site because of its compact size, low cost and processing capabilities.

Differences in public and private sector adoption of telemedicine: Indian case study for sectoral adoption.

Science.gov (United States)

Sood, Sanjay P; Negash, Solomon; Mbarika, Victor W A; Kifle, Mengistu; Prakash, Nupur

2007-01-01

Telemedicine is the use of communication networks to exchange medical information for providing healthcare services and medical education from one site to another. The application of telemedicine is more promising in economically developing countries with agrarian societies. The American Telemedicine Association (ATA) identifies three healthcare services: clinical medical services, health and medical education, and consumer health information. However, it is not clear how these services can be adopted by different sectors: public and private. This paper looks at four Indian case studies, two each in public and private sectors to understand two research questions: Are there differences in telemedicine adoption between public and private hospitals. If there are differences: What are the differences in telemedicine adoption between public and private sectors? Authors have used the extant literature in telemedicine and healthcare to frame theoretical background, describe the research setting, present the case studies, and provide discussion and conclusions about their findings. Authors believe that as India continues to develop its telemedicine infrastructures, especially with continued government support through subsidies to private telemedicine initiatives, its upward trend in healthcare will continue. This is expected to put India on the path to increase its life expectancy rates, especially for it rural community which constitute over 70% of its populace.

A Systematic Review of the Use of Telemedicine in Plastic and Reconstructive Surgery and Dermatology.

Science.gov (United States)

Vyas, Krishna S; Hambrick, H Rhodes; Shakir, Afaaf; Morrison, Shane D; Tran, Duy C; Pearson, Keon; Vasconez, Henry C; Mardini, Samir; Gosman, Amanda A; Dobke, Marek; Granick, Mark S

2017-06-01

Telemedicine, the use of information technology and telecommunication to provide healthcare at a distance, is a burgeoning field with applications throughout medicine. Given the visual nature of plastic surgery and dermatology, telemedicine has a myriad of potential applications within the field. A comprehensive literature review of articles published on telemedicine since January 2010 was performed. Articles were selected for their relevance to plastic and reconstructive surgery and dermatology, and then reviewed for their discussion of the applications, benefits, and limitations of telemedicine in practice. A total of 3119 articles were identified in the initial query. Twenty-three articles met the inclusion criteria in plastic surgery (7 wound management, 5 burn management, 5 trauma, 4 free flap care, 2 in cleft lip/palate repair). Twenty-three (100%) reported a benefit of telemedicine often related to improved postoperative monitoring, increased access to expertise in rural settings, and cost savings, either predicted or actualized. Eight (35%) reported limitations and barriers to the application of telemedicine, including overdiagnosis and dependence on functional telecommunication systems. Sixty-six articles focused on telemedicine in dermatology and also demonstrated significant promise. Telemedicine holds special promise in increasing the efficiency of postoperative care for microsurgical procedures, improving care coordination and management of burn wounds, facilitating interprofessional collaboration across time and space, eliminating a significant number of unnecessary referrals, and connecting patients located far from major medical centers with professional expertise without impinging on-and in some cases improving-the quality or accuracy of care provided. Teledermatology consultation was found to be safe and has a comparable or superior efficacy to the traditional in-patient consultation. The system was consistently rated as convenient and easy to use

State of the Art Telemedicine/Telehealth

National Research Council Canada - National Science Library

Bashshur, Rashid

2001-01-01

.... Reports were derived for the following topics: network organizational models, technology development and application, clinical applications, public health, disease surveillance and personal health, education, and telemedicine diffusion...

Evolution of telemedicine in the space program and earth applications

Science.gov (United States)

Nicogossian, A. E.; Pober, D. F.; Roy, S. A.

2001-01-01

Remote monitoring of crew, spacecraft, and environmental health has always been an integral part of the National Aeronautics and Space Administration's (NASA's) operations. Crew safety and mission success face a number of challenges in outerspace, including physiological adaptations to microgravity, radiation exposure, extreme temperatures and vacuum, and psychosocial reactions to space flight. The NASA effort to monitor and maintain crew health, system performance, and environmental integrity in space flight is a sophisticated and coordinated program of telemedicine combining cutting-edge engineering with medical expertise. As missions have increased in complexity, NASA telemedicine capabilities have grown apace, underlying its role in the field. At the same time, the terrestrial validation of telemedicine technologies to bring healthcare to remote locations provides feedback, improvement, and enhancement of the space program. As NASA progresses in its space exploration program, astronauts will join missions lasting months, even years, that take them millions of miles from home. These long-duration missions necessitate further technological breakthroughs in tele-operations and autonomous technology. Earth-based monitoring will no longer be real-time, requiring telemedicine capabilities to advance with future explorers as they travel deeper into space. The International Space Station will serve as a testbed for the telemedicine technologies to enable future missions as well as improve the quality of healthcare delivery on Earth.

SpecBit, DecayBit and PrecisionBit. GAMBIT modules for computing mass spectra, particle decay rates and precision observables

Energy Technology Data Exchange (ETDEWEB)

Athron, Peter; Balazs, Csaba [Monash University, School of Physics and Astronomy, Melbourne, VIC (Australia); Australian Research Council Centre of Excellence for Particle Physics at the Tera-scale (Australia); Dal, Lars A.; Gonzalo, Tomas E. [University of Oslo, Department of Physics, Oslo (Norway); Edsjoe, Joakim; Farmer, Ben [AlbaNova University Centre, Oskar Klein Centre for Cosmoparticle Physics, Stockholm (Sweden); Stockholm University, Department of Physics, Stockholm (Sweden); Kvellestad, Anders [NORDITA, Stockholm (Sweden); McKay, James; Scott, Pat [Imperial College London, Department of Physics, Blackett Laboratory, London (United Kingdom); Putze, Antje [Universite de Savoie, CNRS, LAPTh, Annecy-le-Vieux (France); Rogan, Chris [Harvard University, Department of Physics, Cambridge, MA (United States); Weniger, Christoph [University of Amsterdam, GRAPPA, Institute of Physics, Amsterdam (Netherlands); White, Martin [Australian Research Council Centre of Excellence for Particle Physics at the Tera-scale (Australia); University of Adelaide, Department of Physics, Adelaide, SA (Australia); Collaboration: The GAMBIT Models Workgroup

2018-01-15

We present the GAMBIT modules SpecBit, DecayBit and PrecisionBit. Together they provide a new framework for linking publicly available spectrum generators, decay codes and other precision observable calculations in a physically and statistically consistent manner. This allows users to automatically run various combinations of existing codes as if they are a single package. The modular design allows software packages fulfilling the same role to be exchanged freely at runtime, with the results presented in a common format that can easily be passed to downstream dark matter, collider and flavour codes. These modules constitute an essential part of the broader GAMBIT framework, a major new software package for performing global fits. In this paper we present the observable calculations, data, and likelihood functions implemented in the three modules, as well as the conventions and assumptions used in interfacing them with external codes. We also present 3-BIT-HIT, a command-line utility for computing mass spectra, couplings, decays and precision observables in the MSSM, which shows how the three modules can easily be used independently of GAMBIT. (orig.)

SpecBit, DecayBit and PrecisionBit: GAMBIT modules for computing mass spectra, particle decay rates and precision observables

Science.gov (United States)

Athron, Peter; Balázs, Csaba; Dal, Lars A.; Edsjö, Joakim; Farmer, Ben; Gonzalo, Tomás E.; Kvellestad, Anders; McKay, James; Putze, Antje; Rogan, Chris; Scott, Pat; Weniger, Christoph; White, Martin

2018-01-01

We present the GAMBIT modules SpecBit, DecayBit and PrecisionBit. Together they provide a new framework for linking publicly available spectrum generators, decay codes and other precision observable calculations in a physically and statistically consistent manner. This allows users to automatically run various combinations of existing codes as if they are a single package. The modular design allows software packages fulfilling the same role to be exchanged freely at runtime, with the results presented in a common format that can easily be passed to downstream dark matter, collider and flavour codes. These modules constitute an essential part of the broader GAMBIT framework, a major new software package for performing global fits. In this paper we present the observable calculations, data, and likelihood functions implemented in the three modules, as well as the conventions and assumptions used in interfacing them with external codes. We also present 3-BIT-HIT, a command-line utility for computing mass spectra, couplings, decays and precision observables in the MSSM, which shows how the three modules can easily be used independently of GAMBIT.

Characterizing the Danish telemedicine ecosystem

DEFF Research Database (Denmark)

Manikas, Konstantinos; Hansen, Klaus Marius

2013-01-01

and interoperability issues, silo solutions, and lack of guidelines and standards. In this paper, we characterise the ecosystem evolved around the telemedicine services in Denmark and study the actors involved in this ecosystem. We establish a method for this study, where we define two actor roles and ways...... of characterizing actor contributions, and apply the method to the largest healthcare region of Denmark. Our findings reveal an ecosystem that is relatively closed to new actors, where the actors tend to be related to single telemedicine applications, the applications have low connectivity, and the most influential...... actors of the ecosystem can be characterised as both being beneficial and inhibitory to the ecosystem prosperity....

Re-use of Low Bandwidth Equipment for High Bit Rate Transmission Using Signal Slicing Technique

DEFF Research Database (Denmark)

Wagner, Christoph; Spolitis, S.; Vegas Olmos, Juan José

: Massive fiber-to-the-home network deployment requires never ending equipment upgrades operating at higher bandwidth. We show effective signal slicing method, which can reuse low bandwidth opto-electronical components for optical communications at higher bit rates.......: Massive fiber-to-the-home network deployment requires never ending equipment upgrades operating at higher bandwidth. We show effective signal slicing method, which can reuse low bandwidth opto-electronical components for optical communications at higher bit rates....

Symbol and Bit Error Rates Analysis of Hybrid PIM-CDMA

Directory of Open Access Journals (Sweden)

Ghassemlooy Z

2005-01-01

Full Text Available A hybrid pulse interval modulation code-division multiple-access (hPIM-CDMA scheme employing the strict optical orthogonal code (SOCC with unity and auto- and cross-correlation constraints for indoor optical wireless communications is proposed. In this paper, we analyse the symbol error rate (SER and bit error rate (BER of hPIM-CDMA. In the analysis, we consider multiple access interference (MAI, self-interference, and the hybrid nature of the hPIM-CDMA signal detection, which is based on the matched filter (MF. It is shown that the BER/SER performance can only be evaluated if the bit resolution conforms to the condition set by the number of consecutive false alarm pulses that might occur and be detected, so that one symbol being divided into two is unlikely to occur. Otherwise, the probability of SER and BER becomes extremely high and indeterminable. We show that for a large number of users, the BER improves when increasing the code weight . The results presented are compared with other modulation schemes.

Mapping telemedicine efforts

DEFF Research Database (Denmark)

Kierkegaard, Patrick

2015-01-01

are being utilized? What medical disciplines are being addressed using telemedicine systems? Methods: All data was surveyed from the "Telemedicinsk Landkort", a newly created database designed to provide a comprehensive and systematic overview of all telemedicine technologies in Denmark. Results......Objectives: The aim of this study is to survey telemedicine services currently in operation across Denmark. The study specifically seeks to answer the following questions: What initiatives are deployed within the different regions? What are the motivations behind the projects? What technologies......: The results of this study suggest that a growing number of telemedicine initiatives are currently in operation across Denmark but that considerable variations existed in terms of regional efforts as the number of operational telemedicine projects varied from region to region. Conclusions: The results...

Telemedicine in healthcare. 1: Exploring its uses, benefits and disadvantages.

Science.gov (United States)

Sarhan, Firas

This first in a two part series on telemedicine in healthcare outlines the background and context for using this technology. It discusses the levels of telemedicine and its possible applications in healthcare, and examines its advantages and disadvantages.

Virtual Telemedicine Visits in Pediatric Home Parenteral Nutrition Patients: A Quality Improvement Initiative.

Science.gov (United States)

Raphael, Bram P; Schumann, Caitlin; Garrity-Gentille, Sara; McClelland, Jennifer; Rosa, Carolyn; Tascione, Christina; Gallotto, Mary; Takvorian-Bené, Melissa; Carey, Alexandra N; McCarthy, Patrick; Duggan, Christopher; Ozonoff, Al

2018-05-04

Despite being less costly than prolonged hospitalization, home parenteral nutrition (HPN) is associated with high rates of post-discharge complications, including frequent readmissions and central line-associated bloodstream infections (CLABSIs). Telemedicine has been associated with improved outcomes and reduced healthcare utilization in other high-risk populations, but no studies to date have supported effectiveness of telemedicine in pediatric HPN. We prospectively collected data on pediatric patients managed at a single HPN program who participated in postdischarge telemedicine visits from March 1, 2014 to March 30, 2016. We excluded patients with a history of HPN and strictly palliative care goals. Univariate analysis was performed for primary outcomes: Community-acquired CLABSI and 30-day readmission rate. Twenty-six families participated in the pilot initiative with median (interquartile range) patient age 1.5 (5.7) years old, diagnosis of short bowel syndrome in 16 (62%), and in-state residence in 17 (55%). Ishikawa (fishbone) diagram identified causes of post-discharge HPN complications. Areas of focus during telemedicine visit included central venous catheter care methods, materials, clinical concerns, and equipment. Compared to historical comparison group, the telemedicine group experienced CLABSI rates of 1.0 versus 2.7 per 1,000 line days and readmission rates of 38% versus 17% (p = 0.03, 0.02, respectively). Telemedicine visits identified opportunities for improvement for families newly discharged on HPN. In a small cohort of patients who experienced telemedicine visits, we found lower CLABSI rates alongside higher readmission rates compared with a historical comparison group. Further studies are needed to optimize telemedicine in delivering care to this high-risk population.

High bit depth infrared image compression via low bit depth codecs

DEFF Research Database (Denmark)

Belyaev, Evgeny; Mantel, Claire; Forchhammer, Søren

2017-01-01

images via 8 bit depth codecs in the following way. First, an input 16 bit depth image is mapped into 8 bit depth images, e.g., the first image contains only the most significant bytes (MSB image) and the second one contains only the least significant bytes (LSB image). Then each image is compressed.......264/AVC codecs, which are usually available in efficient implementations, and compare their rate-distortion performance with JPEG2000, JPEG-XT and H.265/HEVC codecs supporting direct compression of infrared images in 16 bit depth format. A preliminary result shows that two 8 bit H.264/AVC codecs can...

BitPAl: a bit-parallel, general integer-scoring sequence alignment algorithm.

Science.gov (United States)

Loving, Joshua; Hernandez, Yozen; Benson, Gary

2014-11-15

Mapping of high-throughput sequencing data and other bulk sequence comparison applications have motivated a search for high-efficiency sequence alignment algorithms. The bit-parallel approach represents individual cells in an alignment scoring matrix as bits in computer words and emulates the calculation of scores by a series of logic operations composed of AND, OR, XOR, complement, shift and addition. Bit-parallelism has been successfully applied to the longest common subsequence (LCS) and edit-distance problems, producing fast algorithms in practice. We have developed BitPAl, a bit-parallel algorithm for general, integer-scoring global alignment. Integer-scoring schemes assign integer weights for match, mismatch and insertion/deletion. The BitPAl method uses structural properties in the relationship between adjacent scores in the scoring matrix to construct classes of efficient algorithms, each designed for a particular set of weights. In timed tests, we show that BitPAl runs 7-25 times faster than a standard iterative algorithm. Source code is freely available for download at http://lobstah.bu.edu/BitPAl/BitPAl.html. BitPAl is implemented in C and runs on all major operating systems. jloving@bu.edu or yhernand@bu.edu or gbenson@bu.edu Supplementary data are available at Bioinformatics online. © The Author 2014. Published by Oxford University Press.

Telemedicine: the invisible legal barriers to the health care of the future.

Science.gov (United States)

Daly, H L

2000-01-01

Telemedicine has the potential to transform the world of health care just as the Internet transformed the world of commerce. Ms. Daly examines two legal obstacles to expanding the use of telemedicine: licensure and liability. She defines telemedicine and discusses its common applications and significant benefits. Licensure laws and liability rules result in formidable barriers to the expanded use of telemedicine, while also failing to provide sufficient protection for consumers. Ms. Daly argues that for the benefits of telemedicine to reach those most in need, mutual recognition of licensing laws coupled with a universal standard of care is necessary.

ICU Telemedicine Program Financial Outcomes.

Science.gov (United States)

Lilly, Craig M; Motzkus, Christine; Rincon, Teresa; Cody, Shawn E; Landry, Karen; Irwin, Richard S

2017-02-01

ICU telemedicine improves access to high-quality critical care, has substantial costs, and can change financial outcomes. Detailed information about financial outcomes and their trends over time following ICU telemedicine implementation and after the addition of logistic center function has not been published to our knowledge. Primary data were collected for consecutive adult patients of a single academic medical center. We compared clinical and financial outcomes across three groups that differed regarding telemedicine support: a group without ICU telemedicine support (pre-ICU intervention group), a group with ICU telemedicine support (ICU telemedicine group), and an ICU telemedicine group with added logistic center functions and support for quality-care standardization (logistic center group). The primary outcome was annual direct contribution margin defined as aggregated annual case revenue minus annual case direct costs (including operating costs of ICU telemedicine and its related programs). All monetary values were adjusted to 2015 US dollars using Producer Price Index for Health-Care Facilities. Annual case volume increased from 4,752 (pre-ICU telemedicine) to 5,735 (ICU telemedicine) and 6,581 (logistic center). The annual direct contribution margin improved from $7,921,584 (pre-ICU telemedicine) to $37,668,512 (ICU telemedicine) to $60,586,397 (logistic center) due to increased case volume, higher case revenue relative to direct costs, and shorter length of stay. The ability of properly modified ICU telemedicine programs to increase case volume and access to high-quality critical care with improved annual direct contribution margins suggests that there is a financial argument to encourage the wider adoption of ICU telemedicine. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Bit-rate-transparent optical RZ-to-NRZ format conversion based on linear spectral phase filtering

DEFF Research Database (Denmark)

Maram, Reza; Da Ros, Francesco; Guan, Pengyu

2017-01-01

We propose a novel and strikingly simple design for all-optical bit-rate-transparent RZ-to-NRZ conversion based on optical phase filtering. The proposed concept is experimentally validated through format conversion of a 640 Gbit/s coherent RZ signal to NRZ signal.......We propose a novel and strikingly simple design for all-optical bit-rate-transparent RZ-to-NRZ conversion based on optical phase filtering. The proposed concept is experimentally validated through format conversion of a 640 Gbit/s coherent RZ signal to NRZ signal....

BETTER FINGERPRINT IMAGE COMPRESSION AT LOWER BIT-RATES: AN APPROACH USING MULTIWAVELETS WITH OPTIMISED PREFILTER COEFFICIENTS

Directory of Open Access Journals (Sweden)

N R Rema

2017-08-01

Full Text Available In this paper, a multiwavelet based fingerprint compression technique using set partitioning in hierarchical trees (SPIHT algorithm with optimised prefilter coefficients is proposed. While wavelet based progressive compression techniques give a blurred image at lower bit rates due to lack of high frequency information, multiwavelets can be used efficiently to represent high frequency information. SA4 (Symmetric Antisymmetric multiwavelet when combined with SPIHT reduces the number of nodes during initialization to 1/4th compared to SPIHT with wavelet. This reduction in nodes leads to improvement in PSNR at lower bit rates. The PSNR can be further improved by optimizing the prefilter coefficients. In this work genetic algorithm (GA is used for optimizing prefilter coefficients. Using the proposed technique, there is a considerable improvement in PSNR at lower bit rates, compared to existing techniques in literature. An overall average improvement of 4.23dB and 2.52dB for bit rates in between 0.01 to 1 has been achieved for the images in the databases FVC 2000 DB1 and FVC 2002 DB3 respectively. The quality of the reconstructed image is better even at higher compression ratios like 80:1 and 100:1. The level of decomposition required for a multiwavelet is lesser compared to a wavelet.

Application of the advanced communications technology satellite for teleradiology and telemedicine

Science.gov (United States)

Stewart, Brent K.; Carter, Stephen J.; Rowberg, Alan H.

1995-05-01

The authors have an in-kind grant from NASA to investigate the application of the Advanced Communications Technology Satellite (ACTS) to teleradiology and telemedicine using the JPL developed ACTS Mobile Terminal (AMT) uplink. This experiment involves the transmission of medical imagery (CT, MR, CR, US and digitized radiographs including mammograms), between the ACTS/AMT and the University of Washington. This is accomplished by locating the AMT experiment van in various locations throughout Washington state, Idaho, Montana, Oregon and Hawaii. The medical images are transmitted from the ACTS to the downlink at the NASA Lewis Research Center (LeRC) in Cleveland, Ohio, consisting of AMT equipment and the high burst rate-link evaluation terminal (HBR-LET). These images are then routed from LeRC to the University of Washington School of Medicine (UWSoM) through the Internet and public switched Integrated Serviced Digital Network (ISDN). Once images arrive in the UW Radiology Department, they are reviewed using both video monitor softcopy and laser-printed hardcopy. Compressed video teleconferencing and transmission of real-time ultrasound video between the AMT van and the UWSoM are also tested. Image quality comparisons are made using both subjective diagnostic criteria and quantitative engineering analysis. Evaluation is performed during various weather conditions (including rain to assess rain fade compensation algorithms). Compression techniques also are tested to evaluate their effects on image quality, allowing further evaluation of portable teleradiology/telemedicine at lower data rates and providing useful information for additional applications (e.g., smaller remote units, shipboard, emergency disaster, etc.). The medical images received at the UWSoM over the ACTS are directly evaluated against the original digital images. The project demonstrates that a portable satellite-land connection can provide subspecialty consultation and education for rural and remote

Telemedicine on the move: health care heads down the information superhighway.

Science.gov (United States)

Berek, B; Canna, M

1994-01-01

Telemedicine has drawn increasing attention as one of the emerging new service delivery vehicles that will run on the information superhighway. In reality, remote diagnosis and consultation through the application of telecommunications technology have been practiced for many years. But advances in technology and reform imperatives to extend access beyond traditional boundaries are pushing telemedicine into new applications. This is evidenced by the explosion in the number of pilot projects begun within the last 12 months. While demonstrating telemedicine's growing capabilities--for education and administration, as well as medical practice--these projects also raise a number of legal, clinical, and technical questions that must be answered before government and other payers will routinely reimburse for remote services. Academic and industry consortia are springing up to deal with the most compelling issues, including documenting telemedicine's safety and efficacy, developing uniform data and transmission standards, and determining the minimum resolution needed to maintain the integrity of clinical transmissions. Almost every type of medical specialty has proved amenable to performing evaluations via telemedicine links; however, specialties with less direct patient contact, like radiology and pathology, are generally identified as better candidates for telemedicine interactions. The telemedicine equipment required for these consults ranges from the simple to the ultra-sophisticated, depending on the type of system used and its clinical application. The most common system configuration involves a base station in the main facility where specialists and other consultants are housed and a number of remote referral sites. Consults are performed by interactively sharing voice, video, or image data. Increasingly, systems are being introduced that use easy-to-learn, intuitive displays and controls. Systems also require the use of any number of different communication media

Toward computer-assisted diagnosis and telemedicine in ophthalmology

Czech Academy of Sciences Publication Activity Database

Marrugo, A.; Millán, M. S.; Cristóbal, G.; Gabarda, S.; Šorel, Michal; Šroubek, Filip

2012-01-01

Roč. 2012, č. 6 (2012), s. 1-3 ISSN 1818-2259 R&D Projects: GA MŠk 1M0572 Institutional research plan: CEZ:AV0Z10750506 Institutional support: RVO:67985556 Keywords : computer-aided diagnosis * medical and retinal image * deconvolution * telemedicine Subject RIV: JD - Computer Applications, Robotics http://library.utia.cas.cz/separaty/2012/ZOI/sorel-toward computer-assisted diagnosis and telemedicine in ophthalmology.pdf

Sustainable Telemedicine: Designing and Building Infrastructure to Support a Comprehensive Telemedicine Practice.

Science.gov (United States)

Kreofsky, Beth L H; Blegen, R Nicole; Lokken, Troy G; Kapraun, Susan M; Bushman, Matthew S; Demaerschalk, Bart M

2018-04-16

Telemedicine services in medical institutions are often developed in isolation of one another and not as part of a comprehensive telemedicine program. The Center for Connected Care is the administrative home for a broad range of telehealth services at Mayo Clinic. This article speaks of real-time video services, referenced as telemedicine throughout. This article discusses how a large healthcare system designed and built the infrastructure to support a comprehensive telemedicine practice. Based on analysis of existing services, Mayo Clinic developed a multifaceted operational plan that addressed high-priority areas and outlined clear roles and responsibilities of the Center for Connected Care and that of the clinical departments. The plan set priorities and a direction that would lead to long-term success. The plan articulated the governing and operational infrastructure necessary to support telemedicine by defining the role of the Center for Connected Care as the owner of core administrative operations and the role of the clinical departments as the owners of clinical telemedicine services. Additional opportunities were identified to develop product selection processes, implementation services, and staffing models that would be applied to ensure successful telemedicine deployment. The telemedicine team within the Center for Connected Care completed 45 business cases resulting in 54 implementations. The standardization of core products along with key operational offerings around implementation services, and the establishment of a 24/7 support model resulted in improved provider satisfaction and fewer reported technical issues. The foundation for long-term scalability and growth was developed by centralizing operations of telemedicine services, implementing sustainable processes, employing dedicated qualified personnel, and deploying robust products.

Integrating telemedicine and telehealth: putting it all together.

Science.gov (United States)

Weinstein, Ronald S; Lopez, Ana Maria; Krupinski, Elizabeth A; Beinar, Sandra J; Holcomb, Michael; McNeely, Richard A; Latifi, Rifat; Barker, Gail

2008-01-01

Telemedicine and telehealth programs are inherently complex compared with their traditional on-site health care delivery counterparts. Relatively few organizations have developed sustainable, multi-specialty telemedicine programs, although single service programs, such as teleradiology and telepsychiatry programs, are common. A number of factors are barriers to the development of sustainable telemedicine and telehealth programs. First, starting programs is often challenging since relatively few organizations have, in house, a critical mass of individuals with the skill sets required to organize and manage a telemedicine program. Therefore, it is necessary to "boot strap" many of the start-up activities using available personnel. Another challenge is to assemble a management team that has time to champion telemedicine and telehealth while dealing with the broad range of issues that often confront telemedicine programs. Telemedicine programs housed within a single health care delivery system have advantages over programs that serve as umbrella telehealth organizations for multiple health care systems. Planning a telemedicine program can involve developing a shared vision among the participants, including the parent organizations, management, customers and the public. Developing shared visions can be a time-consuming, iterative process. Part of planning includes having the partnering organizations and their management teams reach a consensus on the initial program goals, priorities, strategies, and implementation plans. Staffing requirements of telemedicine and telehealth programs may be met by sharing existent resources, hiring additional personnel, or outsourcing activities. Business models, such as the Application Service Provider (ASP) model used by the Arizona Telemedicine Program, are designed to provide staffing flexibility by offering a combination of in-house and out-sourced services, depending on the needs of the individual participating health care

Telemedicine in Greenland: Citizens' Perspectives.

Science.gov (United States)

Nielsen, Lasse O; Krebs, Hans J; Albert, Nancy M; Anderson, Nick; Catz, Sheryl; Hale, Timothy M; Hansen, John; Hounsgaard, Lise; Kim, Tae Youn; Lindeman, David; Spindler, Helle; Marcin, James P; Nesbitt, Thomas; Young, Heather M; Dinesen, Birthe

2017-05-01

Telemedicine may have the possibility to provide better access to healthcare delivery for the citizens. Telemedicine in arctic remote areas must be tailored according to the needs of the local population. Therefore, we need more knowledge about their needs and their view of telemedicine. The aim of this study has been to explore how citizens living in the Greenlandic settlements experience the possibilities and challenges of telemedicine when receiving healthcare delivery in everyday life. Case study design was chosen as the overall research design. Qualitative interviews (n = 14) were performed and participant observations (n = 80 h) carried out in the local healthcare center in the settlements and towns. A logbook was kept and updated each day during the field research in Greenland. Observations were made of activities in the settlements. Data collected on citizens' views about the possibilities of using telemedicine in Greenland revealed the following findings: Greenlandic citizens are positive toward telemedicine, and telemedicine can help facilitate improved access to healthcare for residents in these Greenlandic settlements. Regarding challenges in using telemedicine in Greenland, the geographical and cultural context hinders accessibility to the Greenlandic healthcare system, and telemedicine equipment is not sufficiently mobile. Greenlandic citizens are positive toward telemedicine and regard telemedicine as a facilitator for improved access for healthcare in the Greenlandic settlements. We have identified challenges, such as geographical and cultural context, that hinder accessibility to the Greenlandic healthcare system.

Fiber Bragg grating based notch filter for bit-rate-transparent NRZ to PRZ format conversion with two-degree-of-freedom optimization

International Nuclear Information System (INIS)

Cao, Hui; Zuo, Jun; Xiong, Bangyun; Cheng, Jianqun; Shu, Xuewen; Shen, Fangcheng; Liu, Xin; Atai, Javid

2015-01-01

We propose a novel notch-filtering scheme for bit-rate transparent all-optical NRZ-to-PRZ format conversion. The scheme is based on a two-degree-of-freedom optimally designed fiber Bragg grating. It is shown that a notch filter optimized for any specific operating bit rate can be used to realize high-Q-factor format conversion over a wide bit rate range without requiring any tuning. (paper)

The effectiveness of telemedicine-delivered opioid agonist therapy in a supervised clinical setting.

Science.gov (United States)

Eibl, Joseph K; Gauthier, Graham; Pellegrini, David; Daiter, Jeffery; Varenbut, Michael; Hogenbirk, John C; Marsh, David C

2017-07-01

Opioid use disorder has been declared a public health crisis across North America and opioid agonist therapy (OAT) is the standard of care for these patients. Despite the increasing adoption of telemedicine as a delivery method for OAT, its effectiveness has not yet been evaluated against traditional in-person treatment. This study compared treatment outcomes for in-person versus telemedicine-delivered OAT. We conducted a non-randomized cohort comparison study using an administrative database for patients who commenced OAT between 2011 and 2012 across 58 clinic sites in the province of Ontario, Canada. Patients were stratified by primary treatment modality as being: in-person (telemedicine), mixed (25-75% by telemedicine), or via telemedicine (>75% appointments by telemedicine). The primary outcome was continuous retention in treatment as defined by one year of uninterrupted therapy, based on pharmacy dosing records. A total of 3733 OAT initiating patients were identified. Patients treated via telemedicine were more likely to be retained in therapy than patients treated in-person (n=1590; aOR=1.27; 95% CI 1.14-1.41; pTelemedicine patients demonstrated a retention rate of 50% at one year whereas in-person patients were retained at a rate of 39%. The mixed group also had higher likelihood of retention than the in-person group (n=418; aOR=1.26; 95% CI 1.08-1.47; p=0.001) and had a retention rate of 47% at one year. Telemedicine may be an effective alternative to delivering in person OAT, and it has the potential to expand access to care in rural, remote, and urban regions. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Establishment of an effective acute stroke telemedicine program for Australia: protocol for the Victorian Stroke Telemedicine project.

Science.gov (United States)

Cadilhac, Dominique A; Moloczij, Natasha; Denisenko, Sonia; Dewey, Helen; Disler, Peter; Winzar, Bruce; Mosley, Ian; Donnan, Geoffrey A; Bladin, Christopher

2014-02-01

Urgent treatment of acute stroke in rural Australia is problematic partly because of limited access to medical specialists. Utilization of telemedicine could improve delivery of acute stroke treatments in rural communities. The study aims to demonstrate enhanced clinical decision making for use of thrombolysis within 4·5 h of ischemic stroke symptom onset in a rural setting using a telemedicine specialist support model. A formative program evaluation research design was used. The Victorian Stroke Telemedicine program was developed and will be evaluated over five stages to ensure successful implementation. The phases include: (a) preimplementation phase to establish the Victorian Stroke Telemedicine program including the clinical pathway, data collection tools, and technology processes; (b) pilot clinical application phase to test the pathway in up to 10 patients; (c) modification phase to refine the program; (d) full clinical implementation phase where the program is maintained for one-year; and (e) a sustainability phase to assess project outcomes over five-years. Qualitative (clinician interviews) and quantitative data (patient, clinician, costs, and technology processes) are collected in each phase. The primary outcome is to achieve a minimum 10% absolute increase in eligible patients treated with thrombolysis. Secondary outcomes are utilization of the telestroke pathway and improvements in processes of stroke care (e.g., time to brain scan). We will report door to telemedicine consultation time, length of telemedicine consultation, clinical utility and acceptability from the perspective of clinicians, and 90-day patient outcomes. This research will provide evidence for an effective telestroke program for use in regional Australian hospitals. © 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization.

UH Telemedicine Proposal

National Research Council Canada - National Science Library

Friedman, Richard

2001-01-01

The purpose of the University of Hawaii Telemedicine Project (UHTP) is to assess and establish an effective telemedicine curriculum uniquely tailored for the training of military healthcare personnel...

Novel relations between the ergodic capacity and the average bit error rate

KAUST Repository

Yilmaz, Ferkan

2011-11-01

Ergodic capacity and average bit error rate have been widely used to compare the performance of different wireless communication systems. As such recent scientific research and studies revealed strong impact of designing and implementing wireless technologies based on these two performance indicators. However and to the best of our knowledge, the direct links between these two performance indicators have not been explicitly proposed in the literature so far. In this paper, we propose novel relations between the ergodic capacity and the average bit error rate of an overall communication system using binary modulation schemes for signaling with a limited bandwidth and operating over generalized fading channels. More specifically, we show that these two performance measures can be represented in terms of each other, without the need to know the exact end-to-end statistical characterization of the communication channel. We validate the correctness and accuracy of our newly proposed relations and illustrated their usefulness by considering some classical examples. © 2011 IEEE.

Bit Error Rate Analysis for MC-CDMA Systems in Nakagami- Fading Channels

Directory of Open Access Journals (Sweden)

Li Zexian

2004-01-01

Full Text Available Multicarrier code division multiple access (MC-CDMA is a promising technique that combines orthogonal frequency division multiplexing (OFDM with CDMA. In this paper, based on an alternative expression for the -function, characteristic function and Gaussian approximation, we present a new practical technique for determining the bit error rate (BER of multiuser MC-CDMA systems in frequency-selective Nakagami- fading channels. The results are applicable to systems employing coherent demodulation with maximal ratio combining (MRC or equal gain combining (EGC. The analysis assumes that different subcarriers experience independent fading channels, which are not necessarily identically distributed. The final average BER is expressed in the form of a single finite range integral and an integrand composed of tabulated functions which can be easily computed numerically. The accuracy of the proposed approach is demonstrated with computer simulations.

High bit depth infrared image compression via low bit depth codecs

DEFF Research Database (Denmark)

Belyaev, Evgeny; Mantel, Claire; Forchhammer, Søren

.264/AVC codecs, which are usually available in efficient implementations, and compare their rate-distortion performance with JPEG2000, JPEG-XT and H.265/HEVC codecs supporting direct compression of infrared images in 16 bit depth format. A preliminary result shows that two 8 bit H.264/AVC codecs can...

A cross-platform solution for light field based 3D telemedicine.

Science.gov (United States)

Wang, Gengkun; Xiang, Wei; Pickering, Mark

2016-03-01

Current telehealth services are dominated by conventional 2D video conferencing systems, which are limited in their capabilities in providing a satisfactory communication experience due to the lack of realism. The "immersiveness" provided by 3D technologies has the potential to promote telehealth services to a wider range of applications. However, conventional stereoscopic 3D technologies are deficient in many aspects, including low resolution and the requirement for complicated multi-camera setup and calibration, and special glasses. The advent of light field (LF) photography enables us to record light rays in a single shot and provide glasses-free 3D display with continuous motion parallax in a wide viewing zone, which is ideally suited for 3D telehealth applications. As far as our literature review suggests, there have been no reports of 3D telemedicine systems using LF technology. In this paper, we propose a cross-platform solution for a LF-based 3D telemedicine system. Firstly, a novel system architecture based on LF technology is established, which is able to capture the LF of a patient, and provide an immersive 3D display at the doctor site. For 3D modeling, we further propose an algorithm which is able to convert the captured LF to a 3D model with a high level of detail. For the software implementation on different platforms (i.e., desktop, web-based and mobile phone platforms), a cross-platform solution is proposed. Demo applications have been developed for 2D/3D video conferencing, 3D model display and edit, blood pressure and heart rate monitoring, and patient data viewing functions. The demo software can be extended to multi-discipline telehealth applications, such as tele-dentistry, tele-wound and tele-psychiatry. The proposed 3D telemedicine solution has the potential to revolutionize next-generation telemedicine technologies by providing a high quality immersive tele-consultation experience. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Implementation of RSA 2048-bit and AES 256-bit with Digital Signature for Secure Electronic Health Record Application

Directory of Open Access Journals (Sweden)

Mohamad Ali Sadikin

2016-10-01

Full Text Available This research addresses the implementation of encryption and digital signature technique for electronic health record to prevent cybercrime such as robbery, modification and unauthorised access. In this research, RSA 2048-bit algorithm, AES 256-bit and SHA 256 will be implemented in Java programming language. Secure Electronic Health Record Information (SEHR application design is intended to combine given services, such as confidentiality, integrity, authentication, and nonrepudiation. Cryptography is used to ensure the file records and electronic documents for detailed information on the medical past, present and future forecasts that have been given only to the intended patients. The document will be encrypted using an encryption algorithm based on NIST Standard. In the application, there are two schemes, namely the protection and verification scheme. This research uses black-box testing and whitebox testing to test the software input, output, and code without testing the process and design that occurs in the system.We demonstrated the implementation of cryptography in SEHR. The implementation of encryption and digital signature in this research can prevent archive thievery.

High bit depth infrared image compression via low bit depth codecs

Science.gov (United States)

Belyaev, Evgeny; Mantel, Claire; Forchhammer, Søren

2017-08-01

Future infrared remote sensing systems, such as monitoring of the Earth's environment by satellites, infrastructure inspection by unmanned airborne vehicles etc., will require 16 bit depth infrared images to be compressed and stored or transmitted for further analysis. Such systems are equipped with low power embedded platforms where image or video data is compressed by a hardware block called the video processing unit (VPU). However, in many cases using two 8-bit VPUs can provide advantages compared with using higher bit depth image compression directly. We propose to compress 16 bit depth images via 8 bit depth codecs in the following way. First, an input 16 bit depth image is mapped into 8 bit depth images, e.g., the first image contains only the most significant bytes (MSB image) and the second one contains only the least significant bytes (LSB image). Then each image is compressed by an image or video codec with 8 bits per pixel input format. We analyze how the compression parameters for both MSB and LSB images should be chosen to provide the maximum objective quality for a given compression ratio. Finally, we apply the proposed infrared image compression method utilizing JPEG and H.264/AVC codecs, which are usually available in efficient implementations, and compare their rate-distortion performance with JPEG2000, JPEG-XT and H.265/HEVC codecs supporting direct compression of infrared images in 16 bit depth format. A preliminary result shows that two 8 bit H.264/AVC codecs can achieve similar result as 16 bit HEVC codec.

Critical to quality in telemedicine service management: application of DFSS (Design for Six Sigma) and SERVQUAL).

Science.gov (United States)

Yun, Eun Kyoung; Chun, Kee Moon

2008-01-01

Telemedicine generally refers to the use of communications and information technologies for the delivery of health care. owever, telemedicine is not merely a simple combination of health care and technology. The researchers propose a systematic approach for assessing needs of telemedicine customers, called critical-to-quality (CTQ) in Six Sigma, with a purpose of continuous quality improvement. The combination approach using DFSS (Design for Six Sigma) and SERVQUAL (Service Quality Framework) was applied to define the critical quality attributes of telemedicine service management and to match them with the current telemedicine process. With a step-by-step procedure, telemedicine service process was reviewed and all the important CTQ candidates identified via a case study. The findings suggest that nurses need further understanding and research methods that will improve and manage the quality of health care service in various medical fields.

5G and Telemedicine: A Business Ecosystem Relationship within CONASENSE Paradigm

DEFF Research Database (Denmark)

Anwar, Sadia; Kumar, Ambuj

2018-01-01

Abstract—The use of smartphones has been increasing rapidly and it is expected that in future most people will have a smartphone capable of high speed Internet connection. The capability of smartphones with high definition display, computation power and multitude of sensors made it an excellent...... candidate for telemedicine application. Telemedicine’s applications and high data medical information generally require high definition visuals and lower latency connection, in addition mobility and reliability. The next generation of wireless communication standard, known as 5G, will provide data speed...... a composite business ecosystem. We also discuss the research challenges concerning 5G and telemedicine. Keywords—5G, Telemedicines, Wireless Communications, Business Modeling, Business Ecosystems....

16-Bit RISC Processor Design for Convolution Application

OpenAIRE

Anand Nandakumar Shardul

2013-01-01

In this project, we propose a 16-bit non-pipelined RISC processor, which is used for signal processing applications. The processor consists of the blocks, namely, program counter, clock control unit, ALU, IDU and registers. Advantageous architectural modifications have been made in the incremented circuit used in program counter and carry select adder unit of the ALU in the RISC CPU core. Furthermore, a high speed and low power modified modifies multiplier has been designed and introduced in ...

Teleneurology applications: Report of the Telemedicine Work Group of the American Academy of Neurology.

Science.gov (United States)

Wechsler, Lawrence R; Tsao, Jack W; Levine, Steven R; Swain-Eng, Rebecca J; Adams, Robert J; Demaerschalk, Bart M; Hess, David C; Moro, Elena; Schwamm, Lee H; Steffensen, Steve; Stern, Barney J; Zuckerman, Steven J; Bhattacharya, Pratik; Davis, Larry E; Yurkiewicz, Ilana R; Alphonso, Aimee L

2013-02-12

To review current literature on neurology telemedicine and to discuss its application to patient care, neurology practice, military medicine, and current federal policy. Review of practice models and published literature on primary studies of the efficacy of neurology telemedicine. Teleneurology is of greatest benefit to populations with restricted access to general and subspecialty neurologic care in rural areas, those with limited mobility, and those deployed by the military. Through the use of real-time audio-visual interaction, imaging, and store-and-forward systems, a greater proportion of neurologists are able to meet the demand for specialty care in underserved communities, decrease the response time for acute stroke assessment, and expand the collaboration between primary care physicians, neurologists, and other disciplines. The American Stroke Association has developed a defined policy on teleneurology, and the American Academy of Neurology and federal health care policy are beginning to follow suit. Teleneurology is an effective tool for the rapid evaluation of patients in remote locations requiring neurologic care. These underserved locations include geographically isolated rural areas as well as urban cores with insufficient available neurology specialists. With this technology, neurologists will be better able to meet the burgeoning demand for access to neurologic care in an era of declining availability. An increase in physician awareness and support at the federal and state level is necessary to facilitate expansion of telemedicine into further areas of neurology.

State Policies Influence Medicare Telemedicine Utilization.

Science.gov (United States)

Neufeld, Jonathan D; Doarn, Charles R; Aly, Reem

2016-01-01

Medicare policy regarding telemedicine reimbursement has changed little since 2000. Many individual states, however, have added telemedicine reimbursement for either Medicaid and/or commercial payers over the same period. Because telemedicine programs must serve patients from all or most payers, it is likely that these state-level policy changes have significant impacts on telemedicine program viability and utilization of services from all payers, not just those services and payers affected directly by state policy. This report explores the impact of two significant state-level policy changes-one expanding Medicaid telemedicine coverage and the other introducing telemedicine parity for commercial payers-on Medicare utilization in the affected states. Medicare claims data from 2011-2013 were examined for states in the Great Lakes region. All valid claims for live interactive telemedicine professional fees were extracted and linked to their states of origin. Allowed encounters and expenditures were calculated in total and on a per 1,000 members per year basis to standardize against changes in the Medicare population by state and year. Medicare telemedicine encounters and professional fee expenditures grew sharply following changes in state Medicaid and commercial payer policy in the examined states. Medicare utilization in Illinois grew by 173% in 2012 (over 2011) following Medicaid coverage expansion, and Medicare utilization in Michigan grew by 118% in 2013 (over 2012) following adoption of telemedicine parity for commercial payers. By contrast, annual Medicare telemedicine utilization growth in surrounding states (in which there were no significant policy changes during these years) varied somewhat but showed no discernible pattern. Although Medicare telemedicine policy has changed little since its inception, changes in state policies with regard to telemedicine reimbursement appear to have significant impacts on the practical viability of telemedicine programs

Selecting a digital camera for telemedicine.

Science.gov (United States)

Patricoski, Chris; Ferguson, A Stewart

2009-06-01

The digital camera is an essential component of store-and-forward telemedicine (electronic consultation). There are numerous makes and models of digital cameras on the market, and selecting a suitable consumer-grade camera can be complicated. Evaluation of digital cameras includes investigating the features and analyzing image quality. Important features include the camera settings, ease of use, macro capabilities, method of image transfer, and power recharging. Consideration needs to be given to image quality, especially as it relates to color (skin tones) and detail. It is important to know the level of the photographer and the intended application. The goal is to match the characteristics of the camera with the telemedicine program requirements. In the end, selecting a digital camera is a combination of qualitative (subjective) and quantitative (objective) analysis. For the telemedicine program in Alaska in 2008, the camera evaluation and decision process resulted in a specific selection based on the criteria developed for our environment.

American Telemedicine Association: First China (Tianjin International Telemedicine Technology Exhibition

Directory of Open Access Journals (Sweden)

Jordana Bernard

2014-09-01

Full Text Available With the support of Tianjin Municipal People’s Government and the People’s Government of Binhai New Area, the “First China (Tianjin International Telemedicine Technology Exhibition” hosted by the American Telemedicine Association (ATA, will be held October 28- 30, 2014 at the Tianjin Binhai International Convention and Exhibition Center. The three day event will feature keynote sessions, concurrent discussion forums, exhibits (e.g., telemedicine, information technology, mHealth, a venture summit, meet-and-greet sessions for international and domestic companies for potential business collaboration, and policy discussions on China healthcare. For registration information: http://www.atacn.org/en/

Design and develop a video conferencing framework for real-time telemedicine applications using secure group-based communication architecture.

Science.gov (United States)

Mat Kiah, M L; Al-Bakri, S H; Zaidan, A A; Zaidan, B B; Hussain, Muzammil

2014-10-01

One of the applications of modern technology in telemedicine is video conferencing. An alternative to traveling to attend a conference or meeting, video conferencing is becoming increasingly popular among hospitals. By using this technology, doctors can help patients who are unable to physically visit hospitals. Video conferencing particularly benefits patients from rural areas, where good doctors are not always available. Telemedicine has proven to be a blessing to patients who have no access to the best treatment. A telemedicine system consists of customized hardware and software at two locations, namely, at the patient's and the doctor's end. In such cases, the video streams of the conferencing parties may contain highly sensitive information. Thus, real-time data security is one of the most important requirements when designing video conferencing systems. This study proposes a secure framework for video conferencing systems and a complete management solution for secure video conferencing groups. Java Media Framework Application Programming Interface classes are used to design and test the proposed secure framework. Real-time Transport Protocol over User Datagram Protocol is used to transmit the encrypted audio and video streams, and RSA and AES algorithms are used to provide the required security services. Results show that the encryption algorithm insignificantly increases the video conferencing computation time.

Identifying Obstacles and Research Gaps of Telemedicine Projects: Approach for a State-of-the-Art Analysis.

Science.gov (United States)

Harst, Lorenz; Timpel, Patrick; Otto, Lena; Wollschlaeger, Bastian; Richter, Peggy; Schlieter, Hannes

2018-01-01

This paper presents an approach for an evaluation of finished telemedicine projects using qualitative methods. Telemedicine applications are said to improve the performance of health care systems. While there are countless telemedicine projects, the vast majority never makes the threshold from testing to implementation and diffusion. Projects were collected from German project databases in the area of telemedicine following systematically developed criteria. In a testing phase, ten projects were subject to a qualitative content analysis to identify limitations, need for further research, and lessons learned. Using Mayring's method of inductive category development, six categories of possible future research were derived. Thus, the proposed method is an important contribution to diffusion and translation research regarding telemedicine, as it is applicable to a systematic research of databases.

100G Flexible IM-DD 850 nm VCSEL Transceiver with Fractional Bit Rate Using Eight-Dimensional PAM

DEFF Research Database (Denmark)

Lu, Xiaofeng; Lyubopytov, Vladimir; Chorchos, Łukasz

2017-01-01

We demonstrate a novel optical transceiver scheme with a net flexible bit rate up to 100Gbit/s with 5 Gbit/s granularity, using an eight-dimensional modulation format family, and investigate its performance on capacity, reach, and power tolerance.......We demonstrate a novel optical transceiver scheme with a net flexible bit rate up to 100Gbit/s with 5 Gbit/s granularity, using an eight-dimensional modulation format family, and investigate its performance on capacity, reach, and power tolerance....

Fifteen-year Experience with Telemedicine Services in Gangwon Province in Korea

Science.gov (United States)

Kim, Hyung-Gi; Choi, Young-A; Choi, Eun-Hi; Kim, Dong-Won; Shin, Se-Gye; Park, Kyung-Suk; Han, Jae-Hyun

2015-01-01

Objectives This study attempted to identify the factors that contribute to successful telemedicine service. This was done by analyzing the operational state of successful telemedicine services offered in Gangwon Province of Korea and their outcome for the last fifteen years. Methods A comparative analysis was made based on reports and a thesis on the satisfaction rate of patients and providers, patient compliance to treatment, and economic assessment of Gangwon telemedicine service, which were carried out in three periods: the years 2006, 2010, and 2012. Results The satisfaction surveys in all three periods showed similar results for patients (4.46±0.70 point) and healthcare practitioners, including nurses (3.82±0.62 point) and physicians (3.60±0.56 point), in decreasing order from the year 2012. Through the survey of patients' compliance with treatment, it was confirmed that telemedicine services increased patients' compliance with drug administration, facilitated improvement of lifestyle habits, improved glycated hemoglobin for patients with diabetes mellitus, and enhanced the rate of blood pressure control. In the survey conducted on patients' willingness to pay for telemedicine services in 2007, it was found that those patients were willing to pay about $3.5 for services. Conclusions The telemedicine services of Gangwon Province increased patients' compliance with drug administration, improved blood glucose control, enhanced blood pressure control for patients with hypertension, and provided economic advantage. PMID:26618035

Dynamic detection-rate-based bit allocation with genuine interval concealment for binary biometric representation.

Science.gov (United States)

Lim, Meng-Hui; Teoh, Andrew Beng Jin; Toh, Kar-Ann

2013-06-01

Biometric discretization is a key component in biometric cryptographic key generation. It converts an extracted biometric feature vector into a binary string via typical steps such as segmentation of each feature element into a number of labeled intervals, mapping of each interval-captured feature element onto a binary space, and concatenation of the resulted binary output of all feature elements into a binary string. Currently, the detection rate optimized bit allocation (DROBA) scheme is one of the most effective biometric discretization schemes in terms of its capability to assign binary bits dynamically to user-specific features with respect to their discriminability. However, we learn that DROBA suffers from potential discriminative feature misdetection and underdiscretization in its bit allocation process. This paper highlights such drawbacks and improves upon DROBA based on a novel two-stage algorithm: 1) a dynamic search method to efficiently recapture such misdetected features and to optimize the bit allocation of underdiscretized features and 2) a genuine interval concealment technique to alleviate crucial information leakage resulted from the dynamic search. Improvements in classification accuracy on two popular face data sets vindicate the feasibility of our approach compared with DROBA.

Open-source telemedicine platform for wireless medical video communication.

Science.gov (United States)

Panayides, A; Eleftheriou, I; Pantziaris, M

2013-01-01

An m-health system for real-time wireless communication of medical video based on open-source software is presented. The objective is to deliver a low-cost telemedicine platform which will allow for reliable remote diagnosis m-health applications such as emergency incidents, mass population screening, and medical education purposes. The performance of the proposed system is demonstrated using five atherosclerotic plaque ultrasound videos. The videos are encoded at the clinically acquired resolution, in addition to lower, QCIF, and CIF resolutions, at different bitrates, and four different encoding structures. Commercially available wireless local area network (WLAN) and 3.5G high-speed packet access (HSPA) wireless channels are used to validate the developed platform. Objective video quality assessment is based on PSNR ratings, following calibration using the variable frame delay (VFD) algorithm that removes temporal mismatch between original and received videos. Clinical evaluation is based on atherosclerotic plaque ultrasound video assessment protocol. Experimental results show that adequate diagnostic quality wireless medical video communications are realized using the designed telemedicine platform. HSPA cellular networks provide for ultrasound video transmission at the acquired resolution, while VFD algorithm utilization bridges objective and subjective ratings.

Open-Source Telemedicine Platform for Wireless Medical Video Communication

Science.gov (United States)

Panayides, A.; Eleftheriou, I.; Pantziaris, M.

2013-01-01

An m-health system for real-time wireless communication of medical video based on open-source software is presented. The objective is to deliver a low-cost telemedicine platform which will allow for reliable remote diagnosis m-health applications such as emergency incidents, mass population screening, and medical education purposes. The performance of the proposed system is demonstrated using five atherosclerotic plaque ultrasound videos. The videos are encoded at the clinically acquired resolution, in addition to lower, QCIF, and CIF resolutions, at different bitrates, and four different encoding structures. Commercially available wireless local area network (WLAN) and 3.5G high-speed packet access (HSPA) wireless channels are used to validate the developed platform. Objective video quality assessment is based on PSNR ratings, following calibration using the variable frame delay (VFD) algorithm that removes temporal mismatch between original and received videos. Clinical evaluation is based on atherosclerotic plaque ultrasound video assessment protocol. Experimental results show that adequate diagnostic quality wireless medical video communications are realized using the designed telemedicine platform. HSPA cellular networks provide for ultrasound video transmission at the acquired resolution, while VFD algorithm utilization bridges objective and subjective ratings. PMID:23573082

Open-Source Telemedicine Platform for Wireless Medical Video Communication

Directory of Open Access Journals (Sweden)

A. Panayides

2013-01-01

Full Text Available An m-health system for real-time wireless communication of medical video based on open-source software is presented. The objective is to deliver a low-cost telemedicine platform which will allow for reliable remote diagnosis m-health applications such as emergency incidents, mass population screening, and medical education purposes. The performance of the proposed system is demonstrated using five atherosclerotic plaque ultrasound videos. The videos are encoded at the clinically acquired resolution, in addition to lower, QCIF, and CIF resolutions, at different bitrates, and four different encoding structures. Commercially available wireless local area network (WLAN and 3.5G high-speed packet access (HSPA wireless channels are used to validate the developed platform. Objective video quality assessment is based on PSNR ratings, following calibration using the variable frame delay (VFD algorithm that removes temporal mismatch between original and received videos. Clinical evaluation is based on atherosclerotic plaque ultrasound video assessment protocol. Experimental results show that adequate diagnostic quality wireless medical video communications are realized using the designed telemedicine platform. HSPA cellular networks provide for ultrasound video transmission at the acquired resolution, while VFD algorithm utilization bridges objective and subjective ratings.

Student laboratory experiments exploring optical fibre communication systems, eye diagrams, and bit error rates

Science.gov (United States)

Walsh, Douglas; Moodie, David; Mauchline, Iain; Conner, Steve; Johnstone, Walter; Culshaw, Brian

2005-06-01

Optical fibre communications has proved to be one of the key application areas, which created, and ultimately propelled the global growth of the photonics industry over the last twenty years. Consequently the teaching of the principles of optical fibre communications has become integral to many university courses covering photonics technology. However to reinforce the fundamental principles and key technical issues students examine in their lecture courses and to develop their experimental skills, it is critical that the students also obtain hands-on practical experience of photonics components, instruments and systems in an associated teaching laboratory. In recognition of this need OptoSci, in collaboration with university academics, commercially developed a fibre optic communications based educational package (ED-COM). This educator kit enables students to; investigate the characteristics of the individual communications system components (sources, transmitters, fibre, receiver), examine and interpret the overall system performance limitations imposed by attenuation and dispersion, conduct system design and performance analysis. To further enhance the experimental programme examined in the fibre optic communications kit, an extension module to ED-COM has recently been introduced examining one of the most significant performance parameters of digital communications systems, the bit error rate (BER). This add-on module, BER(COM), enables students to generate, evaluate and investigate signal quality trends by examining eye patterns, and explore the bit-rate limitations imposed on communication systems by noise, attenuation and dispersion. This paper will examine the educational objectives, background theory, and typical results for these educator kits, with particular emphasis on BER(COM).

Purely Functional Compressed Bit Vectors with Applications and Implementations

OpenAIRE

Kaasinen, Joel

2011-01-01

The study of compressed data structures strives to represent information on a computer concisely — using as little space as possible. Compressed bit vectors are the simplest compressed data structure. They are used as a basis for more complex data structures with applications in, for example, computational biology. Functional programming is a programming paradigm that represents computation using functions without side-effects (such as mutation). Data structures that are representable in...

Patient empowerment and involvement in telemedicine

DEFF Research Database (Denmark)

Konge Nielsen, Marie; Johannessen, Helle

2018-01-01

Basic ideas of empowerment and user involvement in relation to telemedicine are presented, as is a case implying user resistance to telemedicine. Four logics of empowerment are employed to identify the underlying rationale of specific cases of telemedicine. The article concludes, that although...... telemedicine is acknowledged as relevant, the approach to it is often too mechanical to imply empowerment of the patient. Some patient groups may not feel safe by using telemedicine, and user involvement and empowerment will not be possible....

The use of telemedicine in Italian Blood Banks: a nationwide survey.

Science.gov (United States)

Berti, Pierluigi; Verlicchi, Franco; Fiorin, Francesco; Guaschino, Roberto; Cangemi, Adelio

2014-01-01

Telemedicine is defined as the use of electronic information and communication technologies to provide health care between distant people. Many activities in transfusion medicine could benefit from the application of telemedicine. To map the spread of the use of telemedicine in transfusion medicine in Italy, the Italian Society of Transfusion Medicine and Immunohaematology (SIMTI) performed a nationwide survey: the results are presented in this paper. A survey, dealing with different aspects of the use of telemedicine, was performed by sending a questionnaire to 280 Italian Blood Centres. The survey was designed to evaluate the diffusion of telemedicine and the features of the systems, with special attention to the systems' safety and legal adequacy. One section of the questionnaire was designed to identify the features of the systems considered essential by the respondents. Out of 280 Blood Services contacted, 196 (70%) filled in at least one of the questions of the online questionnaire. Globally the use of some form of telemedicine was reported by 70% of the respondents. Telemedicine is used for remote validation of laboratory tests by 32% of the Centres that responded, for remote biological validation of blood units by 34% and for assignment of blood components by 29%. Less frequently, telemedicine is used to control electronic refrigerators, for electronic blood requests and for bed-side identification of patients. The use of telemedicine is widespread in Italian Blood Services. There appears to be some heterogeneity between structures with regards to the evaluation of the systems' safety and their legal adequacy. No telemedicine system should be introduced into practice until it has proven to have the same standards of safety as the corresponding "on site" activity.

Telemedicine - a scientometric and density equalizing analysis.

Science.gov (United States)

Groneberg, David A; Rahimian, Shaghayegh; Bundschuh, Matthias; Schwarzer, Mario; Gerber, Alexander; Kloft, Beatrix

2015-01-01

As a result of the various telemedicine projects in the past years a large number of studies were recently published in this field. However, a precise bibliometric analysis of telemedicine publications does not exist so far. The present study was conducted to establish a data base of the existing approaches. Density-equalizing algorithms were used and data was retrieved from the Thomson Reuters database Web of Science. During the period from 1900 to 2006 a number of 3290 filed items were connected to telemedicine, with the first being published in 1964. The studies originate from 101 countries, with the USA, Great Britain and Canada being the most productive suppliers participating in 56.08 % of all published items. Analyzing the average citation per item for countries with more than 10 publications, Ireland ranked first (10.19/item), New Zealand ranked second (9.5/item) followed by Finland (9.04/item). The citation rate can be assumed as an indicator for research quality. The ten most productive journals include three journals with the main focus telemedicine and another five with the main focus "Information/Informatics". In all subject categories examined for published items related to telemedicine, "Health Care Sciences & Services" ranked first by far. More than 36 % of all publications are assigned to this category, followed by "Medical Informatics" with 9.72 % and "Medicine, General & Internal" with 8.84 % of all publications. In summary it can be concluded that the data shows clearly a strong increase in research productivity. Using science citation analysis it can be assumed that there is a large rise in the interest in telemedicine studies.

Adoption of telemedicine in Scottish remote and rural general practices: a qualitative study.

Science.gov (United States)

King, Gerry; Richards, Helen; Godden, David

2007-01-01

We conducted a qualitative interview study to explore the factors that have facilitated and prevented the adoption of telemedicine in general practice in remote and rural Scotland. Face-to-face interviews were carried out with general practitioners (GPs) and practice nurses in 26 of Scotland's most remote practices and five of the seven most rural health boards. The interview study found that GPs were more positive about the use of computers and telemedicine than nurses. Although electronic access to simple data, such as laboratory results, had become widely accepted, most respondents had very little experience of more sophisticated telemedicine applications, such as videoconferencing. There was widespread scepticism about the potential usefulness of clinical applications of telemedicine, although it was perceived to have potential benefit in facilitating access to educational resources. A number of barriers to the adoption of telemedicine were reported, including concerns that videoconferencing could diminish the quality of communication in educational and clinical settings, and that telemedicine would not fit easily with the organizational routines of the practices. Policy-makers should prioritize strategies to develop educational programmes, as these are more likely to succeed than clinical initiatives. It may then follow that clinicians will see opportunities for use in their clinical work.

Testing a top-down strategy for establishing a sustainable telemedicine program in a developing country: the Arizona telemedicine program-US Army-Republic of Panama Initiative.

Science.gov (United States)

Vega, Silvio; Marciscano, Ivette; Holcomb, Michael; Erps, Kristine A; Major, Janet; Lopez, Ana Maria; Barker, Gail P; Weinstein, Ronald S

2013-10-01

Many developing countries have shown interest in embracing telemedicine and incorporating it into their healthcare systems. In 2000, the U.S. Army Yuma Proving Ground (YPG) initiated a program to assist the Republic of Panama in establishing a demonstration Panamanian rural telemedicine program. YPG engaged the Arizona Telemedicine Program (ATP) to participate in the development and implementation of the program. The ATP recommended adoption of a "top-down" strategy for creating the program. Early buy-in of the Panamanian Ministry of Health and academic leaders was regarded as critical to the achievement of long-term success. High-level meetings with the Minister of Health and the Rectors (i.e., Presidents) of the national universities gained early program support. A telemedicine demonstration project was established on a mountainous Indian reservation 230 miles west of Panama City. Today, three rural telemedicine clinics are linked to a regional Ministry of Health hospital for teleconsultations. Real-time bidirectional videoconferencing utilizes videophones connected over Internet protocol networks at a data rate of 768 kilobits per second to the San Felix Hospital. Telepediatrics, tele-obstetrics, telepulmonology, teledermatology, and tele-emergency medicine services became available. Telemedicine services were provided to the three sites for a total of 1,013 cases, with numbers of cases increasing each year. These three demonstration sites remained in operation after discontinuation of the U.S. involvement in September 2009 and serve as a model program for other telemedicine initiatives in Panama. Access to the assets of a partner-nation was invaluable in the establishment of the first model telemedicine demonstration program in Panama. After 3 years, the Panamanian Telemedicine and Telehealth Program (PTTP) became self-sufficient. The successful achievement of sustainability of the PTTP after disengagement by the United States fits the Latifi-Weinstein model

Two-dimensional optoelectronic interconnect-processor and its operational bit error rate

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Liu, J. Jiang; Gollsneider, Brian; Chang, Wayne H.; Carhart, Gary W.; Vorontsov, Mikhail A.; Simonis, George J.; Shoop, Barry L.

2004-10-01

Two-dimensional (2-D) multi-channel 8x8 optical interconnect and processor system were designed and developed using complementary metal-oxide-semiconductor (CMOS) driven 850-nm vertical-cavity surface-emitting laser (VCSEL) arrays and the photodetector (PD) arrays with corresponding wavelengths. We performed operation and bit-error-rate (BER) analysis on this free-space integrated 8x8 VCSEL optical interconnects driven by silicon-on-sapphire (SOS) circuits. Pseudo-random bit stream (PRBS) data sequence was used in operation of the interconnects. Eye diagrams were measured from individual channels and analyzed using a digital oscilloscope at data rates from 155 Mb/s to 1.5 Gb/s. Using a statistical model of Gaussian distribution for the random noise in the transmission, we developed a method to compute the BER instantaneously with the digital eye-diagrams. Direct measurements on this interconnects were also taken on a standard BER tester for verification. We found that the results of two methods were in the same order and within 50% accuracy. The integrated interconnects were investigated in an optoelectronic processing architecture of digital halftoning image processor. Error diffusion networks implemented by the inherently parallel nature of photonics promise to provide high quality digital halftoned images.

Relevance of health level 7 clinical document architecture and integrating the healthcare enterprise cross-enterprise document sharing profile for managing chronic wounds in a telemedicine context.

Science.gov (United States)

Finet, Philippe; Gibaud, Bernard; Dameron, Olivier; Le Bouquin Jeannès, Régine

2016-03-01

The number of patients with complications associated with chronic diseases increases with the ageing population. In particular, complex chronic wounds raise the re-admission rate in hospitals. In this context, the implementation of a telemedicine application in Basse-Normandie, France, contributes to reduce hospital stays and transport. This application requires a new collaboration among general practitioners, private duty nurses and the hospital staff. However, the main constraint mentioned by the users of this system is the lack of interoperability between the information system of this application and various partners' information systems. To improve medical data exchanges, the authors propose a new implementation based on the introduction of interoperable clinical documents and a digital document repository for managing the sharing of the documents between the telemedicine application users. They then show that this technical solution is suitable for any telemedicine application and any document sharing system in a healthcare facility or network.

Principles of survey development for telemedicine applications.

Science.gov (United States)

Demiris, George

2006-01-01

Surveys can be used in the evaluation of telemedicine applications but they must be properly designed, consistent and accurate. The purpose of the survey and the resources available will determine the extent of testing that a survey instrument should undergo prior to its use. The validity of an instrument is the correspondence between what is being measured and what was intended to be measured. The reliability of an instrument describes the 'consistency' or 'repeatability' of the measurements made with it. Survey instruments should be designed and tested following basic principles of survey development. The actual survey administration also requires consideration, for example data collection and processing, as well as the interpretation of the findings. Surveys are of two different types. Either they are self-administered, or they are administered by interview. In the latter case, they may be administered by telephone or in a face-to-face meeting. It is important to design a survey instrument based on a detailed definition of what it intends to measure and to test it before administering it to the larger sample.

Bit rate maximization for multicast LP-OFDM systems in PLC context

OpenAIRE

Maiga , Ali; Baudais , Jean-Yves; Hélard , Jean-François

2009-01-01

ISBN: 978-88-900984-8-2.; International audience; In this paper, we propose a new resource allocation algorithm based on linear precoding technique for multicast OFDM systems. Linear precoding technique applied to OFDM systems has already proved its ability to significantly increase the system throughput in a powerline communication (PLC) context. Simulations through PLC channels show that this algorithm outperforms the classical multicast method (up to 7.3% bit rate gain) and gives better pe...

Value-chain analysis of a rural health program: toward understanding the cost benefit of telemedicine applications.

Science.gov (United States)

Gamble, John E; Savage, Grant T; Icenogle, Marjorie L

2004-01-01

While telemedicine's clinical effectiveness and educational benefits are accepted, its cost-effectiveness is controversial. This study focuses on telemedicine's cost-effectiveness from a provider's perspective. Reviews of the cost-effectiveness literature in telemedicine are critical of past studies' (a) methodological and analytical weaknesses; (b) focus on answering "Can we do this?" rather than "Should we do this?"; and (c) emphasis on patient benefits. Value chain analysis examines structural and executional cost drivers; a self-sustaining business model balances the cost and value associated with each telemedicine activity. We illustrate this analysis in a rural health program, examining teleradiography and telerehabilitation.

Modeling of Bit Error Rate in Cascaded 2R Regenerators

DEFF Research Database (Denmark)

Öhman, Filip; Mørk, Jesper

2006-01-01

and the regenerating nonlinearity is investigated. It is shown that an increase in nonlinearity can compensate for an increase in noise figure or decrease in signal power. Furthermore, the influence of the improvement in signal extinction ratio along the cascade and the importance of choosing the proper threshold......This paper presents a simple and efficient model for estimating the bit error rate in a cascade of optical 2R-regenerators. The model includes the influences of of amplifier noise, finite extinction ratio and nonlinear reshaping. The interplay between the different signal impairments...

Impact of telemedicine in hospital culture and its consequences on quality of care and safety

Science.gov (United States)

Steinman, Milton; Morbeck, Renata Albaladejo; Pires, Philippe Vieira; Abreu, Carlos Alberto Cordeiro; Andrade, Ana Helena Vicente; Terra, Jose Claudio Cyrineu; Teixeira, José Carlos; Kanamura, Alberto Hideki

2015-01-01

ABSTRACT Objective To describe the impact of the telemedicine application on the clinical process of care and its different effects on hospital culture and healthcare practice. Methods The concept of telemedicine through real time audio-visual coverage was implemented at two different hospitals in São Paulo: a secondary and public hospital, Hospital Municipal Dr. Moysés Deutsch, and a tertiary and private hospital, Hospital Israelita Albert Einstein. Results Data were obtained from 257 teleconsultations records over a 12-month period and were compared to a similar period before telemedicine implementation. For 18 patients (7.1%) telemedicine consultation influenced in diagnosis conclusion, and for 239 patients (92.9%), the consultation contributed to clinical management. After telemedicine implementation, stroke thrombolysis protocol was applied in 11% of ischemic stroke patients. Telemedicine approach reduced the need to transfer the patient to another hospital in 25.9% regarding neurological evaluation. Sepsis protocol were adopted and lead to a 30.4% reduction mortality regarding severe sepsis. Conclusion The application is associated with differences in the use of health services: emergency transfers, mortality, implementation of protocols and patient management decisions, especially regarding thrombolysis. These results highlight the role of telemedicine as a vector for transformation of hospital culture impacting on the safety and quality of care. PMID:26676268

A meta-analysis of telemedicine success in Africa

Directory of Open Access Journals (Sweden)

Dan S Wamala

2013-01-01

Full Text Available The use of information and communication technologies (ICT tools to improve the efficiency of professionalism at work is increasing every time under the dynamic digital environment. Tools such as telemedicine, tele-education, and health informatics have of late been incorporated in the health sector to enable easy access to essential services, for example, in medical areas from referral centers by the patients on one hand and enabling the doctor to doctor consultations for the benefit of patients. Unfortunately, observations indicate dearth efforts and commitment to optimize use of the tools in the majority of the countries south of the Sahara. Sub-Saharan Africa has been left almost behind the rest of the world in terms of development going through decades of economic exploitation by especially the west through its natural and human resources. These factors, ethnic conflicts and endless wars have continued to ruin sub-Saharan Africa′s socio-economic development. Information was obtained through a network of telemedicine practitioners in different African countries using internet communication, through E-mail and reviewing existing literature of their activities. This information was compiled from representative countries in each African region and the previous authors′experiences as telemedicine practioners. Most of these countries have inadequate ICT infrastructure, which yet creates sub-optimal application. Sub-Saharan Africa, made up of 33 of the 48 global poorest countries has to extend its ICT diffusion and policy to match the ever developing global economy. In some countries such as Ethiopia and South Africa there is significant progress in Telemedicine while in countries such as Burkina Faso and Nigeria the progress is slow because of lack of political support. Almost all reference to Africa is made in due respect to sub-Saharan Africa, one with big social, economic, and political problems with resultant high morbidity and mortality

A meta-analysis of telemedicine success in Africa.

Science.gov (United States)

Wamala, Dan S; Augustine, Kaddu

2013-01-01

The use of information and communication technologies (ICT) tools to improve the efficiency of professionalism at work is increasing every time under the dynamic digital environment. Tools such as telemedicine, tele-education, and health informatics have of late been incorporated in the health sector to enable easy access to essential services, for example, in medical areas from referral centers by the patients on one hand and enabling the doctor to doctor consultations for the benefit of patients. Unfortunately, observations indicate dearth efforts and commitment to optimize use of the tools in the majority of the countries south of the Sahara. Sub-Saharan Africa has been left almost behind the rest of the world in terms of development going through decades of economic exploitation by especially the west through its natural and human resources. These factors, ethnic conflicts and endless wars have continued to ruin sub-Saharan Africa's socio-economic development. Information was obtained through a network of telemedicine practitioners in different African countries using internet communication, through E-mail and reviewing existing literature of their activities. This information was compiled from representative countries in each African region and the previous authors'experiences as telemedicine practioners. Most of these countries have inadequate ICT infrastructure, which yet creates sub-optimal application. Sub-Saharan Africa, made up of 33 of the 48 global poorest countries has to extend its ICT diffusion and policy to match the ever developing global economy. In some countries such as Ethiopia and South Africa there is significant progress in Telemedicine while in countries such as Burkina Faso and Nigeria the progress is slow because of lack of political support. Almost all reference to Africa is made in due respect to sub-Saharan Africa, one with big social, economic, and political problems with resultant high morbidity and mortality rates. This also

Performance Analysis for Bit Error Rate of DS- CDMA Sensor Network Systems with Source Coding

Directory of Open Access Journals (Sweden)

Haider M. AlSabbagh

2012-03-01

Full Text Available The minimum energy (ME coding combined with DS-CDMA wireless sensor network is analyzed in order to reduce energy consumed and multiple access interference (MAI with related to number of user(receiver. Also, the minimum energy coding which exploits redundant bits for saving power with utilizing RF link and On-Off-Keying modulation. The relations are presented and discussed for several levels of errors expected in the employed channel via amount of bit error rates and amount of the SNR for number of users (receivers.

Supporting the developers of context-aware mobile telemedicine applications

NARCIS (Netherlands)

Broens, T.H.F.

2005-01-01

Telemedicine, which is defined as providing healthcare and sharing of medical knowledge over distance using telecommunication means, is a promising approach to improve and enhance the healthcare provisioning process. However, only recently, technology has evolved (i.e. miniaturization of high power

The business of telemedicine: strategy primer.

Science.gov (United States)

LeRouge, Cynthia; Tulu, Bengisu; Forducey, Pamela

2010-10-01

There is some tacit understanding that telemedicine can provide cost efficiency along with increased access and equality of care for the geographically disadvantaged. However, concrete strategic guidance for healthcare organizations to attain these benefits is fragmented and limited in existing literature. Telemedicine programs need to move from a grant-funded to a profit-centered status to sustain their existence. This article extends work presented at a recent American Telemedicine Association Business and Finance Special Interest Group course to provide a conceptual framework for strategic planning and for effectively implementing telemedicine programs. An expert panel of telemedicine coordinators provides insight and recommendations.

Designing Telemedicine Systems for Geriatric Patients: A Review of the Usability Studies.

Science.gov (United States)

Narasimha, Shraddhaa; Madathil, Kapil Chalil; Agnisarman, Sruthy; Rogers, Hunter; Welch, Brandon; Ashok, Aparna; Nair, Aswathi; McElligott, James

2017-06-01

One area where telemedicine may prove to be highly effective is in providing medical care to the geriatric population, an age group predicted to account for 20% of the population in the near future. However, even though telemedicine has certain advantages, the usability of these systems with this population merits investigation. This article reviews the literature published from 2000 to 2016 with the goal of analyzing the characteristics of usability-related studies conducted using geriatric participants and the subsequent usability challenges identified. Articles were found using Web of Knowledge and PubMed citation indexing portals using the keywords (1) Telemedicine* AND Geriatrics* (2) Telemedicine* AND Usability* (3) Telemedicine* AND Usability* AND Older Adults*. A total of 297 articles were obtained from the initial search. After further detailed screening, 16 articles were selected for review based on the inclusion criteria. Of these, 60% of the studies focused on the overall usability of telemedicine systems; 6.25% focused on the usability of a telepresence robot; 12.5% compared a face-to-face medical consultation with the use of telemedicine systems, and 25% focused on the study of other aspects of telemedicine in addition to its usability. Findings reported in the studies included high patient satisfaction with telemedicine in 31.25%, whereas another 31.25% indicated a high acceptance of this method of medical consultation. Care coordination in 6.25% of the studies; confidence in telemedicine in 6.25%; trust, privacy, and reliability in 6.25%; and increased convenience when compared to personal visits in 18.75% were also reported. This review suggests limited research providing scientifically valid and reproducible usability evaluation at various stages of telemedicine system development. Telemedicine system designers need to consider the age-related issues in cognition, perception, and behavior of geriatric patients while designing telemedicine

Non-adherence to telemedicine interventions for drug users: systematic review

Directory of Open Access Journals (Sweden)

Taís de Campos Moreira

2014-06-01

Full Text Available OBJECTIVE To estimate rates of non-adherence to telemedicine strategies aimed at treating drug addiction. METHODS A systematic review was conducted of randomized controlled trials investigating different telemedicine treatment methods for drug addiction. The following databases were consulted between May 18, 2012 and June 21, 2012: PubMed, PsycINFO, SciELO, Wiley (The Cochrane Library, Embase, Clinical trials and Google Scholar. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the quality of the studies. The criteria evaluated were: appropriate sequence of data generation, allocation concealment, blinding, description of losses and exclusions and analysis by intention to treat. There were 274 studies selected, of which 20 were analyzed. RESULTS Non-adherence rates varied between 15.0% and 70.0%. The interventions evaluated were of at least three months duration and, although they all used telemedicine as support, treatment methods differed. Regarding the quality of the studies, the values also varied from very poor to high quality. High quality studies showed better adherence rates, as did those using more than one technique of intervention and a limited treatment time. Mono-user studies showed better adherence rates than poly-user studies. CONCLUSIONS Rates of non-adherence to treatment involving telemedicine on the part of users of psycho-active substances differed considerably, depending on the country, the intervention method, follow-up time and substances used. Using more than one technique of intervention, short duration of treatment and the type of substance used by patients appear to facilitate adherence.

Artificial Intelligence Base Telemedicine Robotic

OpenAIRE

Hakika, Kisti; TS, Hendra Yunianto; Afriyanti, Liza

2009-01-01

Telemedicine atau pelayanan kesehatan jarak jauh bukan hal yang baru lagi dalam dunia kesehatan.Penggunaan teknologi sangat membantu dalam mengimplementasikan telemedicine. Namun perkembangantelemedicine mengalami kemajuan seiring dengan perkembangan teknologi informasi. Salah satu perkembanganteknologi adalah robot. Secara umum kegunaan robot adalah untuk menggantikan tugas manusia. Padamakalah ini, akan dibuat simulasi telemedicine berupa konsultasi antara dokter dan pasien menggunakansebua...

Technical Developments and Clinical Use of Telemedicine in Sleep Medicine

Directory of Open Access Journals (Sweden)

Marie Bruyneel

2016-12-01

Full Text Available The use of assistive technology and telemedicine is likely to continue to shape our medical practice in the future, notably in the field of sleep medicine, especially within developed countries. Currently, the number of people suffering from obstructive sleep apnea syndrome (OSAS is increasing. Telemedicine (TM can be used in a variety of ways in sleep medicine: telediagnostics, teleconsultation, teletherapy and telemonitoring of patients being treated with positive pressure devices. In this review, we aim to summarize the recent scientific progresses of these techniques and their potential clinical applications and give consideration to the remaining problems related to TM application.

The Research Agenda in ICU Telemedicine

Science.gov (United States)

Hill, Nicholas S.; Lilly, Craig M.; Angus, Derek C.; Jacobi, Judith; Rubenfeld, Gordon D.; Rothschild, Jeffrey M.; Sales, Anne E.; Scales, Damon C.; Mathers, James A. L.

2011-01-01

ICU telemedicine uses audiovisual conferencing technology to provide critical care from a remote location. Research is needed to best define the optimal use of ICU telemedicine, but efforts are hindered by methodological challenges and the lack of an organized delivery approach. We convened an interdisciplinary working group to develop a research agenda in ICU telemedicine, addressing both methodological and knowledge gaps in the field. To best inform clinical decision-making and health policy, future research should be organized around a conceptual framework that enables consistent descriptions of both the study setting and the telemedicine intervention. The framework should include standardized methods for assessing the preimplementation ICU environment and describing the telemedicine program. This framework will facilitate comparisons across studies and improve generalizability by permitting context-specific interpretation. Research based on this framework should consider the multidisciplinary nature of ICU care and describe the specific program goals. Key topic areas to be addressed include the effect of ICU telemedicine on the structure, process, and outcome of critical care delivery. Ideally, future research should attempt to address causation instead of simply associations and elucidate the mechanism of action in order to determine exactly how ICU telemedicine achieves its effects. ICU telemedicine has significant potential to improve critical care delivery, but high-quality research is needed to best inform its use. We propose an agenda to advance the science of ICU telemedicine and generate research with the greatest potential to improve patient care. PMID:21729894

Goal setting using telemedicine in rural underserved older adults with diabetes: experiences from the informatics for diabetes education and telemedicine project.

Science.gov (United States)

West, Susan P; Lagua, Carina; Trief, Paula M; Izquierdo, Roberto; Weinstock, Ruth S

2010-05-01

To describe the use of telemedicine for setting goals for behavior change and examine the success in achieving these goals in rural underserved older adults with diabetes. Medicare beneficiaries with diabetes living in rural upstate New York who were enrolled in the telemedicine intervention of the Informatics for Diabetes Education and Telemedicine (IDEATel) project (n = 610) participated in home televisits with nurse and dietitian educators every 4-6 weeks for 2-6 years. Behavior change goals related to nutrition, physical activity, monitoring, diabetes health maintenance, and/or use of the home telemedicine unit were established at the conclusion of each televisit and assessed at the next visit. Collaborative goal setting was employed during 18,355 televisits (mean of 33 goal-setting televisits/participant). The most common goals were related to monitoring, followed by diabetes health maintenance, nutrition, exercise, and use of the telemedicine equipment. Overall, 68% of behavioral goals were rated as "improved" or "met." The greatest success was achieved for goals related to proper insulin injection technique and daily foot care. These elderly participants had the most difficulty achieving goals related to use of the computer. No gender differences in goal achievement were observed. Televisits can be successfully used to collaboratively establish behavior change goals to help improve diabetes self-management in underserved elderly rural adults.

Use break-even analysis to optimize bit runs

International Nuclear Information System (INIS)

Kelly, J. Jr.

1992-01-01

Applying a technique known as break-even analysis during the bit selection process enables the operator to more definitively estimate drilling costs. The break-even chart can be used in a variety of ways to evaluate bit and operating parameter alternatives. Frequent application of this technique significantly improves the user's understanding of drilling economics and their ability to plan more effective drilling programs. This paper reports on several examples of drilling cost estimates obtained through application of the break-even analysis, which determines the bit performance required to match established drilling cost records in similar applications. It is especially helpful when new bit features are being considered for the first time. Two common examples with today's rolling cutter bits are changes from steel teeth to tungsten carbide inserts (TCI) and O-ring to metal bearing seals

Current Landscape of Telemedicine Practice in Inflammatory Bowel Disease.

Science.gov (United States)

Patil, Seema A; Cross, Raymond K

2018-04-28

Inflammatory bowel disease (IBD), comprised of Crohn's disease and ulcerative colitis, affects 1.6 million people in the United States. Although effective medical treatments exist to treat the disease, outcomes are still suboptimal. The reasons for poor outcomes vary but include nonadherence to therapy, inadequate monitoring of patients, limited access to IBD specialty care, concurrent psychiatric disease, limited patient knowledge of the disease and treatments, and patient provider discordance. Telemedicine is a candidate intervention that can be used to improve patient outcomes through more frequent monitoring, patient self-management, delivery of education (patient and provider), and to increase access to multidisciplinary IBD care. Telemedicine includes remote monitoring, telehealth, teleconsultation, and teleconferencing.Telemedicine systems have been used in patients with IBD with widespread patient acceptance of the technology. However, early clinical trials demonstrated high attrition rates among intervention patients. In general, use of telemedicine systems have been associated with improved quality of life, improved patient knowledge, and decreased utilization of health care resources. Early studies evaluating telehealth visits report high patient satisfaction, decreased indirect costs to patients, and no decrease in quality of care delivered.Due to widespread access to computers and smart phones among patients, telemedicine will continue to expand in the care of patients with IBD. To optimize use and effectiveness of telemedicine, barriers for use including concerns over increased liability, need for informed consent, licensure restrictions to providing interstate telehealth visits, and cybersecurity need to be addressed.

Application of Telemedicine Technologies to Long Term Spaceflight Support

Science.gov (United States)

Orlov, O. I.; Grigoriev, A. I.

projects on space biology and medicine at the modern high level. In spite of the ISS international cooperation transparency space research programs require to follow the biomedicine ethics and provide confidentiality of the special medical information exchange. That can be achieved in the telemedicine support system built on the network principle. Presently we have all technical facilities needed to create such a system. In Russia activities on space telemedicicine support improvement are carried out by the State Scientific Center of the Russian Federation - Institute for Biomedical Problems of the Russian Academy of Sciences, Mission Control Center of the Russian Aviation and Space Agency, Space Biomedical Center for Training and Research and Yu. Gagarin Cosmonaut Training Center. Communications development and next generation Internet systems creation almost eliminate differences in the types of information technologies implementation both in the earth-based and near-earth space conditions. In prospect of the information community creation the telecommunication system of the near-earth space objects and its telemedicine element will become a natural part of the Earth unified information field that will open unlimited perspectives for flight support system improvement and space biomedical research conducting. Russia has unique data of numerous investigations on simulation of long, up to a year, effects of space flight factors on the human body. The sphere of situations studied by space medicine specialists embraced orbit manned space flights of the escalating duration (438 days in 1995). However a number of biomedical problems related to space flights didn't face optimal solutions. It's evident that during a space flight to Mars biomedical problems will be much more difficult in comparison with those of the orbit flights of the same duration. The summed up factors of such flights specify a level of the total medical risk that require assessment and application of

Experimental confirmation and physical understanding of ultra-high bit rate impulse radio in the THz digital communication channels of the atmosphere

Science.gov (United States)

Mandehgar, Mahboubeh; Yang, Yihong; Grischkowsky, D.

2014-09-01

We have performed highly accurate numerical calculations of high bit rate impulse propagation through the seven digital communication channels of the atmosphere at RH 58% (10 g m-3). These calculations maximized bit rates for pathlengths equal to or longer than 100 m. We have experimentally verified our calculations for three channels with a propagation pathlength of 137 m and RH 65% (11.2 g m-3). Excellent agreement between measurement and theory was obtained for Channel 3 at 252 GHz, bit rate 84 Gb s-1, FWHM bandwidth (BW) 180 GHz; Channel 6 at 672 GHz, 45 Gb s-1, BW 84 GHz; and Channel 7 at 852 GHz, 56.8 Gb s-1, BW 108 GHz.

A review of telemedicine business models.

Science.gov (United States)

Chen, Shengnan; Cheng, Alice; Mehta, Khanjan

2013-04-01

Telemedicine has become an increasingly popular option for long-distance/virtual medical care and education, but many telemedicine ventures fail to grow beyond the initial pilot stage. Studying the business models of successful telemedicine ventures can help develop business strategies for upcoming ventures. This article describes business models of eight telemedicine ventures from different regions of the world using Osterwalder's "Business Model Canvas." The ventures are chosen on the basis of their apparent success and their diverse value chains. The business models are compared to draw inferences and lessons regarding their business strategy and contextual factors that influenced it. Key differences between telemedicine business practices in developing and developed countries are also discussed. The purpose of this article is to inform and inspire the business strategy of the next generation of telemedicine ventures to be economically sustainable and to successfully address local healthcare challenges.

Clinical outcomes resulting from telemedicine interventions: a systematic review

Directory of Open Access Journals (Sweden)

Kraemer Dale

2001-11-01

Full Text Available Abstract Background The use of telemedicine is growing, but its efficacy for achieving comparable or improved clinical outcomes has not been established in many medical specialties. The objective of this systematic review was to evaluate the efficacy of telemedicine interventions for health outcomes in two classes of application: home-based and office/hospital-based. Methods Data sources for the study included deports of studies from the MEDLINE, EMBASE, CINAHL, and HealthSTAR databases; searching of bibliographies of review and other articles; and consultation of printed resources as well as investigators in the field. We included studies that were relevant to at least one of the two classes of telemedicine and addressed the assessment of efficacy for clinical outcomes with data of reported results. We excluded studies where the service did not historically require face-to-face encounters (e.g., radiology or pathology diagnosis. All included articles were abstracted and graded for quality and direction of the evidence. Results A total of 25 articles met inclusion criteria and were assessed. The strongest evidence for the efficacy of telemedicine in clinical outcomes comes from home-based telemedicine in the areas of chronic disease management, hypertension, and AIDS. The value of home glucose monitoring in diabetes mellitus is conflicting. There is also reasonable evidence that telemedicine is comparable to face-to-face care in emergency medicine and is beneficial in surgical and neonatal intensive care units as well as patient transfer in neurosurgery. Conclusions Despite the widespread use of telemedicine in virtually all major areas of health care, evidence concerning the benefits of its use exists in only a small number of them. Further randomized controlled trials must be done to determine where its use is most effective.

Medical liability, safety and confidentiality in maritime telemedicine--the MERMAID position on issues of importance.

Science.gov (United States)

Ladas, P; Giatagatzidis, P; Anogianakis, G; Maglavera, S

1997-01-01

Telemedicine dates to the days of "wireless telegraphy". As an "extraordinary" arrangement for medical services delivered at time of need, telemedicine has thus far escaped the developments that have taken place over the last 50 years in the areas of medical liability, safety and confidentiality. Today, however, telemedicine is also used to increase quality and cost effectiveness of healthcare provision. This trend is set by the U.S. where the U.S. federal government funds telemedicine at an annual rate of more than $100 million i.e., at a rate 30 times or more than what the EU does while state and local agency support and private business investment in telemedicine is 3 to 4 times larger than that of the U.S. federal government. In this respect it must be stressed that technology tends to satisfy the relevant demand for telecommunications. Telemedicine is used in diverse areas such as pathology, surgery, physical therapy, and psychiatry. It is expected to revolutionise health care in the coming decade and, therefore, it will certainly take into account requirements for medical liability, safety and confidentiality in the same way as traditional "establishment" medicine does.

A telemedicine system for wireless home healthcare based on Bluetooth and the Internet.

Science.gov (United States)

Zhao, Xiaoming; Fei, Ding-Yu; Doarn, Charles R; Harnett, Brett; Merrell, Ronald

2004-01-01

The VitalPoll Telemedicine System (VTS) was designed and developed for wireless home healthcare. The aims of this study were: to design the architecture and communication methods for a telemedicine system; to implement a physiologic routing hub to collect data from different medical devices and sensors; and to evaluate the feasibility of this system for applications in wireless home healthcare. The VTS was built using Bluetooth wireless and Internet technologies with client/server architecture. Several medical devices, which acquire vital signs, such as real-time electrocardiogram signals, heart rate, body temperature, and activity (physical motion), were integrated into the VTS. Medical information and data were transmitted over short-range interface (USB, RS232), wireless communication, and the Internet. The medical results were stored in a database and presented using a web browser. The patient's vital signals can be collected, transmitted, and displayed in real time by the VTS. The experiments verified no data loss during Bluetooth and Internet communication. Bluetooth and the Internet provide enough bandwidth channels to tranmit these vital signs. The experimental results show that VTS may be suitable for a practical telemedicine system in home healthcare.

Feasibility of AmbulanCe-Based Telemedicine (FACT study: safety, feasibility and reliability of third generation in-ambulance telemedicine.

Directory of Open Access Journals (Sweden)

Laetitia Yperzeele

Full Text Available Telemedicine is currently mainly applied as an in-hospital service, but this technology also holds potential to improve emergency care in the prehospital arena. We report on the safety, feasibility and reliability of in-ambulance teleconsultation using a telemedicine system of the third generation.A routine ambulance was equipped with a system for real-time bidirectional audio-video communication, automated transmission of vital parameters, glycemia and electronic patient identification. All patients ( ≥ 18 years transported during emergency missions by a Prehospital Intervention Team of the Universitair Ziekenhuis Brussel were eligible for inclusion. To guarantee mobility and to facilitate 24/7 availability, the teleconsultants used lightweight laptop computers to access a dedicated telemedicine platform, which also provided functionalities for neurological assessment, electronic reporting and prehospital notification of the in-hospital team. Key registrations included any safety issue, mobile connectivity, communication of patient information, audiovisual quality, user-friendliness and accuracy of the prehospital diagnosis.Prehospital teleconsultation was obtained in 41 out of 43 cases (95.3%. The success rates for communication of blood pressure, heart rate, blood oxygen saturation, glycemia, and electronic patient identification were 78.7%, 84.8%, 80.6%, 64.0%, and 84.2%. A preliminary prehospital diagnosis was formulated in 90.2%, with satisfactory agreement with final in-hospital diagnoses. Communication of a prehospital report to the in-hospital team was successful in 94.7% and prenotification of the in-hospital team via SMS in 90.2%. Failures resulted mainly from limited mobile connectivity and to a lesser extent from software, hardware or human error. The user acceptance was high.Ambulance-based telemedicine of the third generation is safe, feasible and reliable but further research and development, especially with regard to high

A High Resolution Switched Capacitor 1bit Sigma-Delta Modulator for Low-Voltage/Low-Power Applications

DEFF Research Database (Denmark)

Furst, Claus Efdmann

1996-01-01

A high resolution 1bit Sigma-Delta modulator for low power/low voltage applications is presented. The modulator operates at a supply of 1-1.5V, the current drain is 0.1mA. The maximum resolution is 87dB equivalent to 14 bits of resolution. This is achieved with a signal-band of 5kHz, over-samplin...

American Telemedicine Association: 18th Annual International Meeting & Tradeshow

Directory of Open Access Journals (Sweden)

Benjamin Forstag

2012-12-01

Full Text Available For 18 years, the American Telemedicine Association (ATA Annual International Meeting & Exposition has been the premier forum for professionals in the telemedicine, telehealth and mHealth space -- one of the fastest growing meetings in the country. ATA 2013 is on course to be the largest ATA meeting ever, with over 6,000 projected attendees.  The program will include 500 educational sessions and posters, highlighting the latest innovations, applications and research in telemedicine. The 2013 exhibit hall will feature nearly 300 of the leading vendors in remote healthcare technologies. With over 6000 projected attendees, from all around the world, there's no better place to meet and network with your peers and thought leaders in the field. Detailed program information--including courses, sessions and CME information--will be available January 2013 at:http://www.americantelemed.org.

Experimental confirmation and physical understanding of ultra-high bit rate impulse radio in the THz digital communication channels of the atmosphere

International Nuclear Information System (INIS)

Mandehgar, Mahboubeh; Yang, Yihong; Grischkowsky, D

2014-01-01

We have performed highly accurate numerical calculations of high bit rate impulse propagation through the seven digital communication channels of the atmosphere at RH 58% (10 g m −3 ). These calculations maximized bit rates for pathlengths equal to or longer than 100 m. We have experimentally verified our calculations for three channels with a propagation pathlength of 137 m and RH 65% (11.2 g m −3 ). Excellent agreement between measurement and theory was obtained for Channel 3 at 252 GHz, bit rate 84 Gb s −1 , FWHM bandwidth (BW) 180 GHz; Channel 6 at 672 GHz, 45 Gb s −1 , BW 84 GHz; and Channel 7 at 852 GHz, 56.8 Gb s −1 , BW 108 GHz. (special issue article)

Reconfigurable Digital Coherent Receiver for Metro-Access Networks Supporting Mixed Modulation Formats and Bit-rates

DEFF Research Database (Denmark)

Caballero Jambrina, Antonio; Guerrero Gonzalez, Neil; Arlunno, Valeria

2013-01-01

A single, reconfigurable, digital coherent receiver is proposed and experimentally demonstrated for converged wireless and optical fiber transport. The capacity of reconstructing the full transmitted optical field allows for the demodulation of mixed modulation formats and bit-rates. We performed...

Efficacy of site-independent telemedicine in the STRokE DOC trial: a randomised, blinded, prospective study.

Science.gov (United States)

Meyer, Brett C; Raman, Rema; Hemmen, Thomas; Obler, Richard; Zivin, Justin A; Rao, Ramesh; Thomas, Ronald G; Lyden, Patrick D

2008-09-01

To increase the effective use of thrombolytics for acute stroke, the expertise of vascular neurologists must be disseminated more widely. We prospectively assessed whether telemedicine (real-time, two-way audio and video, and digital imaging and communications in medicine [DICOM] interpretation) or telephone was superior for decision making in acute telemedicine consultations. From January, 2004, to August, 2007, patients older than 18 years who presented with acute stroke symptoms at one of four remote spoke sites were randomly assigned, through a web-based, permuted blocks system, to telemedicine or telephone consultation to assess their suitability for treatment with thrombolytics, on the basis of standard criteria. The primary outcome measure was whether the decision to give thrombolytic treatment was correct, as determined by central adjudication. Secondary outcomes were the rate of thrombolytic use, 90-day functional outcomes (Barthel index [BI] and modified Rankin scale [mRS]), the incidence of intracerebral haemorrhages, and technical observations. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00283868. 234 patients were assessed prospectively. 111 patients were randomised to telemedicine, and 111 patients were randomised to telephone consultation; 207 completed the study. Mean National Institutes of Health stroke scale score at presentation was 9.5 (SD 8.1) points (11.4 [8.7] points in the telemedicine group versus 7.7 [7.0] points in the telephone group; p=0.002). One telemedicine consultation was aborted for technical reasons, although it was included in the analyses. Correct treatment decisions were made more often in the telemedicine group than in the telephone group (108 [98%] vs 91 [82%], odds ratio [OR] 10.9, 95% CI 2.7-44.6; p=0.0009). Intravenous thrombolytics were used at an overall rate of 25% (31 [28%] telemedicine vs 25 [23%] telephone, 1.3, 0.7-2.5; p=0.43). 90-day functional outcomes were not

Participatory design methods in telemedicine research

DEFF Research Database (Denmark)

Danbjørg, Dorthe Boe; Clemensen, Jane; Rothmann, Mette Juel

together with the patients. Participatory design is a research design and methodology that encourages the participation of users in the design process of technological solutions. Therefore, it has a potential for designing technologies that actually reflect the needs of the users, why it is relevant within...... telemedicine. The aim of this presentation is to explain the process and theoretical framework of a PD project; give an example of a project including the applied methods, and to determine its application to telemedicine with focus on the rationale for genuine participation. Theory: Participation implies....... Methods: Key activities of a Participatory Design project comprise methods such as fieldwork; literature reviewing; development and testing, and user activities as workshops. Methods that support telling, making, enacting. For instance telling activities as drivers for participation, where practitioners...

A 9-Bit 50 MSPS Quadrature Parallel Pipeline ADC for Communication Receiver Application

Science.gov (United States)

Roy, Sounak; Banerjee, Swapna

2018-03-01

This paper presents the design and implementation of a pipeline Analog-to-Digital Converter (ADC) for superheterodyne receiver application. Several enhancement techniques have been applied in implementing the ADC, in order to relax the target specifications of its building blocks. The concepts of time interleaving and double sampling have been used simultaneously to enhance the sampling speed and to reduce the number of amplifiers used in the ADC. Removal of a front end sample-and-hold amplifier is possible by employing dynamic comparators with switched capacitor based comparison of input signal and reference voltage. Each module of the ADC comprises two 2.5-bit stages followed by two 1.5-bit stages and a 3-bit flash stage. Four such pipeline ADC modules are time interleaved using two pairs of non-overlapping clock signals. These two pairs of clock signals are in phase quadrature with each other. Hence the term quadrature parallel pipeline ADC has been used. These configurations ensure that the entire ADC contains only eight operational-trans-conductance amplifiers. The ADC is implemented in a 0.18-μm CMOS process and supply voltage of 1.8 V. The proto-type is tested at sampling frequencies of 50 and 75 MSPS producing an Effective Number of Bits (ENOB) of 6.86- and 6.11-bits respectively. At peak sampling speed, the core ADC consumes only 65 mW of power.

Eleven years of experience with low-bandwidth telemedicine in a nurse-led rural clinic in Scotland.

Science.gov (United States)

Harvey, Sylvia; Peterkin, Gordon; Wootton, Richard

2010-01-01

A pilot trial of telemedicine in primary care began in the village of Letham in 1998. The service provided conventional consultations with the district nurse, plus teleconsultations with a general practitioner (GP) at the health centre in Forfar, a few km away. In the first year, the videoconferencing link was used by 14 patients, all aged over 65 years. The telemedicine service was judged to be successful and subsequently expanded to patients of any age. It was used for a wide range of health matters, including postnatal care, mental health problems, physical ailments, receiving test results and discussions with the doctor. During the 11-year study period, a total of 646 teleconsultations were conducted, a median rate of 65 per year. A qualitative evaluation of the service was conducted in 1999. Although the GPs involved expressed some reservations about the limited video quality, all three user groups were positive about the service. Nonetheless, the telemedicine service was not adopted as a routine method of health-care delivery by the NHS. To enable any telemedicine application to move from the pilot trial stage to routine service requires several things to happen at an organisational and contractual level. Ultimately an organizational decision about adoption is required, followed by appropriate mechanisms to enable diffusion.

Synchronization of random bit generators based on coupled chaotic lasers and application to cryptography.

Science.gov (United States)

Kanter, Ido; Butkovski, Maria; Peleg, Yitzhak; Zigzag, Meital; Aviad, Yaara; Reidler, Igor; Rosenbluh, Michael; Kinzel, Wolfgang

2010-08-16

Random bit generators (RBGs) constitute an important tool in cryptography, stochastic simulations and secure communications. The later in particular has some difficult requirements: high generation rate of unpredictable bit strings and secure key-exchange protocols over public channels. Deterministic algorithms generate pseudo-random number sequences at high rates, however, their unpredictability is limited by the very nature of their deterministic origin. Recently, physical RBGs based on chaotic semiconductor lasers were shown to exceed Gbit/s rates. Whether secure synchronization of two high rate physical RBGs is possible remains an open question. Here we propose a method, whereby two fast RBGs based on mutually coupled chaotic lasers, are synchronized. Using information theoretic analysis we demonstrate security against a powerful computational eavesdropper, capable of noiseless amplification, where all parameters are publicly known. The method is also extended to secure synchronization of a small network of three RBGs.

Pulse shaping for all-optical signal processing of ultra-high bit rate serial data signals

DEFF Research Database (Denmark)

Palushani, Evarist

The following thesis concerns pulse shaping and optical waveform manipulation for all-optical signal processing of ultra-high bit rate serial data signals, including generation of optical pulses in the femtosecond regime, serial-to-parallel conversion and terabaud coherent optical time division...

Telemedicine Consultations in Oral and Maxillofacial Surgery: A Follow-Up Study.

Science.gov (United States)

Wood, Eric W; Strauss, Robert A; Janus, Charles; Carrico, Caroline K

2016-02-01

The purpose of this study was to follow up on the previous study in evaluating the efficiency and reliability of telemedicine consultations for preoperative assessment of patients. A retrospective study of 335 patients over a 6-year period was performed to evaluate success rates of telemedicine consultations in adequately assessing patients for surgical treatment under anesthesia. Success or failure of the telemedicine consultation was measured by the ability to triage patients appropriately for the hospital operating room versus the clinic, to provide an accurate diagnosis and treatment plan, and to provide a sufficient medical and physical assessment for planned anesthesia. Data gathered from the average distance traveled and data from a previous telemedicine study performed by the National Institute of Justice were used to estimate the cost savings of using telemedicine consultations over the 6-year period. Practitioners performing the consultation were successful 92.2% of the time in using the data collected to make a diagnosis and treatment plan. Patients were triaged correctly 99.6% of the time for the clinic or hospital operating room. Most patients (98.0%) were given sufficient medical and physical assessment and were able to undergo surgery with anesthesia as planned at the clinic appointment immediately after telemedicine consultation. Most patients (95.9%) were given an accurate diagnosis and treatment plan. The estimated amount saved by providing consultation by telemedicine and eliminating in-office consultation was substantial at $134,640. This study confirms the findings from previous studies that telemedicine consultations are as reliable as those performed by traditional methods. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Making the business case for telemedicine: an interactive spreadsheet.

Science.gov (United States)

McCue, Michael J; Palsbo, Susan E

2006-04-01

The objective of this study was to demonstrate the business case for telemedicine in nonrural areas. We developed an interactive spreadsheet to conduct multiple financial analyses under different capital investment, revenue, and expense scenarios. We applied the spreadsheet to the specific case of poststroke rehabilitation in urban settings. The setting involved outpatient clinics associated with a freestanding rehabilitation hospital in Oklahoma. Our baseline scenario used historical financial data from face-to-face encounters as the baseline for payer and volume mix. We assumed a cost of capital of 10% to finance the project. The outcome measures were financial breakeven points and internal rate of return. A total of 340 telemedicine visits will generate a positive net cash flow each year. The project is expected to recoup the initial investment by the fourth year, produce a positive present value dollar return of more than $2,000, and earn rate of return of 20%, which exceeds the hospital's cost of capital. The business case is demonstrated for this scenario. Urban telemedicine programs can be financially self-sustaining without accounting for reductions in travel time by providers or patients. Urban telemedicine programs can be a sound business investment and not depend on grants or subsidies for start-up funding. There are several key decision points that affect breakeven points and return on investment. The best business strategy is to approach the decision as whether or not to build a new clinic.

Early phase telemedicine requirements elicitation in collaboration with medical practitioners

NARCIS (Netherlands)

Larburu Rubio, Nekane; Widya, I.A.; Bults, Richard G.A.; Hermens, Hermanus J.; Napolitano, Carlo

2013-01-01

Ubiquity of Information and Communication Technology enables innovative telemedicine treatment applications for disease management of ambulant patients. Development of new treatment applications must comply with medical protocols and ‘way of working’ to obtain safety and efficacy evidence before

Telemedicine in a pediatric headache clinic: A prospective survey.

Science.gov (United States)

Qubty, William; Patniyot, Irene; Gelfand, Amy

2018-05-08

The aim of this prospective study was to survey our patients about their experience with our clinic's telemedicine program to better understand telemedicine's utility for families, and to improve patient satisfaction and ultimately patient care. This was a prospective survey study of patients and their families who had a routine telemedicine follow-up visit with the University of California San Francisco Pediatric Headache Program. The survey was administered to patients and a parent(s) following their telemedicine visit. Fifty-one of 69 surveys (74%) were completed. All (51/51) patients and families thought that (1) telemedicine was more convenient compared to a clinic visit, (2) telemedicine caused less disruption of their daily routine, and (3) they would choose to do telemedicine again. The mean round-trip travel time from home to clinic was 6.8 hours (SD ± 8.6 hours). All participants thought telemedicine was more cost-effective than a clinic visit. Parents estimated that participating in a telemedicine visit instead of a clinic appointment saved them on average $486. This prospective, pediatric headache telemedicine study shows that telemedicine is convenient, perceived to be cost-effective, and patient-centered. Providing the option of telemedicine for routine pediatric headache follow-up visits results in high patient and family satisfaction. © 2018 American Academy of Neurology.

Application of morphological bit planes in retinal blood vessel extraction.

Science.gov (United States)

Fraz, M M; Basit, A; Barman, S A

2013-04-01

The appearance of the retinal blood vessels is an important diagnostic indicator of various clinical disorders of the eye and the body. Retinal blood vessels have been shown to provide evidence in terms of change in diameter, branching angles, or tortuosity, as a result of ophthalmic disease. This paper reports the development for an automated method for segmentation of blood vessels in retinal images. A unique combination of methods for retinal blood vessel skeleton detection and multidirectional morphological bit plane slicing is presented to extract the blood vessels from the color retinal images. The skeleton of main vessels is extracted by the application of directional differential operators and then evaluation of combination of derivative signs and average derivative values. Mathematical morphology has been materialized as a proficient technique for quantifying the retinal vasculature in ocular fundus images. A multidirectional top-hat operator with rotating structuring elements is used to emphasize the vessels in a particular direction, and information is extracted using bit plane slicing. An iterative region growing method is applied to integrate the main skeleton and the images resulting from bit plane slicing of vessel direction-dependent morphological filters. The approach is tested on two publicly available databases DRIVE and STARE. Average accuracy achieved by the proposed method is 0.9423 for both the databases with significant values of sensitivity and specificity also; the algorithm outperforms the second human observer in terms of precision of segmented vessel tree.

Digital echocardiography and telemedicine applications in pediatric cardiology.

Science.gov (United States)

Sable, Craig

2002-01-01

Digital echocardiography offers several advantages over videotape, including easy review, comparison, storage, postprocessing, and sharing of studies, quantitative analysis, and superior resolution. Newer echocardiography systems can write digital data to computer hardware, whereas older systems require digitization of analog data. Clinical and digital data compression is required to reduce study size. Clinical compression has been validated in several adult studies and one pediatric study. JPEG and MPEG digital compression ratios of 26:1 and 200:1, respectively, approximate S-videotape quality. JPEG is the DICOM 3.0 standard and is ideal for short loops, serial comparisons, and quantitative analysis. MPEG (the motion picture standard) lends itself to digitization of video streams and may be more attractive to pediatric cardiologists. Options for data storage and transfer range from limited local review to multiple offline review stations linked by a wide-area network. Telemedicine expands the capabilities of digital echocardiography in a "store and forward" or "real-time" format. Real-time neonatal telecardiology is accurate, impacts patient care, is cost-effective, and does not increase utilization. Cost, increased reliance on sonographers' skills, lack of accepted standards, and legal, licensure, and billing issues are obstacles to widespread acceptance of digital echocardiography and telemedicine.

Telemedicine Provides Non-Inferior Research Informed Consent for Remote Study Enrollment: A Randomized Controlled Trial

Science.gov (United States)

Bobb, Morgan R.; Van Heukelom, Paul G.; Faine, Brett A.; Ahmed, Azeemuddin; Messerly, Jeffrey T.; Bell, Gregory; Harland, Karisa K.; Simon, Christian; Mohr, Nicholas M.

2016-01-01

Objective Telemedicine networks are beginning to provide an avenue for conducting emergency medicine research, but using telemedicine to recruit participants for clinical trials has not been validated. The goal of this consent study is to determine whether patient comprehension of telemedicine-enabled research informed consent is non-inferior to standard face-to-face research informed consent. Methods A prospective, open-label randomized controlled trial was performed in a 60,000-visit Midwestern academic Emergency Department (ED) to test whether telemedicine-enabled research informed consent provided non-inferior comprehension compared with standard consent. This study was conducted as part of a parent clinical trial evaluating the effectiveness of oral chlorhexidine gluconate 0.12% in preventing hospital-acquired pneumonia among adult ED patients with expected hospital admission. Prior to being recruited into the study, potential participants were randomized in a 1:1 allocation ratio to consent by telemedicine versus standard face-to-face consent. Telemedicine connectivity was provided using a commercially available interface (REACH platform, Vidyo Inc., Hackensack, NJ) to an emergency physician located in another part of the ED. Comprehension of research consent (primary outcome) was measured using the modified Quality of Informed Consent (QuIC) instrument, a validated tool for measuring research informed consent comprehension. Parent trial accrual rate and qualitative survey data were secondary outcomes. Results One-hundred thirty-one patients were randomized (n = 64, telemedicine), and 101 QuIC surveys were completed. Comprehension of research informed consent using telemedicine was not inferior to face-to-face consent (QuIC scores 74.4 ± 8.1 vs. 74.4 ± 6.9 on a 100-point scale, p = 0.999). Subjective understanding of consent (p=0.194) and parent trial study accrual rates (56% vs. 69%, p = 0.142) were similar. Conclusion Telemedicine is non-inferior to face

A cost-effectiveness analysis of shipboard telemedicine.

Science.gov (United States)

Stoloff, P H; Garcia, F E; Thomason, J E; Shia, D S

1998-01-01

The U.S. Navy is considering the installation of telemedicine equipment on more than 300 ships. Besides improving the quality of care, benefits would arise from avoiding medical evacuations (MEDEVACs) and returning patients to work more quickly. Because telemedicine has not yet been fully implemented by the Navy, we relied on projections of anticipated savings and costs, rather than actual expenditures, to determine cost-effectiveness. To determine the demand for telemedicine and the cost-effectiveness of various technologies (telephone and fax, e-mail and Internet, video teleconferencing (VTC), teleradiology, and diagnostic instruments), as well as their bandwidth requirements. A panel of Navy medical experts with telemedicine experience reviewed a representative sample of patient visits collected over a 1-year period and estimated the man-day savings and quality-of-care enhancements that might have occurred had telemedicine technologies been available. The savings from potentially avoiding MEDEVACs was estimated from a survey of ships' medical staff. These sample estimates were then projected to the medical workload of the entire fleet. Off-the-shelf telemedicine equipment prices were combined with installation, maintenance, training, and communication costs to obtain the lifecycle costs of the technology. If telemedicine were available to the fleet, ship medical staffs would initiate nearly 19, 000 consults in a year-7% of all patient visits. Telemedicine would enhance quality of care in two-thirds of these consults. Seventeen percent of the MEDEVACs would be preventable with telemedicine (representing 155,000 travel miles), with a savings of $4400 per MEDEVAC. If the ship's communication capabilities were available, e-mail and Internet and telephone and fax would be cost-effective on all ships (including small ships and submarines). Video teleconferencing would be cost-effective on large ships (aircraft carriers and amphibious) only. Teleradiology would be cost

International telemedicine consultations for neurodevelopmental disabilities.

Science.gov (United States)

Pearl, Phillip L; Sable, Craig; Evans, Sarah; Knight, Joseph; Cunningham, Parker; Lotrecchiano, Gaetano R; Gropman, Andrea; Stuart, Sheela; Glass, Penny; Conway, Anne; Ramadan, Issam; Paiva, Tania; Batshaw, Mark L; Packer, Roger J

2014-06-01

A telemedicine program was developed between the Children's National Medical Center (CNMC) in Washington, DC, and the Sheikh Khalifa Bin Zayed Foundation in the United Arab Emirates (UAE). A needs assessment and a curriculum of on-site training conferences were devised preparatory to an ongoing telemedicine consultation program for children with neurodevelopmental disabilities in the underserved eastern region of the UAE. Weekly telemedicine consultations are provided by a multidisciplinary faculty. Patients are presented in the UAE with their therapists and families. Real-time (video over Internet protocol; average connection, 768 kilobits/s) telemedicine conferences are held weekly following previews of medical records. A full consultation report follows each telemedicine session. Between February 29, 2012 and June 26, 2013, 48 weekly 1-h live interactive telemedicine consultations were conducted on 48 patients (28 males, 20 females; age range, 8 months-22 years; median age, 5.4 years). The primary diagnoses were cerebral palsy, neurogenetic disorders, autism, neuromuscular disorders, congenital anomalies, global developmental delay, systemic disease, and epilepsy. Common comorbidities were cognitive impairment, communication disorders, and behavioral disorders. Specific recommendations included imaging and DNA studies, antiseizure management, spasticity management including botulinum toxin protocols, and specific therapy modalities including taping techniques, customized body vests, and speech/language and behavioral therapy. Improved outcomes reported were in clinician satisfaction, achievement of therapy goals for patients, and requests for ongoing sessions. Weekly telemedicine sessions coupled with triannual training conferences were successfully implemented in a clinical program dedicated to patients with neurodevelopmental disabilities by the Center for Neuroscience at CNMC and the UAE government. International consultations in neurodevelopmental

Telemedicine in education: bridging the gap.

Science.gov (United States)

O'Shea, Jesse; Berger, Ryan; Samra, Cynthia; Van Durme, Daniel

2015-01-01

The increasing cost and inequitable access to quality healthcare, coupled with the merger of the information technology and health service sectors, has given rise to the modern field of telemedicine. Telemedicine, meaning medicine at a distance, allows us to transcend geographic and socioeconomic boundaries to deliver high quality care to remote and/or in-need patients. As technology becomes more affordable and a physician shortage looms, telemedicine is gaining attention as a possible solution to healthcare delivery. Simultaneously, telemedicine holds great promise with regard to medical education. Several studies integrating telemedicine in medical education have shown positive outcomes, demonstrating similar or greater efficacy compared with traditional educational methods with high student-reported enthusiasm. Other domestic and international telemedicine projects, largely spearheaded by universities, have also achieved great success. In a novel approach, by pairing medical schools with in-need partner communities, utilizing similar faculty resources as traditional learning methods with standardized patients, students can gain valuable experience and skills while serving actual patients. This progressive approach to medical education fosters collaboration, communication, longitudinal care and teaches students needed skills for their future practices as 21 st Century healthcare providers.

FPGA-based Bit-Error-Rate Tester for SEU-hardened Optical Links

CERN Document Server

Detraz, S; Moreira, P; Papadopoulos, S; Papakonstantinou, I; Seif El Nasr, S; Sigaud, C; Soos, C; Stejskal, P; Troska, J; Versmissen, H

2009-01-01

The next generation of optical links for future High-Energy Physics experiments will require components qualified for use in radiation-hard environments. To cope with radiation induced single-event upsets, the physical layer protocol will include Forward Error Correction (FEC). Bit-Error-Rate (BER) testing is a widely used method to characterize digital transmission systems. In order to measure the BER with and without the proposed FEC, simultaneously on several devices, a multi-channel BER tester has been developed. This paper describes the architecture of the tester, its implementation in a Xilinx Virtex-5 FPGA device and discusses the experimental results.

Towards technical interoperability in telemedicine.

Energy Technology Data Exchange (ETDEWEB)

Craft, Richard Layne, II

2004-05-01

For telemedicine to realize the vision of anywhere, anytime access to care, the question of how to create a fully interoperable technical infrastructure must be addressed. After briefly discussing how 'technical interoperability' compares with other types of interoperability being addressed in the telemedicine community today, this paper describes reasons for pursuing technical interoperability, presents a proposed framework for realizing technical interoperability, identifies key issues that will need to be addressed if technical interoperability is to be achieved, and suggests a course of action that the telemedicine community might follow to accomplish this goal.

Investigation of PDC bit failure base on stick-slip vibration analysis of drilling string system plus drill bit

Science.gov (United States)

Huang, Zhiqiang; Xie, Dou; Xie, Bing; Zhang, Wenlin; Zhang, Fuxiao; He, Lei

2018-03-01

The undesired stick-slip vibration is the main source of PDC bit failure, such as tooth fracture and tooth loss. So, the study of PDC bit failure base on stick-slip vibration analysis is crucial to prolonging the service life of PDC bit and improving ROP (rate of penetration). For this purpose, a piecewise-smooth torsional model with 4-DOF (degree of freedom) of drilling string system plus PDC bit is proposed to simulate non-impact drilling. In this model, both the friction and cutting behaviors of PDC bit are innovatively introduced. The results reveal that PDC bit is easier to fail than other drilling tools due to the severer stick-slip vibration. Moreover, reducing WOB (weight on bit) and improving driving torque can effectively mitigate the stick-slip vibration of PDC bit. Therefore, PDC bit failure can be alleviated by optimizing drilling parameters. In addition, a new 4-DOF torsional model is established to simulate torsional impact drilling and the effect of torsional impact on PDC bit's stick-slip vibration is analyzed by use of an engineering example. It can be concluded that torsional impact can mitigate stick-slip vibration, prolonging the service life of PDC bit and improving drilling efficiency, which is consistent with the field experiment results.

Clinical Telemedicine Utilization in Ontario over the Ontario Telemedicine Network.

Science.gov (United States)

O'Gorman, Laurel D; Hogenbirk, John C; Warry, Wayne

2016-06-01

Northern Ontario is a region in Canada with approximately 775,000 people in communities scattered across 803,000 km(2). The Ontario Telemedicine Network (OTN) facilitates access to medical care in areas that are often underserved. We assessed how OTN utilization differed throughout the province. We used OTN medical service utilization data collected through the Ontario Health Insurance Plan and provided by the Ministry of Health and Long Term Care. Using census subdivisions grouped by Northern and Southern Ontario as well as urban and rural areas, we calculated utilization rates per fiscal year and total from 2008/2009 to 2013/2014. We also used billing codes to calculate utilization by therapeutic area of care. There were 652,337 OTN patient visits in Ontario from 2008/2009 to 2013/2014. Median annual utilization rates per 1,000 people were higher in northern areas (rural, 52.0; urban, 32.1) than in southern areas (rural, 6.1; urban, 3.1). The majority of usage in Ontario was in mental health and addictions (61.8%). Utilization in other areas of care such as surgery, oncology, and internal medicine was highest in the rural north, whereas primary care use was highest in the urban south. Utilization was higher and therapeutic areas of care were more diverse in rural Northern Ontario than in other parts of the province. Utilization was also higher in urban Northern Ontario than in Southern Ontario. This suggests that telemedicine is being used to improve access to medical care services, especially in sparsely populated regions of the province.

A role for telemedicine in Mali | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

When Bagayoko chose telemedicine as the focus for his doctoral thesis, he knew it ... and new medical applications for information and communication technologies. While in Switzerland, Bagayoko came across mobile technology used for ski ...

FastBit: Interactively Searching Massive Data

Energy Technology Data Exchange (ETDEWEB)

Wu, Kesheng; Ahern, Sean; Bethel, E. Wes; Chen, Jacqueline; Childs, Hank; Cormier-Michel, Estelle; Geddes, Cameron; Gu, Junmin; Hagen, Hans; Hamann, Bernd; Koegler, Wendy; Lauret, Jerome; Meredith, Jeremy; Messmer, Peter; Otoo, Ekow; Perevoztchikov, Victor; Poskanzer, Arthur; Prabhat,; Rubel, Oliver; Shoshani, Arie; Sim, Alexander; Stockinger, Kurt; Weber, Gunther; Zhang, Wei-Ming

2009-06-23

As scientific instruments and computer simulations produce more and more data, the task of locating the essential information to gain insight becomes increasingly difficult. FastBit is an efficient software tool to address this challenge. In this article, we present a summary of the key underlying technologies, namely bitmap compression, encoding, and binning. Together these techniques enable FastBit to answer structured (SQL) queries orders of magnitude faster than popular database systems. To illustrate how FastBit is used in applications, we present three examples involving a high-energy physics experiment, a combustion simulation, and an accelerator simulation. In each case, FastBit significantly reduces the response time and enables interactive exploration on terabytes of data.

Parent Participation in Pediatric Intensive Care Unit Rounds via Telemedicine: Feasibility and Impact.

Science.gov (United States)

Yager, Phoebe H; Clark, Maureen; Cummings, Brian M; Noviski, Natan

2017-06-01

To evaluate feasibility and impact of telemedicine for remote parent participation in pediatric intensive care unit (PICU) rounds when parents are unable to be present at their child's bedside. Parents of patients admitted to a 14-bed PICU were approached, and those unable to attend rounds were eligible subjects. Nurse and physician caregivers were also surveyed. Parents received an iPad (Apple Inc, Cupertino, California) with an application enabling audio-video connectivity with the care team. At a predetermined time for bedside rounds with the PICU team, parents entered a virtual meeting room to participate. Following each telemedicine encounter, participants (parent, physician, nurse) completed a brief survey rating satisfaction (0?=?not satisfied, 10?=?completely satisfied) and disruption (0?=?no disruption at all, 10?=?very disruptive). A total of 153 surveys were completed following 51 telemedicine encounters involving 13 patients. Parents of enrolled patients cited work demands (62%), care for other dependents (46%), and transportation difficulties (31%) as reasons for study participation. The median levels of satisfaction and disruption were 10 (range 5-10) and 0 (range 0-5), respectively. All parents reported that telemedicine encounters had a positive effect on their level of reassurance regarding their child's care and improved communication with the care team. This proof-of-concept study indicates that remote parent participation in PICU rounds is feasible, enhances parent-provider communication, and offers parents reassurance. Providers reported a high level of satisfaction with minimal disruption. Technological advancements to streamline teleconferencing workflow are needed to ensure program sustainability. Copyright © 2017. Published by Elsevier Inc.

Design of a low power 10 bit 300 ksps multi-channel SAR ADC for wireless sensor network applications

International Nuclear Information System (INIS)

Hong Hui; Li Shiliang; Zhou Tao

2015-01-01

This paper presents a low power 10 bit 300 ksps successive approximation register analog-to-digital converter (SAR ADC) which is applied in wireless sensor network (WSN) applications. A single ended energy-saving split capacitor DAC array and a latch comparator with a rail to rail input stage are utilized to implement the ADC, which can reduce power dissipation while expanding the full scale input range and improve the signal-to-noise ratio (SNR). For power optimization the supply voltage of the SAR ADC is designed to be as low as 2 V. Four analog input channels are designed which make the ADC more suitable for WSN applications. The prototype circuit is fabricated using 3.3 V, 0.35 μm 2P4M CMOS technology and occupies an active chip area of 1.23 mm 2 . The test results show that the power dissipation is only 200 μW at a 2 V power supply and a sampling rate of 166 ksps. The calculated SNR is 58.25 dB, the ENOB is 9.38 bit and the FOM is 4.95 pJ/conversion-step. (paper)

3.56-bits/cm Compact Inkjet Printed and Application Specific Chipless RFID Tag

KAUST Repository

Khan, Munawar M.

2015-10-26

© 2002-2011 IEEE. In this letter, a 28.5-bit chipless RFID tag, based on paper substrate and realized using inkjet printing technique is presented. Operating within ultrawideband, the tag occupies a compact size of 2 × 4 cm2. Focusing on applications requiring time and date identification, a novel encoding technique is presented that allows efficient frequency band allocation based on the number of required instances of time and date variables. A figure of merit (FOM) relating coding capacity and tag dimensions coined as code density is also introduced. A systematic design process followed by simulations and verified through measurements reveal a high code density of 3.56 bits/cm2 for the presented chipless tag.

Telemedicine is helping the parents of children with neurodevelopmental disorders living in remote and deprived areas.

Science.gov (United States)

Stuckey, Ruth; Domingues-Montanari, Sophie

2017-08-01

Telecommunication technologies are advancing rapidly with huge investment to improve infrastructure in rural areas. Telemedicine brings the benefits of telecommunication to healthcare, especially in resource-limited and remote communities. The recent literature on telemedicine in paediatrics will be reviewed, with particular focus on its application to help children with neurodevelopmental disorders and their families living in remote regions and/or low-income countries, and gaps identified for future research. Studies show that telemedicine can enable a family's access to appropriately qualified help that physically may only be available hundreds of miles away, helping to overcome geographic barriers. Telemedicine can also train parents and equip them with the knowledge and skills to better care for their children. Despite some technological barriers to implementation, telemedicine can help transform all stages of autism treatment. However, more studies are required in low- and middle-income countries to fully elucidate the benefits offered by telemedicine to autistic children and their families.

Adoption of routine telemedicine in Norway: the current picture

Science.gov (United States)

Zanaboni, Paolo; Knarvik, Undine; Wootton, Richard

2014-01-01

Background Telemedicine appears to be ready for wider adoption. Although existing research evidence is useful, the adoption of routine telemedicine in healthcare systems has been slow. Objective We conducted a study to explore the current use of routine telemedicine in Norway, at national, regional, and local levels, to provide objective and up-to-date information and to estimate the potential for wider adoption of telemedicine. Design A top-down approach was used to collect official data on the national use of telemedicine from the Norwegian Patient Register. A bottom-up approach was used to collect complementary information on the routine use of telemedicine through a survey conducted at the five largest publicly funded hospitals. Results Results show that routine telemedicine has been adopted in all health regions in Norway and in 68% of hospitals. Despite being widely adopted, the current level of use of telemedicine is low compared to the number of face-to-face visits. Examples of routine telemedicine can be found in several clinical specialties. Most services connect different hospitals in secondary care, and they are mostly delivered as teleconsultations via videoconference. Conclusions Routine telemedicine in Norway has been widely adopted, probably for geographical reasons, as in other settings. However, the level of use of telemedicine in Norway is rather low, and it has significant potential for further development as an alternative to face-to-face outpatient visits. This study is a first attempt to map routine telemedicine at regional, institutional, and clinical levels, and it provides useful information to understand the adoption of telemedicine in routine healthcare and to measure change in future updates. PMID:24433942

Mapping telemedicine efforts: surveying regional initiatives in Denmark.

Science.gov (United States)

Kierkegaard, Patrick

2015-05-01

The aim of this study is to survey telemedicine services currently in operation across Denmark. The study specifically seeks to answer the following questions: What initiatives are deployed within the different regions? What are the motivations behind the projects? What technologies are being utilized? What medical disciplines are being supported using telemedicine systems? All data were surveyed from the Telemedicinsk Landkort, a newly created database designed to provide a comprehensive and systematic overview of all telemedicine technologies in Denmark. The results of this study suggest that a growing numbers of telemedicine initiatives are currently in operation across Denmark but that considerable variations exist in terms of regional efforts as the number of operational telemedicine projects varied from region to region. The results of this study provide a timely picture of the factors that are shaping the telemedicine landscape of Denmark and suggest potential strategies to help policymakers increase and improve national telemedicine deployment.

Toward a More Usable Home-Based Video Telemedicine System: A Heuristic Evaluation of the Clinician User Interfaces of Home-Based Video Telemedicine Systems.

Science.gov (United States)

Agnisarman, Sruthy; Narasimha, Shraddhaa; Chalil Madathil, Kapil; Welch, Brandon; Brinda, Fnu; Ashok, Aparna; McElligott, James

2017-04-24

Telemedicine is the use of technology to provide and support health care when distance separates the clinical service and the patient. Home-based telemedicine systems involve the use of such technology for medical support and care connecting the patient from the comfort of their homes with the clinician. In order for such a system to be used extensively, it is necessary to understand not only the issues faced by the patients in using them but also the clinician. The aim of this study was to conduct a heuristic evaluation of 4 telemedicine software platforms-Doxy.me, Polycom, Vidyo, and VSee-to assess possible problems and limitations that could affect the usability of the system from the clinician's perspective. It was found that 5 experts individually evaluated all four systems using Nielsen's list of heuristics, classifying the issues based on a severity rating scale. A total of 46 unique problems were identified by the experts. The heuristics most frequently violated were visibility of system status and Error prevention amounting to 24% (11/46 issues) each. Esthetic and minimalist design was second contributing to 13% (6/46 issues) of the total errors. Heuristic evaluation coupled with a severity rating scale was found to be an effective method for identifying problems with the systems. Prioritization of these problems based on the rating provides a good starting point for resolving the issues affecting these platforms. There is a need for better transparency and a more streamlined approach for how physicians use telemedicine systems. Visibility of the system status and speaking the users' language are keys for achieving this. ©Sruthy Agnisarman, Shraddhaa Narasimha, Kapil Chalil Madathil, Brandon Welch, FNU Brinda, Aparna Ashok, James McElligott. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 24.04.2017.

Linear transceiver design for nonorthogonal amplify-and-forward protocol using a bit error rate criterion

KAUST Repository

Ahmed, Qasim Zeeshan

2014-04-01

The ever growing demand of higher data rates can now be addressed by exploiting cooperative diversity. This form of diversity has become a fundamental technique for achieving spatial diversity by exploiting the presence of idle users in the network. This has led to new challenges in terms of designing new protocols and detectors for cooperative communications. Among various amplify-and-forward (AF) protocols, the half duplex non-orthogonal amplify-and-forward (NAF) protocol is superior to other AF schemes in terms of error performance and capacity. However, this superiority is achieved at the cost of higher receiver complexity. Furthermore, in order to exploit the full diversity of the system an optimal precoder is required. In this paper, an optimal joint linear transceiver is proposed for the NAF protocol. This transceiver operates on the principles of minimum bit error rate (BER), and is referred as joint bit error rate (JBER) detector. The BER performance of JBER detector is superior to all the proposed linear detectors such as channel inversion, the maximal ratio combining, the biased maximum likelihood detectors, and the minimum mean square error. The proposed transceiver also outperforms previous precoders designed for the NAF protocol. © 2002-2012 IEEE.

The Current State of Telemedicine in Urology.

Science.gov (United States)

Miller, Adam; Rhee, Eugene; Gettman, Matthew; Spitz, Aaron

2018-03-01

Telemedicine use in urology is an evolving practice. In this article, the authors review the early experience of telemedicine specifically as it relates to urologic practice and discuss the future implications and the utility of telemedicine as it applies to other fields. Copyright © 2017 Elsevier Inc. All rights reserved.

A Review of Telemedicine Services in Finland

DEFF Research Database (Denmark)

Khatri, Vikramajeet; Peterson, Carrie Beth; Kyriazakos, Sofoklis

2011-01-01

Telemedicine is gaining popularity due to the provision of ubiquitous health care services that is a fundamental need for every socialized society. In this paper, telemedicine services in Finland are discussed, as well as how they came into existence, how they are funded, evaluated, and what...... are their impacts on health care systems and society. Telemedicine services like teleradiology, telelaboratory, telepsychiatry and remote consultations, are being offered in all hospital districts. Primary health care centers in Finland are lacking telemedicine services, and are planning to have them. Electronic...

Bit-Grooming: Shave Your Bits with Razor-sharp Precision

Science.gov (United States)

Zender, C. S.; Silver, J.

2017-12-01

Lossless compression can reduce climate data storage by 30-40%. Further reduction requires lossy compression that also reduces precision. Fortunately, geoscientific models and measurements generate false precision (scientifically meaningless data bits) that can be eliminated without sacrificing scientifically meaningful data. We introduce Bit Grooming, a lossy compression algorithm that removes the bloat due to false-precision, those bits and bytes beyond the meaningful precision of the data.Bit Grooming is statistically unbiased, applies to all floating point numbers, and is easy to use. Bit-Grooming reduces geoscience data storage requirements by 40-80%. We compared Bit Grooming to competitors Linear Packing, Layer Packing, and GRIB2/JPEG2000. The other compression methods have the edge in terms of compression, but Bit Grooming is the most accurate and certainly the most usable and portable.Bit Grooming provides flexible and well-balanced solutions to the trade-offs among compression, accuracy, and usability required by lossy compression. Geoscientists could reduce their long term storage costs, and show leadership in the elimination of false precision, by adopting Bit Grooming.

A cohort study following up on a randomised controlled trial of a telemedicine application in COPD patients

DEFF Research Database (Denmark)

Dyrvig, Anne-Kirstine; Gerke, Oke; Kidholm, Kristian

2015-01-01

pulmonary disease (COPD) is no exception. METHODS: In this article, the effects of implementing a telemedicine intervention for COPD patients were analysed using data collected before, during, and after a randomised controlled trial (RCT).More specifically, regression techniques using robust variance...... estimators were used to analyse whether the use of telemedicine, patient age, and gender could explain the risk of readmission, length of hospital admission, and death during a five-year observation period. RESULTS: Increased risk of readmission was significantly related to both use of telemedicine...... and increased age in three sub-periods of the study, whereas women showed a more pronounced risk of readmission than men only during and after the RCT period. The number of days admitted to hospital was higher for patients using telemedicine and being of older age. Risk of death during the observation period...

Economic Evaluation of Telemedicine for Patients in ICUs.

Science.gov (United States)

Yoo, Byung-Kwang; Kim, Minchul; Sasaki, Tomoko; Melnikow, Joy; Marcin, James P

2016-02-01

Despite telemedicine's potential to improve patients' health outcomes and reduce costs in the ICU, hospitals have been slow to introduce telemedicine in the ICU due to high up-front costs and mixed evidence on effectiveness. This study's first aim was to conduct a cost-effectiveness analysis to estimate the incremental cost-effectiveness ratio of telemedicine in the ICU, compared with ICU without telemedicine, from the healthcare system perspective. The second aim was to examine potential cost saving of telemedicine in the ICU through probabilistic analyses and break-even analyses. Simulation analyses performed by standard decision models. Hypothetical ICU defined by the U.S. literature. Hypothetical adult patients in ICU defined by the U.S. literature. The intervention was the introduction of telemedicine in the ICU, which was assumed to affect per-patient per-hospital-stay ICU cost and hospital mortality. Telemedicine in the ICU operation costs included the telemedicine equipment-installation (start-up) costs with 5-year depreciation, maintenance costs, and clinician staffing costs. Telemedicine in the ICU effectiveness was measured by cumulative quality-adjusted life years for 5 years after ICU discharge. The base case cost-effectiveness analysis estimated telemedicine in the ICU to extend 0.011 quality-adjusted life years with an incremental cost of $516 per patient compared with ICU without telemedicine, resulting in an incremental cost-effectiveness ratio of $45,320 per additional quality-adjusted life year (= $516/0.011). The probabilistic cost-effectiveness analysis estimated an incremental cost-effectiveness ratio of $50,265 with a wide 95% CI from a negative value (suggesting cost savings) to $375,870. These probabilistic analyses projected that cost saving is achieved 37% of 1,000 iterations. Cost saving is also feasible if the per-patient per-hospital-stay operational cost and physician cost were less than $422 and less than $155, respectively, based on

Scaling up Telemedicine

DEFF Research Database (Denmark)

Christensen, Jannie Kristine Bang; Nielsen, Jeppe Agger; Gustafsson, Jeppe

through negotiating, mobilizing coalitions, and legitimacy building. To illustrate and further develop this conceptualization, we build on insights from a longitudinal case study (2008-2014) and provide a rich empirical account of how a Danish telemedicine pilot was transformed into a large......-scale telemedicine project through simultaneous translation and theorization efforts in a cross-sectorial, politicized social context. Although we focus on upscaling as a bottom up process (from pilot to large scale), we argue that translation and theorization, and associated political behavior occurs in a broader...

The principles of telemedicine in practice

Directory of Open Access Journals (Sweden)

Ilvana Vučković

2003-11-01

Full Text Available Telemedicine (distance medicine represents a field of medicine that has been in a tremendous expansion over the last couple of years thanks to the fast development of telecommunications and reduction of their costs. It enables a direct communication (visual between the peripheral hospitals and referral facilities in the interior of the country as well as a connection of centres with referral centres abroad in the fields of diagnostics, consultations or education. The main objective is to encourage interest in telemedicine among physicians and other health care experts, initiate an exchange of opinions, and experience about the application of telecommunication technology in medicine, so to reach a common perception of its role in the context of future development of the health care system in Bosnia and Herzegovina. As a standard, current equipment consists of computers, which are equipped with frame grabbers and communication modem for communication through a public telecommunication system. Input data can all be visual data (X-Ray, CT, MRI, ultrasound, ECG, histological finding, cariogram, and of course photos of the patients, of operational/surgical field. The Institute of Pathology of the Sarajevo Medical Faculty has actively participated in the experimental project “SHARED” (1996-2000 together with the Radiology and Ophthalmology Clinic of the Sarajevo Clinical Centre. The past experience in using telemedicine has shown that the introduction of such a telemedicine system in B&H would be of great significance in the future in the context of providing better and more efficient health services to the patients. In practice, that means a more simple approach to some services and data for patients, a better and faster circulation of information and experience of medical experts and health care workers with cost control at the same time. 

Designing Home-Based Telemedicine Systems for the Geriatric Population: An Empirical Study.

Science.gov (United States)

Narasimha, Shraddhaa; Agnisarman, Sruthy; Chalil Madathil, Kapil; Gramopadhye, Anand; McElligott, James T

2018-02-01

Background and Introduction: Telemedicine, the process of providing healthcare remotely using communication devices, has the potential to be useful for the geriatric population when specifically designed for this age group. This study explored the design of four video telemedicine systems currently available and outlined issues with these systems that impact usability among the geriatric population. Based on the results, design suggestions were developed to improve telemedicine systems for this population. Using a between-subjects experimental design, the study considered four telemedicine systems used in Medical University of South Carolina. The study was conducted at a local retirement home. The participant pool consisted of 40 adults, 60 years or older. The dependent measures used were the mean times for telemedicine session initiation and video session, mean number of errors, post-test satisfaction ratings, the NASA-Task Load Index (NASA-TLX) workload measures, and the IBM-Computer Systems Usability Questionnaire measures. Statistical significance was found among the telemedicine systems' initiation times. The analysis of the qualitative data revealed several issues, including lengthy e-mail content, icon placement, and chat box design, which affect the usability of these systems for the geriatric population. Human factor-based design modifications, including short, precise e-mail content, appropriately placed icons, and the inclusion of instructions, are recommended to address the issues found in the qualitative study.

Telemedicine: opportunities and risks

International Nuclear Information System (INIS)

Vogl, R.

2002-01-01

Problem. Due to the rapid progress in the fields of information technology and data networks, telemedicine applications are growing in number. Besides curative telemedicine, the electronic exchange of medical data and the integration of health information systems between health care providers is gaining importance. Through the improved accessibility of electronic patient record information, considerable risks arise.Methods. A project for the interconnection of medical picture archiving and communication systems (PACS) between several hospitals is presented and the possibilities for further developing such networking systems utilizing new software technologies for transparent data access between different locations (GRID) and for decision support (software agents) are considered.Results. The availability of the electronic patient record via the data network and the perspective of semi intelligent software systems automatically preparing the data bears great potential for a boost in treatment quality and efficiency. Systems for unique electronic patient identification and for secure digital signature are a prerequisite, but per se not enough to ensure the protection of data against illegitimate access.Conclusion. Despite quality and efficiency benefits, challenges in the protection of sensible data and in the change of the physicians role result. (orig.) [de

A bit-rate flexible and power efficient all-optical demultiplexer realised by monolithically integrated Michelson interferometer

DEFF Research Database (Denmark)

Vaa, Michael; Mikkelsen, Benny; Jepsen, Kim Stokholm

1996-01-01

A novel bit-rate flexible and very power efficient all-optical demultiplexer using differential optical control of a monolithically integrated Michelson interferometer with MQW SOAs is demonstrated at 40 to 10 Gbit/s. Gain switched DFB lasers provide ultra stable data and control signals....

Performance analysis for the bit-error rate of SAC-OCDMA systems

Science.gov (United States)

Feng, Gang; Cheng, Wenqing; Chen, Fujun

2015-09-01

Under low power, Gaussian statistics by invoking the central limit theorem is feasible to predict the upper bound in the spectral-amplitude-coding optical code division multiple access (SAC-OCDMA) system. However, this case severely underestimates the bit-error rate (BER) performance of the system under high power assumption. Fortunately, the exact negative binomial (NB) model is a perfect replacement for the Gaussian model in the prediction and evaluation. Based on NB statistics, a more accurate closed-form expression is analyzed and derived for the SAC-OCDMA system. The experiment shows that the obtained expression provides a more precise prediction of the BER performance under the low and high power assumptions.

Telemedicine in the Solomon Islands: 2006 to 2009.

Science.gov (United States)

Martiniuk, Alexandra; Negin, Joel; Hersch, Fred; Dalipanda, Tenneth; Jagilli, Rooney; Houasia, Patrick; Gorringe, Lilijana; Christie, Annie

2011-01-01

Telemedicine has been used in the Solomon Islands since 2000. We used quantitative and qualitative methods to examine telemedicine use in the Solomon Islands from January 2006 to June 2009. During the study period 66 telemedicine cases were submitted to the store and forward telemedicine system being used there. These included orthopaedic, oncology, cardiothoracic, infectious, congenital, gastroenterology and dermatology cases. Most cases (52%) were submitted by doctors at the National Referral Hospital (NRH) in Honiara. The majority of responses came from the NRH (27%). A final, firm recommendation regarding patient diagnosis and/or care was given for 46% of the cases. Interviews were conducted with 23 stakeholders in the Solomon Islands and in Australia to better understand the current and future use of telemedicine. The interviews identified the fragility of the Solomon Islands infrastructure, including the lack of training, as the largest barrier to the future use of telemedicine. The best use of telemedicine appears to be case sharing within the Solomon Islands, with connections to clinicians in other countries as a secondary benefit when particular expertise is required.

Crossing the Telemedicine Chasm: Have the U.S. Barriers to Widespread Adoption of Telemedicine Been Significantly Reduced?

Directory of Open Access Journals (Sweden)

Cynthia LeRouge

2013-11-01

Full Text Available Barriers have challenged widespread telemedicine adoption by health care organizations for 40 years. These barriers have been technological, financial, and legal and have also involved business strategy and human resources. The article canvasses recent trends—events and activities in each of these areas as well as US health reform activities that might help to break down these barriers. The key to telemedicine success in the future is to view it as an integral part of health care services and not as a stand-alone project. Telemedicine must move from experimental and separate to integrated and equivalent to other health services within health care organizations. Furthermore, telemedicine serves as vital connective tissue for expanding health care organization networks.

Telemedicine + OCT: toward design of optimized algorithms for high-quality compressed images

Science.gov (United States)

Mousavi, Mahta; Lurie, Kristen; Land, Julian; Javidi, Tara; Ellerbee, Audrey K.

2014-03-01

Telemedicine is an emerging technology that aims to provide clinical healthcare at a distance. Among its goals, the transfer of diagnostic images over telecommunication channels has been quite appealing to the medical community. When viewed as an adjunct to biomedical device hardware, one highly important consideration aside from the transfer rate and speed is the accuracy of the reconstructed image at the receiver end. Although optical coherence tomography (OCT) is an established imaging technique that is ripe for telemedicine, the effects of OCT data compression, which may be necessary on certain telemedicine platforms, have not received much attention in the literature. We investigate the performance and efficiency of several lossless and lossy compression techniques for OCT data and characterize their effectiveness with respect to achievable compression ratio, compression rate and preservation of image quality. We examine the effects of compression in the interferogram vs. A-scan domain as assessed with various objective and subjective metrics.

Telemedicine and European law.

Science.gov (United States)

Callens, Stefaan

2003-01-01

A Directive of the European Union was first published in 2000, which dealt with telemedicine as part of its provisions. This E-Commerce Directive, as it became known, was subjected to further study which revealed some problems relative to the practice of telemedicine. Among the subjects discussed in this paper are those of privacy, data protection, free movement of services, the impact of electronic communication and ethical issues.

VA Telemedicine: An Analysis of Cost and Time Savings.

Science.gov (United States)

Russo, Jack E; McCool, Ryan R; Davies, Louise

2016-03-01

The Veterans Affairs (VA) healthcare system provides beneficiary travel reimbursement ("travel pay") to qualifying patients for traveling to appointments. Travel pay is a large expense for the VA and hence the U.S. Government, projected to cost nearly $1 billion in 2015. Telemedicine in the VA system has the potential to save money by reducing patient travel and thus the amount of travel pay disbursed. In this study, we quantify this savings and also report trends in VA telemedicine volumes over time. All telemedicine visits based at the VA Hospital in White River Junction, VT between 2005 and 2013 were reviewed (5,695 visits). Travel distance and time saved as a result of telemedicine were calculated. Clinical volume in the mental health department, which has had the longest participation in telemedicine, was analyzed. Telemedicine resulted in an average travel savings of 145 miles and 142 min per visit. This led to an average travel payment savings of $18,555 per year. Telemedicine volume grew significantly over the study period such that by the final year the travel pay savings had increased to $63,804, or about 3.5% of the total travel pay disbursement for that year. The number of mental health telemedicine visits rose over the study period but remained small relative to the number of face-to-face visits. A higher proportion of telemedicine visits involved new patients. Telemedicine at the VA saves travel distance and time, although the reduction in travel payments remains modest at current telemedicine volumes.

Fast physical random bit generation with chaotic semiconductor lasers

Science.gov (United States)

Uchida, Atsushi; Amano, Kazuya; Inoue, Masaki; Hirano, Kunihito; Naito, Sunao; Someya, Hiroyuki; Oowada, Isao; Kurashige, Takayuki; Shiki, Masaru; Yoshimori, Shigeru; Yoshimura, Kazuyuki; Davis, Peter

2008-12-01

Random number generators in digital information systems make use of physical entropy sources such as electronic and photonic noise to add unpredictability to deterministically generated pseudo-random sequences. However, there is a large gap between the generation rates achieved with existing physical sources and the high data rates of many computation and communication systems; this is a fundamental weakness of these systems. Here we show that good quality random bit sequences can be generated at very fast bit rates using physical chaos in semiconductor lasers. Streams of bits that pass standard statistical tests for randomness have been generated at rates of up to 1.7 Gbps by sampling the fluctuating optical output of two chaotic lasers. This rate is an order of magnitude faster than that of previously reported devices for physical random bit generators with verified randomness. This means that the performance of random number generators can be greatly improved by using chaotic laser devices as physical entropy sources.

Sygeplejerskers arbejde med telemedicin i en tværsektoriel kontekst / Nurses working with Telemedicine in a cross-sectional setting

DEFF Research Database (Denmark)

Lunde, Anita; Drachmann, Astrid Lykke; Christiansen, Karin

2017-01-01

has to be meaningful and a flexible and technically reliable solution. The possession of technical skills and a personal in-terest in telemedicine are advantageous. More important, however, are high clinical skills and competences in caring relationships. Nurses from diverse clinical settings report......The introduction of telemedicine will transform the health care sector and bring changes to the role and function of nurses. In this inquiry we ask, what competences are required in the ‘doing’ of telemedicine? The project is based on interviews with two focus groups involving nurses from...... the primary and secondary sectors, working with telemedicine in a project entitled, Hor-sens på forkant med sundhed (Horsens on the frontiers of Health). The analysis is da-ta-driven and reveals that cultivation of competences is closely associated to structural conditions. Nurses emphasize that telemedicine...

WhatsApp: a telemedicine platform for facilitating remote oral medicine consultation and improving clinical examinations.

Science.gov (United States)

Petruzzi, Massimo; De Benedittis, Michele

2016-03-01

Increased use of smartphone and related software applications has created a new era in clinical data exchange among patients and clinicians. This study describes use of the smartphone-based application WhatsApp to share clinical oral medicine information. Clinical images and related questions were submitted by general dentists, physicians, dental hygienists, and patients to the authors via WhatsApp. For each submission, a clinical impression was made and categorized as traumatic, infective, neoplastic, autoimmune, or unclassified. Submissions were summarized by sender type, number of photographs per sender, and category of question. Patients were invited to undergo a clinical examination with biopsy, when indicated. The telemedicine impression was compared to the clinicopathologic diagnosis. Three hundred and thirty-nine images were received for 96 patients; 92 (95.8%) patients underwent clinicopathologic examination, and 45 (49%) received a biopsy. General dentists (62%) and dental hygienists (26%) were the most frequent senders. The most common question was related to diagnosis (56%). The telemedicine impression agreed with the clinicopathologic assessment for 82% of cases. Telemedicine applications, such as WhatsApp, can support communication about oral conditions among clinicians and patients. Telemedicine consultation reduced geographic barriers to initial clinical consultation and encouraged the significant majority of patients to pursue expert clinical examination. Copyright © 2016 Elsevier Inc. All rights reserved.

Engaging Elderly People in Telemedicine Through Gamification.

Science.gov (United States)

de Vette, Frederiek; Tabak, Monique; Dekker-van Weering, Marit; Vollenbroek-Hutten, Miriam

2015-12-18

Telemedicine can alleviate the increasing demand for elderly care caused by the rapidly aging population. However, user adherence to technology in telemedicine interventions is low and decreases over time. Therefore, there is a need for methods to increase adherence, specifically of the elderly user. A strategy that has recently emerged to address this problem is gamification. It is the application of game elements to nongame fields to motivate and increase user activity and retention. This research aims to (1) provide an overview of existing theoretical frameworks for gamification and explore methods that specifically target the elderly user and (2) explore user classification theories for tailoring game content to the elderly user. This knowledge will provide a foundation for creating a new framework for applying gamification in telemedicine applications to effectively engage the elderly user by increasing and maintaining adherence. We performed a broad Internet search using scientific and nonscientific search engines and included information that described either of the following subjects: the conceptualization of gamification, methods to engage elderly users through gamification, or user classification theories for tailored game content. Our search showed two main approaches concerning frameworks for gamification: from business practices, which mostly aim for more revenue, emerge an applied approach, while academia frameworks are developed incorporating theories on motivation while often aiming for lasting engagement. The search provided limited information regarding the application of gamification to engage elderly users, and a significant gap in knowledge on the effectiveness of a gamified application in practice. Several approaches for classifying users in general were found, based on archetypes and reasons to play, and we present them along with their corresponding taxonomies. The overview we created indicates great connectivity between these taxonomies

Team medicine in head injury. Usefulness of telemedicine in cooperation with medically depopulated areas

International Nuclear Information System (INIS)

Takazawa, Hiroki; Morita, Takahiro; Narisawa, Ayumi; Saito, Atsushi; Koyama, Shinya; Sasaki, Tatsuya; Nishijima, Michiharu

2011-01-01

Our hospital is located between Tsugaru and Shimokita Peninsulas that are wide medically depopulated areas. The depopulated Tsugaru District has only 2 neurosurgical units, and many patients have to be transferred from the district general hospitals. Since 1989, we have been using an image transfer system that is useful for accurately diagnosing patients with head injury. Between January 2005 and September 2010, 644 patients with head injury were admitted to our hospital. The patients who used and did not use telemedicine were 78 and 566, respectively. In both groups, the background (age, gender, and type of head injury), surgery rate, and time of entry into the operating room were analyzed. There were no significant differences in the age, gender, and type of head injuries between the 2 groups. The surgery rate was 25.6% (28 patients) in the telemedicine group and 12.4% (70 patients) in the direct admission group. The average amount of time between admission and entry into the operating room was 2 h and 13 min in the telemedicine group and 2 h and 57 min in the direct admission group. There were significant differences between the telemedicine and direct admission groups (p<0.05). These results suggest that telemedicine is useful in the treatment of patients with head injuries in a widely depopulated area. (author)

Crossing the Telemedicine Chasm: Have the U.S. Barriers to Widespread Adoption of Telemedicine Been Significantly Reduced? †

Science.gov (United States)

LeRouge, Cynthia; Garfield, Monica J.

2013-01-01

Barriers have challenged widespread telemedicine adoption by health care organizations for 40 years. These barriers have been technological, financial, and legal and have also involved business strategy and human resources. The article canvasses recent trends—events and activities in each of these areas as well as US health reform activities that might help to break down these barriers. The key to telemedicine success in the future is to view it as an integral part of health care services and not as a stand-alone project. Telemedicine must move from experimental and separate to integrated and equivalent to other health services within health care organizations. Furthermore, telemedicine serves as vital connective tissue for expanding health care organization networks. PMID:24287864

BetaBit: A fast generator of autocorrelated binary processes for geophysical research

Science.gov (United States)

Serinaldi, Francesco; Lombardo, Federico

2017-05-01

We introduce a fast and efficient non-iterative algorithm, called BetaBit, to simulate autocorrelated binary processes describing the occurrence of natural hazards, system failures, and other physical and geophysical phenomena characterized by persistence, temporal clustering, and low rate of occurrence. BetaBit overcomes the simulation constraints posed by the discrete nature of the marginal distributions of binary processes by using the link existing between the correlation coefficients of this process and those of the standard Gaussian processes. The performance of BetaBit is tested on binary signals with power-law and exponentially decaying autocorrelation functions (ACFs) corresponding to Hurst-Kolmogorov and Markov processes, respectively. An application to real-world sequences describing rainfall intermittency and the occurrence of strong positive phases of the North Atlantic Oscillation (NAO) index shows that BetaBit can also simulate surrogate data preserving the empirical ACF as well as signals with autoregressive moving average (ARMA) dependence structures. Extensions to cyclo-stationary processes accounting for seasonal fluctuations are also discussed.

e-health in eating disorders: Virtual Reality and telemedicine in assessment and treatment.

Science.gov (United States)

Riva, Giuseppe; Bacchetta, Monica; Cesa, Gianluca; Conti, Sara; Molinari, Enrico

2002-01-01

e-health, the integration of telehealth technologies with the Internet and shared virtual reality could become a significant enabler of consumer health initiatives. In fact, they provide an increasingly accessible communication channel for a growing part of the population. In the past decade medical applications of virtual reality (VR) and telemedicine have been rapidly developing, and the technology has changed from a research curiosity to a commercially and clinically important area of medical informatics technology. The chapter details the characteristics of the Experiential Cognitive Therapy (ECT), an integrated inpatient/outpatient (4 weeks) and telemedicine approach (24 weeks) that tries to enhance the classical cognitive-behavioral method used in the treatment of eating disorders, through VR sessions and telemedicine support in the follow-up stage. Particularly, using VR and telemedicine, ECT is able to address body experience disturbances, interpersonal relationships, self efficacy and motivation to change, key issues for the development and maintenance of eating disorders that are somehow neglected by actual clinical guidelines.

Telemedicine for Epilepsy Support in Resource-poor Settings

Directory of Open Access Journals (Sweden)

Victor ePatterson

2014-08-01

Full Text Available The ProblemEpilepsy is a common disease worldwide causing significant physical and social. disability. It is one of the most treatable neurological diseases. Yet in rural, poorer countries like much of India and Nepal most people with epilepsy are not on any treatment often because they cannot access doctors. Conventional ApproachesIt is being appreciated that perhaps doctors are not the solution and that enabling health workers to treat epilepsy may be better. Few details however have been put forward about how that might be achieved.Thinking differentlyUntreated epilepsy should be considered a public health problem like HIV/AIDS, the various steps needed for treatment identified and solutions found. Telemedicine ApproachesTelemedicine might contribute to two steps - diagnosis and review. A tool which enables non-doctors to diagnose episodes as epileptic has been developed as a mobile phone app and has good applicability, sensitivity and specificity for the diagnosis. There are a number of ways in which the use of phone review or SMS can improve management.ConclusionsTelemedicine, as part of a public health program, can potentially help the millions of people in the resource-poor world with untreated epilepsy.

Mobile Cloud Computing for Telemedicine Solutions

Directory of Open Access Journals (Sweden)

Mihaela GHEORGHE

2014-01-01

Full Text Available Mobile Cloud Computing is a significant technology which combines emerging domains such as mobile computing and cloud computing which has conducted to the development of one of the most IT industry challenging and innovative trend. This is still at the early stage of devel-opment but its main characteristics, advantages and range of services which are provided by an internet-based cluster system have a strong impact on the process of developing telemedi-cine solutions for overcoming the wide challenges the medical system is confronting with. Mo-bile Cloud integrates cloud computing into the mobile environment and has the advantage of overcoming obstacles related to performance (e.g. battery life, storage, and bandwidth, envi-ronment (e.g. heterogeneity, scalability, availability and security (e.g. reliability and privacy which are commonly present at mobile computing level. In this paper, I will present a compre-hensive overview on mobile cloud computing including definitions, services and the use of this technology for developing telemedicine application.

100G Flexible IM-DD 850 nm VCSEL Transceiver with Fractional Bit Rate Using Eight-Dimensional PAM

DEFF Research Database (Denmark)

Lu, Xiaofeng; Lyubopytov, Vladimir; Chorchos, Łukasz

2017-01-01

We demonstrate a novel optical transceiver scheme with a net flexible bit rate up to 100Gbit/s with 5 Gbit/s granularity, using an eight-dimensional modulation format family, and investigate its performance on capacity, reach, and power tolerance....

A software reconfigurable optical multiband UWB system utilizing a bit-loading combined with adaptive LDPC code rate scheme

Science.gov (United States)

He, Jing; Dai, Min; Chen, Qinghui; Deng, Rui; Xiang, Changqing; Chen, Lin

2017-07-01

In this paper, an effective bit-loading combined with adaptive LDPC code rate algorithm is proposed and investigated in software reconfigurable multiband UWB over fiber system. To compensate the power fading and chromatic dispersion for the high frequency of multiband OFDM UWB signal transmission over standard single mode fiber (SSMF), a Mach-Zehnder modulator (MZM) with negative chirp parameter is utilized. In addition, the negative power penalty of -1 dB for 128 QAM multiband OFDM UWB signal are measured at the hard-decision forward error correction (HD-FEC) limitation of 3.8 × 10-3 after 50 km SSMF transmission. The experimental results show that, compared to the fixed coding scheme with the code rate of 75%, the signal-to-noise (SNR) is improved by 2.79 dB for 128 QAM multiband OFDM UWB system after 100 km SSMF transmission using ALCR algorithm. Moreover, by employing bit-loading combined with ALCR algorithm, the bit error rate (BER) performance of system can be further promoted effectively. The simulation results present that, at the HD-FEC limitation, the value of Q factor is improved by 3.93 dB at the SNR of 19.5 dB over 100 km SSMF transmission, compared to the fixed modulation with uncoded scheme at the same spectrum efficiency (SE).

Modern methods of drilling wells by large diameter bits and possible fields of application

Energy Technology Data Exchange (ETDEWEB)

Arnold, W

1970-04-01

For the needs of up-to-date mining in construction of shafts and mining installations, large diameter wells are often used. In the near future, application of this type of well will be of great importance in the oil industry for stimulation of oil and gas recovery by atomic explosion. Such wells can be used for mineral extraction from subsea and other accessible deposits. The presented state of drilling techniques and technology by large diameter bits is described and similarities and differences with deep-well drilling are pointed out. Some economical data indicate the advantage of drilling by large-diameter bits in comparison with standard methods of construction of shafts and mining installations.

A 10-bit 100 MSamples/s BiCMOS D/A Converter

DEFF Research Database (Denmark)

Jørgensen, Ivan Herald Holger; Tunheim, Svein Anders

1997-01-01

This paper presents a 10-bit Digital-to-Analogue Converter (DAC) based on the current steering principle. The DAC is processed in a 0.8 micron BiCMOS process and is designed to operate at a sampling rate of 100MSamples/s. The DAC is intended for applications using direct digital synthesis...

Telemedicine Workplace Environments: Designing for Success

OpenAIRE

Elizabeth A. Krupinski

2014-01-01

When designing a facility for telemedicine, there are several things to consider from a human factors point of view, as well as from a practicality point of view. Although the future practice of telemedicine is likely to be more of a mobile-based practice and centered more in the home than it is now, it is still very important to consider ways to optimize the design of clinic-based telemedicine facilities. This is true on both ends of a consultation?where the patient is and where the consulta...

Comparison of Bit Error Rate of Line Codes in NG-PON2

Directory of Open Access Journals (Sweden)

Tomas Horvath

2016-05-01

Full Text Available This article focuses on simulation and comparison of line codes NRZ (Non Return to Zero, RZ (Return to Zero and Miller’s code for NG-PON2 (Next-Generation Passive Optical Network Stage 2 using. Our article provides solutions with Q-factor, BER (Bit Error Rate, and bandwidth comparison. Line codes are the most important part of communication over the optical fibre. The main role of these codes is digital signal representation. NG-PON2 networks use optical fibres for communication that is the reason why OptSim v5.2 is used for simulation.

Navy Telemedicine: Current Research and Future Directions

National Research Council Canada - National Science Library

Reed, Cheryl

2002-01-01

.... This report reviews military and civilian models for evaluating telemedicine systems in order to determine future directions for Navy telemedicine research within the current funding environment...

Quantitative 3-D imaging topogrammetry for telemedicine applications

Science.gov (United States)

Altschuler, Bruce R.

1994-01-01

The technology to reliably transmit high-resolution visual imagery over short to medium distances in real time has led to the serious considerations of the use of telemedicine, telepresence, and telerobotics in the delivery of health care. These concepts may involve, and evolve toward: consultation from remote expert teaching centers; diagnosis; triage; real-time remote advice to the surgeon; and real-time remote surgical instrument manipulation (telerobotics with virtual reality). Further extrapolation leads to teledesign and telereplication of spare surgical parts through quantitative teleimaging of 3-D surfaces tied to CAD/CAM devices and an artificially intelligent archival data base of 'normal' shapes. The ability to generate 'topogrames' or 3-D surface numerical tables of coordinate values capable of creating computer-generated virtual holographic-like displays, machine part replication, and statistical diagnostic shape assessment is critical to the progression of telemedicine. Any virtual reality simulation will remain in 'video-game' realm until realistic dimensional and spatial relational inputs from real measurements in vivo during surgeries are added to an ever-growing statistical data archive. The challenges of managing and interpreting this 3-D data base, which would include radiographic and surface quantitative data, are considerable. As technology drives toward dynamic and continuous 3-D surface measurements, presenting millions of X, Y, Z data points per second of flexing, stretching, moving human organs, the knowledge base and interpretive capabilities of 'brilliant robots' to work as a surgeon's tireless assistants becomes imaginable. The brilliant robot would 'see' what the surgeon sees--and more, for the robot could quantify its 3-D sensing and would 'see' in a wider spectral range than humans, and could zoom its 'eyes' from the macro world to long-distance microscopy. Unerring robot hands could rapidly perform machine-aided suturing with

The evolution of telemedicine and nano-technology

Science.gov (United States)

Park, Dong Kyun; Young Jung, Eun; Chan Moon, Byung

2012-10-01

This paper will cover definition and history of telemedicine, changes in medical paradigm and roll of telemedicine and roll of nano-technology for evolution of telemedicine. Hypothetically, telemedicine is distance communication for medical purpose and modern definition explains telemedicine as `a system of health care delivery in which physicians examine distant patients through the use of telecommunications technology. Medical service will change to personalized medicine based on gene information to prevent and manage diseases due to decrease of acute diseases, population aging and increase of prevalence in chronic diseases, which means current medical services based on manualized treatment for diseases will change to personalized medicine based on individual gene information. Also, international healthcare will be activated to provide high quality medical services with low cost using developed transportation. Moreover, hospital centered medical services will change to patients centered medical service due to increase of patient's rights. Development in sensor technology is required for telemedicine to be applied as basic infrastructure for medical services. Various researches in nano-biosensor field are conducted due to introduction of new technologies. However, most researches are in fundamental levels that requires more researches for stability and clinical usefulness. Nano technology is expected to achieve innovative development and define new criteria for disease prevention and management.

Standards and Guidelines in Telemedicine and Telehealth

Science.gov (United States)

Krupinski, Elizabeth A.; Bernard, Jordana

2014-01-01

The development of guidelines and standards for telemedicine is an important and valuable process to help insure effective and safe delivery of quality healthcare. Some organizations, such as the American Telemedicine Association (ATA), have made the development of standards and guidelines a priority. The practice guidelines developed so far have been well received by the telemedicine community and are being adopted in numerous practices, as well as being used in research to support the practice and growth of telemedicine. Studies that utilize published guidelines not only help bring them into greater public awareness, but they also provide evidence needed to validate existing guidelines and guide the revision of future versions. Telemedicine will continue to grow and be adopted by more healthcare practitioners and patients in a wide variety of forms not just in the traditional clinical environments, and practice guidelines will be a key factor in fostering this growth. Creation of guidelines is important to payers and regulators as well as increasingly they are adopting and integrating them into regulations and policies. This paper will review some of the recent ATA efforts in developing telemedicine practice guidelines, review the role of research in guidelines development, review data regarding their use, and discuss some of areas where guidelines are still needed. PMID:27429261

Multi-purpose HealthCare Telemedicine Systems with mobile communication link support

Directory of Open Access Journals (Sweden)

Karayiannis D

2003-03-01

Full Text Available Abstract The provision of effective emergency telemedicine and home monitoring solutions are the major fields of interest discussed in this study. Ambulances, Rural Health Centers (RHC or other remote health location such as Ships navigating in wide seas are common examples of possible emergency sites, while critical care telemetry and telemedicine home follow-ups are important issues of telemonitoring. In order to support the above different growing application fields we created a combined real-time and store and forward facility that consists of a base unit and a telemedicine (mobile unit. This integrated system: can be used when handling emergency cases in ambulances, RHC or ships by using a mobile telemedicine unit at the emergency site and a base unit at the hospital-expert's site, enhances intensive health care provision by giving a mobile base unit to the ICU doctor while the telemedicine unit remains at the ICU patient site and enables home telemonitoring, by installing the telemedicine unit at the patient's home while the base unit remains at the physician's office or hospital. The system allows the transmission of vital biosignals (3–12 lead ECG, SPO2, NIBP, IBP, Temp and still images of the patient. The transmission is performed through GSM mobile telecommunication network, through satellite links (where GSM is not available or through Plain Old Telephony Systems (POTS where available. Using this device a specialist doctor can telematically "move" to the patient's site and instruct unspecialized personnel when handling an emergency or telemonitoring case. Due to the need of storing and archiving of all data interchanged during the telemedicine sessions, we have equipped the consultation site with a multimedia database able to store and manage the data collected by the system. The performance of the system has been technically tested over several telecommunication means; in addition the system has been clinically validated in three

Evaluation Framework for Telemedicine Using the Logical Framework Approach and a Fishbone Diagram.

Science.gov (United States)

Chang, Hyejung

2015-10-01

Technological advances using telemedicine and telehealth are growing in healthcare fields, but the evaluation framework for them is inconsistent and limited. This paper suggests a comprehensive evaluation framework for telemedicine system implementation and will support related stakeholders' decision-making by promoting general understanding, and resolving arguments and controversies. This study focused on developing a comprehensive evaluation framework by summarizing themes across the range of evaluation techniques and organized foundational evaluation frameworks generally applicable through studies and cases of diverse telemedicine. Evaluation factors related to aspects of information technology; the evaluation of satisfaction of service providers and consumers, cost, quality, and information security are organized using the fishbone diagram. It was not easy to develop a monitoring and evaluation framework for telemedicine since evaluation frameworks for telemedicine are very complex with many potential inputs, activities, outputs, outcomes, and stakeholders. A conceptual framework was developed that incorporates the key dimensions that need to be considered in the evaluation of telehealth implementation for a formal structured approach to the evaluation of a service. The suggested framework consists of six major dimensions and the subsequent branches for each dimension. To implement telemedicine and telehealth services, stakeholders should make decisions based on sufficient evidence in quality and safety measured by the comprehensive evaluation framework. Further work would be valuable in applying more comprehensive evaluations to verify and improve the comprehensive framework across a variety of contexts with more factors and participant group dimensions.

Analysis and design of software ecosystem architectures – Towards the 4S telemedicine ecosystem

DEFF Research Database (Denmark)

Christensen, Henrik Bærbak; Hansen, Klaus Marius; Kyng, Morten

2014-01-01

performed a descriptive, revelatory case study of the Danish telemedicine ecosystem and for ii), we experimentally designed, implemented, and evaluated the architecture of 4S. Results We contribute in three areas. First, we define the software ecosystem architecture concept that captures organization......, and application stove-pipes that inhibit the adoption of telemedical solutions. To which extent can a software ecosystem approach to telemedicine alleviate this? Objective In this article, we define the concept of software ecosystem architecture as the structure(s) of a software ecosystem comprising elements...... experience in creating and evolving the 4S telemedicine ecosystem. Conclusion The concept of software ecosystem architecture can be used analytically and constructively in respectively the analysis and design of software ecosystems....

Adaptive bit plane quadtree-based block truncation coding for image compression

Science.gov (United States)

Li, Shenda; Wang, Jin; Zhu, Qing

2018-04-01

Block truncation coding (BTC) is a fast image compression technique applied in spatial domain. Traditional BTC and its variants mainly focus on reducing computational complexity for low bit rate compression, at the cost of lower quality of decoded images, especially for images with rich texture. To solve this problem, in this paper, a quadtree-based block truncation coding algorithm combined with adaptive bit plane transmission is proposed. First, the direction of edge in each block is detected using Sobel operator. For the block with minimal size, adaptive bit plane is utilized to optimize the BTC, which depends on its MSE loss encoded by absolute moment block truncation coding (AMBTC). Extensive experimental results show that our method gains 0.85 dB PSNR on average compare to some other state-of-the-art BTC variants. So it is desirable for real time image compression applications.

Risk of Telemedicine Infeasibility: An Evidential Reasoning Approach

Directory of Open Access Journals (Sweden)

Sofienne Mansouri

2017-10-01

Full Text Available The viability of a telemedicine system is the strength of its business continuity. Business continuity can only stand if the telemedicine system remains continuously feasible. This article studies telemedicine risk in terms of its feasibility on all its five components: economical, technical, social, operational, and legal/ethical. Any deficiencies in one or more of the feasibility components will affect the system business continuity risk and can lead to infeasibility and possible dissolution. The telemedicine computing environment is full of uncertainties and ambiguities and it just involves too much background knowledge that Bayesian theory cannot accommodate. Decision theory however offers a basic evidence-based multi-criteria decision mechanism that can tackle those decision problems treating both quantitative and qualitative criteria under various uncertainties including ignorance and randomness. We propose an evidential reasoning model to assess a telemedicine business continuity risk based on infeasibility. This business continuity risk is modelled using Dempster and Shafer Theory as the plausibility of infeasibility of the telemedicine system. A numerical example is provided to demonstrate the working of the proposed risk assessment model.

A bit faster : ReedHycalog focuses new drill bit technology on the needs of western Canadian drillers

Energy Technology Data Exchange (ETDEWEB)

Wells, P.

2009-06-15

ReedHycalog, a division of National Oilwell Varco Inc., is advancing its drill bit technology and is setting performance records in an effort to meet the needs of drillers in western Canada. This article described the company's new drill bit technology. Through its motor series polycrystalline diamond cutter (PDC) bits, ReedHycalog developed and commercialized several unique and proprietary drill bit features that reduced variations in torque. This lowered the risk of stick-slip while improving lateral stability, directional control and drilling efficiency. The design of the motor series bits was reviewed along with laboratory and field testing. Smooth torque was identified as one of the greatest challenges when drilling with a drill bit on a directional assembly. Test results revealed that there are 4 distinct characteristics for optimal steerable motor performance, such as smooth torque control components (TCC) that were specifically positioned in the cone of the bit to prevent cutter over engagement reducing in torque fluctuations for optimal tool face control; optimized cutter backrakes that provided high penetration rates in rotating mode, while TCCs were optimized to control torque when sliding; gauge inserts for lateral control that provided a low-friction bearing surface; and laterally exposed gauge cutters that cleaned up the hole in rotating mode, and a tapered upper section that reduced gauge pad interference while in sliding mode. The motor series bits performed extremely well in the vertical, build and horizontal intervals with multiple operators. 1 ref., 3 figs.

Telemedicine and anaesthesia.

Science.gov (United States)

Chatrath, Veena; Attri, Joginder Pal; Chatrath, Raman

2010-05-01

Telemedicine is the use of electronic information and communication technology to provide and support healthcare when distance separates the participants. India is characterised by low penetration of healthcare services where primary healthcare facilities for rural population are highly inadequate. The majority of doctors practice in urban and semi-urban areas, whereas the major proportion of population lives in rural areas. This calls for the innovative methods for utilisation of science and technology for the benefit of our society. There are few reports in the literature which support the use of telemedicine technology for pre-operative assessment, intra-operative consultation, monitoring and post-operative follow-up, which is discussed in this article.

Correct mutual information, quantum bit error rate and secure transmission efficiency in Wojcik's eavesdropping scheme on ping-pong protocol

OpenAIRE

Zhang, Zhanjun

2004-01-01

Comment: The wrong mutual information, quantum bit error rate and secure transmission efficiency in Wojcik's eavesdropping scheme [PRL90(03)157901]on ping-pong protocol have been pointed out and corrected

Feasibility of AmbulanCe-Based Telemedicine (FACT) Study : Safety, Feasibility and Reliability of Third Generation Ambulance Telemedicine

NARCIS (Netherlands)

Yperzeele, Laetitia; Van Hooff, Robbert-Jan; De Smedt, Ann; Espinoza, Alexis Valenzuela; Van Dyck, Rita; Van de Casseye, Rohny; Convents, Andre; Hubloue, Ives; Lauwaert, Door; De Keyser, Jacques; Brouns, Raf

2014-01-01

Background: Telemedicine is currently mainly applied as an in-hospital service, but this technology also holds potential to improve emergency care in the prehospital arena. We report on the safety, feasibility and reliability of in-ambulance teleconsultation using a telemedicine system of the third

Trends in telemedicine utilizing artificial intelligence

Science.gov (United States)

Pacis, Danica Mitch M.; Subido, Edwin D. C.; Bugtai, Nilo T.

2018-02-01

With the growth and popularity of the utilization of artificial intelligence (AI) in several fields and industries, studies in the field of medicine have begun to implement its capabilities in handling and analyzing data to telemedicine. With the challenges in the implementation of telemedicine, there has been a need to expand its capabilities and improve procedures to be specialized to solve specific problems. The versatility and flexibility of both AI and telemedicine gave the endless possibilities for development and these can be seen in the literature reviewed in this paper. The trends in the development of the utilization of this technology can be classified in to four: patient monitoring, healthcare information technology, intelligent assistance diagnosis, and information analysis collaboration. Each trend will be discussed and presented with examples of recent literature and the problems they aim to address. Related references will also be tabulated and categorized to see the future and potential of this current trend in telemedicine.

Carbon footprint of telemedicine solutions--unexplored opportunity for reducing carbon emissions in the health sector.

Science.gov (United States)

Holmner, Asa; Ebi, Kristie L; Lazuardi, Lutfan; Nilsson, Maria

2014-01-01

The healthcare sector is a significant contributor to global carbon emissions, in part due to extensive travelling by patients and health workers. To evaluate the potential of telemedicine services based on videoconferencing technology to reduce travelling and thus carbon emissions in the healthcare sector. A life cycle inventory was performed to evaluate the carbon reduction potential of telemedicine activities beyond a reduction in travel related emissions. The study included two rehabilitation units at Umeå University Hospital in Sweden. Carbon emissions generated during telemedicine appointments were compared with care-as-usual scenarios. Upper and lower bound emissions scenarios were created based on different teleconferencing solutions and thresholds for when telemedicine becomes favorable were estimated. Sensitivity analyses were performed to pinpoint the most important contributors to emissions for different set-ups and use cases. Replacing physical visits with telemedicine appointments resulted in a significant 40-70 times decrease in carbon emissions. Factors such as meeting duration, bandwidth and use rates influence emissions to various extents. According to the lower bound scenario, telemedicine becomes a greener choice at a distance of a few kilometers when the alternative is transport by car. Telemedicine is a potent carbon reduction strategy in the health sector. But to contribute significantly to climate change mitigation, a paradigm shift might be required where telemedicine is regarded as an essential component of ordinary health care activities and not only considered to be a service to the few who lack access to care due to geography, isolation or other constraints.

Safety of Medical Abortion Provided Through Telemedicine Compared With In Person.

Science.gov (United States)

Grossman, Daniel; Grindlay, Kate

2017-10-01

To compare the proportion of medical abortions with a clinically significant adverse event among telemedicine and in-person patients at a clinic system in Iowa during the first 7 years of the service. We conducted a retrospective cohort study. We analyzed data on clinically significant adverse events (hospital admission, surgery, blood transfusion, emergency department treatment, and death) for all medical abortions performed by telemedicine or in person at a clinic system in Iowa between July 1, 2008, and June 30, 2015. Data on adverse events came from required reporting forms submitted to the mifepristone distributor. We calculated the prevalence of adverse events and 95% CIs comparing telemedicine with in-person patients. The analysis was designed as a noninferiority study. Assuming the prevalence of adverse events to be 0.3%, telemedicine provision was considered to be inferior to in-person provision if the prevalence were 0.6% or higher. The required sample size was 6,984 in each group (one-sided α=0.025, power 90%). To explore whether patients with adverse events presented to emergency departments and were not reported, we conducted a survey of the 119 emergency departments in Iowa, asking whether they had treated a woman with an adverse event in the prior year. During the study period, 8,765 telemedicine and 10,405 in-person medical abortions were performed. Forty-nine clinically significant adverse events were reported (no deaths or surgery; 0.18% of telemedicine patients with any adverse event [95% CI 0.11-0.29%] and 0.32% of in-person patients [95% CI 0.23-0.45%]). The difference in adverse event prevalence was 0.13% (95% CI -0.01% to 0.28%, P=.07). Forty-two emergency departments responded to the survey (35% response rate); none reported treating a woman with an adverse event after medical abortion. Adverse events are rare with medical abortion, and telemedicine provision is noninferior to in-person provision with regard to clinically significant

Changes in the job situation due to telemedicine.

Science.gov (United States)

Aas, I H Monrad

2002-01-01

Little is known either about how telemedicine changes the job situation or about how the working environment might be improved for those involved in telemedicine. To investigate these issues, qualitative interviews were carried out with 30 people in Norway working with telepsychiatry (12 respondents), teledermatology (six respondents), a telepathology frozen-section service (10 respondents) and tele-otolaryngology (two respondents). The median annual number of remote consultations in telepsychiatry was nine, in teledermatology 81 and in the telepathology frozen-section service nine. The positive aspects of working with telemedicine included less travelling, which gave more time for other work, less need to travel in poor weather, new contacts, an increased sense of professional security (because support was readily available) and the satisfaction of seeing partners in communication. At its present volume, telemedicine generally fits into daily work patterns quite well. Problems do occur, but they can be solved by appropriate organizational measures. Long-term scheduling of telemedical sessions may be important. Many telemedicine workers want to have the equipment in their own office. Working with telemedicine can be tiring and those interviewed wanted to limit the number of hours per week. A solution may be to use large clinics, such as university clinics, where the telemedical work could be distributed between several specialists. Large telemedicine clinics with a full-time dedicated staff would need careful consideration of working practices.

Bits and q-bits as versatility measures

Directory of Open Access Journals (Sweden)

José R.C. Piqueira

2004-06-01

Full Text Available Using Shannon information theory is a common strategy to measure any kind of variability in a signal or phenomenon. Some methods were developed to adapt information entropy measures to bird song data trying to emphasize its versatility aspect. This classical approach, using the concept of bit, produces interesting results. Now, the original idea developed in this paper is to use the quantum information theory and the quantum bit (q-bit concept in order to provide a more complete vision of the experimental results.Usar a teoria da informação de Shannon é uma estratégia comum para medir todo tipo de variabilidade em um sinal ou fenômeno. Alguns métodos foram desenvolvidos para adaptar a medida de entropia informacional a dados de cantos de pássaro, tentando enfatizar seus aspectos de versatilidade. Essa abordagem clássica, usando o conceito de bit, produz resultados interessantes. Agora, a idéia original desenvolvida neste artigo é usar a teoria quântica da informação e o conceito de q-bit, com a finalidade de proporcionar uma visão mais completa dos resultados experimentais.

A minimum bit error-rate detector for amplify and forward relaying systems

KAUST Repository

Ahmed, Qasim Zeeshan; Alouini, Mohamed-Slim; Aissa, Sonia

2012-01-01

In this paper, a new detector is being proposed for amplify-and-forward (AF) relaying system when communicating with the assistance of L number of relays. The major goal of this detector is to improve the bit error rate (BER) performance of the system. The complexity of the system is further reduced by implementing this detector adaptively. The proposed detector is free from channel estimation. Our results demonstrate that the proposed detector is capable of achieving a gain of more than 1-dB at a BER of 10 -5 as compared to the conventional minimum mean square error detector when communicating over a correlated Rayleigh fading channel. © 2012 IEEE.

A minimum bit error-rate detector for amplify and forward relaying systems

KAUST Repository

Ahmed, Qasim Zeeshan

2012-05-01

In this paper, a new detector is being proposed for amplify-and-forward (AF) relaying system when communicating with the assistance of L number of relays. The major goal of this detector is to improve the bit error rate (BER) performance of the system. The complexity of the system is further reduced by implementing this detector adaptively. The proposed detector is free from channel estimation. Our results demonstrate that the proposed detector is capable of achieving a gain of more than 1-dB at a BER of 10 -5 as compared to the conventional minimum mean square error detector when communicating over a correlated Rayleigh fading channel. © 2012 IEEE.

A qualitative study of the organizational consequences of telemedicine.

Science.gov (United States)

Aas, I H

2001-01-01

The organizational consequences of telemedicine have frequently been mentioned in the telemedicine community, but there are few empirical studies. A study was therefore carried out of what happens in organizations when telemedicine is implemented. Qualitative interviews were undertaken with 30 persons working in teledermatology, telepsychiatry, a telepathology frozen-section service and tele-otolaryngology. Almost all respondents reported numerous organizational changes, some important. Changes in work processes were the most common. Examples of the organizational consequences of telemedicine were organizational restructuring, new organizational units, changed mechanisms for internal coordination, different flows of patients through the health-care system, improved coordination of care, new job descriptions, relocation of the place of work, employment of personnel living far away from the workplace, effects on employees not directly involved in telemedicine, sharing of experiences, minor staffing changes, clinical teamwork independent of co-location, administrative meetings arranged by telemedicine, merger of organizations independent of location, less travel by staff (and patients), a possible beneficial effect on the quality of care, and limited opposition to the adoption of the technology. Telemedicine may be important in the future organization of the disciplines studied and in health-care generally. The infrastructure of electronic networks may play an important role for organizations as the volume of telemedicine activity increases and economies of scale are realized.

The Centralization and Decentralization of Telemedicine Networks in Korea and Japan

Directory of Open Access Journals (Sweden)

Soo-kyung Park

2013-06-01

Full Text Available This study scrutinizes telemedicine networks with regard to regionalization and the propensities and determinants of core telemedicine users (doctors and patients by employing two case areas, Choongbook in Korea and Kagawa in Japan. According to the results, telemedicine networks in Choongbook are dominated by an inter-regional level (in particular, a national level, and most of the telemedicine networks are observed between clinical sites in Choongbook and tertiary care centers in Kyunggi. In contrast, telemedicine networks in Kagawa are dispersed within the diagnostic boundary of Kagawa at a regional level. Interviews with crucial decision-makers revealed the reasons why many patients enjoy health care via telemedicine at an inter-regional level, which include psychological considerations regarding quality and level of health care services, personal stakes in telemedicine service sites, acceptability and credibility of good tertiary care centers, and easy access to and use of medical institutions. In Kagawa, both the existing health care system and the telemedicine system support the maintenance of stable regional health care within Kagawa. Importantly, human relationships based on the regional health care system contribute to creating telemedicine networks within the original purpose of the telemedicine system regarding regionalization. Also, telemedicine’s technological value, convenience, and utility are associated with the regionalization of telemedicine networks within one diagnostic area.

High-Intensity Telemedicine Decreases Emergency Department Use by Senior Living Community Residents.

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Shah, Manish N; Wasserman, Erin B; Wang, Hongyue; Gillespie, Suzanne M; Noyes, Katia; Wood, Nancy E; Nelson, Dallas; Dozier, Ann; McConnochie, Kenneth M

2016-03-01

The failure to provide timely acute illness care can lead to adverse consequences or emergency department (ED) use. We evaluated the effect on ED use of a high-intensity telemedicine program that provides acute illness care for senior living community (SLC) residents. We performed a prospective cohort study over 3.5 years. Six SLCs cared for by a primary care geriatrics practice were intervention facilities, with the remaining 16 being controls. Consenting patients at intervention facilities could access telemedicine for acute illness care. Patients were provided patient-to-provider, real-time, or store-and-forward high-intensity telemedicine (i.e., technician-assisted with resources beyond simple videoconferencing) to diagnose and treat acute illnesses. The primary outcome was the rate of ED use. We enrolled 494 of 705 (70.1%) subjects/proxies in the intervention group; 1,058 subjects served as controls. Control and intervention subjects visited the ED 2,238 and 725 times, respectively, with 47.3% of control and 43.4% of intervention group visits resulting in discharge home. Among intervention subjects, ED use decreased at an annualized rate of 18% (rate ratio [RR]=0.82; 95% confidence interval [CI], 0.70-0.95), whereas in the control group there was no statistically significant change in ED use (RR=1.01; 95% CI, 0.95-1.07; p=0.009 for group-by-time interaction). Primary care use and mortality were not significantly different. High-intensity telemedicine significantly reduced ED use among SLC residents without increasing other utilization or mortality. This alternative to traditional acute illness care can enhance access to acute illness care and should be integrated into population health programs.

Engaging Elderly People in Telemedicine Through Gamification

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Tabak, Monique; Dekker - van Weering, Marit; Vollenbroek-Hutten, Miriam

2015-01-01

Background Telemedicine can alleviate the increasing demand for elderly care caused by the rapidly aging population. However, user adherence to technology in telemedicine interventions is low and decreases over time. Therefore, there is a need for methods to increase adherence, specifically of the elderly user. A strategy that has recently emerged to address this problem is gamification. It is the application of game elements to nongame fields to motivate and increase user activity and retention. Objective This research aims to (1) provide an overview of existing theoretical frameworks for gamification and explore methods that specifically target the elderly user and (2) explore user classification theories for tailoring game content to the elderly user. This knowledge will provide a foundation for creating a new framework for applying gamification in telemedicine applications to effectively engage the elderly user by increasing and maintaining adherence. Methods We performed a broad Internet search using scientific and nonscientific search engines and included information that described either of the following subjects: the conceptualization of gamification, methods to engage elderly users through gamification, or user classification theories for tailored game content. Results Our search showed two main approaches concerning frameworks for gamification: from business practices, which mostly aim for more revenue, emerge an applied approach, while academia frameworks are developed incorporating theories on motivation while often aiming for lasting engagement. The search provided limited information regarding the application of gamification to engage elderly users, and a significant gap in knowledge on the effectiveness of a gamified application in practice. Several approaches for classifying users in general were found, based on archetypes and reasons to play, and we present them along with their corresponding taxonomies. The overview we created indicates great

Telemedicine and anaesthesia

Directory of Open Access Journals (Sweden)

Veena Chatrath

2010-01-01

Full Text Available Telemedicine is the use of electronic information and communication technology to provide and support healthcare when distance separates the participants. India is characterised by low penetration of healthcare services where primary healthcare facilities for rural population are highly inadequate. The majority of doctors practice in urban and semi-urban areas, whereas the major proportion of population lives in rural areas. This calls for the innovative methods for utilisation of science and technology for the benefit of our society. There are few reports in the literature which support the use of telemedicine technology for pre-operative assessment, intra-operative consultation, monitoring and post-operative follow-up, which is discussed in this article.

Telemedicine Can Replace the Neurologist on a Mobile Stroke Unit.

Science.gov (United States)

Wu, Tzu-Ching; Parker, Stephanie A; Jagolino, Amanda; Yamal, Jose-Miguel; Bowry, Ritvij; Thomas, Abraham; Yu, Amy; Grotta, James C

2017-02-01

The BEST-MSU study (Benefits of Stroke Treatment Delivered Using a Mobile Stroke Unit) is a comparative effectiveness trial in patients randomized to mobile stroke unit or standard management. A substudy tested interrater agreement for tissue-type plasminogen activator eligibility between a telemedicine vascular neurologist and onboard vascular neurologist. On scene, both the telemedicine vascular neurologist and onboard vascular neurologist independently evaluated the patient, documenting their tissue-type plasminogen activator treatment decision, National Institutes of Health Stroke Scale score, and computed tomographic interpretation. Agreement was determined using Cohen κ statistic. Telemedicine-related technical failures that impeded remote assessment were recorded. Simultaneous and independent telemedicine vascular neurologist and onboard vascular neurologist assessment was attempted in 174 patients. In 4 patients (2%), the telemedicine vascular neurologist could not make a decision because of technical problems. The telemedicine vascular neurologist agreed with the onboard vascular neurologist on 88% of evaluations (κ=0.73). Remote telemedicine vascular neurologist assessment is reliable and accurate, supporting either telemedicine vascular neurologist or onboard vascular neurologist assessment on our mobile stroke unit. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02190500. © 2017 American Heart Association, Inc.

Using Telemedicine to Address Crowding in the ED.

Science.gov (United States)

Guss, Benjamin; Mishkin, David; Sharma, Rahul

2016-11-01

Some health systems are piloting telemedicine solutions in the ED to address crowding and decrease patient wait times. One new program, implemented at the Lisa Perry Emergency Center at New York Presbyterian (NYP) Weill Cornell Medical Center in New York, involves offering low-acuity patients the option of visiting an off-site physician via telemedicine hookup. Administrators note that the approach can get patients in and out of the ED within 30 minutes, and patients have thus far been highly satisfied with the approach. However, an earlier telemedicine program piloted at the University of San Diego Health System’s (UCSD) Hillcrest Hospital in 2013 got bogged down due to administrative and insurance reimbursement hurdles, although the approach showed enough promise that there is interest in restarting the program. In the NYP program, patients are identified as appropriate candidates for the program at triage. They can opt to be seen remotely or through traditional means in the ED’s fast-track section. Administrators note that patients with complex problems requiring extensive workups are not suitable for the telemedicine approach. The most challenging aspect of implementing a successful telemedicine program in the ED is getting the workflows right, according to administrators. An earlier ED-based telemedicine program piloted at UCSD ran into difficulties because the model required the involvement of two physicians, and some insurers did not want to pay for the telemedicine visits. However, patients were receptive.

Bit-padding information guided channel hopping

KAUST Repository

Yang, Yuli

2011-02-01

In the context of multiple-input multiple-output (MIMO) communications, we propose a bit-padding information guided channel hopping (BP-IGCH) scheme which breaks the limitation that the number of transmit antennas has to be a power of two based on the IGCH concept. The proposed scheme prescribes different bit-lengths to be mapped onto the indices of the transmit antennas and then uses padding technique to avoid error propagation. Numerical results and comparisons, on both the capacity and the bit error rate performances, are provided and show the advantage of the proposed scheme. The BP-IGCH scheme not only offers lower complexity to realize the design flexibility, but also achieves better performance. © 2011 IEEE.

A Fast Soft Bit Error Rate Estimation Method

Directory of Open Access Journals (Sweden)

Ait-Idir Tarik

2010-01-01

Full Text Available We have suggested in a previous publication a method to estimate the Bit Error Rate (BER of a digital communications system instead of using the famous Monte Carlo (MC simulation. This method was based on the estimation of the probability density function (pdf of soft observed samples. The kernel method was used for the pdf estimation. In this paper, we suggest to use a Gaussian Mixture (GM model. The Expectation Maximisation algorithm is used to estimate the parameters of this mixture. The optimal number of Gaussians is computed by using Mutual Information Theory. The analytical expression of the BER is therefore simply given by using the different estimated parameters of the Gaussian Mixture. Simulation results are presented to compare the three mentioned methods: Monte Carlo, Kernel and Gaussian Mixture. We analyze the performance of the proposed BER estimator in the framework of a multiuser code division multiple access system and show that attractive performance is achieved compared with conventional MC or Kernel aided techniques. The results show that the GM method can drastically reduce the needed number of samples to estimate the BER in order to reduce the required simulation run-time, even at very low BER.

Telemedicine and advances in urban and rural healthcare delivery in Africa.

Science.gov (United States)

Mars, Maurice

2013-01-01

Telecardiology holds great promise for Africa, from tele-echocardiography and tele-ECG s, to home monitoring and text messaging for medication adherence monitoring. The burden of disease is great and there is an extreme shortage of health professionals. Telemedicine can provide access to scarce specialist care, improve the quality of care in rural areas and reduce the need for rural patients to travel to seek medical attention. International cross border service can alleviate the shortage of doctors. But telecardiology, and telemedicine uptake in general, has been poor in Africa. Legal and ethical issues around local and cross border telemedicine have not been resolved. The literature was reviewed and obstacles to telemedicine in Africa and current telemedicine activities in Africa, are described. There are few sustained telemedicine services in Africa with the exception of tele-education. There is an expectation that mobile phones will facilitate a range of telemedicine activities in Africa. Africa needs telemedicine. © 2013.

Narrative review of telemedicine consultation in medical practice

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Di Cerbo A

2015-01-01

Full Text Available Alessandro Di Cerbo,1,2 Julio Cesar Morales-Medina,3 Beniamino Palmieri,1,2 Tommaso Iannitti4 1Poliambulatorio del Secondo Parere, 2Department of General Surgery and Surgical Specialties, Surgical Clinic, University of Modena and Reggio Emilia Medical School, Modena, Italy; 3Centro de Investigación en Reproducción Animal, CINVESTAV, Universidad Autónoma de Tlaxcala, Tlaxcala de Xicohténcatl, Mexico; 4Department of Neuroscience, Sheffield Institute for Translational Neuroscience (SITraN, University of Sheffield, Sheffield, UK Background: The use of telemedicine has grown across several medical fields, due to the increasing number of “e-patients”.Objective: This narrative review gives an overview of the growing use of telemedicine in different medical specialties, showing how its use can improve medical care.Methods: A PubMed/Medline, Embase, Web of Science, and Scopus search was performed using the following keywords: telemedicine, teleconsultation, telehealth, e-health, and e-­medicine. Selected papers from 1996 to 2014 were chosen on the basis of their content (quality and novelty.Results: Telemedicine has already been applied to different areas of medical practice, and it is as effective as face-to-face medical care, at least for the diagnosis and treatment of some pathological conditions.Conclusion: Telemedicine is time- and cost-effective for both patients and health care professionals, encouraging its use on a larger scale. Telemedicine provides specialist medical care to patients who have poor access to hospitals, and ensures continuity of care and optimal use of available health resources. The use of telemedicine opens new perspectives for patients seeking a medical second opinion for their pathology, since they can have remote access to medical resources that would otherwise require enormous costs and time. Keywords: telemedicine, health care, patient

Telemedicine and telepharmacy: current status and future implications.

Science.gov (United States)

Angaran, D M

1999-07-15

Uses of telemedicine are described and potential roles for pharmacists are discussed. Telemedicine has been defined as "the use of electronic information and communications technologies to provide and support health care when distance separates the participants." Technologies included in telemedicine are videoconferencing, telephones, computers, the Internet, fax, radio, and television. Telepharmacy has the same basic definition but refers to pharmaceutical care provision. Although the videotelemedicine market is expected to grow considerably, lack of reimbursement and high costs are continuing obstacles. Pharmacy is using video-conferencing for education, training, and management purposes. The telephone has changed from a dial-and-talk instrument to a multimedia access tool. Medical devices are being attached to telephone lines to provide remote monitoring and therapy, and call centers are providing medication counseling, prior authorization, refill authorization, and formulary compliance monitoring. Although the Internet has quickly become a star performer, utilization by health care lags behind that of other industries. The Internet-fueled empowerment of consumers and their expectations for speed, access, and convenience are creating more unmet expectations of the traditional health care system. Pharmacy has both organizational and individual practitioner Web sites, but it is online drugstores that are attracting most attention. Potential benefits of telemedicine include improved access to care, greater efficiency in diagnosis and treatment, higher productivity, and market positioning for the coming century. Telemedicine will tax the economic, regulatory, legal, ethical, and clinical care expertise of the entire health care system. Studies of the effectiveness, cost, and societal implications of telemedicine are needed, along with practice models and standards, training programs, and solutions to regulatory, licensing, and legal questions. Securing reimbursement

Telemedicine for Trauma, Emergencies, and Disaster Management

CERN Document Server

Latifi, Rifat

2010-01-01

Telemedicine has evolved to become an important field of medicine and healthcare, involving everything from simple patient care to actual performance of operations at a distance. This groundbreaking volume addresses the complex technical and clinical development in the management of trauma, disaster, and emergency situations using telemedicine. The book explains how telemedicine and related technologies can be used to effectively handle a wide range of scenarios, from a situation as small as a car crash, to major disasters such as an earthquake. Professionals find critical discussions on the p

Bit-error-rate testing of fiber optic data links for MMIC-based phased array antennas

Science.gov (United States)

Shalkhauser, K. A.; Kunath, R. R.; Daryoush, A. S.

1990-01-01

The measured bit-error-rate (BER) performance of a fiber optic data link to be used in satellite communications systems is presented and discussed. In the testing, the link was measured for its ability to carry high burst rate, serial-minimum shift keyed (SMSK) digital data similar to those used in actual space communications systems. The fiber optic data link, as part of a dual-segment injection-locked RF fiber optic link system, offers a means to distribute these signals to the many radiating elements of a phased array antenna. Test procedures, experimental arrangements, and test results are presented.

Bit error rate testing of fiber optic data links for MMIC-based phased array antennas

Science.gov (United States)

Shalkhauser, K. A.; Kunath, R. R.; Daryoush, A. S.

1990-01-01

The measured bit-error-rate (BER) performance of a fiber optic data link to be used in satellite communications systems is presented and discussed. In the testing, the link was measured for its ability to carry high burst rate, serial-minimum shift keyed (SMSK) digital data similar to those used in actual space communications systems. The fiber optic data link, as part of a dual-segment injection-locked RF fiber optic link system, offers a means to distribute these signals to the many radiating elements of a phased array antenna. Test procedures, experimental arrangements, and test results are presented.

Inclusive bit error rate analysis for coherent optical code-division multiple-access system

Science.gov (United States)

Katz, Gilad; Sadot, Dan

2002-06-01

Inclusive noise and bit error rate (BER) analysis for optical code-division multiplexing (OCDM) using coherence techniques is presented. The analysis contains crosstalk calculation of the mutual field variance for different number of users. It is shown that the crosstalk noise depends deeply on the receiver integration time, the laser coherence time, and the number of users. In addition, analytical results of the power fluctuation at the received channel due to the data modulation at the rejected channels are presented. The analysis also includes amplified spontaneous emission (ASE)-related noise effects of in-line amplifiers in a long-distance communication link.

Novel ultra-wideband photonic signal generation and transmission featuring digital signal processing bit error rate measurements

DEFF Research Database (Denmark)

Gibbon, Timothy Braidwood; Yu, Xianbin; Tafur Monroy, Idelfonso

2009-01-01

We propose the novel generation of photonic ultra-wideband signals using an uncooled DFB laser. For the first time we experimentally demonstrate bit-for-bit DSP BER measurements for transmission of a 781.25 Mbit/s photonic UWB signal.......We propose the novel generation of photonic ultra-wideband signals using an uncooled DFB laser. For the first time we experimentally demonstrate bit-for-bit DSP BER measurements for transmission of a 781.25 Mbit/s photonic UWB signal....

Making medical treatments resilient to technological disruptions in telemedicine systems

NARCIS (Netherlands)

Larburu Rubio, Nekane; Widya, I.A.; Bults, Richard G.A.; Hermens, Hermanus J.

Telemedicine depends on Information and Communication Technology (ICT) to support remote treatment of patients. This dependency requires the telemedicine system design to be resilient for ICT performance degradation or subsystem failures. Nevertheless, using telemedicine systems create a dependency

Augmented Reality as a Telemedicine Platform for Remote Procedural Training.

Science.gov (United States)

Wang, Shiyao; Parsons, Michael; Stone-McLean, Jordan; Rogers, Peter; Boyd, Sarah; Hoover, Kristopher; Meruvia-Pastor, Oscar; Gong, Minglun; Smith, Andrew

2017-10-10

Traditionally, rural areas in many countries are limited by a lack of access to health care due to the inherent challenges associated with recruitment and retention of healthcare professionals. Telemedicine, which uses communication technology to deliver medical services over distance, is an economical and potentially effective way to address this problem. In this research, we develop a new telepresence application using an Augmented Reality (AR) system. We explore the use of the Microsoft HoloLens to facilitate and enhance remote medical training. Intrinsic advantages of AR systems enable remote learners to perform complex medical procedures such as Point of Care Ultrasound (PoCUS) without visual interference. This research uses the HoloLens to capture the first-person view of a simulated rural emergency room (ER) through mixed reality capture (MRC) and serves as a novel telemedicine platform with remote pointing capabilities. The mentor's hand gestures are captured using a Leap Motion and virtually displayed in the AR space of the HoloLens. To explore the feasibility of the developed platform, twelve novice medical trainees were guided by a mentor through a simulated ultrasound exploration in a trauma scenario, as part of a pilot user study. The study explores the utility of the system from the trainees, mentor, and objective observers' perspectives and compares the findings to that of a more traditional multi-camera telemedicine solution. The results obtained provide valuable insight and guidance for the development of an AR-supported telemedicine platform.

Augmented Reality as a Telemedicine Platform for Remote Procedural Training

Science.gov (United States)

Wang, Shiyao; Parsons, Michael; Stone-McLean, Jordan; Rogers, Peter; Boyd, Sarah; Hoover, Kristopher; Meruvia-Pastor, Oscar; Gong, Minglun; Smith, Andrew

2017-01-01

Traditionally, rural areas in many countries are limited by a lack of access to health care due to the inherent challenges associated with recruitment and retention of healthcare professionals. Telemedicine, which uses communication technology to deliver medical services over distance, is an economical and potentially effective way to address this problem. In this research, we develop a new telepresence application using an Augmented Reality (AR) system. We explore the use of the Microsoft HoloLens to facilitate and enhance remote medical training. Intrinsic advantages of AR systems enable remote learners to perform complex medical procedures such as Point of Care Ultrasound (PoCUS) without visual interference. This research uses the HoloLens to capture the first-person view of a simulated rural emergency room (ER) through mixed reality capture (MRC) and serves as a novel telemedicine platform with remote pointing capabilities. The mentor’s hand gestures are captured using a Leap Motion and virtually displayed in the AR space of the HoloLens. To explore the feasibility of the developed platform, twelve novice medical trainees were guided by a mentor through a simulated ultrasound exploration in a trauma scenario, as part of a pilot user study. The study explores the utility of the system from the trainees, mentor, and objective observers’ perspectives and compares the findings to that of a more traditional multi-camera telemedicine solution. The results obtained provide valuable insight and guidance for the development of an AR-supported telemedicine platform. PMID:28994720

Augmented Reality as a Telemedicine Platform for Remote Procedural Training

Directory of Open Access Journals (Sweden)

Shiyao Wang

2017-10-01

Full Text Available Traditionally, rural areas in many countries are limited by a lack of access to health care due to the inherent challenges associated with recruitment and retention of healthcare professionals. Telemedicine, which uses communication technology to deliver medical services over distance, is an economical and potentially effective way to address this problem. In this research, we develop a new telepresence application using an Augmented Reality (AR system. We explore the use of the Microsoft HoloLens to facilitate and enhance remote medical training. Intrinsic advantages of AR systems enable remote learners to perform complex medical procedures such as Point of Care Ultrasound (PoCUS without visual interference. This research uses the HoloLens to capture the first-person view of a simulated rural emergency room (ER through mixed reality capture (MRC and serves as a novel telemedicine platform with remote pointing capabilities. The mentor’s hand gestures are captured using a Leap Motion and virtually displayed in the AR space of the HoloLens. To explore the feasibility of the developed platform, twelve novice medical trainees were guided by a mentor through a simulated ultrasound exploration in a trauma scenario, as part of a pilot user study. The study explores the utility of the system from the trainees, mentor, and objective observers’ perspectives and compares the findings to that of a more traditional multi-camera telemedicine solution. The results obtained provide valuable insight and guidance for the development of an AR-supported telemedicine platform.

Engaging elderly people in telemedicine through gamification

NARCIS (Netherlands)

de Vette, Anna Frederiek Alberdien; Tabak, Monique; van Weering, Marit; Vollenbroek-Hutten, Miriam Marie Rosé

2015-01-01

BACKGROUND: Telemedicine can alleviate the increasing demand for elderly care caused by the rapidly aging population. However, user adherence to technology in telemedicine interventions is low and decreases over time. Therefore, there is a need for methods to increase adherence, specifically of the

The Model for Assessment of Telemedicine (MAST)

DEFF Research Database (Denmark)

Kidholm, Kristian; Clemensen, Jane; Caffery, Liam J

2017-01-01

The evaluation of telemedicine can be achieved using different evaluation models or theoretical frameworks. This paper presents a scoping review of published studies which have applied the Model for Assessment of Telemedicine (MAST). MAST includes pre-implementation assessment (e.g. by use...

Low-Bit Rate Feedback Strategies for Iterative IA-Precoded MIMO-OFDM-Based Systems

Science.gov (United States)

Teodoro, Sara; Silva, Adão; Dinis, Rui; Gameiro, Atílio

2014-01-01

Interference alignment (IA) is a promising technique that allows high-capacity gains in interference channels, but which requires the knowledge of the channel state information (CSI) for all the system links. We design low-complexity and low-bit rate feedback strategies where a quantized version of some CSI parameters is fed back from the user terminal (UT) to the base station (BS), which shares it with the other BSs through a limited-capacity backhaul network. This information is then used by BSs to perform the overall IA design. With the proposed strategies, we only need to send part of the CSI information, and this can even be sent only once for a set of data blocks transmitted over time-varying channels. These strategies are applied to iterative MMSE-based IA techniques for the downlink of broadband wireless OFDM systems with limited feedback. A new robust iterative IA technique, where channel quantization errors are taken into account in IA design, is also proposed and evaluated. With our proposed strategies, we need a small number of quantization bits to transmit and share the CSI, when comparing with the techniques used in previous works, while allowing performance close to the one obtained with perfect channel knowledge. PMID:24678274

Nursing Roles within a Stroke Telemedicine Network

Directory of Open Access Journals (Sweden)

Terri-Ellen J. Kiernan

2010-01-01

Full Text Available Time sensitive acute stroke treatments and the growing shortage of vascular neurologists compound to create a gap in the delivery of care to meet the American Stroke Association guidelines in underserviced regions. Audio/video consultation (telemedicine, which has been evolving since the late 1990's, is a putative solution. While telemedicine can serve as a valuable facilitative tool, the telestroke consultation is only one piece of a complex collaboration between hub and spoke environments and clinical personnel. The growing use of telemedicine in stroke offers more opportunities for all nurses to participate in the continuum of cerebrovascular disease care. A review of this collaboration will include but will not be limited to: algorithms of the acute stroke evaluation, hub and spoke staff meetings, stroke education for spoke staff, and patient follow–up post acute treatment. Our team's telemedicine experience, utilizing research, education, and clinical practice, will be described.

Telemedicine.

Science.gov (United States)

Dorman, T

2000-09-01

Telemedicine began from the humble beginnings of the first telephone call from Alexander Graham Bell to his associate, Watson. These systems already have been used for educational programs, consultative care, image transfer, second opinions, and direct acute patient care. Most of the original programs failed because of several reasons, primarily because of lack of funding when a grant ended. The major lesson of these programs is that a solid business plan is needed initially for long-term survival. The reliability of telemedical examinations has been demonstrated superficially, but more conclusive work in this area is needed. Studies that evaluate clinical, financial, and satisfaction outcomes are required simultaneously. Further integration of medical informatics into telemedicine systems is needed before these systems can achieve more acceptance. Twenty years ago, few people predicted this technologic revolution. Innovations arise almost daily. The future seems promising for telemedical systems, but much work is required. Partnerships with industry must move beyond niche projects, and regulatory and medicolegal issues must be resolved. Anesthesiologists can expect their practice to be affected directly by technology, and should embrace it, evaluate it, and help lead its use in this millennium.

Antimicrobial stewardship through telemedicine and its impact on multi-drug resistance.

Science.gov (United States)

Dos Santos, Rodrigo P; Dalmora, Camila H; Lukasewicz, Stephani A; Carvalho, Otávio; Deutschendorf, Caroline; Lima, Raquel; Leitzke, Tiago; Correa, Nilson C; Gambetta, Marcelo V

2018-01-01

Introduction Telemedicine technologies are increasingly being incorporated into infectious disease practice. We aimed to demonstrate the impact of antimicrobial stewardship through telemedicine on bacterial resistance rates. Methods We conducted a quasi-experimental study in a 220-bed hospital in southern Brazil. An antimicrobial stewardship program incorporating the use of telemedicine was implemented. Resistance and antimicrobial consumption rates were determined and analysed using a segmented regression model. Results After the intervention, the rate of appropriate antimicrobial prescription increased from 51.4% at baseline to 81.4%. Significant reductions in the consumption of fluoroquinolones (level change, β = -0.80; P change, β = -0.01; P = 0.98), first-generation cephalosporins (level change, β = -0.91; P change, β = +0.01; P = 0.96), vancomycin (level change, β = -0.47; P = 0.04; trend change, β = +0.17; P = 0.66) and polymyxins (level change, β = -0.15; P = 0.56; trend change, β = -1.75; P change, β = +0.84; P change, β = +0.14; P = 0.41) and cefuroxime (level change, β = +0.21; P = 0.17; trend change, β = +0.66; P = 0.02). A significant decrease in the rate of carbapenem-resistant Acinetobacter spp. isolation (level change, β = +0.66; P = 0.01; trend change, β = -1.26; P resistance.

Bit-error-rate performance analysis of self-heterodyne detected radio-over-fiber links using phase and intensity modulation

DEFF Research Database (Denmark)

Yin, Xiaoli; Yu, Xianbin; Tafur Monroy, Idelfonso

2010-01-01

We theoretically and experimentally investigate the performance of two self-heterodyne detected radio-over-fiber (RoF) links employing phase modulation (PM) and quadrature biased intensity modulation (IM), in term of bit-error-rate (BER) and optical signal-to-noise-ratio (OSNR). In both links, self...

FODA/IBEA satellite access scheme for MIXED traffic at variable bit and coding rates system description

OpenAIRE

Celandroni, Nedo; Ferro, Erina; Mihal, Vlado; Potort?, Francesco

1992-01-01

This report describes the FODA system working at variable coding and bit rates (FODA/IBEA-TDMA) FODA/IBEA is the natural evolution of the FODA-TDMA satellite access scheme working at 2 Mbit/s fixed rate with data 1/2 coded or uncoded. FODA-TDMA was used in the European SATINE-II experiment [8]. We remind here that the term FODA/IBEA system is comprehensive of the FODA/IBEA-TDMA (1) satellite access scheme and of the hardware prototype realised by the Marconi R.C. (U.K.). Both of them come fro...

Third Intensive Balkan Telemedicine and e-Health Seminar

Science.gov (United States)

2009-03-01

and Cultural Affairs HD High Definition ISDN Integrates Services Digital Network IStTeH International Society for Telemedicine and eHealth IT...Lievens1,2, Marlina Jordanova, MD, PhD3,4 1International Society for Telemedicine & eHealth , Switzerland;2Med-e-Tel, Grimbergen, Belgium; 3Med-e-Tel...Approach F. Lievens 1,2,3, M. Jordanova 4,5 1 Board Member and Secretary, International Society for Telemedicine & eHealth (ISfTeH), Switzerland 2

Economic Evaluation of Pediatric Telemedicine Consultations to Rural Emergency Departments.

Science.gov (United States)

Yang, Nikki H; Dharmar, Madan; Yoo, Byung-Kwang; Leigh, J Paul; Kuppermann, Nathan; Romano, Patrick S; Nesbitt, Thomas S; Marcin, James P

2015-08-01

Comprehensive economic evaluations have not been conducted on telemedicine consultations to children in rural emergency departments (EDs). We conducted an economic evaluation to estimate the cost, effectiveness, and return on investment (ROI) of telemedicine consultations provided to health care providers of acutely ill and injured children in rural EDs compared with telephone consultations from a health care payer prospective. We built a decision model with parameters from primary programmatic data, national data, and the literature. We performed a base-case cost-effectiveness analysis (CEA), a probabilistic CEA with Monte Carlo simulation, and ROI estimation when CEA suggested cost-saving. The CEA was based on program effectiveness, derived from transfer decisions following telemedicine and telephone consultations. The average cost for a telemedicine consultation was $3641 per child/ED/year in 2013 US dollars. Telemedicine consultations resulted in 31% fewer patient transfers compared with telephone consultations and a cost reduction of $4662 per child/ED/year. Our probabilistic CEA demonstrated telemedicine consultations were less costly than telephone consultations in 57% of simulation iterations. The ROI was calculated to be 1.28 ($4662/$3641) from the base-case analysis and estimated to be 1.96 from the probabilistic analysis, suggesting a $1.96 return for each dollar invested in telemedicine. Treating 10 acutely ill and injured children at each rural ED with telemedicine resulted in an annual cost-savings of $46,620 per ED. Telephone and telemedicine consultations were not randomly assigned, potentially resulting in biased results. From a health care payer perspective, telemedicine consultations to health care providers of acutely ill and injured children presenting to rural EDs are cost-saving (base-case and more than half of Monte Carlo simulation iterations) or cost-effective compared with telephone consultations. © The Author(s) 2015.

Communication network for telemedicine | Debretsion | Zede Journal

African Journals Online (AJOL)

Telemedicine is the most promising one for improving the access to specialized health services to all remote, rural areas in all developing countries. Exploiting the technological advancements in the field of electronics, signal processing and software a communication network for telemedicine is proposedfor the existing ...

A Low-Power Single-Bit Continuous-Time ΔΣ Converter with 92.5 dB Dynamic Range for Biomedical Applications

Directory of Open Access Journals (Sweden)

Vishal Saxena

2012-07-01

Full Text Available A third-order single-bit CT-ΔΣ modulator for generic biomedical applications is implemented in a 0.15 µm FDSOI CMOS process. The overall power efficiency is attained by employing a single-bit ΔΣ and a subthreshold FDSOI process. The loop-filter coefficients are determined using a systematic design centering approach by accounting for the integrator non-idealities. The single-bit CT-ΔΣ modulator consumes 110 µW power from a 1.5 V power supply when clocked at 6.144 MHz. The simulation results for the modulator exhibit a dynamic range of 94.4 dB and peak SNDR of 92.4 dB for 6 kHz signal bandwidth. The figure of merit (FoM for the third-order, single-bit CT-ΔΣ modulator is 0.271 pJ/level.

UH Telemedicine Proposal

National Research Council Canada - National Science Library

Friedman, Richard

2001-01-01

.... To accomplish this task, a clinical telemedicine service was established such that a hub of physician specialists in Honolulu is available to primary care providers and patients in rural and/or remote clinics...

Controlling torque and cutting costs: steerable drill bits deliver in Latin America

Energy Technology Data Exchange (ETDEWEB)

Barton, Steve; Garcia, Alexis; Amorim, Dalmo [ReedHycalog, Stonehouse (United Kingdom); Iramina, Wilson [University of Sao Paulo (USP), SP (Brazil); Herrera, Gabriel

2008-07-01

Tool face Control is widely regarded as one of the greatest directional drilling challenges with a Fixed Cutter (FC) drill bit on a Steerable Motor assembly. Tool face offset is proportional to the torque generated by the bit, and by nature, FC bits are capable of generating high levels of torque. If large changes in downhole torque are produced while drilling, this will cause rotation of the drill string, and loss of tool face orientation. This results in inefficient drilling and increases risk of bit and downhole tool damage. This paper examines the effect of various FC drill bit components to determine the key design requirements to deliver a smooth torque response and an improved directional performance. Included is a review of the results from comprehensive laboratory testing to determine the effectiveness of a number of different configurations of removable Torque Controlling Components (TCC). These, in combination with specific cutting structure layouts, combine to provide predictable torque response while optimized for high rates of penetration. In addition, unique gauge geometry is disclosed that was engineered to reduce drag and deliver improved borehole quality. This gauge design produces less torque when sliding and beneficial gauge pad interaction with the borehole when in rotating mode. Field performance studies from within Latin America clearly demonstrate that matching TCC, an optimized cutting structure, and gauge geometry to a steerable assembly delivers smooth torque response and improved directional control. Benefits with regard to improved stability are also discussed. Successful application has resulted in significant time and cost savings for the operator, demonstrating that Stability and Steerability improvements can be achieved with an increase in penetration rate. (author)

Impact of a University-Based Outpatient Telemedicine Program on Time Savings, Travel Costs, and Environmental Pollutants.

Science.gov (United States)

Dullet, Navjit W; Geraghty, Estella M; Kaufman, Taylor; Kissee, Jamie L; King, Jesse; Dharmar, Madan; Smith, Anthony C; Marcin, James P

2017-04-01

The objective of this study was to estimate travel-related and environmental savings resulting from the use of telemedicine for outpatient specialty consultations with a university telemedicine program. The study was designed to retrospectively analyze the telemedicine consultation database at the University of California Davis Health System (UCDHS) between July 1996 and December 2013. Travel distances and travel times were calculated between the patient home, the telemedicine clinic, and the UCDHS in-person clinic. Travel cost savings and environmental impact were calculated by determining differences in mileage reimbursement rate and emissions between those incurred in attending telemedicine appointments and those that would have been incurred if a visit to the hub site had been necessary. There were 19,246 consultations identified among 11,281 unique patients. Telemedicine visits resulted in a total travel distance savings of 5,345,602 miles, a total travel time savings of 4,708,891 minutes or 8.96 years, and a total direct travel cost savings of $2,882,056. The mean per-consultation round-trip distance savings were 278 miles, average travel time savings were 245 minutes, and average cost savings were $156. Telemedicine consultations resulted in a total emissions savings of 1969 metric tons of CO 2 , 50 metric tons of CO, 3.7 metric tons of NO x , and 5.5 metric tons of volatile organic compounds. This study demonstrates the positive impact of a health system's outpatient telemedicine program on patient travel time, patient travel costs, and environmental pollutants. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

[Telecardiology: Tasks and duties of telemedicine].

Science.gov (United States)

Borbás, János; Forczek, Erzsébet; Sepp, Róbert; Bari, Ferenc

2017-11-01

Telemedicine is a young science that integrates innovations of information-technology and telecommunications into medical science. A successful telemedicine procedure should guarantee reduced workload of the healthcare system with well secured and cost-effective processes. Our goal was to collect the development phases of telemedicine projects through existing telecardiology solutions. Subsequent to reviewing international publications we analyzed the past and present situation of blood pressure monitoring, remote diagnostics of electrocardiography, implantable cardioverter defibrillator monitoring and pocket ultrasound devices. In case of new solutions (a) several internationally accepted, confidently reproducible "good practices" are needed for creating (b) guidelines and recommendations of international medical associations. They have to ensure (c) cost-effective work, with well-designed sustainability and (d) patient confidentiality. Improving (e) education for professionals and patients is essential. We recommend to telemedicine developers to use our standards in order to introduce their products more effectively into clinical practice. It is encouraging that current possibilities of telecardiology partly or fully meet the aforementioned criteria. Further development of the topic can contribute to financial sustainability of our healthcare and might be able to resolve limitations of human resources. Orv Hetil. 2017; 158(44): 1741-1746.

Technology and quality control in telemedicine

International Nuclear Information System (INIS)

Barman, Mallika Roy; Pratik Kumar; Subramaniam, Kailash

2003-01-01

Transferring of medical electronic data from one place to another is known as telemedicine. All relevant medical opinions and investigations, like EGG, x-ray, sonography, GT scan, MRI and angiography can be transferred from one location to another by telemedicine. In developing countries like India where rural population is more and specialized doctors and hospital are few and located more in cities, it should be very useful

Bit-Wise Arithmetic Coding For Compression Of Data

Science.gov (United States)

Kiely, Aaron

1996-01-01

Bit-wise arithmetic coding is data-compression scheme intended especially for use with uniformly quantized data from source with Gaussian, Laplacian, or similar probability distribution function. Code words of fixed length, and bits treated as being independent. Scheme serves as means of progressive transmission or of overcoming buffer-overflow or rate constraint limitations sometimes arising when data compression used.

The Principles Of Liability On Telemedicine Practices

Directory of Open Access Journals (Sweden)

Arman Anwar

2016-09-01

Full Text Available This research was aimed at analyzing and finding the principle of liability in telemedicine medical practice proportionally.This research is a legal research with the approach of statute approach, conceptual approach and comparative approach, as well as the approach to the case approach. According to Article 24 paragraph (1 of the 1945 Constitution and Article 5 (1 of Act No. 48 of 2009 on Judicial Authority, determine that the judge shall explore, and understand the legal values and sense of justice in society. Thus Article 1367 paragraph (3 BW and Article 46 of Act No. 44 of 2009 on Hospitals in the application must be in the context of the intended. The principle of liability risk in medical practice telemedicine in proportion refers to professional liability among medical practitioners telemedicine. The theoretical legitimacy is based on professional relationships in the delegation of medical action based on the code of ethics, professional standards, and service standards, and standard operating procedures. Consequences on liability does not necessarily have to be based on errors primary physician (primary care physician / PCP or primary nurse as subordinate as mean vicarious liability doctrine. Nomenclature "proportional" in a significant liability risk as the distribution of rights and obligations of professionals in proportion to each party's fault based on the values of equality (equitability, feasibility and appropriateness (fair and reasionableness. Accountability based on the viewpoint of interactive justice according to the values of professional skill, prudence or accuracy, responsibility, and colleague and the desire to do good for the sake of healing patients (doing good.

Secure self-calibrating quantum random-bit generator

International Nuclear Information System (INIS)

Fiorentino, M.; Santori, C.; Spillane, S. M.; Beausoleil, R. G.; Munro, W. J.

2007-01-01

Random-bit generators (RBGs) are key components of a variety of information processing applications ranging from simulations to cryptography. In particular, cryptographic systems require 'strong' RBGs that produce high-entropy bit sequences, but traditional software pseudo-RBGs have very low entropy content and therefore are relatively weak for cryptography. Hardware RBGs yield entropy from chaotic or quantum physical systems and therefore are expected to exhibit high entropy, but in current implementations their exact entropy content is unknown. Here we report a quantum random-bit generator (QRBG) that harvests entropy by measuring single-photon and entangled two-photon polarization states. We introduce and implement a quantum tomographic method to measure a lower bound on the 'min-entropy' of the system, and we employ this value to distill a truly random-bit sequence. This approach is secure: even if an attacker takes control of the source of optical states, a secure random sequence can be distilled

The Role of Telemedicine in Auditory Rehabilitation: A Systematic Review.

Science.gov (United States)

Bush, Matthew L; Thompson, Robin; Irungu, Catherine; Ayugi, John

2016-12-01

The purpose of this study was to assess the feasibility and effectiveness of live telemedicine applications in hearing amplification and cochlear implantation. A systematic search was performed in PubMed, MEDLINE, PsychINFO, CINALH, and Web of Science to identify peer-reviewed research. Inclusion criteria were titles containing words from the search terms 1) audiology, otolaryngology, and hearing impairment, 2) rehabilitative methods, and 3) telemedicine. Exclusion criteria were: 1) non-English articles, and 2) non-original research. Twelve eligible studies were identified. The studies employed a prospective design in nine of the articles and retrospective case series in three. The use of telemedicine for the provision of cochlear implant services was examined in eight of the articles and with hearing aids in four of the articles. The types of services include intraoperative cochlear implant telemetry; implant programming and assessment of electrode-specific measures and speech recognition after implantation. Hearing aid programming and remote gain assessments were also reported. Many studies assess patient and provider satisfaction along with encounter time comparison. The studies occurred from 2009 to 2014 and took place in seven countries. This review examined the feasibility of remote telemedicine connection to provide in auditory rehabilitation services through hearing aids and cochlear implants. There are significant concerns regarding Internet bandwidth limitations for remote clinics. There is a paucity of research examining reimbursement and cost-effectiveness for services. Further prospective research investigating cost-effectiveness and bandwidth limitations is warranted to assess long-term sustainability of remote audiological rehabilitative service delivery.

All-optical wavelength conversion at bit rates above 10 Gb/s using semiconductor optical amplifiers

DEFF Research Database (Denmark)

Jørgensen, Carsten; Danielsen, Søren Lykke; Stubkjær, Kristian

1997-01-01

This work assesses the prospects for high-speed all-optical wavelength conversion using the simple optical interaction with the gain in semiconductor optical amplifiers (SOAs) via the interband carrier recombination. Operation and design guidelines for conversion speeds above 10 Gb/s are described...... and the various tradeoffs are discussed. Experiments at bit rates up to 40 Gb/s are presented for both cross-gain modulation (XGM) and cross-phase modulation (XPM) in SOAs demonstrating the high-speed capability of these techniques...

Combined reflection and transmission microscope for telemedicine applications in field settings.

Science.gov (United States)

Biener, Gabriel; Greenbaum, Alon; Isikman, Serhan O; Lee, Kelvin; Tseng, Derek; Ozcan, Aydogan

2011-08-21

We demonstrate a field-portable upright and inverted microscope that can image specimens in both reflection and transmission modes. This compact and cost-effective dual-mode microscope weighs only ∼135 grams (image of the specimen onto an opto-electronic sensor-array that is positioned above the beam-splitter cube. In addition to this, the illumination beam is also partially transmitted through the same specimen, which then casts lensfree in-line holograms of the same objects onto a second opto-electronic sensor-array that is positioned underneath the beam-splitter cube. By rapid digital reconstruction of the acquired lensfree holograms, transmission images (both phase and amplitude) of the same specimen are also created. We tested the performance of this field-portable microscope by imaging various micro-particles, blood smears as well as a histopathology slide corresponding to skin tissue. Being compact, light-weight and cost-effective, this combined reflection and transmission microscope might especially be useful for telemedicine applications in resource limited settings. This journal is © The Royal Society of Chemistry 2011

Information Retrieval in Telemedicine: a Comparative Study on Bibliographic Databases.

Science.gov (United States)

Ahmadi, Maryam; Sarabi, Roghayeh Ershad; Orak, Roohangiz Jamshidi; Bahaadinbeigy, Kambiz

2015-06-01

The first step in each systematic review is selection of the most valid database that can provide the highest number of relevant references. This study was carried out to determine the most suitable database for information retrieval in telemedicine field. Cinhal, PubMed, Web of Science and Scopus databases were searched for telemedicine matched with Education, cost benefit and patient satisfaction. After analysis of the obtained results, the accuracy coefficient, sensitivity, uniqueness and overlap of databases were calculated. The studied databases differed in the number of retrieved articles. PubMed was identified as the most suitable database for retrieving information on the selected topics with the accuracy and sensitivity ratios of 50.7% and 61.4% respectively. The uniqueness percent of retrieved articles ranged from 38% for Pubmed to 3.0% for Cinhal. The highest overlap rate (18.6%) was found between PubMed and Web of Science. Less than 1% of articles have been indexed in all searched databases. PubMed is suggested as the most suitable database for starting search in telemedicine and after PubMed, Scopus and Web of Science can retrieve about 90% of the relevant articles.

Telemedicine in wound care.

Science.gov (United States)

Chanussot-Deprez, Caroline; Contreras-Ruiz, José

2008-12-01

Telemedical wound care is one of the applications of teledermatology. We present our experience using telemedicine in the successful assessment and treatment of three patients with hard-to-heal ulcers. Three patients were seen at the PEMEX General Hospital in Veracruz, Mexico. The first patient was a 53-year-old man with hypertension, morbid obesity, chronic venous insufficiency, recurrent erysipelas, leg ulcers and lymphoedema. There was one ulcer on his left lower leg (20 x 10 cm) and one on his right leg (9 x 7 cm). The second patient was a 73-year-old woman with class III obesity and ulcers in her right leg, secondary to surgical debridement of bullous erysipelas. The third patient was a 51-year-old female with rheumatoid arthritis with one ulcer on each leg and chronic lymphostasis. Photographs with a digital camera were taken and sent weekly via email to a wound care specialist in Mexico City. The photographs allowed the expert to diagnose and evaluate the chronic wounds periodically. In the present cases, telemedicine allowed us to have a rapid evaluation, diagnosis and treatment. The images were of enough quality to be useful and small enough to be sent via regular email to the remote physician who immediately gave his feedback. The expert was confident to give therapeutic recommendations in this way, and we considered this method to be very cost-effective, saving the patient and the health care system, especially in transportation.

Towards reinforcing telemedicine adoption amongst clinicians in Nigeria.

Science.gov (United States)

Adenuga, Kayode I; Iahad, Noorminshah A; Miskon, Suraya

2017-08-01

Telemedicine systems have been considered as a necessary measure to alleviate the shortfall in skilled medical specialists in developing countries. However, the obvious challenge is whether clinicians are willing to use this technological innovation, which has aided medical practice globally. One factor which has received little academic attention is the provision of suitable encouragement for clinicians to adopt telemedicine, in the form of rewards, motivation or incentives. A further consideration for telemedicine usage in developing countries, especially sub-Saharan Africa and Nigeria in particular, are to the severe shortage of available practising clinicians. The researchers therefore explore the need to positively reinforce the adoption of telemedicine amongst clinicians in Nigeria, and also offer a rationale for this using the UTAUT model. Data were collected using a structured paper-based questionnaire, with 252 physicians and nurses from six government hospitals in Ondo state, Nigeria. The study applied SmartPLS 2.0 for analysis to determine the relationship between six variables. Demographic moderating variables, age, gender and profession, were included. The results indicate that performance expectancy (ptelemedicine systems, as predicted using the extended UTAUT model. Our results showed that the use of telemedicine by clinicians in the Nigerian context is perceived as a dual responsibility which requires suitable reinforcement. In addition, performance expectancy, effort expectancy, facilitating condition and reinforcement determinants are influential factors in the use of telemedicine services for remote-patient clinical diagnosis and management by the Nigerian clinicians. Copyright © 2017. Published by Elsevier B.V.

Minimal-post-processing 320-Gbps true random bit generation using physical white chaos.

Science.gov (United States)

Wang, Anbang; Wang, Longsheng; Li, Pu; Wang, Yuncai

2017-02-20

Chaotic external-cavity semiconductor laser (ECL) is a promising entropy source for generation of high-speed physical random bits or digital keys. The rate and randomness is unfortunately limited by laser relaxation oscillation and external-cavity resonance, and is usually improved by complicated post processing. Here, we propose using a physical broadband white chaos generated by optical heterodyning of two ECLs as entropy source to construct high-speed random bit generation (RBG) with minimal post processing. The optical heterodyne chaos not only has a white spectrum without signature of relaxation oscillation and external-cavity resonance but also has a symmetric amplitude distribution. Thus, after quantization with a multi-bit analog-digital-convertor (ADC), random bits can be obtained by extracting several least significant bits (LSBs) without any other processing. In experiments, a white chaos with a 3-dB bandwidth of 16.7 GHz is generated. Its entropy rate is estimated as 16 Gbps by single-bit quantization which means a spectrum efficiency of 96%. With quantization using an 8-bit ADC, 320-Gbps physical RBG is achieved by directly extracting 4 LSBs at 80-GHz sampling rate.

The business case for telemedicine.

Science.gov (United States)

Henny, Chris; Hartington, Katharine; Scott, Stuart; Tveiten, Agnar; Canals, Luisa

2013-01-01

Following the coming into force of the International Labour Organisation Maritime Labour Convention (ILO/MLC) and International Maritime Organisation Standards for Training, Certification and Watchkeeping, Manila 2010 (IMO/STCW) amendments, the objective of this article is to provide the shipping community with an initial assessment of the economic reasons and business case, in support of both publicly financed and private telemedicine being implemented on board commercial vessels. It provides the global scale of the requirement, the number of Telemedicine Assistance Services (TMAS) calls handled by participating TMAS, the average direct and indirect costs incurred by both TMAS and ship operators, responding to medical emergencies, and also provides a calculation of the market size of about 760 million Euro/year. It estimates a return on investment per ship, of implementing telemedicine on board to meet the MLC and STCW requirements at less than 1 year. 1. There are both financial and soft benefits, such as crew retention and being perceived as a quality employer offering a telemedicine service on board. 2. It is quite possible to obtain a 20% savings to the industry of perhaps 152 million Euro/year from the deployment of telemedicine on board. 3. The deployment of a telemedical service on ships is an opportunity to encourage further cooperation between TMAS and also with the private TMAS sector. 4. There is clearly a great need, on a global basis, for more cooperation, particularly in standardisation of pre-boarding medical files available, the equipmentrequired on board at a minimum, and level of service quality provided. 5. A collection of a common TMAS annual set of normalised statistics from the stakeholders in the maritime industry is needed. Should someone not be tasked with collecting this? 6. Open registries and countries where the private sector only providestele medicine, should be encouraged to work with the global public TMAS system and contribute to

The Use of Telemedicine and Mobile Technology to Promote Population Health and Population Management for Psychiatric Disorders.

Science.gov (United States)

Turvey, Carolyn; Fortney, John

2017-10-16

This article discusses recent applications in telemedicine to promote the goals of population health and population management for people suffering psychiatric disorders. The use of telemedicine to promote collaborative care, self-monitoring and chronic disease management, and population screening has demonstrated broad applicability and effectiveness. Collaborative care using videoconferencing to facilitate mental health specialty consults has demonstrated effectiveness in the treatment of depression, PTSD, and also ADHD in pediatric populations. Mobile health is currently being harnessed to monitor patient symptom trajectories with the goal of using machine learning algorithms to predict illness relapse. Patient portals serve as a bridge between patients and providers. They provide an electronically secure shared space for providers and patients to collaborate and optimize care. To date, research has supported the effectiveness of telemedicine in promoting population health. Future endeavors should focus on developing the most effective clinical protocols for using these technologies to ensure long-term use and maximum effectiveness in reducing population burden of mental health.

Monte Carlo Simulation Modeling of a Regional Stroke Team's Use of Telemedicine.

Science.gov (United States)

Torabi, Elham; Froehle, Craig M; Lindsell, Christopher J; Moomaw, Charles J; Kanter, Daniel; Kleindorfer, Dawn; Adeoye, Opeolu

2016-01-01

The objective of this study was to evaluate operational policies that may improve the proportion of eligible stroke patients within a population who would receive intravenous recombinant tissue plasminogen activator (rt-PA) and minimize time to treatment in eligible patients. In the context of a regional stroke team, the authors examined the effects of staff location and telemedicine deployment policies on the timeliness of thrombolytic treatment, and estimated the efficacy and cost-effectiveness of six different policies. A process map comprising the steps from recognition of stroke symptoms to intravenous administration of rt-PA was constructed using data from published literature combined with expert opinion. Six scenarios were investigated: telemedicine deployment (none, all, or outer-ring hospitals only) and staff location (center of region or anywhere in region). Physician locations were randomly generated based on their zip codes of residence and work. The outcomes of interest were onset-to-treatment (OTT) time, door-to-needle (DTN) time, and the proportion of patients treated within 3 hours. A Monte Carlo simulation of the stroke team care-delivery system was constructed based on a primary data set of 121 ischemic stroke patients who were potentially eligible for treatment with rt-PA. With the physician located randomly in the region, deploying telemedicine at all hospitals in the region (compared with partial or no telemedicine) would result in the highest rates of treatment within 3 hours (80% vs. 75% vs. 70%) and the shortest OTT (148 vs. 164 vs. 176 minutes) and DTN (45 vs. 61 vs. 73 minutes) times. However, locating the on-call physician centrally coupled with partial telemedicine deployment (five of the 17 hospitals) would be most cost-effective with comparable eligibility and treatment times. Given the potential societal benefits, continued efforts to deploy telemedicine appear warranted. Aligning the incentives between those who would have to fund

Giga-bit optical data transmission module for Beam Instrumentation

CERN Document Server

Roedne, L T; Cenkeramaddi, L R; Jiao, L

Particle accelerators require electronic instrumentation for diagnostic, assessment and monitoring during operation of the transferring and circulating beams. A sensor located near the beam provides an electrical signal related to the observable quantity of interest. The front-end electronics provides analog-to-digital conversion of the quantity being observed and the generated data are to be transferred to the external digital back-end for data processing, and to display to the operators and logging. This research project investigates the feasibility of radiation-tolerant giga-bit data transmission over optic fibre for beam instrumentation applications, starting from the assessment of the state of the art technology, identification of challenges and proposal of a system level solution, which should be validated with a PCB design in an experimental setup. Radiation tolerance of 10 kGy (Si) Total Ionizing Dose (TID) over 10 years of operation, Bit Error Rate (BER) 10-6 or better. The findings and results of th...

Application of a 16-bit microprocessor to the digital control of machine tools

International Nuclear Information System (INIS)

Issaly, Alain

1979-01-01

After an overview of machine tools (various types, definition standardization, associated technologies for motors and position sensors), this research thesis describes the principles of computer-based digital control: classification of machine tool command systems, machining programming, programming languages, dialog function, interpolation function, servo-control function, tool compensation function. The author reports the application of a 16-bit microprocessor to the computer-based digital control of a machine tool: feasibility, selection of microprocessor, hardware presentation, software development and description, machining mode, translation-loading mode

Tele-education service using telemedicine network in healthcare industry.

Science.gov (United States)

Mahadevan, S; Muralidhar, Kanchi; Shetty, Devi

2012-11-01

We have used a telemedicine facility to conduct academic teaching/training sessions. The objective of this study was to examine the feasibility, advantages, and disadvantages of this method of e-learning sessions. The teaching/learning sessions were organized twice a week between the two teaching hospitals. The success of each academic session was analyzed in terms of satisfaction of the participating candidates, infrastructure difficulties (if any), and the overall outcome of the program. In total, 293 academic sessions were held from 2008 to 2010. Each session's presentation was 45 min long and was made using Microsoft(®) (Redmond, WA) PowerPoint. We have found that telemedicine proved to be effective in establishing communication not only between the patient and the physician, but also between the teacher and the student. Several candidates benefited from the application of this technology. Candidates expressed satisfaction and were content with the teaching methods adapted.

Bit Loading Algorithms for Cooperative OFDM Systems

Directory of Open Access Journals (Sweden)

Gui Bo

2008-01-01

Full Text Available Abstract We investigate the resource allocation problem for an OFDM cooperative network with a single source-destination pair and multiple relays. Assuming knowledge of the instantaneous channel gains for all links in the entire network, we propose several bit and power allocation schemes aiming at minimizing the total transmission power under a target rate constraint. First, an optimal and efficient bit loading algorithm is proposed when the relay node uses the same subchannel to relay the information transmitted by the source node. To further improve the performance gain, subchannel permutation, in which the subchannels are reallocated at relay nodes, is considered. An optimal subchannel permutation algorithm is first proposed and then an efficient suboptimal algorithm is considered to achieve a better complexity-performance tradeoff. A distributed bit loading algorithm is also proposed for ad hoc networks. Simulation results show that significant performance gains can be achieved by the proposed bit loading algorithms, especially when subchannel permutation is employed.

Bit Loading Algorithms for Cooperative OFDM Systems

Directory of Open Access Journals (Sweden)

Bo Gui

2007-12-01

Full Text Available We investigate the resource allocation problem for an OFDM cooperative network with a single source-destination pair and multiple relays. Assuming knowledge of the instantaneous channel gains for all links in the entire network, we propose several bit and power allocation schemes aiming at minimizing the total transmission power under a target rate constraint. First, an optimal and efficient bit loading algorithm is proposed when the relay node uses the same subchannel to relay the information transmitted by the source node. To further improve the performance gain, subchannel permutation, in which the subchannels are reallocated at relay nodes, is considered. An optimal subchannel permutation algorithm is first proposed and then an efficient suboptimal algorithm is considered to achieve a better complexity-performance tradeoff. A distributed bit loading algorithm is also proposed for ad hoc networks. Simulation results show that significant performance gains can be achieved by the proposed bit loading algorithms, especially when subchannel permutation is employed.

Designing embedded systems with 32-bit PIC microcontrollers and MikroC

CERN Document Server

Ibrahim, Dogan

2013-01-01

The new generation of 32-bit PIC microcontrollers can be used to solve the increasingly complex embedded system design challenges faced by engineers today. This book teaches the basics of 32-bit C programming, including an introduction to the PIC 32-bit C compiler. It includes a full description of the architecture of 32-bit PICs and their applications, along with coverage of the relevant development and debugging tools. Through a series of fully realized example projects, Dogan Ibrahim demonstrates how engineers can harness the power of this new technology to optimize their embedded design

Hageseth's principle of extraterritorial jurisdiction and international telemedicine.

Science.gov (United States)

McLean, Thomas R; McLean, Alexander B

2008-01-01

At what point does an international telemedicine transaction create a sufficient commercial nexus to allow one country the authority to impose its laws on a foreign telemedicine providers? Some light on this matter was shed by the US case of Hageseth versus Superior Court. The authority for extraterritorial jurisdiction is found in the US Constitution, which requires the states to cooperate in matters of law enforcement. Similar cooperation from foreign nations cannot be expected. Unless a defendant is charged with a capital offence, nations are rarely willing to extradite their citizens. As the unlicensed practice of medicine is not a capital offence, it is unlikely that an unlicensed telemedicine provider would be extradited to the US. Because low-volume unlicensed offshore telemedicine providers are unlikely to be extradited or to be subject to trade sanctions, they may be able to operate beyond the law.

Telemedicine and robotics: paving the way to the globalization of surgery.

Science.gov (United States)

Senapati, S; Advincula, A P

2005-12-01

The concept of delivering health services at a distance, or telemedicine is becoming an emerging tool for the field of surgery. For the surgical services, telepresence surgery through robotics is gradually being incorporated into health care practices. This article will provide a brief overview of the principles surrounding telemedicine and telepresence surgery as they specifically relate to robotics. Where limitations have been reached in laparoscopy, robotics has allowed further steps forward. The development of robotics in medicine has been a progression from passive to immersive technology. In gynecology, the utilization of robotics has evolved from the use of Aesop, a robotic arm for camera manipulation, to full robotic systems such as Zeus, and the daVinci surgical system. These systems have not only been used directly for a variety of procedures but have also become a useful tool for conferencing and the mentoring of surgeons from afar. As this mode of technology becomes assimilated into the culture of surgery and medicine globally, caution must be taken to carefully navigate the economic, legal and ethical implications of telemedicine. Despite the challenges faced, telepresence surgery holds promise for more widespread applications.

A Novel Least Significant Bit First Processing Parallel CRC Circuit

Directory of Open Access Journals (Sweden)

Xiujie Qu

2013-01-01

Full Text Available In HDLC serial communication protocol, CRC calculation can first process the most or least significant bit of data. Nowadays most CRC calculation is based on the most significant bit (MSB first processing. An algorithm of the least significant bit (LSB first processing parallel CRC is proposed in this paper. Based on the general expression of the least significant bit first processing serial CRC, using state equation method of linear system, we derive a recursive formula by the mathematical deduction. The recursive formula is applicable to any number of bits processed in parallel and any series of generator polynomial. According to the formula, we present the parallel circuit of CRC calculation and implement it with VHDL on FPGA. The results verify the accuracy and effectiveness of this method.

Determinants of successful telemedicine implementations: a literature study

NARCIS (Netherlands)

Broens, T.H.F.; Huis in 't Veld, M.H.A.; Vollenbroek-Hutten, Miriam Marie Rosé; Hermens, Hermanus J.; van Halteren, Aart; Nieuwenhuis, Lambertus Johannes Maria

Telemedicine implementations often remain in the pilot phase and do not succeed in scaling-up to robust products that are used in daily practice. We conducted a qualitative literature review of 45 conference papers describing telemedicine interventions in order to identify determinants that had

The Efficacy of Telemedicine-Supported Discharge Within an In Home Model of Care.

Science.gov (United States)

Greenup, Edwin P; McCusker, Melissa; Potts, Boyd A; Bryett, Andrew

2017-09-01

To determine if mobile videoconferencing technology can facilitate the discharge of low-acuity patients receiving in-home care without compromising short-term health outcomes. A 6-month trial commenced in July 2015 with 345 patients considered unsuited to Criteria Led Discharge (CLD) receiving in-home care included as participants. Nurses providing clinical support to patients in their homes were supplied with a tablet computer (Apple iPad) with Internet connectivity (Telstra 4G Network) and videoconferencing software (Cisco Jabber for Telepresence). Device usage data combined with hospital admission records were collected to determine (a) instances where a telemedicine-facilitated discharge occurred and (b) if the accepted measure of short-term health outcomes (readmission within 28 days) was adversely affected by this alternative method. Telemedicine technology facilitated the discharge of 10.1% (n = 35) of patients considered unsuitable for CLD from the Hospital in the Home model during the trial period. Statistically insignificant differences in rates of readmission between patients discharged in person versus those participating in the telemedicine-supported model suggest that the clinical standards of the service have been maintained. The results of evaluating telemedicine support for nurses providing low-acuity in-home care indicate that patients may be discharged remotely while maintaining the existing clinical standards of the service.

Transforming Gastroenterology Care With Telemedicine.

Science.gov (United States)

Siegel, Corey A

2017-04-01

Health care is changing rapidly, so we must change with the times to develop more efficient, practical, cost-effective, and, importantly, high-quality methods to care for patients. We teach medical students that optimal patient care requires face-to-face interaction to collect information on the patient's history and perform the physical examination. However, management of many patients-especially those with chronic diseases-does not always require physical examination. Telemedicine offers an opportunity to take advantage of technology while leveraging the progressive push toward efficiency and value but also requires the belief that excellent patient care is not always provided in person. Telemedicine can include a variety of aspects of patient care adapted to be performed remotely, such as telemonitoring, tele-education, teleconsultation, and telecare. All of these have been evaluated in gastroenterology practice and have demonstrated feasibility and patient preference but have produced mixed results regarding patient outcomes. By combining telemedicine tools and new care models, we can redesign chronic disease management to include fewer in-person visits when patients are well yet increase access for patients who need to be seen. This change could lead to higher-value care by improving the experience of care, decreasing costs, and improving the health of the population. Barriers include reimbursement, licensing, and fear of litigation. However, if we hope to meet the needs of patients within our changing health care system, telemedicine should be incorporated into our strategy. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Need and feasibility of telemedicine in non-urban day care centres.

Science.gov (United States)

Setia, Monika; DelliFraine, Jami L

2010-01-01

There appear to have been no studies of telemedicine in rural day care centres. We have assessed the feasibility of using telemedicine in eight rural day care centres in Pennsylvania, from the day care centres' perspective. The average number of children in these centres was 76 (range 20-150). The centres sent an average of 4.7 children home each month because of illness. Using telephone and face-to-face interviews, we assessed their perceived need for and familiarity with telemedicine, as well as their openness and preparedness for implementing telemedicine. Most day care centres reported a need for telemedicine and were open to learning how to use it. Some centres were concerned about adequate space for the equipment, but overall, the centres felt that their resources were adequate. Telemedicine in rural day care centres appears to be feasible, and would have the potential to save time and money for parents, as well as perhaps improving health care for children in rural areas.

The Promise of Telemedicine for Movement Disorders: an Interdisciplinary Approach.

Science.gov (United States)

Ben-Pazi, H; Browne, P; Chan, P; Cubo, E; Guttman, M; Hassan, A; Hatcher-Martin, J; Mari, Z; Moukheiber, E; Okubadejo, N U; Shalash, A

2018-04-13

Advances in technology have expanded telemedicine opportunities covering medical practice, research, and education. This is of particular importance in movement disorders (MDs), where the combination of disease progression, mobility limitations, and the sparse distribution of MD specialists increase the difficulty to access. In this review, we discuss the prospects, challenges, and strategies for telemedicine in MDs. Telemedicine for MDs has been mainly evaluated in Parkinson's disease (PD) and compared to in-office care is cost-effective with similar clinical care, despite the barriers to engagement. However, particular groups including pediatric patients, rare MDs, and the use of telemedicine in underserved areas need further research. Interdisciplinary telemedicine and tele-education for MDs are feasible, provide similar care, and reduce travel costs and travel time compared to in-person visits. These benefits have been mainly demonstrated for PD but serve as a model for further validation in other movement disorders.

The role of telemedicine and mobile health in the monitoring of sleep-breathing disorders: improving patient outcomes

Directory of Open Access Journals (Sweden)

Villanueva JA

2017-02-01

specially improved by telemedicine by using remote continuous positive airway-pressure data, self-management platforms, and mobile applications for patient feedback. Incorporating new procedures with novel technologies and sensors will probably change the process. Instead of replicating traditional visits, mHealth may provide shorter and more frequent assessments; alarm systems on the patients’ devices could alert physicians or mobile applications with simple questionnaires may help on follow-up. With telemedicine, patients will not be treated in the same way. Keywords: mHealth, telemedicine, obstructive sleep apnea, continuous positive airway pressure

Use of telemedicine technologies in the management of infectious diseases: a review.

Science.gov (United States)

Parmar, Parmvir; Mackie, David; Varghese, Sunil; Cooper, Curtis

2015-04-01

Telemedicine technologies are rapidly being integrated into infectious diseases programs with the aim of increasing access to infectious diseases specialty care for isolated populations and reducing costs. We summarize the utility and effectiveness of telemedicine in the evaluation and treatment of infectious diseases patients. The use of telemedicine in the management of acute infectious diseases, chronic hepatitis C, human immunodeficiency virus, and active pulmonary tuberculosis is considered. We recapitulate and evaluate the advantages of telemedicine described in other studies, present challenges to adopting telemedicine, and identify future opportunities for the use of telemedicine within the realm of clinical infectious diseases. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Trusting telemedicine: A discussion on risks, safety, legal implications and liability of involved stakeholders.

Science.gov (United States)

Parimbelli, E; Bottalico, B; Losiouk, E; Tomasi, M; Santosuosso, A; Lanzola, G; Quaglini, S; Bellazzi, R

2018-04-01

The main purpose of the article is to raise awareness among all the involved stakeholders about the risks and legal implications connected to the development and use of modern telemedicine systems. Particular focus is given to the class of "active" telemedicine systems, that imply a real-world, non-mediated, interaction with the final user. A secondary objective is to give an overview of the European legal framework that applies to these systems, in the effort to avoid defensive medicine practices and fears, which might be a barrier to their broader adoption. We leverage on the experience gained during two international telemedicine projects, namely MobiGuide (pilot studies conducted in Spain and Italy) and AP@home (clinical trials enrolled patients in Italy, France, the Netherlands, United Kingdom, Austria and Germany), whose development our group has significantly contributed to in the last 4 years, to create a map of the potential criticalities of active telemedicine systems and comment upon the legal framework that applies to them. Two workshops have been organized in December 2015 and March 2016 where the topic has been discussed in round tables with system developers, researchers, physicians, nurses, legal experts, healthcare economists and administrators. We identified 8 features that generate relevant risks from our example use cases. These features generalize to a broad set of telemedicine applications, and suggest insights on possible risk mitigation strategies. We also discuss the relevant European legal framework that regulate this class of systems, providing pointers to specific norms and highlighting possible liability profiles for involved stakeholders. Patients are more and more willing to adopt telemedicine systems to improve home care and day-by-day self-management. An essential step towards a broader adoption of these systems consists in increasing their compliance with existing regulations and better defining responsibilities for all the

A Case Study - On Patient Empowerment and Integration of Telemedicine to National Healthcare Services

DEFF Research Database (Denmark)

Urazimbetova, Surayya

Patient empowerment in the digitalized healthcare can be supported by means of telemedicine. As opposed to Electronic Patient Records developed by a few large business suppliers for healthcare professionals, telemedical applications include innovative solutions of small-medium size suppliers...... and are targeted at specific groups of patients (e.g., hip operated or dermatology patients) and their care network. Based on an integration experiment we argue that in order to support the national visions for patient empowerment and connectedness of healthcare at the same time, it is necessary to achieve...... the integration of telemedicine to the national healthcare services on a business logic (functional) integration level. In this paper, (1) we identify the lack of business logic (functional) level integration opportunities for patient oriented telemedical applications with national healthcare services; (2) we...

Telemedicine in Alentejo

Science.gov (United States)

Bayer, Steffen; Gonçalves, Luís; Barlow, James

2014-01-01

Abstract Alentejo covers a third of Portugal, yet it is home to only 5% of the population. Residents of the region are poorer, older, and less educated than the rest of the country. There is a shortage of physicians in several specialties. The low population density, a concentration of specialized services, and a poor public transportation network all create barriers to access. Telemedicine was introduced in 1998 to help address these challenges. In this article, we provide an overview of the program and its current status, focusing on infrastructure, services, and activity volume. We also discuss the impact the program has had from the perspectives of patients and healthcare professionals. From 1998 to 2011, there were 132,546 episodes of service using telemedicine, including real-time teleconsultations, teleradiology, teleultrasound, and telepathology. At present, the network includes 20 primary care units and five hospitals, covering almost 30,000 km2 and 500,000 people. Units have high-resolution videoconferencing equipment, access to patients' clinical records, an image archive, and peripherals, such as electronic dermatoscopes and phonendoscopes. Teleconsultations are available in 15 medical specialties and areas, ranging from neurology to pediatric surgery. In 2008, regional health authorities started a tele-education program, and by the end of 2011, 876 healthcare professionals, across 52 locations, had participated in remote learning sessions. More than a decade since telemedicine was introduced in Alentejo, it is now an integral part of everyday service provision. A comprehensive assessment of the costs and consequences of the program is currently underway. PMID:24180419

Compact, Light-weight and Cost-effective Microscope based on Lensless Incoherent Holography for Telemedicine Applications

Science.gov (United States)

Mudanyali, Onur; Tseng, Derek; Oh, Chulwoo; Isikman, Serhan O.; Sencan, Ikbal; Bishara, Waheb; Oztoprak, Cetin; Seo, Sungkyu; Khademhosseini, Bahar; Ozcan, Aydogan

2010-01-01

Despite the rapid progress in optical imaging, most of the advanced microscopy modalities still require complex and costly set-ups that unfortunately limit their use beyond well equipped laboratories. In the meantime, microscopy in resource-limited settings has requirements significantly different from those encountered in advanced laboratories, and such imaging devices should be cost-effective, compact, light-weight and appropriately accurate and simple to be usable by minimally trained personnel. Furthermore, these portable microscopes should ideally be digitally integrated as part of a telemedicine network that connects various mobile health-care providers to a central laboratory or hospital. Toward this end, here we demonstrate a lensless on-chip microscope weighing ~46 grams with dimensions smaller than 4.2cm × 4.2cm × 5.8cm that achieves sub-cellular resolution over a large field of view of ~24 mm2. This compact and light-weight microscope is based on digital in-line holography and does not need any lenses, bulky optical/mechanical components or coherent sources such as lasers. Instead, it utilizes a simple light-emitting-diode (LED) and a compact opto-electronic sensor-array to record lensless holograms of the objects, which then permits rapid digital reconstruction of regular transmission or differential interference contrast (DIC) images of the objects. Because this lensless incoherent holographic microscope has orders-of-magnitude improved light collection efficiency and is very robust to mechanical misalignments it may offer a cost-effective tool especially for telemedicine applications involving various global health problems in resource limited settings. PMID:20401422

Japanese experience of telemedicine in oncology.

Science.gov (United States)

Mizushima, H; Uchiyama, E; Nagata, H; Matsuno, Y; Sekiguchi, R; Ohmatsu, H; Hojo, F; Shimoda, T; Wakao, F; Shinkai, T; Yamaguchi, N; Moriyama, N; Kakizoe, T; Abe, K; Terada, M

2001-05-01

We started telemedicine projects from 1990 with a telepathology system within Tsukiji Campus of National Cancer Center. In 1994, we connected Tsukiji Campus and Kashiwa Campus by 6 Mbps optical fiber leased line using IP protocol for data transmission, for teleconference, telepathology, and teleradiology projects. We also started connection of regional cancer centers and are now forming a cancer center network of 14 cancer centers. We are at present organizing 130 teleconferences per year with an attendance of more than 16000 people as summary. We have also used a high-resolution image transferring system, such as SHD (2000 pixelsx2000 pixels resolution) system on one side, and an economical telemedicine system using JAVA and a WWW browser (NCC_image) on the other side. We think that providing information is another field of telemedicine. We began the experimental gopher and WWW service in 1993. We are now providing official up-to-date cancer information for patients and healthcare professionals. We are getting more than 400000 hits per month. We are also providing a teleconference video session which is held every week on the Internet using a Real Video system with synchronized slide presentation on the WWW browser. We are also organizing a Cancer Image Reference Database System including DICOM images with viewer software. This paper is a summary of the telemedicine projects performed at the National Cancer Center.

Telemedicine in Majuro Hospital, Marshall Islands.

Science.gov (United States)

Gunawardane, K J

2000-09-01

Since March 1998 up to June 2000, telemedicine activities in Marshall Islands have mainly been for Referrals to Tripler Army Medical Center (TAMC) in Hawaii. The activities are based on a computer which has the Internet connection and accessories including a digital camera, flatbed scanner with a transparency adapter, color printer, a video printer, ophthalmoscope, otoscope and a video Lens, all of which were donated by Project Akamai in Hawaii. Two sessions of training were conducted by representatives from Akamai Project and from PBMA at the very beginning of the establishment of the unit, to all levels of Health Care Providers in Ministry of Health in Majuro. The computer and Internet facility is available 24 hours. Since March 1998 to June 2000, there had been 144 telemedicine consultations to TAMC. Out of a total of 326 off-island referrals for the same period, approximately 80 patients have been sent to TAMC using the PIHCP/Telemedicine program. This accounts for approximately 25% of total off-island referrals. This represents a significant reduction in cost. In addition to cost reduction the telemedicine unit most important impact is on the health providers, especially the physicians working at Majuro Hospital. Availability of medical information through internet has helped them to feel less isolated from the constantly changing field of medical science.

Analysis of bit-rock interaction during stick-slip vibrations using PDC cutting force model

Energy Technology Data Exchange (ETDEWEB)

Patil, P.A.; Teodoriu, C. [Technische Univ. Clausthal, Clausthal-Zellerfeld (Germany). ITE

2013-08-01

Drillstring vibration is one of the limiting factors maximizing the drilling performance and also causes premature failure of drillstring components. Polycrystalline diamond compact (PDC) bit enhances the overall drilling performance giving the best rate of penetrations with less cost per foot but the PDC bits are more susceptible to the stick slip phenomena which results in high fluctuations of bit rotational speed. Based on the torsional drillstring model developed using Matlab/Simulink for analyzing the parametric influence on stick-slip vibrations due to drilling parameters and drillstring properties, the study of relations between weight on bit, torque on bit, bit speed, rate of penetration and friction coefficient have been analyzed. While drilling with the PDC bits, the bit-rock interaction has been characterized by cutting forces and the frictional forces. The torque on bit and the weight on bit have both the cutting component and the frictional component when resolved in horizontal and vertical direction. The paper considers that the bit is undergoing stick-slip vibrations while analyzing the bit-rock interaction of the PDC bit. The Matlab/Simulink bit-rock interaction model has been developed which gives the average cutting torque, T{sub c}, and friction torque, T{sub f}, values on cutters as well as corresponding average weight transferred by the cutting face, W{sub c}, and the wear flat face, W{sub f}, of the cutters value due to friction.

Differences in Readiness between Rural Hospitals and Primary Care Providers for Telemedicine Adoption and Implementation: Findings from a Statewide Telemedicine Survey

Science.gov (United States)

Martin, Amy Brock; Probst, Janice C.; Shah, Kyle; Chen, Zhimin; Garr, David

2012-01-01

Purpose: Published advantages of and challenges with telemedicine led us to examine the scope of telemedicine adoption, implementation readiness, and barriers in a southern state where adoption has been historically low. We hypothesized that rural hospitals and primary care providers (RPCPs) differ on adoption, readiness, and implementation…

A Holistic Approach to Bit Preservation

DEFF Research Database (Denmark)

Zierau, Eld Maj-Britt Olmütz

2011-01-01

This thesis presents three main results for a holistic approach to bit preservation, where the ultimate goal is to find the optimal bit preservation strategy for specific digital material that must be digitally preserved. Digital material consists of sequences of bits, where a bit is a binary digit...... which can have the value 0 or 1. Bit preservation must ensure that the bits remain intact and readable in the future, but bit preservation is not concerned with how bits can be interpreted as e.g. an image. A holistic approach to bit preservation includes aspects that influence the final choice of a bit...... a holistic approach and include aspects of digital representation, confidentiality, availability, bit safety and costs when defining requirements for the bit preservation. Analysis of such requirements and choice of the final bit preservation solution can be supported by the three main results presented...

Telemedicine and Palliative Care: an Increasing Role in Supportive Oncology.

Science.gov (United States)

Worster, Brooke; Swartz, Kristine

2017-06-01

With the emergence of telemedicine as a routine form of care in various venues, the opportunities to use technology to care for the most vulnerable, most ill cancer patients are extremely appealing. Increasingly, evidence supports early integration of palliative care with standard oncologic care, supported by recent NCCN guidelines to increase and improve access to palliative care. This review looks at the use of telemedicine to expand access to palliative care as well as provide better care for patients and families where travel is difficult, if not impossible. When telemedicine has been used, often in Europe, for palliative care, the results show improvements in symptom management, comfort with care as well as patient and family satisfaction. One barrier to use of telemedicine is the concerns with technology and technology-related complications in population that is often elderly, frail and not always comfortable with non-face-to-face physician care. There remain significant opportunities to explore this intersection of supportive care and telemedicine.

Evolution of telemedicine from an applied communication perspective in the United States.

Science.gov (United States)

Whitten, Pamela; Sypher, Beverly Davenport

2006-10-01

Telemedicine, the use of telecommunication technologies to provide health services over some distance, has a history that spans more than five decades. Technological development and deployment have been interrelated with shifting paradigmatic views. This paper proposes that telemedicine has evolved through three generations that began with telemedicine as a communication medium to complement traditional services to a technology of automation and decision tools that expands the scope and range of health services and creates a unique health communication context. This paper provides a literature review and overviews three proposed evolutionary stages for telemedicine to date, namely synchronous versus asynchronous modalities, data transfer and storage, and automating decision making and robotics. Finally, we conclude with a discussion of the barriers for telemedicine and a call for engineers to join with social scientists and medical professionals to set an agenda for future telemedicine development.

MED5/355: Using Web-technology for Asynchronous Telemedicine Consulting

OpenAIRE

Reviakin, Y; Sukhanov, A

1999-01-01

Introduction Common telemedicine consultations can be divided in two classes: real-time telemedicine consultations and asynchronous telemedicine consultations. The advantage of real-time consultations is obvious - this is a natural discussion between physicians, which may be realised on the basis of desktop videoconferences. But the problems are also obvious: the necessity of additional hardware and the elevated demands for channel bandwidth. Because of the latter, the use of asynchronous tel...

Adopting Telemedicine for the Self-Management of Hypertension: Systematic Review.

Science.gov (United States)

Mileski, Michael; Kruse, Clemens Scott; Catalani, Justin; Haderer, Tara

2017-10-24

Hypertension is a chronic condition that affects adults of all ages. In the United States, 1 in 3 adults has hypertension, and about half of the hypertensive population is adequately controlled. This costs the nation US $46 billion each year in health care services and medications required for treatment and missed workdays. Finding easier ways of managing this condition is key to successful treatment. A solution to reduce visits to physicians for chronic conditions is to utilize telemedicine. Research is limited on the effects of utilizing telemedicine in health care facilities. There are potential benefits for implementing telemedicine programs with patients dealing with chronic conditions. The purpose of this review was to weigh the facilitators against the barriers for implementing telemedicine. Searches were methodically conducted in the Cumulative Index to Nursing and Allied Health Literature Complete (CINAHL Complete) via Elton B Stephens Company (EBSCO) and PubMed (which queries MEDLINE) to collect information about self-management of hypertension through the use of telemedicine. Results identify facilitators and barriers corresponding to the implementation of self-management of hypertension using telemedicine. The most common facilitators include increased access, increase in health and quality, patient knowledge and involvement, technology growth with remote monitoring, cost-effectiveness, and increased convenience/ease. The most prevalent barriers include lack of evidence, self-management difficult to maintain, no long-term results/more areas to address, and long-term added workload commitment. This review guides health care professionals in incorporating new practices and identifying the best methods to introduce telemedicine into their practices. Understanding the facilitators and barriers to implementation is important, as is understanding how these factors will impact a successful implementation of telemedicine in the area of self-management of

Portable emergency telemedicine system over wireless broadband and 3G networks.

Science.gov (United States)

Hong, SungHye; Kim, SangYong; Kim, JungChae; Lim, DongKyu; Jung, SeokMyung; Kim, DongKeun; Yoo, Sun K

2009-01-01

The telemedicine system aims at monitoring patients remotely without limit in time and space. However the existing telemedicine systems exchange medical information simply in a specified location. Due to increasing speed in processing data and expanding bandwidth of wireless networks, it is possible to perform telemedicine services on personal digital assistants (PDA). In this paper, a telemedicine system on PDA was developed using wideband mobile networks such as Wi-Fi, HSDPA, and WiBro for high speed bandwidths. This system enables to utilize and exchange variety and reliable patient information of video, biosignals, chatting messages, and triage data. By measuring bandwidths of individual data of the system over wireless networks, and evaluating the performance of this system using PDA, we demonstrated the feasibility of the designed portable emergency telemedicine system.

Telemedicine: an enhanced emergency care program for older adults

Directory of Open Access Journals (Sweden)

Takahashi PY

2014-07-01

Full Text Available Paul Y Takahashi,1 Anupam Chandra,1 Frederick North,1 Jennifer L Pecina,2 Benjavan Upatising,3 Gregory J Hanson11Mayo Clinic Division of Primary Care Internal Medicine, 2Mayo Clinic Department of Family Medicine, Rochester, MN, USA; 3Regenstrief Center for Healthcare Engineering, Purdue University, West Lafayette, IN, USAAbstract: Recent changes and consolidations in health care systems have resulted in an increase in new health care delivery models. Telemedicine holds great promise as one of these models. There is a great potential for new patient evaluation and treatment models in emergency care (EC, especially when patients are miles away from a medical team. Evaluations can be performed in a patient's home, a nursing care facility, and in hospitals that focus on advanced subspecialty care. Due to rapid developments in this area, current care models are constantly being evaluated and modified. This review article outlines current telemedicine models for EC and summarizes their potential benefits to patients and the health care system. The review examines the role that the telephone, a fundamental tool of telemedicine, plays in these new models. The review also examines evidence of improved health care outcomes by highlighting the role of telemedicine in reducing hospitalizations. The patient is the primary focus; as a result, this review also examined patient experiences and satisfaction levels regarding telemedicine health care teams. The authors support these technological advances and their potential for information transfer. Health care providers need to continue developing these models by making use of increasing amounts of information. One of the main implementation barriers of these new models in the US and other countries is the issue of payment and reimbursement. Despite this, advancements in EC telemedicine continue.Keywords: telemedicine, emergency care, geriatric, patient evaluation models

A biometric method to secure telemedicine systems.

Science.gov (United States)

Zhang, G H; Poon, Carmen C Y; Li, Ye; Zhang, Y T

2009-01-01

Security and privacy are among the most crucial issues for data transmission in telemedicine systems. This paper proposes a solution for securing wireless data transmission in telemedicine systems, i.e. within a body sensor network (BSN), between the BSN and server as well as between the server and professionals who have assess to the server. A unique feature of this solution is the generation of random keys by physiological data (i.e. a biometric approach) for securing communication at all 3 levels. In the performance analysis, inter-pulse interval of photoplethysmogram is used as an example to generate these biometric keys to protect wireless data transmission. The results of statistical analysis and computational complexity suggest that this type of key is random enough to make telemedicine systems resistant to attacks.

Health information systems to improve health care: A telemedicine case study

Directory of Open Access Journals (Sweden)

Liezel Cilliers

2013-03-01

Full Text Available Background: E-health has been identified as an integral part of the future of South African public healthcare. Telemedicine was first introduced in South Africa in 1997 and since then the cost of running the Telemedicine projects has increased substantially. Despite these efforts to introduce the system, only 34% of the Telemedicine sites in South Africa are functional at present. Objectives: Literature has suggested that one of the barriers to the successful implementation of health information systems is the user acceptance by health care workers of systems such as Telemedicine. This study investigated the user acceptance of Telemedicine in the public health care system in the Eastern Cape Province, making use of the Unified Theory of the Use and Acceptance of Technology. Method: The study employed a quantitative survey approach. A questionnaire was developed making use of existing literature and was distributed to various clinics around the province where Telemedicine has been implemented. Statistics were produced making use of Statistical Package for the Social Sciences (SPSS. Results: In general, the health care workers did understand the value and benefit of health information systems to improve the effectiveness and efficiency of the health care system. The barriers to the effective implementation of a health information system include the lack of knowledge and the lack of awareness regarding the Telemedicine system. This in turn means that the user is apprehensive when making use of the system thus contributing to less frequent usage. Conclusion: Health care workers do acknowledge that information systems can help to increase the effectiveness of the health care system. In general, the acceptance of Telemedicine in the Eastern Cape Department of Health is positive, but in order to integrate it into standard work practices, more must be done with regards to the promotion and education of telemedicine.

The role of telemedicine in obstructive sleep apnea management.

Science.gov (United States)

Lugo, Vera; Villanueva, Jair Asir; Garmendia, Onintza; Montserrat, Josep M

2017-09-01

Obstructive sleep apnea (OSA) is a common disease that leads in notorious symptoms and comorbidities. Although general measures are important, continuous positive airway pressure (CPAP) is the best treatment option. However, compliance can be suboptimal and telemedicine may play a role to improve it. Areas covered: Review authors searched EMBASE, PubMed and Cochrane data bases using the following keywords: continuous positive airway pressure, Obstructive sleep apnea, telemedicine, respiratory telemedicine, information and communication technology. Papers published between 2000 and 2016 in English language were considered. Expert commentary: To improve OSA management, there is a pressing need to develop new cost-effective strategies, particularly those related to OSA treatment, from measures such as lifestyle changes to CPAP use. Two broad strategies should be implemented: 1) adequate pre-, peri-, and post-titration measures to ensure correct diagnosis, adequate training, and appropriate support during follow up; and 2) the use of technological advances including both the optimization of CPAP devices and the use of telemedicine, specially focused on the first days or weeks of treatment. Telemedicine can help with these processes, especially when it is personalized to the needs of each patient group.

Telemedicine Services for the Arctic: A Systematic Review

Science.gov (United States)

Walderhaug, Ståle; Hartvigsen, Gunnar

2017-01-01

Background Telemedicine services have been successfully used in areas where there are adequate infrastructures such as reliable power and communication lines. However, despite the increasing number of merchants and seafarers, maritime and Arctic telemedicine have had limited success. This might be linked with various factors such as lack of good infrastructure, lack of trained onboard personnel, lack of Arctic-enhanced telemedicine equipment, extreme weather conditions, remoteness, and other geographical challenges. Objective The purpose of this review was to assess and analyze the current status of telemedicine services in the context of maritime conditions, extreme weather (ie, Arctic weather), and remote accidents and emergencies. Moreover, the paper aimed to identify successfully implemented telemedicine services in the Arctic region and in maritime settings and remote emergency situations and present state of the art systems for these areas. Finally, we identified the status quo of telemedicine services in the context of search and rescue (SAR) scenarios in these extreme conditions. Methods A rigorous literature search was conducted between September 7 and October 28, 2015, through various online databases. Peer reviewed journals and articles were considered. Relevant articles were first identified by reviewing the title, keywords, and abstract for a preliminary filter with our selection criteria, and then we reviewed full-text articles that seemed relevant. Information from the selected literature was extracted based on some predefined categories, which were defined based on previous research and further elaborated upon via iterative brainstorming. Results The initial hits were vetted using the title, abstract, and keywords, and we retrieved a total of 471 papers. After removing duplicates from the list, 422 records remained. Then, we did an independent assessment of the articles and screening based on the inclusion and exclusion criteria, which eliminated

High-Surety Telemedicine in a Distributed, 'Plug-and-Play' Environment

International Nuclear Information System (INIS)

Craft, Richard L.; Funkhouser, Donald R.; Gallagher, Linda K.; Garcia, Rudy J.; Parks, Raymond C.; Warren, Steve

1999-01-01

Commercial telemedicine systems are increasingly functional, incorporating video-conferencing capabilities, diagnostic peripherals, medication reminders, and patient education services. However, these systems (1) rarely utilize information architectures which allow them to be easily integrated with existing health information networks and (2) do not always protect patient confidentiality with adequate security mechanisms. Using object-oriented methods and software wrappers, we illustrate the transformation of an existing stand-alone telemedicine system into 'plug-and-play' components that function in a distributed medical information environment. We show, through the use of open standards and published component interfaces, that commercial telemedicine offerings which were once incompatible with electronic patient record systems can now share relevant data with clinical information repositories while at the same time hiding the proprietary implementations of the respective systems. Additionally, we illustrate how leading-edge technology can secure this distributed telemedicine environment, maintaining patient confidentiality and the integrity of the associated electronic medical data. Information surety technology also encourages the development of telemedicine systems that have both read and write access to electronic medical records containing patient-identifiable information. The win-win approach to telemedicine information system development preserves investments in legacy software and hardware while promoting security and interoperability in a distributed environment

Analysis of Button Bit Wear and Performance of Down-The-Hole ...

African Journals Online (AJOL)

Michael O. Mensah

2015-12-02

Dec 2, 2015 ... revealed that wear of rock drill bit is influenced by rock properties. ... equivalent quartz content and silica content are dominant rock properties affecting wear rate of bit button of DTH drill. ..... Cutting, Drilling and Blasting: Rock.

Telemedicine and burns: an overview.

Science.gov (United States)

Atiyeh, B; Dibo, S A; Janom, H H

2014-06-30

Access to specialized burn care is becoming more difficult and is being restricted by the decreasing number of specialized burn centers. It is also limited by distance and resources for many patients, particularly those living in poverty or in rural medically underserved communities. Telemedicine is a rapidly evolving technology related to the practice of medicine at a distance through rapid access to remote medical expertise by telecommunication and information technologies. Feasibility of telemedicine in burn care has been demonstrated by various centers. Its use facilitates the delivery of care to patients with burn injuries of all sizes. It allows delivery of acute care and can be appropriately used for a substantial portion of the long-term management of patients after a burn by guiding less-experienced surgeons to treat and follow-up patients more appropriately. Most importantly, it allows better effective triage which reduces unnecessary time and resource demanding referrals that might overwhelm system capacities. However, there are still numerous barriers to the implementation of telemedicine, including technical difficulties, legal uncertainties, limited financial support, reimbursement issues, and an inadequate evidence base of its value and efficiency.

Quality of life in patients receiving telemedicine enhanced chronic heart failure disease management: A meta-analysis.

Science.gov (United States)

Knox, Liam; Rahman, Rachel J; Beedie, Chris

2017-08-01

Background Previous reviews have investigated the effectiveness of telemedicine in the treatment of heart failure (HF). Dependent variables have included hospitalisations, mortality rates, disease knowledge and health costs. Few reviews, however, have examined the variable of health-related quality of life (QoL). Methods Randomised controlled trials comparing the delivery methods of any form of telemedicine with usual care for the provision of HF disease-management were identified via searches of all relevant databases and reference lists. Studies had to report a quantitative measure for mental, physical or overall QoL in order to be included. Results A total of 33 studies were identified. However, poor reporting of data resulted in the exclusion of seven, leaving 26 studies with 7066 participants. Three separate, random effects meta-analyses were conducted for mental, physical and overall QoL. Telemedicine was not significantly more effective than usual care on mental and physical QoL (standardised mean difference (SMD) 0.03, (95% confidence interval (CI) -0.05-0.12), p = 0.45 and SMD 0.24, (95% CI -0.08-0.56), p = 0.14, respectively). However, when compared to usual care, telemedicine was associated with a small significant increase in overall QoL (SMD 0.23, (95% CI 0.09-0.37), p = 0.001). Moderator analyses indicated that telemedicine delivered over a long-duration (≥52 weeks) and via telemonitoring was most beneficial. Conclusion Compared to usual care, telemedicine significantly increases overall QoL in patients receiving HF disease management. Statistically non-significant but nonetheless positive trends were also observed for physical QoL. These findings provide preliminary support for the use of telemedicine in the management of heart failure without jeopardising patient well-being.

THE APPLICATION OF LASERS IN MEASUREMENT OF FLUID FLOW THROUGH DRILLING BIT NOZZLES

Directory of Open Access Journals (Sweden)

Radenko Drakulić

1993-12-01

Full Text Available Two optical methods based on laser and video technology and digital signal and image processing techniques - Laser Doppler velocimetry (LDV and Particle image velocimetry (PIV were applied in highly accurate fluid flow measurement. Their application in jet velocity measurement of flows through drilling bit nozzles is presented. The role of nozzles in drilling technology together with procedures and tests performed on their optimization are reviewed. In addition, some experimental results for circular nozzle obtained both with LDV and PIV are elaborated. The experimental set-up and the testing procedure arc briefly discussed, as well as potential improvements in the design. Possible other applications of LDV and PIV in the domain of petroleum engineering are suggested (the paper is published in Croatian.

Performance evaluations of hybrid modulation with different optical labels over PDQ in high bit-rate OLS network systems.

Science.gov (United States)

Xu, M; Li, Y; Kang, T Z; Zhang, T S; Ji, J H; Yang, S W

2016-11-14

Two orthogonal modulation optical label switching(OLS) schemes, which are based on payload of polarization multiplexing-differential quadrature phase shift keying(POLMUX-DQPSK or PDQ) modulated with identifications of duobinary (DB) label and pulse position modulation(PPM) label, are researched in high bit-rate OLS network. The BER performance of hybrid modulation with payload and label signals are discussed and evaluated in theory and simulation. The theoretical BER expressions of PDQ, PDQ-DB and PDQ-PPM are given with analysis method of hybrid modulation encoding in different the bit-rate ratios of payload and label. Theoretical derivation results are shown that the payload of hybrid modulation has a certain gain of receiver sensitivity than payload without label. The sizes of payload BER gain obtained from hybrid modulation are related to the different types of label. The simulation results are consistent with that of theoretical conclusions. The extinction ratio (ER) conflicting between hybrid encoding of intensity and phase types can be compromised and optimized in OLS system of hybrid modulation. The BER analysis method of hybrid modulation encoding in OLS system can be applied to other n-ary hybrid modulation or combination modulation systems.

Clinical Examination Component of Telemedicine, Telehealth, mHealth, and Connected Health Medical Practices.

Science.gov (United States)

Weinstein, Ronald S; Krupinski, Elizabeth A; Doarn, Charles R

2018-05-01

Telemedicine and telehealth are the practices of medicine at a distance. Performing the equivalent of a complete clinical examination by telemedicine would be unusual. However, components of a more traditional clinical examination are part of the telemedicine workup for specific conditions. Telemedicine clinical examinations are facilitated, and enhanced, through the integration of a class of medical devices referred to as telemedicine peripherals (eg, electronic stethoscopes, tele-ophthalmoscopes, video-otoscopes, and so forth). Direct-to-consumer telehealth is a rapidly expanding segment of the health care service industry. Copyright © 2018 Elsevier Inc. All rights reserved.

24-Hour Relativistic Bit Commitment.

Science.gov (United States)

Verbanis, Ephanielle; Martin, Anthony; Houlmann, Raphaël; Boso, Gianluca; Bussières, Félix; Zbinden, Hugo

2016-09-30

Bit commitment is a fundamental cryptographic primitive in which a party wishes to commit a secret bit to another party. Perfect security between mistrustful parties is unfortunately impossible to achieve through the asynchronous exchange of classical and quantum messages. Perfect security can nonetheless be achieved if each party splits into two agents exchanging classical information at times and locations satisfying strict relativistic constraints. A relativistic multiround protocol to achieve this was previously proposed and used to implement a 2-millisecond commitment time. Much longer durations were initially thought to be insecure, but recent theoretical progress showed that this is not so. In this Letter, we report on the implementation of a 24-hour bit commitment solely based on timed high-speed optical communication and fast data processing, with all agents located within the city of Geneva. This duration is more than 6 orders of magnitude longer than before, and we argue that it could be extended to one year and allow much more flexibility on the locations of the agents. Our implementation offers a practical and viable solution for use in applications such as digital signatures, secure voting and honesty-preserving auctions.

Telemedicine in the management of chronic pain: a cost analysis study.

Science.gov (United States)

Pronovost, Antoine; Peng, Philip; Kern, Ralph

2009-08-01

Telemedicine provides patients with easy and remote access to consultant expertise irrespective of geographic location. In a randomized controlled trial, this study has applied a rigorous costing methodology to the use of telemedicine in chronic pain management. We performed a randomized two-period crossover trial comparing in-person (IP) consultation with telemedicine (TM) consultation in the management of chronic pain. Over an 18-month period, 26 patients each completed two diaries capturing their direct and indirect travel costs, daily pain scores, and satisfaction with physician consultation. Costing models were developed to account for direct, indirect, fixed, and variable costs in order to perform break-even analyses. Sensitivity analysis was performed over a broad range of assumptions. Direct patient costs were significantly lower in the TM group than in the IP group, with median cost and interquartile range 133 dollars (28-377) vs 443 dollars (292-1075), respectively (P = 0.001). More patients were highly satisfied with the TM consultation than with the IP consultation (56 and 24%, respectively; P sensitivity analysis controlling for annual patient volume and round-trip distance indicated that TM remains cost-effective at volumes >50 patients/year or at round-trip distances >200 km. Telemedicine is cost-effective over a broad range of assumptions, including annual patient volumes, travel distance, fuel costs, amortization, and discount rates. This study provides data from a real-world setting to determine relevant thresholds and targets for establishing a TM program for patients who are undergoing chronic pain therapy.

Development of a jet-assisted polycrystalline diamond drill bit

Energy Technology Data Exchange (ETDEWEB)

Pixton, D.S.; Hall, D.R.; Summers, D.A.; Gertsch, R.E.

1997-12-31

A preliminary investigation has been conducted to evaluate the technical feasibility and potential economic benefits of a new type of drill bit. This bit transmits both rotary and percussive drilling forces to the rock face, and augments this cutting action with high-pressure mud jets. Both the percussive drilling forces and the mud jets are generated down-hole by a mud-actuated hammer. Initial laboratory studies show that rate of penetration increases on the order of a factor of two over unaugmented rotary and/or percussive drilling rates are possible with jet-assistance.

Quality of data computational models and telemedicine treatment effects

NARCIS (Netherlands)

Larburu Rubio, Nekane; Widya, I.A.; Bults, Richard G.A.; Hermens, Hermanus J.

2014-01-01

Clinical decision-support functions of telemedicine systems use patient's monitored clinical data to support treatment of outpatients. However, the quality of monitored clinical data may vary due to performance variations of technological resources inside a deployed telemedicine system. This paper

Practical Relativistic Bit Commitment

NARCIS (Netherlands)

Lunghi, T.; Kaniewski, J.; Bussières, F.; Houlmann, R.; Tomamichel, M.; Wehner, S.D.C.; Zbinden, H

2015-01-01

Bit commitment is a fundamental cryptographic primitive in which Alice wishes to commit a secret bit to Bob. Perfectly secure bit commitment between two mistrustful parties is impossible through an asynchronous exchange of quantum information. Perfect security is, however, possible when Alice and

Innovation Network Development Model in Telemedicine: A Change in Participation.

Science.gov (United States)

Goodarzi, Maryam; Torabi, Mashallah; Safdari, Reza; Dargahi, Hossein; Naeimi, Sara

2015-10-01

This paper introduces a telemedicine innovation network and reports its implementation in Tehran University of Medical Sciences. The required conditions for the development of future projects in the field of telemedicine are also discussed; such projects should be based on the common needs and opportunities in the areas of healthcare, education, and technology. The development of the telemedicine innovation network in Tehran University of Medical Sciences was carried out in two phases: identifying the beneficiaries of telemedicine, and codification of the innovation network memorandum; and brainstorming of three workgroup members, and completion and clustering ideas. The present study employed a qualitative survey by using brain storming method. Thus, the ideas of the innovation network members were gathered, and by using Freeplane software, all of them were clustered and innovation projects were defined. In the services workgroup, 87 and 25 ideas were confirmed in phase 1 and phase 2, respectively. In the education workgroup, 8 new programs in the areas of telemedicine, tele-education and teleconsultation were codified. In the technology workgroup, 101 and 11 ideas were registered in phase 1 and phase 2, respectively. Today, innovation is considered a major infrastructural element of any change or progress. Thus, the successful implementation of a telemedicine project not only needs funding, human resources, and full equipment. It also requires the use of innovation models to cover several different aspects of change and progress. The results of the study can provide a basis for the implementation of future telemedicine projects using new participatory, creative, and innovative models.

Example of Occupational Surveillance in a Telemedicine Setting: Application of Epidemiologic Methods at NASA Johnson Space Center

Science.gov (United States)

Babiak-Vazquez, Adriana; Ruffaner, Lanie M.; Wear, Mary L.; Crucian, Brian; Sams, Clarence; Lee, Lesley R.; Van Baalen, Mary

2016-01-01

In 2010, NASA implemented Lifetime Surveillance of Astronaut Health, a formal occupational surveillance program for the U.S. astronaut corps. Because of the nature of the space environment, space medicine presents unique challenges and opportunities for epidemiologists. One such example is the use of telemedicine while crewmembers are in flight, where the primary source of information about crew health is verbal communication between physicians and their crewmembers. Due to restricted medical capabilities, the available health information is primarily crewmember report of signs and symptoms, rather than diagnoses. As epidemiologists at NASA, Johnson Space Center, we have shifted our paradigm from tracking diagnoses based on traditional terrestrial clinical practice to one in which we also incorporate reported symptomology as potential antecedents of disease. In this presentation we describe how characterization of reported signs and symptoms can be used to establish incidence rates for inflight immunologic events. We describe interdisciplinary data sources of information that are used in combination with medical information to analyze the data. We also delineate criteria for symptom classification inclusion. Finally, we present incidence tables and graphs to illustrate the final outcomes. Using signs and symptoms reported via telemedicine, the epidemiologists provide summary evidence regarding incidence of potential inflight medical conditions. These results inform our NASA physicians and scientists, and support evaluation of the occupational health risks associated with spaceflight.

Efficacy and cost effectiveness of telemedicine for improving access to care in the Paris region: study protocols for eight trials.

Science.gov (United States)

Charrier, Nathanael; Zarca, Kevin; Durand-Zaleski, Isabelle; Calinaud, Christine

2016-02-08

With the development of information and communication technologies, telemedicine has been proposed as a way to improve patient management by facilitating access to appropriate diagnosis and treatment. The Paris Ile de France Regional Health Agency is currently funding a comprehensive program of telemedicine experiments. This article describes the protocols for the evaluation of the implementation of telemedicine in the Paris region. Over 2,500 patients have been included in eight studies addressing the use of telemedicine in the context of specific diseases or settings. Two projects are randomized controlled trials, while the six other projects are based on before-after designs (differences in differences studies). Based on the MAST model and the French national framework, we identified endpoints to assess the impact of telemedicine on five dimensions: clinical effectiveness, cost-effectiveness, security of the application, patient satisfaction and quality of life and perception of professionals. Telemedicine encompasses a wide range of services and stakeholders, and thus study protocols must be tailored to the specific constraints and interests of the users. NCT02110433 (03/07/2014), NCT02157740 (05/27/2014), NCT02374697 (02/05/2015), NCT02157727 (05/27/2014), NCT02229279 (08/28/2014), NCT02368769 (02/05/2015), NCT02164747 (NCT02164747), NCT02309905 (11/27/2014).

Telemedicine and distributed medical intelligence.

Science.gov (United States)

Warner, D; Tichenor, J M; Balch, D C

1996-01-01

Recent trends in health care informatics and telemedicine indicate that systems are being developed with a primary focus on technology and business, not on the process of medicine itself. The authors present a new model of health care information, distributed medical intelligence, which promotes the development of an integrative medical communication system addressing the process of providing expert medical knowledge to the point of need. The model incorporates audio, video, high-resolution still images, and virtual reality applications into an integrated medical communications network. Three components of the model (care portals, Docking Station, and the bridge) are described. The implementation of this model at the East Carolina University School of Medicine is also outlined.

Telemedicine Use Decreases Rural Emergency Department Length of Stay for Transferred North Dakota Trauma Patients.

Science.gov (United States)

Mohr, Nicholas M; Vakkalanka, J Priyanka; Harland, Karisa K; Bell, Amanda; Skow, Brian; Shane, Dan M; Ward, Marcia M

2018-03-01

Telemedicine has been proposed as one strategy to improve local trauma care and decrease disparities between rural and urban trauma outcomes. This study was conducted to describe the effect of telemedicine on management and clinical outcomes for trauma patients in North Dakota. Cohort study of adult (age ≥18 years) trauma patients treated in North Dakota Critical Access Hospital (CAH) Emergency Departments (EDs) from 2008 to 2014. Records were linked to a telemedicine network's call records, indicating whether telemedicine was available and/or used at the institution at the time of the care. Multivariable generalized estimating equations were developed to identify associations between telemedicine consultation and availability and outcomes such as transfer, timeliness of care, trauma imaging, and mortality. Of the 7,500 North Dakota trauma patients seen in CAH, telemedicine was consulted for 11% of patients in telemedicine-capable EDs and 4% of total trauma patients. Telemedicine utilization was independently associated with decreased initial ED length of stay (LOS) (30 min, 95% confidence interval [CI] 14-45 min) for transferred patients. Telemedicine availability was associated with an increase in the probability of interhospital transfer (adjusted odds ratio [aOR] 1.2, 95% CI 1.1-1.4). Telemedicine availability was associated with increased total ED LOS (15 min, 95% CI 10-21 min), and computed tomography scans (aOR 1.6, 95% CI 1.3-1.9). ED-based telemedicine consultation is requested for the most severely injured rural trauma patients. Telemedicine consultation was associated with more rapid interhospital transfer, and telemedicine availability is associated with increased radiography use and transfer. Future work should evaluate how telemedicine could target patients likely to benefit from telemedicine consultation.

Perceived risks and use of psychotherapy via telemedicine for patients at risk for suicide.

Science.gov (United States)

Gilmore, Amanda K; Ward-Ciesielski, Erin F

2017-01-01

Introduction Suicide is a major public health problem and its human, emotional, and economic costs are significant. Individuals in rural areas are at highest risk for suicide. However, telemedicine services are typically not rendered to individuals who are actively suicidal. The goals of the current study were to identify the risks of using telemedicine for mental healthcare from the perspective of licensed mental health providers and to determine factors associated with the use of telemedicine with patients who are at high risk for suicide. Methods A total of 52 licensed mental health providers were recruited online through several professional organization listservs and targeted emails. Providers completed online questionnaires regarding demographics, caseload of suicidal patients, perceived risks for using telemedicine with patients at risk for suicide, attitudes towards telemedicine, and use of telemedicine with patients at risk for suicide. Results Three key perceived risks associated with using telemedicine were identified, including assessment, lack of control over patient, and difficulties triaging patients if needed. It was also found that individuals who had more positive attitudes towards telemedicine, younger providers, and more experienced providers were more likely to use telemedicine with patients who are at high risk for suicide. Discussion To our knowledge, this is the first study to examine the perceived risks and use of telemedicine with patients at high risk for suicide. It is essential to continue this line of research to develop protocols for the provision of evidence-based therapy via telemedicine for this high-risk group.

Access and Quality of Care in Direct-to-Consumer Telemedicine.

Science.gov (United States)

Uscher-Pines, Lori; Mulcahy, Andrew; Cowling, David; Hunter, Gerald; Burns, Rachel; Mehrotra, Ateev

2016-04-01

Direct-to-consumer (DTC) telemedicine serves millions of patients; however, there is limited research on the care provided. This study compared the quality of care at Teladoc ( www.teladoc.com ), a large DTC telemedicine company, with that at physician offices and compared access to care for Teladoc users and nonusers. Claims from all enrollees 18-64 years of age in the California Public Employees' Retirement System health maintenance organization between April 2012 and October 2013 were analyzed. We compared the performance of Teladoc and physician offices on applicable Healthcare Effectiveness Data and Information Set measures. Using geographic information system analyses, we compared Teladoc users and nonusers with respect to rural location and available primary care physicians. Of enrollees offered Teladoc (n = 233,915), 3,043 adults had a total of 4,657 Teladoc visits. For the pharyngitis performance measure (ordering strep test), Teladoc performed worse than physician offices (3% versus 50%, p located within a healthcare professional shortage area (odds ratio = 1.12, p = 0.10) or rural location (odds ratio = 1.0, p = 0.10). Teladoc providers were less likely to order diagnostic testing and had poorer performance on appropriate antibiotic prescribing for bronchitis. Teladoc users were not preferentially located in underserved communities. Short-term needs include ongoing monitoring of quality and additional marketing and education to increase telemedicine use among underserved patients.

State of the art in telemedicine - concepts, management, monitoring and evaluation of the telemedicine programme in Alentejo (Portugal).

Science.gov (United States)

Oliveira, Tiago Cravo; Branquinho, Maria José; Gonçalves, Luís

2012-01-01

Alentejo - one of five Portuguese continental regions - faces major problems impacting the health and social system of the region. Here, the low population density, the low educational and income level as well as an aging population have to be mentioned. Faced with the task of ensuring equal access to healthcare for all its inhabitants, the regional health authorities created the telemedicine program. From 1998 until 2000, the program developed in an experimental fashion, with teleconsultations involving a number of providers: primary health care centers, regional hospitals, and central hospitals. Between 2000 and 2010, there were a total of 135,000 telemedicine acts including teleconsultations, teleradiology (computerised tomography and x-rays), ultrasound telemedicine and telepathology. Presently, the network comprises 20 health centers and 6 hospitals, covering 4 districts. The platform is composed of high resolution videoconferencing equipment, software with patients' clinical records, an image archive, and a number of peripherals, such as electronic dermatoscopes and phonendoscopes. Teleconsultations are provided by fifteen medical specialties, across 3 district hospitals, ranging from neurology to pediatric surgery. In 2008, health authorities started the telelearning program, initially using point to point videoconferencing, and by the end of 2010, 848 healthcare professionals, across 52 locations, had participated in remote learning sessions, covering topics from chronic wound treatment, to infection control, to medical error. As of 2011, point to multipoint telelearning is also in operation. This paper provides an overview of the telemedicine program in Alentejo, including both infrastructure and operations. Preliminary results of an ongoing evaluation of the impact of teleconsultations on key indicators of the regional healthcare system are also presented (including current utilization and plans for future expansion). This article builds on the experience

7 CFR 1700.31 - Distance Learning and Telemedicine Loan and Grant Program.

Science.gov (United States)

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Distance Learning and Telemedicine Loan and Grant... § 1700.31 Distance Learning and Telemedicine Loan and Grant Program. RUS, through the Telecommunications Program, makes grants and loans to furnish and improve telemedicine services and distance learning...

The Challenge of e-Health Presence on a Petroleum Platform: Using Telemedicine to Make Operation of Pre-Salt Wells a Reality.

Science.gov (United States)

Nunes Ferreira, R; Lopes da Rosa, T; Benevenuto de Campos Lima, C; Brito Alves de Lima, G; dos Santos Ramos, P; Dias da Silva, T; Barbieri, A; Takeo Ueda, E

2015-01-01

Telemedicine can be defined as the use of electronic media for the transmission of clinical data and information from one location to another using information technology and telecommunication in order to provide immediate clinical health care at long distances. This new approach can involve specialized medical service centers in the oil production at great distances from the offshore installations in Brazil. The importance of the right health diagnosis, taken at the proper time, will make a serious difference in the facilities, which will be located around 300 km offshore. This paper presents an overview of telemedicine and its different applications, comparing them according to level of maturity and applicability. Important results from a case study in a fixed oil platform are analyzed. At the end of this work, the strategy of telemedicine implementation in a Brazilian petroleum operator is discussed.

A Model of Computation for Bit-Level Concurrent Computing and Programming: APEC

Science.gov (United States)

Ajiro, Takashi; Tsuchida, Kensei

A concurrent model of computation and a language based on the model for bit-level operation are useful for developing asynchronous and concurrent programs compositionally, which frequently use bit-level operations. Some examples are programs for video games, hardware emulation (including virtual machines), and signal processing. However, few models and languages are optimized and oriented to bit-level concurrent computation. We previously developed a visual programming language called A-BITS for bit-level concurrent programming. The language is based on a dataflow-like model that computes using processes that provide serial bit-level operations and FIFO buffers connected to them. It can express bit-level computation naturally and develop compositionally. We then devised a concurrent computation model called APEC (Asynchronous Program Elements Connection) for bit-level concurrent computation. This model enables precise and formal expression of the process of computation, and a notion of primitive program elements for controlling and operating can be expressed synthetically. Specifically, the model is based on a notion of uniform primitive processes, called primitives, that have three terminals and four ordered rules at most, as well as on bidirectional communication using vehicles called carriers. A new notion is that a carrier moving between two terminals can briefly express some kinds of computation such as synchronization and bidirectional communication. The model's properties make it most applicable to bit-level computation compositionally, since the uniform computation elements are enough to develop components that have practical functionality. Through future application of the model, our research may enable further research on a base model of fine-grain parallel computer architecture, since the model is suitable for expressing massive concurrency by a network of primitives.

Telemedicine optoelectronic biomedical data processing system

Science.gov (United States)

Prosolovska, Vita V.

2010-08-01

The telemedicine optoelectronic biomedical data processing system is created to share medical information for the control of health rights and timely and rapid response to crisis. The system includes the main blocks: bioprocessor, analog-digital converter biomedical images, optoelectronic module for image processing, optoelectronic module for parallel recording and storage of biomedical imaging and matrix screen display of biomedical images. Rated temporal characteristics of the blocks defined by a particular triggering optoelectronic couple in analog-digital converters and time imaging for matrix screen. The element base for hardware implementation of the developed matrix screen is integrated optoelectronic couples produced by selective epitaxy.

Pediatric Critical Care Telemedicine Program: A Single Institution Review.

Science.gov (United States)

Hernandez, Maria; Hojman, Nayla; Sadorra, Candace; Dharmar, Madan; Nesbitt, Thomas S; Litman, Rebecca; Marcin, James P

2016-01-01

Rural and community emergency departments (EDs) often receive and treat critically ill children despite limited access to pediatric expertise. Increasingly, pediatric critical care programs at children's hospitals are using telemedicine to provide consultations to these EDs with the goal of increasing the quality of care. We conducted a retrospective review of a pediatric critical care telemedicine program at a single university children's hospital. Between the years 2000 and 2014, we reviewed all telemedicine consultations provided to children in rural and community EDs, classified the visits using a comprehensive evidence-based set of chief complaints, and reported the consultations' impact on patient disposition. We also reviewed the total number of pediatric ED visits to calculate the relative frequency with which telemedicine consultations were provided. During the study period, there were 308 consultations provided to acutely ill and/or injured children for a variety of chief complaints, most commonly for respiratory illnesses, acute injury, and neurological conditions. Since inception, the number of consultations has been increasing, as has the number of participating EDs (n = 18). Telemedicine consultations were conducted on 8.6% of seriously ill children, the majority of which resulted in admission to the receiving hospital (n = 150, 49%), with a minority of patients requiring transport to the university children's hospital (n = 103, 33%). This single institutional, university children's hospital-based review demonstrates that a pediatric critical care telemedicine program used to provide consultations to seriously ill children in rural and community EDs is feasible, sustainable, and used relatively infrequently, most typically for the sickest pediatric patients.

77 FR 27015 - Distance Learning and Telemedicine Grant Program

Science.gov (United States)

2012-05-08

... DEPARTMENT OF AGRICULTURE Rural Utilities Service Distance Learning and Telemedicine Grant Program AGENCY: Rural Utilities Service, USDA. ACTION: Notice of Funding for FY 2012 of the Distance Learning and... awards for its Distance Learning and Telemedicine (DLT) Grant Program. For Fiscal Year 2012, $15 million...

Consumer preferences for telemedicine devices and services in South Korea.

Science.gov (United States)

Ahn, Joongha; Shin, Jungwoo; Lee, Jongsu; Shin, Kwangsoo; Park, Hayoung

2014-02-01

The scope of healthcare has been expanding from caring for sick people to keeping people from becoming sick, and telemedicine will play a significant role in this new healthcare paradigm. This study investigated consumer preferences and willingness to pay for attributes of telemedicine services in South Korea. A market simulation was conducted to examine the market shares of alternative services and their relationships to the perceived usefulness of service types and preferred device types. Using a conjoint survey, we collected data on consumer preferences for six telemedicine service attributes. Data analysis used the Bayesian mixed logit model. The market simulation estimated the probabilities of a specific service alternative being chosen using estimated model coefficients. Wearable devices were the most preferred, followed by smart-home and smartphone devices. Consumers perceived managing blood glucose to be the most useful telemedicine service, followed by monitoring oxygen saturation and blood pressure. The market simulation indicated that consumer preferences for device types were associated with the types of chronic diseases for which management through telemedicine services is perceived to be useful. As the focus of healthcare moves from treating patients to keeping individuals healthy, a key factor for the successful deployment of telemedicine services is understanding consumer perceptions and attitudes. The results of this study revealed the dynamics of consumer preferences with regard to service attributes.

Telemedicine in rural areas: general practitioners’ representations and experiences

Science.gov (United States)

Durupt, Maxime; Bouchy, Olivier; Christophe, Sonia; Kivits, Joëlle; Boivin, Jean-Marc

2016-10-19

Introduction: Telemedicine is a rapidly growing new mode of healthcare practice. It is particularly used and needed in remote areas in Lorraine (North East of France) that currently face a shortage of general practitioners and specialists. The objective of this study was to analyse general practitioner’s representations of telemedicine and teleconsultation. The study also identified the advantages and disadvantages of this new mode of medical practice. Methods: A qualitative research was led: 5 focus groups were conducted with 32 doctors in areas faced with the problems of health professional shortages between June 2014 and July 2015. Results: This study reveals a general ignorance of telemedicine. Doctors want to play a central role in this new form of medical practice which must remain optional. Their reluctance essentially concerns financial and legal aspects that constitute obstacles to the development of telemedicine. Finally, this new mode of medical practice must comply with a legal framework regarding medical responsibility and personal data protection. Discussion.More than 100 medical procedures are delivered by telemedicine in Lorraine each month. This new technology is a solution to provide healthcare services in medically underserved areas. However, general practitioners want to preserve the “doctor-patient” relationship and do not wish to change their practice.

Using the cloud to provide telemedicine services in a developing country

Directory of Open Access Journals (Sweden)

Liezel Cilliers

2014-11-01

Objectives: The aim of the article is to provide critical success factors (CSF that will enable the deployment of telemedicine in the cloud in order to improve health care services in developing countries. Methods: A thorough literature review was performed of peer reviewed articles in order to identify possible barriers for telemedicine to be deployed in the cloud. Furthermore, the Technology Organization Environmental Model was used in order to group the barriers according to the various factors and, from this process, critical success factors were formulated for consideration. Conclusion: Five critical success factors were formulated in order to implement telemedicine making use of the cloud in developing countries. These include having a national integrated plan for telemedicine; promoting best practices within a legislation framework; involving the end user; providing education to improve levels of telemedicine awareness amongst staff and patients, and addressing technological issues.

Time-space modal logic for verification of bit-slice circuits

Science.gov (United States)

Hiraishi, Hiromi

1996-03-01

The major goal of this paper is to propose a new modal logic aiming at formal verification of bit-slice circuits. The new logic is called as time-space modal logic and its major feature is that it can handle two transition relations: one for time transition and the other for space transition. As for a verification algorithm, a symbolic model checking algorithm of the new logic is shown. This could be applicable to verification of bit-slice microprocessor of infinite bit width and 1D systolic array of infinite length. A simple benchmark result shows the effectiveness of the proposed approach.

Arogyasree: An Enhanced Grid-Based Approach to Mobile Telemedicine

Directory of Open Access Journals (Sweden)

Sriram Kailasam

2010-01-01

Full Text Available A typical telemedicine system involves a small set of hospitals providing remote healthcare services to a small section of the society using dedicated nodal centers. However, in developing nations like India where majority live in rural areas that lack specialist care, we envision the need for much larger Internet-based telemedicine systems that would enable a large pool of doctors and hospitals to collectively provide healthcare services to entire populations. We propose a scalable, Internet-based P2P architecture for telemedicine integrating multiple hospitals, mobile medical specialists, and rural mobile units. This system, based on the store and forward model, features a distributed context-aware scheduler for providing timely and location-aware telemedicine services. Other features like zone-based overlay structure and persistent object space abstraction make the system efficient and easy to use. Lastly, the system uses the existing internet infrastructure and supports mobility at doctor and patient ends.

FastBit: an efficient indexing technology for accelerating data-intensive science

International Nuclear Information System (INIS)

Wu Kesheng

2005-01-01

FastBit is a software tool for searching large read-only datasets. It organizes user data in a column-oriented structure which is efficient for on-line analytical processing (OLAP), and utilizes compressed bitmap indices to further speed up query processing. Analyses have proven the compressed bitmap index used in FastBit to be theoretically optimal for onedimensional queries. Compared with other optimal indexing methods, bitmap indices are superior because they can be efficiently combined to answer multi-dimensional queries whereas other optimal methods can not. In this paper, we first describe the searching capability of FastBit, then briefly highlight two applications that make extensive use of FastBit, namely Grid Collector and DEX

FastBit: An Efficient Indexing Technology For AcceleratingData-Intensive Science

Energy Technology Data Exchange (ETDEWEB)

Wu, Kesheng

2005-06-27

FastBit is a software tool for searching large read-only data sets. It organizes user data in a column-oriented structure which is efficient for on-line analytical processing (OLAP), and utilizes compressed bitmap indices to further speed up query processing. Analyses have proven the compressed bitmap index used in FastBit to be theoretically optimal for one-dimensional queries. Compared with other optimal indexing methods, bitmap indices are superior because they can be efficiently combined to answer multi-dimensional queries whereas other optimal methods cannot. In this paper, we first describe the searching capability of FastBit, then briefly highlight two applications that make extensive use of FastBit, namely Grid Collector and DEX.

FastBit: an efficient indexing technology for accelerating data-intensive science

Science.gov (United States)

Wu, Kesheng

2005-01-01

FastBit is a software tool for searching large read-only datasets. It organizes user data in a column-oriented structure which is efficient for on-line analytical processing (OLAP), and utilizes compressed bitmap indices to further speed up query processing. Analyses have proven the compressed bitmap index used in FastBit to be theoretically optimal for onedimensional queries. Compared with other optimal indexing methods, bitmap indices are superior because they can be efficiently combined to answer multi-dimensional queries whereas other optimal methods can not. In this paper, we first describe the searching capability of FastBit, then briefly highlight two applications that make extensive use of FastBit, namely Grid Collector and DEX.

The Portable Dynamic Fundus Instrument: Uses in telemedicine and research

Science.gov (United States)

Hunter, Norwood; Caputo, Michael; Billica, Roger; Taylor, Gerald; Gibson, C. Robert; Manuel, F. Keith; Mader, Thomas; Meehan, Richard

1994-01-01

For years ophthalmic photographs have been used to track the progression of many ocular diseases such as macular degeneration and glaucoma as well as the ocular manifestations of diabetes, hypertension, and hypoxia. In 1987 a project was initiated at the Johnson Space Center (JSC) to develop a means of monitoring retinal vascular caliber and intracranial pressure during space flight. To conduct telemedicine during space flight operations, retinal images would require real-time transmissions from space. Film-based images would not be useful during in-flight operations. Video technology is beneficial in flight because the images may be acquired, recorded, and transmitted to the ground for rapid computer digital image processing and analysis. The computer analysis techniques developed for this project detected vessel caliber changes as small as 3 percent. In the field of telemedicine, the Portable Dynamic Fundus Instrument demonstrates the concept and utility of a small, self-contained video funduscope. It was used to record retinal images during the Gulf War and to transmit retinal images from the Space Shuttle Columbia during STS-50. There are plans to utilize this device to provide a mobile ophthalmic screening service in rural Texas. In the fall of 1993 a medical team in Boulder, Colorado, will transmit real-time images of the retina during remote consultation and diagnosis. The research applications of this device include the capability of operating in remote locations or small, confined test areas. There has been interest shown utilizing retinal imaging during high-G centrifuge tests, high-altitude chamber tests, and aircraft flight tests. A new design plan has been developed to incorporate the video instrumentation into face-mounted goggle. This design would eliminate head restraint devices, thus allowing full maneuverability to the subjects. Further development of software programs will broaden the application of the Portable Dynamic Fundus Instrument in

Telemedicine in dermatology: Evaluation of secondary and tertiary teledermatology

NARCIS (Netherlands)

van der Heijden, J.P.

2013-01-01

The field of dermatology was one of the first adaptors of telemedicine, dating back to 1995, and has one of the highest scientific output in the field of telemedicine. The research described in this thesis expanded on this scientific knowledge base by answering the following research questions: 1.

Fixed-Rate Compressed Floating-Point Arrays.

Science.gov (United States)

Lindstrom, Peter

2014-12-01

Current compression schemes for floating-point data commonly take fixed-precision values and compress them to a variable-length bit stream, complicating memory management and random access. We present a fixed-rate, near-lossless compression scheme that maps small blocks of 4(d) values in d dimensions to a fixed, user-specified number of bits per block, thereby allowing read and write random access to compressed floating-point data at block granularity. Our approach is inspired by fixed-rate texture compression methods widely adopted in graphics hardware, but has been tailored to the high dynamic range and precision demands of scientific applications. Our compressor is based on a new, lifted, orthogonal block transform and embedded coding, allowing each per-block bit stream to be truncated at any point if desired, thus facilitating bit rate selection using a single compression scheme. To avoid compression or decompression upon every data access, we employ a software write-back cache of uncompressed blocks. Our compressor has been designed with computational simplicity and speed in mind to allow for the possibility of a hardware implementation, and uses only a small number of fixed-point arithmetic operations per compressed value. We demonstrate the viability and benefits of lossy compression in several applications, including visualization, quantitative data analysis, and numerical simulation.

Cost-Benefit Analysis of Telemedicine Systems/Units in Greek Remote Areas.

Science.gov (United States)

Kouskoukis, Marios-Nikolaos; Botsaris, Charalambos

2017-06-01

Telemedicine units and information technology systems provide special healthcare services to remote populations using telecommunication technology, in order to reduce or even remove the usual and typical face-to-face contact between doctor and patient. This innovative approach to medical care delivery has been expanding for several years and currently covers various medical specialties. To facilitate installation of telemedicine systems/units in Greek remote areas, this article presents results of a cost-benefit analysis for two Greek islands, Patmos and Leros, using specific economic criteria. Net present value (NPV), internal rate of return (IRR), and payback period were calculated, in order to monetize the economic benefits and the costs savings, estimate the depreciation of each project, and highlight the social benefits. Costs were reduced (through saved air medical transportations) by €19,005 for Patmos and €78,225 for Leros each year. NPV and IRR were positive; NPV was €29,608 for Patmos and €293,245 for Leros, and IRR was 21.5% for Patmos and 140.5% for Leros. Each project depreciated faster than the 5-year life-cycle period, and specifically in 3.13 years for Patmos and in 0.70 years for Leros. The establishment of telemedicine systems/units in Patmos and Leros was evaluated and assessed positively, with large savings, economical and social, gained by reducing or even removing the face-to-face contact between doctor and patient. Telemedicine systems/units seem to be a promising solution, especially in Greece, where the problem of primary healthcare services in remote/inaccessible areas is of great concern.

Telemedicine in Space Flight - Summary of a NASA Workshop

Science.gov (United States)

Barsten, K. N.; Watkins, S. D.; Otto, C.; Baumann, D. K.

2011-01-01

The Exploration Medical Capability Element of the Human Research Program at NASA Johnson Space Center hosted the Telemedicine Workshop in January 2011 to discuss the medical operational concept for a crewed mission to a near-Earth asteroid (NEA) and to identify areas for future work and collaboration. With the increased likelihood of a medical incident on a long duration exploration mission to a near-Earth asteroid, as well as the fact that there will likely be limited medical capabilities and resources available to diagnose and treat medical conditions, it is anticipated that a more structured use of telemedicine will become highly desirable. The workshop was convened to solicit expert opinion on current telemedicine practices and on medical care in remote environments. Workshop Objectives: The workshop brought together leaders in telemedicine and remote medicine from The University of Texas Medical Branch, Henry Ford Hospital, Ontario Telemedicine Network, U.S. Army Institute of Surgical Research, University of Miami, American Telemedicine Association, Doctors Without Borders, and the Pan American Health Organization. The primary objectives of the workshop were to document the medical operations concept for a crewed mission to a NEA, to determine gaps between current capabilities and the capabilities outlined in the operations concept, to identify research required to close these gaps, and to discuss potential collaborations with external-to-NASA organizations with similar challenges. Summary of Discussions and Conclusions: The discussions held during the workshop and the conclusions reached by the workshop participants were grouped into seven categories: Crew Medical Officers, Patient Area in Spacecraft, Training, Electronic Medical Records, Intelligent Care Systems, Consultation Protocols, Prophylactic Surgical Procedures, and Data Prioritization. The key points discussed under each category will be presented.

Licensing telemedicine: the need for a national system.

Science.gov (United States)

Jacobson, P D; Selvin, E

2000-01-01

The expansion of information technology has shattered geographic boundaries, allowing for extraordinarily increased access to health information and expanded opportunities for telemedicine practice across state boundaries. But despite its recent growth, telemedicine technology remains embedded in a state-based licensure system that places severe limits on its expansion. The current system of medical licensure is based primarily on statutes written at the turn of the 20th century. This system is inadequate to address the emerging medical practices and future uses of medical technology in the telecommunications age. To respond to the changes offered by the telecommunications revolution, we need to design a new regulatory structure for the 21st century. The purpose of this article is to propose a policy of national telemedicine licensure. The primary goal here is not to simply develop a policy proposal, but to discuss the rationale for national licensure and place it on the policy agenda. A national licensure system will expand the market for telemedicine, promote both the use and development of new technologies, and simultaneously eliminate many of the legal and regulatory ambiguities that plague and constrain the present system.

Reaching the Unreachable: Novel Approaches to Telemedicine Screening of Underserved Populations for Vitreoretinal Disease.

Science.gov (United States)

Murchison, Ann P; Haller, Julia A; Mayro, Eileen; Hark, Lisa; Gower, Emily; Huisingh, Carrie; Rhodes, Lindsay; Friedman, David S; Lee, David J; Lam, Byron L

2017-07-01

Telemedicine involves electronic communication between a physician in one location and a patient in another location to provide remote medical care. Ophthalmologists are increasingly employing telemedicine, particularly in retinal disease screening and monitoring. Telemedicine has been utilized to decrease barriers to care and yield greater patient satisfaction and lower costs, while maintaining high sensitivity and specificity. This review discusses common patient barriers to eye care, innovative approaches to retinal disease screening and monitoring using telemedicine, and eye care policy initiatives needed to enact large-scale telemedicine eye disease screening programs.

Feasibility Study of 8-Bit Microcontroller Applications for Ethernet

Directory of Open Access Journals (Sweden)

Lech Gulbinovič

2011-08-01

Full Text Available Feasibility study of 8-bit microcontroller applications for Ethernet is presented. Designed device is based on ATmega32 microcontroller and 10 Mbps Ethernet controller ENC28J60. Device is simulated as mass queuing theoretical model with ticket booking counter. Practical explorations are accomplished and characteristics are determined. Practical results are compared to theoretical ones. Program code and device packet processing speed optimization are discussed. Microcontroller packet processing speed and packet latency depend on packet size. For ICMP protocol packet processing speed varies 1.4–2.1 Mbps, latency – 0.8–8.4 ms. UDP protocol packet processing speed varies 1.3–1.8 Mbps, latency – 1.1–9.6 ms. Packet processing speed depends on compilation settings and program code compression level. Best results are reached on optimization le­vel ‑O3, then speed increased ~3% but program code size increased 68% comparing to –Os optimization level.Article in Lithuanian

Quantum dynamics of quantum bits

International Nuclear Information System (INIS)

Nguyen, Bich Ha

2011-01-01

The theory of coherent oscillations of the matrix elements of the density matrix of the two-state system as a quantum bit is presented. Different calculation methods are elaborated in the case of a free quantum bit. Then the most appropriate methods are applied to the study of the density matrices of the quantum bits interacting with a classical pumping radiation field as well as with the quantum electromagnetic field in a single-mode microcavity. The theory of decoherence of a quantum bit in Markovian approximation is presented. The decoherence of a quantum bit interacting with monoenergetic photons in a microcavity is also discussed. The content of the present work can be considered as an introduction to the study of the quantum dynamics of quantum bits. (review)

Telemedicine in the context of different medical specialities. The Polish perspective.

Science.gov (United States)

Rudowski, Robert

2003-01-01

Two types of telemedicine are considered in the paper: pre-recorded and real-time. The advantages and disadvantages of each type are described.The choice of telemedicine type depends on medical speciality. The separate branch of telemedicine--teleprevention of civilization diseases is discussed and examples of relevant WWW services in Poland are given. The own work examples of the Dept. of Medical Informatics, MUW, namely Onco-service of 200 protocols used in hematology and oncology and Cardio.net--a distributed teleinformation system for cardiology, are presented. the barriers of the development of telemedicine in Poland are caused by the organization of health service--Patients Funds using different software, no messaging standards and different reimbursement systems.

Telemedicine services in the Republic of Ireland: an evolving policy context.

Science.gov (United States)

MacFarlane, Anne; Murphy, Andrew William; Clerkin, Pauline

2006-05-01

The Republic of Ireland is characterised by few urban conurbations and a high rural population, including significant numbers of island dwellers. Information communication technologies (ICT), including telemedicine, present opportunities to address rural health-service delivery issues. As in other countries, the recent National Health Information Strategy is regarded as pivotal to the modernisation of the Irish health care system. There is, however, a dearth of research about telemedicine in Ireland. This paper reports, to the best of our knowledge, the first systematic review of telemedicine in the two regional health boards in the Republic of Ireland. Details of 11 telemedicine services, all initiated by local policy, will be presented. Results of an interview study with service providers about their experiences of the practices and processes involved in telemedicine service delivery are also provided. The focus of our analysis is two-fold. We assess the resonance of these Irish data with the international literature with particular reference to a recently developed model for the normalisation of telemedicine. For the first time, this model which was developed in the United Kingdom is applied to a fresh set of empirical data in a different health care context. We then discuss a number of health information policy issues for Ireland and elsewhere arising from our analysis.

The Use of Telemedicine Access to Schools to Facilitate Expert Assessment of Children with Asthma

Directory of Open Access Journals (Sweden)

David A. Bergman

2008-01-01

Full Text Available Research has shown that access to an asthma specialist improves asthma outcomes. We hypothesized that we could improve access to expert asthma care through a telemedicine link between an asthma specialist and a school-based asthma program. We conducted a prospective cohort study in 3 urban schools to ascertain the feasibility of using an asthma-focused telemedicine solution. Each subject was seen by an asthma expert at 0, 8, and 32 weeks. The assessment and recommendations for care were sent to the primary care physician (PCP and parents were told to contact their physician for follow-up care. Eighty three subjects participated in the study. Subjects experienced improvement (P<.05 in family social activities and the number of asthma attacks. Ninety four percent of subjects rated the program as good or excellent. This study demonstrates the feasibility and acceptance of a school-based asthma program using a telemedicine link to an asthma specialist.

Neurosurgery and Telemedicine in the United States: Assessment of the Risks and Opportunities.

Science.gov (United States)

Kahn, Elyne N; La Marca, Frank; Mazzola, Catherine A

2016-05-01

Telemedicine has seen substantial growth in the past 20 years, related to technologic advancements and evolving reimbursement policies. The risks and opportunities of neurosurgical telemedicine are nuanced. We reviewed general and peer-reviewed literature as it relates to telemedicine and neurosurgery, with particular attention to best practices, relevant state and federal policy conditions, economic evaluations, and prospective clinical studies. Despite technologic development, growing interest, and increasing reimbursement opportunities, telemedicine's utilization remains limited because of concerns regarding an apparent lack of need for telemedicine services, lack of widespread reimbursement, lack of interstate licensure reciprocity, lack of universal access to necessary technology, concerns about maintaining patient confidentiality, and concerns and limited precedent regarding liability issues. The Veterans Health Administration, a component of the U.S. Department of Veterans Affairs, represents a setting in which these concerns can be largely obviated and is a model for telemedicine best practices. Results from the VA demonstrate substantial cost savings and patient satisfaction with remote care for chronic neurologic conditions. Overall, the economic and clinical benefits of telemedicine will likely come from 1) diminished travel times and lost work time for patients; 2) remote consultation of subspecialty experts, such as neurosurgeons; and 3) remote consultation to assist with triage and care in time-sensitive scenarios, including acute stroke care and "teletrauma." Telemedicine is effective in many health care scenarios and will become more relevant to neurosurgical patient care. We favor proceeding with legislation to reduce barriers to telemedicine's growth. Copyright © 2016 Elsevier Inc. All rights reserved.

Power consumption analysis of constant bit rate data transmission over 3G mobile wireless networks

DEFF Research Database (Denmark)

Wang, Le; Ukhanova, Ann; Belyaev, Evgeny

2011-01-01

This paper presents the analysis of the power consumption of data transmission with constant bit rate over 3G mobile wireless networks. Our work includes the description of the transition state machine in 3G networks, followed by the detailed energy consumption analysis and measurement results...... of the radio link power consumption. Based on these description and analysis, we propose power consumption model. The power model was evaluated on the smartphone Nokia N900, which follows a 3GPP Release 5 and 6 supporting HSDPA/HSPA data bearers. Further we propose method of parameters selection for 3GPP...... transition state machine that allows to decrease power consumption on the mobile device....

Doctor-patient communication: a comparison between telemedicine consultation and face-to-face consultation.

Science.gov (United States)

Liu, Xiao; Sawada, Yoshie; Takizawa, Takako; Sato, Hiroko; Sato, Mahito; Sakamoto, Hironosuke; Utsugi, Toshihiro; Sato, Kunio; Sumino, Hiroyuki; Okamura, Shinichi; Sakamaki, Tetsuo

2007-01-01

The objective of this study was to compare doctor-patient communications in clinical consultations via telemedicine technology to doctor-patient communications in face-to-face clinical consultations. Five doctors who had been practicing internal medicine for 8 to 18 years, and twenty patients were enrolled in this study; neither doctors nor patients had previous experience of telemedicine. The patients received both a telemedicine consultation and a face-to-face consultation. Three measures--video observation, medical record volume, and participants' satisfaction--were used for the assessment. It was found that the time spent on the telemedicine consultation was substantially longer than the time spent on the face-to-face consultation. No statistically significant differences were found in the number of either closed or open-ended questions asked by doctors between both types of consultation. Empathy-utterances, praise-utterances, and facilitation-utterances were, however, seen less in the telemedicine consultations than in the face-to-face consultations. The volume of the medical records was statistically smaller in the telemedicine consultations than in the face-to-face consultations. Patients were satisfied with the telemedicine consultation, but doctors were dissatisfied with it and felt hampered by the communication barriers. This study suggests that new training programs are needed for doctors to develop improved communication skills and the ability to express empathy in telemedicine consultations.

Heart failure patients monitored with telemedicine: patient satisfaction, a review of the literature.

Science.gov (United States)

Kraai, I H; Luttik, M L A; de Jong, R M; Jaarsma, T; Hillege, H L

2011-08-01

Remote monitoring of the clinical status of heart failure patients has developed rapidly and is the subject of several trials. Patient satisfaction is an important outcome, as recommended by the U.S. Food and Drug Administration to use in clinical research, and should be included in studies concerning remote monitoring. The objective of this review is to describe the current state of the literature on patient satisfaction with noninvasive telemedicine, regarding definition, measurement, and overall level of patient satisfaction with telemedicine. The Pubmed, Embase, Cochrane, and Cinahl databases were searched using heart failure-, satisfaction-, and telemedicine-related search terms. The literature search identified 193 publications, which were reviewed by 2 independent reviewers. Fourteen articles were included. None of the articles described a clear definition or concept of patient satisfaction with telemedicine. Patient satisfaction with telemedicine was measured with self-developed questionnaires or face-to-face or telephonic interviews. None of the articles used the same questionnaire or telephonic survey to measure patient satisfaction. Only one questionnaire was assessed for validity and reliability. In general, patients seemed to be satisfied or very satisfied with the use of telemedicine. Measurement of patient satisfaction is still underexposed in telemedicine research and the measurement of patient satisfaction with telemedicine underappreciated with poorly constructed questionnaires. Copyright © 2011 Elsevier Inc. All rights reserved.

Accepting telemedicine in a circulatory medicine ward in major hospitals in South Korea: patients' and health professionals' perception of real-time electrocardiogram monitoring.

Science.gov (United States)

Lee, Seo-Joon; Jung, Tae-Young; Lee, Tae-Ro; Han, Jae-Hoon

2018-04-20

South Korean government is currently in progress of expanding the coverage of telemedicine projects as part of an attempt to vitalize service industry, but is facing fierce opposition from KMA. Practice of telemedicine requires sufficient discussions among related parties. Although the participation of medical specialists is important, agreement from the public is essential. Three main tertiary care centers in Seoul were selected for data collection. A total of 224 patients (patients n = 180, patient guardian n = 44) and medical professionals (n = 41) were selected using simple random sampling. Mixed method of quantitative survey and qualitative semi-interview was used. This study analyzed patients' and medical professionals' perception about the application of telemedicine in cardiology ward in tertiary care centers to provide baseline data when developing and applying telemedicine services. Results implied high need for encouraging telemedicine projects in order to appeal needs among population by providing experience (p < 0.001) and knowledge (p < 0.001). Other results showed that the need for electrocardiography monitoring was high among not only in remote areas but also in areas close to the capital. 64.52% of all participants thought that telemedicine was needed, and 73.21% of participants were willing to use telemedicine service if provided. Semi-interviews revealed that participants expected more cost and time saving services through remote treatment, by not having to visit long distance hospitals frequently. Research results oppose Korean Medical Association's opinion that the population is against enforcing telemedicine related laws. The findings in this study reflect an up-to-date perception of telemedicine among patients and medical professionals in a tertiary care centers' cardiology ward. Moreover, the study provides a baseline that is needed in order to overcome past failures and to successfully implement telemedicine in South

Acceptability, Feasibility, and Cost of Telemedicine for Nonacute Headaches: A Randomized Study Comparing Video and Traditional Consultations.

Science.gov (United States)

Müller, Kai Ivar; Alstadhaug, Karl Bjørnar; Bekkelund, Svein Ivar

2016-05-30

The feasibility of telemedicine in diagnosing and treating nonacute headaches, such as primary headaches (migraine and tension-type) and medication-overuse headaches has not been previously investigated. By eliminating the need of travel to specialists, telemedicine may offer significant time and money savings. Our objective was to estimate the acceptance of telemedicine and investigate the feasibility and cost savings of telemedicine consultations in diagnosing and treating nonacute headaches. From September 2012 to March 2015, nonacute headache patients from Northern Norway who were referred to neurologists through an electronic application system were consecutively screened and randomized to participate in either telemedicine or traditional specialist visits. All patients were consulted by two neurologists at the neurological department in Tromsø University Hospital. Feasibility outcomes were compared between telemedicine and traditional groups. Baseline characteristics and costs were then compared between rural and urban patients. Travel costs were calculated by using the probabilistic method of the Norwegian traveling agency: the cheapest means of public transport for each study participant. Loss of pay was calculated based on the Norwegian full-time employee's average salary: 3.5 hours spent on travel and consultation=one day's salary. Distance and time spent on travel were estimated by using Google Maps. Of 557 headache patients screened, 479 were found eligible and 402 accepted telemedicine participation (83.9%, 402/479) and were included in the final analyses. Of these, 202 received traditional specialist consultations and 200 received telemedicine. All patients in the telemedicine group were satisfied with the video quality, and 198 (99%, 198/200) were satisfied with the sound quality. The baseline characteristics as well as headache diagnostics and follow-up appointments, and the investigation, advice, and prescription practices were not statistically

Cabo Verde telemedicine program: initial results of nationwide implementation.

Science.gov (United States)

Latifi, Rifat; Dasho, Erion; Merrell, Ronald C; Lopes, Miguel; Azevedo, Vanda; Bekteshi, Flamur; Osmani, Kalterina L; Qesteri, Orland; Kucani, Julian; Lecaj, Ismet

2014-11-01

Telemedicine and e-health have been suggested as one solution for closing the health disparity gap between the developed world and the developing world. Yet evidence is lacking from current successful programs in the developing world and, in particular, from sub-Saharan Africa. The primary objective of our study was to present the preliminary results of our efforts in building the Integrated Telemedicine and e-Health Program for Cabo Verde (ITeHP-CV), with an emphasis on initial utilization and results. This is a prospective study of data collected while we worked to establish a fully functional, integrated national telemedicine network and virtual education network in Cabo Verde. We used the International Virtual e-Hospital Foundation strategic approach known as "initiate-build-operate-transfer" over a 26-month period (November 2011-December 2013). We describe herein the five main pillars of this process that have been implemented: (1) capacity building; (2) network development and deployment of equipment; (3) implementation of clinical telemedicine; (4) implementation of activities related to continuing medical education, delivered from within the country and from abroad; and (5) establishment and use of the electronic virtual library. Based on comprehensive technical and medical assessment of the country's needs, 10 fully functional telemedicine centers in all nine inhabited islands of the Republic of Cabo Verde have been established. RESULTS are presented under the five main pillars of capacity building, network deployment, implementation of clinical telemedicine, implementation of continuing medical education activities, and establishment of the electronic virtual library. The ITeHP-CV has been successfully launched, and the initial results are encouraging. The continuity of the program and sustainability are primary goals once the program is transferred fully to the Ministry of Health of Cabo Verde. A long-term follow-up study is required in order to ensure

Rate-distortion optimization for compressive video sampling

Science.gov (United States)

Liu, Ying; Vijayanagar, Krishna R.; Kim, Joohee

2014-05-01

The recently introduced compressed sensing (CS) framework enables low complexity video acquisition via sub- Nyquist rate sampling. In practice, the resulting CS samples are quantized and indexed by finitely many bits (bit-depth) for transmission. In applications where the bit-budget for video transmission is constrained, rate- distortion optimization (RDO) is essential for quality video reconstruction. In this work, we develop a double-level RDO scheme for compressive video sampling, where frame-level RDO is performed by adaptively allocating the fixed bit-budget per frame to each video block based on block-sparsity, and block-level RDO is performed by modelling the block reconstruction peak-signal-to-noise ratio (PSNR) as a quadratic function of quantization bit-depth. The optimal bit-depth and the number of CS samples are then obtained by setting the first derivative of the function to zero. In the experimental studies the model parameters are initialized with a small set of training data, which are then updated with local information in the model testing stage. Simulation results presented herein show that the proposed double-level RDO significantly enhances the reconstruction quality for a bit-budget constrained CS video transmission system.

Adjustable Nyquist-rate System for Single-Bit Sigma-Delta ADC with Alternative FIR Architecture

Science.gov (United States)

Frick, Vincent; Dadouche, Foudil; Berviller, Hervé

2016-09-01

This paper presents a new smart and compact system dedicated to control the output sampling frequency of an analogue-to-digital converters (ADC) based on single-bit sigma-delta (ΣΔ) modulator. This system dramatically improves the spectral analysis capabilities of power network analysers (power meters) by adjusting the ADC's sampling frequency to the input signal's fundamental frequency with a few parts per million accuracy. The trade-off between straightforwardness and performance that motivated the choice of the ADC's architecture are preliminary discussed. It particularly comes along with design considerations of an ultra-steep direct-form FIR that is optimised in terms of size and operating speed. Thanks to compact standard VHDL language description, the architecture of the proposed system is particularly suitable for application-specific integrated circuit (ASIC) implementation-oriented low-power and low-cost power meter applications. Field programmable gate array (FPGA) prototyping and experimental results validate the adjustable sampling frequency concept. They also show that the system can perform better in terms of implementation and power capabilities compared to dedicated IP resources.

A call for formal telemedicine training during stroke fellowship

Science.gov (United States)

Jia, Judy; Gildersleeve, Kasey; Ankrom, Christy; Cai, Chunyan; Rahbar, Mohammad; Savitz, Sean I.; Wu, Tzu-Ching

2016-01-01

During the 20 years since US Food and Drug Administration approval of IV tissue plasminogen activator for acute ischemic stroke, vascular neurology consultation via telemedicine has contributed to an increased frequency of IV tissue plasminogen activator administration and broadened geographic access to the drug. Nevertheless, a growing demand for acute stroke coverage persists, with the greatest disparity found in rural communities underserved by neurologists. To provide efficient and consistent acute care, formal training in telemedicine during neurovascular fellowship is warranted. Herein, we describe our experiences incorporating telestroke into the vascular neurology fellowship curriculum and propose recommendations on integrating formal telemedicine training into the Accreditation Council for Graduate Medical Education vascular neurology fellowship. PMID:27016522

Expert advice provided through telemedicine improves healing of chronic wounds: prospective cluster controlled study.

Science.gov (United States)

Zarchi, Kian; Haugaard, Vibeke B; Dufour, Deirdre N; Jemec, Gregor B E

2015-03-01

Telemedicine is widely considered as an efficient approach to manage the growing problem of chronic wounds. However, to date, there is no convincing evidence to support the clinical efficacy of telemedicine in wound management. In this prospective cluster controlled study, we tested the hypothesis that advice on wound management provided by a team of wound-care specialists through telemedicine would significantly improve the likelihood of wound healing compared with the best available conventional practice. A total of 90 chronic wound patients in home care met all study criteria and were included: 50 in the telemedicine group and 40 in the conventional group. Patients with pressure ulcers, surgical wounds, and cancer wounds were excluded. During the 1-year follow-up, complete wound healing was achieved in 35 patients (70%) in the telemedicine group compared with 18 patients (45%) in the conventional group. After adjusting for important covariates, offering advice on wound management through telemedicine was associated with significantly increased healing compared with the best available conventional practice (telemedicine vs. conventional practice: adjusted hazard ratio 2.19; 95% confidence interval: 1.15-4.17; P=0.017). This study strongly supports the use of telemedicine to connect home-care nurses to a team of wound experts in order to improve the management of chronic wounds.

Telemedicine and primary health: The virtual doctor project Zambia

OpenAIRE

Mupela, Evans; Mustarde, Paul; Jones, Huw

2011-01-01

This paper is a commentary on a project application of telemedicine to alleviate primary health care problems in Lundazi district in the Eastern province of Zambia. The project dubbed 'The Virtual Doctor Project' will use hard body vehicles fitted with satellite communication devices and modern medical equipment to deliver primary health care services to some of the neediest areas of the country. The relevance and importance of the project lies in the fact that these areas are hard-to-reach d...

Smart BIT/TSMD Integration

Science.gov (United States)

1991-12-01

integracion . Smart BIT/TSMD provides Rome Laboratory with a laboratory testbed to evaluate and assess the individual characteristics as well as the integration...that assessment. These windows are color-keyed to tie together multiple windows for the same Smart BIT techniques. The display of the neural net- work... Multiple accelerometer icons of any type may therefore be placed (non-overlapping) in the accelerometer Time Line region. The BIT Time Line Editor allows

A 10-bit 200-kS/s SAR ADC IP core for a touch screen SoC

International Nuclear Information System (INIS)

Tong Xingyuan; Yang Yintang; Zhu Zhangming; Sheng Wenfang

2010-01-01

Based on a 5 MSBs (most-significant-bits)-plus-5 LSBs (least-significant-bits) C-R hybrid D/A conversion and low-offset pseudo-differential comparison approach, with capacitor array axially symmetric layout topology and resistor string low gradient mismatch placement method, an 8-channel 10-bit 200-kS/s SAR ADC (successive-approximation-register analog-to-digital converter) IP core for a touch screen SoC (system-on-chip) is implemented in a 0.18 μm 1P5M CMOS logic process. Design considerations for the touch screen SAR ADC are included. With a 1.8 V power supply, the DNL (differential non-linearity) and INL (integral non-linearity) of this converter are measured to be about 0.32 LSB and 0.81 LSB respectively. With an input frequency of 91 kHz at 200-kS/s sampling rate, the spurious-free dynamic range and effective-number-of-bits are measured to be 63.2 dB and 9.15 bits respectively, and the power is about 136 μW. This converter occupies an area of about 0.08 mm 2 . The design results show that it is very suitable for touch screen SoC applications. (semiconductor integrated circuits)

Stakeholders' resistance to telemedicine with focus on physicians: utilizing the Delphi technique.

Science.gov (United States)

Choi, Woo Seok; Park, Joowoong; Choi, Jin Young Brian; Yang, Jae-Suk

2018-01-01

Introduction Sufficient infrastructure for information and communications technology (ICT) and a well-established policy are necessary factors for smooth implementation of telemedicine. However, despite these necessary conditions being met, there are situations where telemedicine still fails to be accepted as a system due to the low receptivity of stakeholders. In this study, we analyse stakeholders' resistance to an organization's implementation of telemedicine. Focusing on the physicians' interests, we propose a strategy to minimize conflicts and improve acceptance. Methods The Delphi study involved 190 telemedicine professionals who were recommended by 485 telemedicine-related personnel in South Korea. Results Out of 190 professionals, 60% of enrolled participants completed the final questionnaires. The stakeholders were categorized into four groups: policy-making officials, physicians, patients, and industrialists. Among these, the physicians were most opposed to the adoption of telemedicine. The main causes of such opposition were found to be the lack of a medical services delivery system and the threat of disruption for primary care clinics. Very little consensus was observed among the stakeholders, except on the following points: the need for expansion of the national health insurance budget by the government, and the need for enhancement of physicians' professional autonomy to facilitate smooth agreements. Discussion Our analysis on the causes of the resistance to telemedicine, carried out with the groups mentioned above, has important implications for policy-makers deriving strategies to achieve an appropriate consensus.

Experience with Quality Assurance in Two Store-and-Forward Telemedicine Networks.

Science.gov (United States)

Wootton, Richard; Liu, Joanne; Bonnardot, Laurent; Venugopal, Raghu; Oakley, Amanda

2015-01-01

Despite the increasing use of telemedicine around the world, little has been done to incorporate quality assurance (QA) into these operations. The purpose of the present study was to examine the feasibility of QA in store-and-forward teleconsulting using a previously published framework. During a 2-year study period, we examined the feasibility of using QA tools in two mature telemedicine networks [Médecins Sans Frontières (MSF) and New Zealand Teledermatology (NZT)]. The tools included performance reporting to assess trends, automated follow-up of patients to obtain outcomes data, automated surveying of referrers to obtain user feedback, and retrospective assessment of randomly selected cases to assess quality. In addition, the senior case coordinators in each network were responsible for identifying potential adverse events from email reports received from users. During the study period, there were 149 responses to the patient follow-up questions relating to the 1241 MSF cases (i.e., 12% of cases), and there were 271 responses to the follow-up questions relating to the 639 NZT cases (i.e., 42% of cases). The collection of user feedback reports was combined with the collection of patient follow-up data, thus producing the same response rates. The outcomes data suggested that the telemedicine advice proved useful for the referring doctor in the majority of cases and was likely to benefit the patient. The user feedback was overwhelmingly positive, over 90% of referrers in the two networks finding the advice received to be of educational benefit. The feedback also suggested that the teleconsultation had provided cost savings in about 20% of cases, either to the patient/family, or to the hospital/clinic treating the patient. Various problems were detected by regular monitoring, and certain adverse events were identified from email reports by the users. A single aberrant quality reading was detected by using a process control chart. The present study demonstrates

Multistandard Receiver Design for Telemedicine Monitoring System

Directory of Open Access Journals (Sweden)

Hongmei Wang

2018-01-01

Full Text Available In short-distance wireless communications for telemedicine monitoring, different medical data measurement equipment has different wireless transmission modes. A multistandard receiver is designed that can adapt to different medical data measuring equipment. Using a second-order bandpass sampling for the design of antialiasing filters, two aliasing signals can be separated. Simultaneously, constraint conditions for sampling frequency are not as critical. The design is useful for a multistandard receiver in a telemedicine monitoring system and has the advantages such as saving spectrum resources and facilitating spectrum planning.

Effectiveness of telemedicine and distance learning applications for patients with chronic heart failure. A protocol for prospective parallel group non-randomised open label study

OpenAIRE

Vanagas, Giedrius; Umbrasienė, Jelena; Šlapikas, Rimvydas

2012-01-01

Introduction Chronic heart failure in Baltic Sea Region is responsible for more hospitalisations than all forms of cancer combined and is one of the leading causes of hospitalisations in elderly patients. Frequent hospitalisations, along with other direct and indirect costs, place financial burden on healthcare systems. We aim to test the hypothesis that telemedicine and distance learning applications is superior to the current standard of home care. Methods and analysis Prospective parallel ...

Access to expert stroke care with telemedicine: REACH MUSC

Directory of Open Access Journals (Sweden)

Abby Swanson Kazley

2012-03-01

Full Text Available Stroke is a leading cause of death and disability, and rtPA can significantly reduce the long-term impact of acute ischemic stroke (AIS if given within 3 hours of symptom onset. South Carolina is located in the stroke belt and has a high rate of stroke and stroke mortality. Many small rural SC hospitals do not maintain the expertise needed to treat AIS patients with rtPA. MUSC is an academic medical center using REACH MUSC telemedicine to deliver stroke care to 15 hospitals in the state, increasing the likelihood of timely treatment with rtPA. The purpose of this study is to determine the increase in access to rtPA through the use of telemedicine for AIS in the general population and in specific segments of the population based on age, gender, race, ethnicity, education, urban/rural residence, poverty, and stroke mortality.We used a retrospective cross-sectional design examining Census data from 2000 and Geographic Information Systems (GIS analysis to identify South Carolina residents that live within 30 or 60 minutes of a Primary Stroke Center (PSC or a REACH MUSC site. We include all South Carolina citizens in our analysis and specifically examine the population’s age, gender, race, ethnicity, education, urban/rural residence, poverty, and stroke mortality. Our sample includes 4,012,012 South Carolinians. The main measure is access to expert stroke care at a Primary Stroke Center (PSC or a REACH MUSC hospital within 30 or 60 minutes. We find that without REACH MUSC, only 38% of the population has potential access to expert stroke care in SC within sixty minutes given that most PSCs will maintain expert stroke coverage. REACH MUSC allows 76% of the population to be within sixty minutes of expert stroke care, and 43% of the population to be within 30 minute drive time of expert stroke care. These increases in access are especially significant for groups that have faced disparities in care and high rates of AIS. The use of telemedicine can

Hanford coring bit temperature monitor development testing results report

International Nuclear Information System (INIS)

Rey, D.

1995-05-01

Instrumentation which directly monitors the temperature of a coring bit used to retrieve core samples of high level nuclear waste stored in tanks at Hanford was developed at Sandia National Laboratories. Monitoring the temperature of the coring bit is desired to enhance the safety of the coring operations. A unique application of mature technologies was used to accomplish the measurement. This report documents the results of development testing performed at Sandia to assure the instrumentation will withstand the severe environments present in the waste tanks

Nanocrystalline, superhard, ductile ceramic coatings for roller-cone bit bearings

Energy Technology Data Exchange (ETDEWEB)

Namavar, F.; Colter, P.; Karimy, H. [Spire Corp., Bedford, MA (United States)] [and others

1997-12-31

The established method for construction of roller bits utilizes carburized steel, frequently with inserted metal bearing surfaces. This construction provides the necessary surface hardness while maintaining other desirable properties in the core. Protective coatings are a logical development where enhanced hardness, wear resistance, corrosion resistance, and surface properties are required. The wear properties of geothermal roller-cone bit bearings could be further improved by application of protective ceramic hard coatings consisting of nanometer-sized crystallites. Nanocrystalline protective coatings provide the required combination of hardness and toughness which has not been available thus far using traditional ceramics having larger grains. Increased durability of roller-cone bit bearings will ultimately reduce the cost of drilling geothermal wells through increased durability.

Multipurpose Health Care Telemedicine System

National Research Council Canada - National Science Library

Kyriacou, E

2001-01-01

.... Ambulances, Rural Health Centers (RHC) or other remote health location, Ships navigating in wide seas and Airplanes in flight are common examples of possible emergency sites, while critical care telemetry, and telemedicine home follow-ups...

Bit Error-Rate Minimizing Detector for Amplify-and-Forward Relaying Systems Using Generalized Gaussian Kernel

KAUST Repository

Ahmed, Qasim Zeeshan

2013-01-01

In this letter, a new detector is proposed for amplifyand- forward (AF) relaying system when communicating with the assistance of relays. The major goal of this detector is to improve the bit error rate (BER) performance of the receiver. The probability density function is estimated with the help of kernel density technique. A generalized Gaussian kernel is proposed. This new kernel provides more flexibility and encompasses Gaussian and uniform kernels as special cases. The optimal window width of the kernel is calculated. Simulations results show that a gain of more than 1 dB can be achieved in terms of BER performance as compared to the minimum mean square error (MMSE) receiver when communicating over Rayleigh fading channels.

Power consumption analysis of constant bit rate video transmission over 3G networks

DEFF Research Database (Denmark)

Ukhanova, Ann; Belyaev, Evgeny; Wang, Le

2012-01-01

This paper presents an analysis of the power consumption of video data transmission with constant bit rate over 3G mobile wireless networks. The work includes the description of the radio resource control transition state machine in 3G networks, followed by a detailed power consumption analysis...... and measurements of the radio link power consumption. Based on this description and analysis, we propose our power consumption model. The power model was evaluated on a smartphone Nokia N900, which follows 3GPP Release 5 and 6 supporting HSDPA/HSUPA data bearers. We also propose a method for parameter selection...... for the 3GPP transition state machine that allows to decrease power consumption on a mobile device taking signaling traffic, buffer size and latency restrictions into account. Furthermore, we discuss the gain in power consumption vs. PSNR for transmitted video and show the possibility of performing power...

Arizona TeleMedicine Project.

Science.gov (United States)

Arizona Univ., Tucson. Coll. of Medicine.

Designed to provide health services for American Indians living on rurally isolated reservations, the Arizona TeleMedicine Project proposes to link Phoenix and Tucson medical centers, via a statewide telecommunications system, with the Hopi, San Carlos Apache, Papago, Navajo, and White Mountain Apache reservations. Advisory boards are being…

Bit-coded regular expression parsing

DEFF Research Database (Denmark)

Nielsen, Lasse; Henglein, Fritz

2011-01-01

the DFA-based parsing algorithm due to Dub ´e and Feeley to emit the bits of the bit representation without explicitly materializing the parse tree itself. We furthermore show that Frisch and Cardelli’s greedy regular expression parsing algorithm can be straightforwardly modified to produce bit codings...

[The integration of telemedicine concepts in the regional care of rural areas: Possibilities, limitations, perspectives].

Science.gov (United States)

van den Berg, Neeltje; Schmidt, S; Stentzel, U; Mühlan, H; Hoffmann, W

2015-04-01

In rural areas with a low population density and (imminent) gaps in regional health care, telemedicine concepts can be a promising option in supporting the supply of medical care.Telemedicine connections can be established between different health care providers (e.g., hospitals) or directly between health care providers and patients.Different scenarios for the implementation of telemedicine have been developed, from the monitoring of chronically ill patients to the support of acute care. Examples of frequently applied telemedicine concepts are teleradiology, telemedicine stroke networks, and the telemedicine monitoring of patients with heart failure. The development of concepts for other indications and patient groups is apparently difficult in Germany; one reason could be that research institutions are involved in only a small number of projects. However, the participation of research institutes would be of importance in creating more scientific evidence. The development of appropriate evaluation designs for analyzing the effectiveness of telemedicine concepts and economic effects is an important task and challenge for the future. Mandatory evaluation criteria should be developed to provide a basis for the translation of positively evaluated telemedicine concepts into routine care.

Informed consent for telemedicine in South Africa: A survey of ...

African Journals Online (AJOL)

Informed consent for telemedicine in South Africa: A survey of consent practices among healthcare professionals in Durban, KwaZulu-Natal. C Jack, M Mars. Abstract. Background. The Health Professions Council of South Africa is drafting guidelines to regulate the practice of telemedicine. These emphasise the need for ...

Quality assurance of teleconsultations in a store-and-forward telemedicine network - obtaining patient follow-up data and user feedback

Directory of Open Access Journals (Sweden)

Richard eWootton

2014-11-01

Full Text Available User surveys in telemedicine networks confirm that follow up data are essential, both for the specialists who provide advice and for those running the system. We have examined the feasibility of a method for obtaining follow-up data automatically in a store-and-forward network. We distinguish between follow-up, which is information about the progress of a patient and is based on outcomes, and user feedback, which is more general information about the telemedicine system itself, including user satisfaction and the benefits resulting from the use of telemedicine. In the present study, we were able to obtain both kinds of information using a single questionnaire. During a 9-month pilot trial in the MSF telemedicine network, an email request for follow-up was sent automatically by the telemedicine system to each referrer exactly 21 days after the initial submission of the case. A total of 201 requests for follow-up were issued by the system and these elicited 41 responses (a response rate of 20%. The responses were largely positive. For example, 95% of referrers found the advice helpful, 90% said that it clarified their diagnosis, 94% said that it assisted with management of the patient and 95% said that the telemedicine response was of educational benefit to them. Analysis of the characteristics of the referrers who did not respond, and their cases, did not suggest anything different about them in comparison with referrers who did respond. We were not able to identify obvious factors associated with a failure to respond. Obtaining data by automatic request is feasible. It provides useful information for specialists and for those running the network. Since obtaining follow-up data is essential to best practice, one proposal to improve the response rate is to simplify the automatic requests so that only patient follow-up information is asked for, and to restrict user feedback requests to the cases being assessed each month by the quality assurance

Delivering tertiary centre specialty care to ALS patients via telemedicine: a retrospective cohort analysis.

Science.gov (United States)

Selkirk, Stephen M; Washington, Monique O; McClellan, Frances; Flynn, Broderick; Seton, Jacinta M; Strozewski, Richard

2017-08-01

This study was undertaken to determine if ALS patients evaluated via telemedicine received the same quality of care as patients evaluated by traditional face-to-face encounters. A retrospective cohort study design was used. Participants were patients diagnosed with ALS that received multidisciplinary care at the tertiary Cleveland VA ALS Centre between 1 March 2008- and 31 anuary 2015. Participants were not randomised, but chose telemedicine based on preference, disability level or distance from the clinic. Telemedicine in this study consisted of a video conferencing platform enabling remote rather than face-to-face encounters with participants. There was no significant association between receiving quality ALS care and the mode of care. There was a trend for telemedicine patients to utilise home health care less often than those that received clinic care (AOR 0.50; 95% CI 0.16-1.59). There was no significant difference in survival time between the two groups (log-rank test χ 2  = 3.62, df = 1, p = 0.05). Patients receiving telemedicine had a higher probability of remaining stable or having telemedicine (HR = 0.39, 95% CI = 0.16-0.93). Patients managed by telemedicine received the same quality of care and had similar outcomes to those patients seen via traditional face-to-face encounters. Telemedicine is an effective platform for delivering high quality tertiary ALS care.

High-Surety Telemedicine in a Distributed, 'Plug-andPlan' Environment

Energy Technology Data Exchange (ETDEWEB)

Craft, Richard L.; Funkhouser, Donald R.; Gallagher, Linda K.; Garcia, Rudy J.; Parks, Raymond C.; Warren, Steve

1999-05-17

Commercial telemedicine systems are increasingly functional, incorporating video-conferencing capabilities, diagnostic peripherals, medication reminders, and patient education services. However, these systems (1) rarely utilize information architectures which allow them to be easily integrated with existing health information networks and (2) do not always protect patient confidentiality with adequate security mechanisms. Using object-oriented methods and software wrappers, we illustrate the transformation of an existing stand-alone telemedicine system into `plug-and-play' components that function in a distributed medical information environment. We show, through the use of open standards and published component interfaces, that commercial telemedicine offerings which were once incompatible with electronic patient record systems can now share relevant data with clinical information repositories while at the same time hiding the proprietary implementations of the respective systems. Additionally, we illustrate how leading-edge technology can secure this distributed telemedicine environment, maintaining patient confidentiality and the integrity of the associated electronic medical data. Information surety technology also encourages the development of telemedicine systems that have both read and write access to electronic medical records containing patient-identifiable information. The win-win approach to telemedicine information system development preserves investments in legacy software and hardware while promoting security and interoperability in a distributed environment.

Telemedicine-based system for quality management and peer review in radiology.

Science.gov (United States)

Morozov, Sergey; Guseva, Ekaterina; Ledikhova, Natalya; Vladzymyrskyy, Anton; Safronov, Dmitry

2018-06-01

Quality assurance is the key component of modern radiology. A telemedicine-based quality assurance system helps to overcome the "scoring" approach and makes the quality control more accessible and objective. A concept for quality assurance in radiology is developed. Its realization is a set of strategies, actions, and tools. The latter is based on telemedicine-based peer review of 23,199 computed tomography (CT) and magnetic resonance imaging (MRI) images. The conception of the system for quality management in radiology represents a chain of actions: "discrepancies evaluation - routine support - quality improvement activity - discrepancies evaluation". It is realized by an audit methodology, telemedicine, elearning, and other technologies. After a year of systemic telemedicine-based peer reviews, the authors have estimated that clinically significant discrepancies were detected in 6% of all cases, while clinically insignificant ones were found in 19% of cases. Most often, problems appear in musculoskeletal records; 80% of the examinations have diagnostic or technical imperfections. The presence of routine telemedicine support and personalized elearning allowed improving the diagnostics quality. The level of discrepancies has decreased significantly (p elearning significantly decrease the number of discrepancies. • Teleradiology allows linking all primary-level hospitals to a common peer review network.

Telemedicine and Pediatric Obesity Treatment: Review of the literature and lessons learned

OpenAIRE

Cohen, Gail M.; Irby, Megan B.; Boles, Katie; Jordan, Christine; Skelton, Joseph A.

2012-01-01

Pediatric obesity is more prevalent in rural areas, yet rural families may not have access to pediatric obesity treatment programs. Use of new technologies, particularly telemedicine, has proven effective in other behavioral fields, such as psychiatry. This paper reviews the literature on the use of telemedicine in pediatric obesity treatment, and describes one tertiary-care pediatric obesity telemedicine program. We performed a systematic review of the literature from 1990–2011 using the fol...

A global productivity and bibliometric analysis of telemedicine and teledermatology publication trends during 1980–2013

Directory of Open Access Journals (Sweden)

Engin Şenel

2015-03-01

Conclusion: Most items have been published from high-income, developed countries. Thus the physicians in undeveloped and developing countries, in which telemedicine and teledermatology applications are crucial to deliver medical care and services, should be encouraged to perform novel studies.

An Analysis of Telemedicine in Taiwan: A Business Model Perspective

Directory of Open Access Journals (Sweden)

Tung-Cheng Lin

2011-12-01

Conclusions: The framework we proposed serves as a useful tool to obtain more insights into the future development of telemedicine. The cost of operating a telemedicine service system is currently not low. The practitioner could reduce the cost through modifying value proposition, service process or allying with more experienced partner.

Telemedicine in the 'Hood.

Science.gov (United States)

Elgrably, Jordan

1998-01-01

Telemedicine, the ability to examine patients while physically removed from them by using high-tech virtual treatment, is used increasingly to diagnose and prescribe treatment for patients in nontraditional settings. In Los Angeles (California), Charles R. Drew University of Medicine and King-Drew Medical Center communicate in real time with…

Pharmacists providing care in the outpatient setting through telemedicine models: a narrative review

Directory of Open Access Journals (Sweden)

Littauer SL

2017-12-01

Full Text Available Telemedicine refers to the delivery of clinical services using technology that allows two-way, real time, interactive communication between the patient and the clinician at a distant site. Commonly, telemedicine is used to improve access to general and specialty care for patients in rural areas. This review aims to provide an overview of existing telemedicine models involving the delivery of care by pharmacists via telemedicine (including telemonitoring and video, but excluding follow-up telephone calls and to highlight the main areas of chronic-disease management where these models have been applied. Studies within the areas of hypertension, diabetes, asthma, anticoagulation and depression were identified, but only two randomized controlled trials with adequate sample size demonstrating the positive impact of telemonitoring combined with pharmacist care in hypertension were identified. The evidence for the impact of pharmacist-based telemedicine models is sparse and weak, with the studies conducted presenting serious threats to internal and external validity. Therefore, no definitive conclusions about the impact of pharmacist-led telemedicine models can be made at this time. In the Unites States, the increasing shortage of primary care providers and specialists represents an opportunity for pharmacists to assume a more prominent role managing patients with chronic disease in the ambulatory care setting. However, lack of reimbursement may pose a barrier to the provision of care by pharmacists using telemedicine.

Emergency Telemedicine: Achieving and Maintaining Compliance with the Emergency Medical Treatment and Labor Act.

Science.gov (United States)

Rockwell, Kimberly Lovett; Gilroy, Alexis

2018-03-12

Telemedicine is a growing and important platform for medical delivery in the emergency department. Emergency telemedicine outlays often confront and conflict with important federal healthcare regulations. Because of this, academic medical centers, critical access hospitals, and other providers interested in implementing emergency telemedicine have often delayed or forgone such services due to reasonable fears of falling out of compliance with regulatory restrictions imposed by the Emergency Medical Treatment and Labor Act ("EMTALA"). This article offers insights into methods for implementing emergency telemedicine services while maintaining EMTALA compliance. Critical analysis of EMTALA and its attendant regulations. The primary means of ensuring EMTALA compliance while implementing emergency telemedicine programs include incorporating critical clinical details into the services contracts and implementing robust written policies that anticipate division of labor issues, the need for backup coverage, triaging, patient transfer protocols, and credentialing issues. With adequate up-front due diligence and meaningful contracting, hospitals and telemedicine providers can avoid common EMTALA liability pitfalls.

Flexible Bit Preservation on a National Basis

DEFF Research Database (Denmark)

Jurik, Bolette; Nielsen, Anders Bo; Zierau, Eld

2012-01-01

In this paper we present the results from The Danish National Bit Repository project. The project aim was establishment of a system that can offer flexible and sustainable bit preservation solutions to Danish cultural heritage institutions. Here the bit preservation solutions must include support...... of bit safety as well as other requirements like e.g. confidentiality and availability. The Danish National Bit Repository is motivated by the need to investigate and handle bit preservation for digital cultural heritage. Digital preservation relies on the integrity of the bits which digital material...

Presettable up-down CAMAC counter for 24 bit

International Nuclear Information System (INIS)

Kuhn, K.; Meyer, U.; Weidhase, F.

1976-01-01

A module containing a presettable binary up-down CAMAC counter for 24 bit is described. The use of dataway is discussed. As an example for application in nuclear physics, control of beam position by the up-down counter is illustrated

Design of a 12-bit 80MS/s pipeline analog-to-digital converter for PLC-VDSL applications

Science.gov (United States)

Ruiz-Amaya, Jesus; Delgado-Restituto, Manuel; Fernandez-Bootello, Juan F.; de la Rosa, Jose M.

2005-06-01

This paper describes the design of a 12-bit 80MS/s pipeline Analog-to-Digital converter implemented in 0.13mm CMOS logic technology. The design has been computer-aided by a developed toolbox for the simulation, synthesis and verification of Nyquist-Rate Analog-to-Digital and Digital-to-Analog Converters in MATLAB. The embedded simulator uses SIMULINK C-coded S-functions to model all required subcircuits including their main error mechanisms. This approach allows to drastically speed up the simulation CPU-time and makes the proposed tool an advantageous alternative for fast exploration of requirements and as a design validation tool. The converter is based on a 10-stage pipeline preceded by a sample/hold with bootstrapping technique. Each stage gives 1.5 effective bits, except for the first one which provides 2.5 effective bits to improve linearity. The Analog-to-Digital architecture uses redundant bits for digital correction, it is planned to be implemented without using calibration and employs a subranging pipeline look-ahead technique to increase speed. Substrate biased MOSFETs in the depletion region are used as capacitors, linearized by a series compensation. Simulation results show that the Multi-Tone Power Ratio is higher than 56dB for several DMT test signals and the estimated Signal-to-Noise Ratio yield is supposed to be better than 62 dB from DC to Nyquist frequency. The converter dissipates less than 150mW from a 3.3V supply and occupies less than 4 mm2 die area. The results have been checked with all process corners from -40° to 85° and power supply from 3V to 3.6V.

NASA/DARPA advanced communications technology satellite project for evaluation of telemedicine outreach using next-generation communications satellite technology: Mayo Foundation participation.

Science.gov (United States)

Gilbert, B K; Mitchell, M P; Bengali, A R; Khandheria, B K

1999-08-01

To describe the development of telemedicine capabilities-application of remote consultation and diagnostic techniques-and to evaluate the feasibility and practicality of such clinical outreach to rural and underserved communities with limited telecommunications infrastructures. In 1992, Mayo Foundation (Rochester, Minn, Jacksonville, Fla, and Scottsdale, Ariz), the National Aeronautics and Space Administration, and the Defense Advanced Research Projects Agency collaborated to create a complex network of fiberoptic landlines, video recording systems, satellite terminals, and specially developed data translators linking Mayo sites with other locations in the continental United States on an on-demand basis. The purpose was to transmit data via the asynchronous transfer mode (ATM) digital communications protocol over the Advanced Communications Technology Satellite. The links were intended to provide a conduit for transmission of data for patient-specific consultations between physicians, evaluation of medical imagery, and medical education for clinical staffs at remote sites. Low-data-rate (LDR) experiments went live late in 1993. Mayo Clinic Rochester successfully provided medical consultation and services to 2 small regional medical facilities. High-data-rate (HDR) experiments included studies of remote digital echocardiography, store-and-forward telemedicine, cardiac catheterization, and teleconsultation for congenital heart disease. These studies combined landline data transmission with use of the satellite. The complexity of the routing paths and network components, immaturity of available software, and inexperience with existing telecommunications caused significant study delays. These experiments demonstrated that next-generation satellite technology can provide batch and real-time imagery for telemedicine. The first-generation of the ATM and satellite network technology used in these experiments created several technical problems and inconveniences that should

Ethical practice in Telehealth and Telemedicine.

Science.gov (United States)

Chaet, Danielle; Clearfield, Ron; Sabin, James E; Skimming, Kathryn

2017-10-01

This article summarizes the report of the American Medical Association's (AMA) Council on Ethical and Judicial Affairs (CEJA) on ethical practice in telehealth and telemedicine. Through its reports and recommendations, CEJA is responsible for maintaining and updating the AMA Code of Medical Ethics (Code). CEJA reports are developed through an iterative process of deliberation with input from multiple stakeholders; report recommendations, once adopted by the AMA House of Delegates, become ethics policy of the AMA and are issued as Opinions in the Code. To provide enduring guidance for the medical profession as a whole, CEJA strives to articulate expectations for conduct that are as independent of specific technologies or models of practice as possible. The present report, developed at the request of the House of Delegates, provides broad guidance for ethical conduct relating to key issues in telehealth/telemedicine. The report and recommendations were debated at meetings of the House in June and November 2015; recommendations were adopted in June 2016 and published as Opinion E-1.2.12, Ethical Practice in Telemedicine, in November 2016. A summary of the key points of the recommendations can be found in Appendix A (online), and the full text of the opinion can be found in Appendix B (online).

Quality-of-data broker for quality-of-data-aware telemedicine systems

NARCIS (Netherlands)

Larburu Rubio, Nekane; Bults, Richard G.A.; van Sinderen, Marten J.; Widya, I.A.; Hermens, Hermanus J.

2016-01-01

Purpose: Telemedicine systems must provide clinical data of sufficient quality (according to medical standards) to support safe treatment guidance of outpatients. Quality of clinical data (QoD) typically varies due to unstable performance of ICT-components of these telemedicine systems. Therefore,

String bit models for superstring

International Nuclear Information System (INIS)

Bergman, O.; Thorn, C.B.

1995-01-01

The authors extend the model of string as a polymer of string bits to the case of superstring. They mainly concentrate on type II-B superstring, with some discussion of the obstacles presented by not II-B superstring, together with possible strategies for surmounting them. As with previous work on bosonic string work within the light-cone gauge. The bit model possesses a good deal less symmetry than the continuous string theory. For one thing, the bit model is formulated as a Galilei invariant theory in (D - 2) + 1 dimensional space-time. This means that Poincare invariance is reduced to the Galilei subgroup in D - 2 space dimensions. Naturally the supersymmetry present in the bit model is likewise dramatically reduced. Continuous string can arise in the bit models with the formation of infinitely long polymers of string bits. Under the right circumstances (at the critical dimension) these polymers can behave as string moving in D dimensional space-time enjoying the full N = 2 Poincare supersymmetric dynamics of type II-B superstring

String bit models for superstring

Energy Technology Data Exchange (ETDEWEB)

Bergman, O.; Thorn, C.B.

1995-12-31

The authors extend the model of string as a polymer of string bits to the case of superstring. They mainly concentrate on type II-B superstring, with some discussion of the obstacles presented by not II-B superstring, together with possible strategies for surmounting them. As with previous work on bosonic string work within the light-cone gauge. The bit model possesses a good deal less symmetry than the continuous string theory. For one thing, the bit model is formulated as a Galilei invariant theory in (D {minus} 2) + 1 dimensional space-time. This means that Poincare invariance is reduced to the Galilei subgroup in D {minus} 2 space dimensions. Naturally the supersymmetry present in the bit model is likewise dramatically reduced. Continuous string can arise in the bit models with the formation of infinitely long polymers of string bits. Under the right circumstances (at the critical dimension) these polymers can behave as string moving in D dimensional space-time enjoying the full N = 2 Poincare supersymmetric dynamics of type II-B superstring.

A low power 12-bit ADC for nuclear instrumentation

International Nuclear Information System (INIS)

Adachi, R.; Landis, D.; Madden, N.; Silver, E.; LeGros, M.

1992-10-01

A low power, successive approximation, analog-to-digital converter (ADC) for low rate, low cost, battery powered applications is described. The ADC is based on a commercial 50 mW successive approximation CMOS device (CS5102). An on-chip self-calibration circuit reduces the inherent differential nonlinearity to 7%. A further reduction of the differential nonlinearity to 0.5% is attained with a four bit Gatti function. The Gatti function is distributed to minimize battery power consumption. All analog functions reside with the ADC while the noisy digital functions reside in the personal computer based histogramming memory. Fiber optic cables carry afl digital information between the ADC and the personal computer based histogramming memory

US and territory telemedicine policies: identifying gaps in perinatal care

Science.gov (United States)

Okoroh, Ekwutosi M.; Kroelinger, Charlan D.; Smith, Alexander M.; Goodman, David A.; Barfield, Wanda D.

2016-01-01

BACKGROUND Perinatal regionalization is a system of maternal and neonatal risk-appropriate health care delivery in which resources are ideally allocated for mothers and newborns during pregnancy, labor and delivery, and postpartum, in order to deliver appropriate care. Typically, perinatal risk-appropriate care is provided in-person, but with the advancement of technologies, the opportunity to provide care remotely has emerged. Telemedicine provides distance-based care to patients by consultation, diagnosis, and treatment in rural or remote US jurisdictions (states and territories). OBJECTIVE We sought to summarize the telemedicine policies of states and territories and assess if maternal and neonatal risk-appropriate care is specified. STUDY DESIGN We conducted a 2014 systematic World Wide Web–based review of publicly available rules, statutes, regulations, laws, planning documents, and program descriptions among US jurisdictions (N=59) on telemedicine care. Policies including language on the topics of consultation, diagnosis, or treatment, and those specific to maternal and neonatal risk-appropriate care were categorized for analysis. RESULTS Overall, 36 jurisdictions (32 states; 3 territories; and District of Columbia) (61%) had telemedicine policies with language referencing consultation, diagnosis, or treatment; 29 (49%) referenced consultation, 30 (51%) referenced diagnosis, and 35 (59%) referenced treatment. In all, 26 jurisdictions (22 states; 3 territories; and District of Columbia) (44%), referenced all topics. Only 3 jurisdictions (3 states; 0 territories) (5%), had policy language specifically addressing perinatal care. CONCLUSION The majority of states have published telemedicine policies, but few specify policy language for perinatal risk-appropriate care. By ensuring that language specific to the perinatal population is included in telemedicine policies, access to maternal and neonatal care can be increased in rural, remote, and resource

A Robust Automated Cataract Detection Algorithm Using Diagnostic Opinion Based Parameter Thresholding for Telemedicine Application

Directory of Open Access Journals (Sweden)

Shashwat Pathak

2016-09-01

Full Text Available This paper proposes and evaluates an algorithm to automatically detect the cataracts from color images in adult human subjects. Currently, methods available for cataract detection are based on the use of either fundus camera or Digital Single-Lens Reflex (DSLR camera; both are very expensive. The main motive behind this work is to develop an inexpensive, robust and convenient algorithm which in conjugation with suitable devices will be able to diagnose the presence of cataract from the true color images of an eye. An algorithm is proposed for cataract screening based on texture features: uniformity, intensity and standard deviation. These features are first computed and mapped with diagnostic opinion by the eye expert to define the basic threshold of screening system and later tested on real subjects in an eye clinic. Finally, a tele-ophthamology model using our proposed system has been suggested, which confirms the telemedicine application of the proposed system.

Insecurity of imperfect quantum bit seal

International Nuclear Information System (INIS)

Chau, H.F.

2006-01-01

Quantum bit seal is a way to encode a classical bit quantum mechanically so that everyone can obtain non-zero information on the value of the bit. Moreover, such an attempt should have a high chance of being detected by an authorized verifier. Surely, a reader looks for a way to get the maximum amount of information on the sealed bit and at the same time to minimize her chance of being caught. And a verifier picks a sealing scheme that maximizes his chance of detecting any measurement of the sealed bit. Here, I report a strategy that passes all measurement detection procedures at least half of the time for all quantum bit sealing schemes. This strategy also minimizes a reader's chance of being caught under a certain scheme. In this way, I extend the result of Bechmann-Pasquinucci et al. by proving that quantum seal is insecure in the case of imperfect sealed bit recovery

Bit-Vector Search Filtering with Application to a Kanji Dictionary

DEFF Research Database (Denmark)

Skala, Matthew

2016-01-01

dimensionality in geometric problems also causes their query languages to become expressive and inefficient. The IDSgrep kanji dictionary software approaches a highly expressive tree-matching query problem with a filtering technique set in 128-bit Hamming space. It can be a model for other highly expressive...

Telemedicine and Diabetic Eye Disease

Centers for Disease Control (CDC) Podcasts

We know that the leading cause of blindness in working-age adults is eye disease related to poorly managed diabetes. In a prevention research study, telemedicine was shown to increase the number of people getting screened for diabetic eye disease.

Practical scheme to share a secret key through a quantum channel with a 27.6% bit error rate

International Nuclear Information System (INIS)

Chau, H.F.

2002-01-01

A secret key shared through quantum key distribution between two cooperative players is secure against any eavesdropping attack allowed by the laws of physics. Yet, such a key can be established only when the quantum channel error rate due to eavesdropping or imperfect apparatus is low. Here, a practical quantum key distribution scheme by making use of an adaptive privacy amplification procedure with two-way classical communication is reported. Then, it is proven that the scheme generates a secret key whenever the bit error rate of the quantum channel is less than 0.5-0.1√(5)≅27.6%, thereby making it the most error resistant scheme known to date

Pediatric Diabetes Telemedicine Program Improves Access to Care for Rural Families: Role of APRNs.

Science.gov (United States)

Smith, Nancy Marie; Satyshur, Rosemarie DiMauro

2016-01-01

Type 1 diabetes mellitus has increased in children by 23% from 2001 to 2009. Rural communities additionally have increased disparities related to access barriers and a large minority population with poorer overall health. Research evidence supports telemedicine as an effective alternative to bring preventive diabetes care to remote areas. This article presents an overview of the leadership role of advanced practice registered nurses (APRNs) with the implementation and evaluation of a pediatric diabetes telemedicine program at a rural pediatric outpatient specialty clinic in partnership with a tertiary center telemedicine network. The telemedicine program quality improvement (QI) project explored caregiver satisfaction with a convenience sample of caregivers (N = 14) using a nine-item Telemedicine Diabetes Caregiver Satisfaction Survey (TDCSS), with responses ranging from 1 = strongly disagree to 5 = strongly agree. Findings indicate caregivers were highly satisfied with communication/ privacy (M = 4.8), access to care (M = 4.1), and quality of services (M = 5.0). The multidisciplinary collaborative teamwork, continuous QI, and dependable technology were integral to the quality of the telemedicine clinical initiative. APRNs provided technology expertise, interdisciplinary collaboration leadership, care coordination, and advocacy for policy changes. Results demonstrate that telemedicine and APRN leadership can help implement innovative programs into rural communities to improve access to care, healthcare cost, and outcomes.

Real-time minimal-bit-error probability decoding of convolutional codes

Science.gov (United States)

Lee, L.-N.

1974-01-01

A recursive procedure is derived for decoding of rate R = 1/n binary convolutional codes which minimizes the probability of the individual decoding decisions for each information bit, subject to the constraint that the decoding delay be limited to Delta branches. This new decoding algorithm is similar to, but somewhat more complex than, the Viterbi decoding algorithm. A real-time, i.e., fixed decoding delay, version of the Viterbi algorithm is also developed and used for comparison to the new algorithm on simulated channels. It is shown that the new algorithm offers advantages over Viterbi decoding in soft-decision applications, such as in the inner coding system for concatenated coding.

Real-time minimal bit error probability decoding of convolutional codes

Science.gov (United States)

Lee, L. N.

1973-01-01

A recursive procedure is derived for decoding of rate R=1/n binary convolutional codes which minimizes the probability of the individual decoding decisions for each information bit subject to the constraint that the decoding delay be limited to Delta branches. This new decoding algorithm is similar to, but somewhat more complex than, the Viterbi decoding algorithm. A real-time, i.e. fixed decoding delay, version of the Viterbi algorithm is also developed and used for comparison to the new algorithm on simulated channels. It is shown that the new algorithm offers advantages over Viterbi decoding in soft-decision applications such as in the inner coding system for concatenated coding.

Modern X86 assembly language programming 32-bit, 64-bit, SSE, and AVX

CERN Document Server

Kusswurm, Daniel

2014-01-01

Modern X86 Assembly Language Programming shows the fundamentals of x86 assembly language programming. It focuses on the aspects of the x86 instruction set that are most relevant to application software development. The book's structure and sample code are designed to help the reader quickly understand x86 assembly language programming and the computational capabilities of the x86 platform. Major topics of the book include the following: 32-bit core architecture, data types, internal registers, memory addressing modes, and the basic instruction setX87 core architecture, register stack, special

Will available bit rate (ABR) services give us the capability to offer virtual LANs over wide-area ATM networks?

Science.gov (United States)

Ferrandiz, Ana; Scallan, Gavin

1995-10-01

The available bit rate (ABR) service allows connections to exceed their negotiated data rates during the life of the connections when excess capacity is available in the network. These connections are subject to flow control from the network in the event of network congestion. The ability to dynamically adjust the data rate of the connection can provide improved utilization of the network and be a valuable service to end users. ABR type service is therefore appropriate for the transmission of bursty LAN traffic over a wide area network in a manner that is more efficient and cost effective than allocating bandwdith at the peak cell rate. This paper describes the ABR service and discusses if it is realistic to operate a LAN like service over a wide area using ABR.

Bit error rate analysis of free-space optical communication over general Malaga turbulence channels with pointing error

KAUST Repository

Alheadary, Wael Ghazy

2016-12-24

In this work, we present a bit error rate (BER) and achievable spectral efficiency (ASE) performance of a freespace optical (FSO) link with pointing errors based on intensity modulation/direct detection (IM/DD) and heterodyne detection over general Malaga turbulence channel. More specifically, we present exact closed-form expressions for adaptive and non-adaptive transmission. The closed form expressions are presented in terms of generalized power series of the Meijer\\'s G-function. Moreover, asymptotic closed form expressions are provided to validate our work. In addition, all the presented analytical results are illustrated using a selected set of numerical results.

Enhancing Performance and Bit Rates in a Brain-Computer Interface System With Phase-to-Amplitude Cross-Frequency Coupling: Evidences From Traditional c-VEP, Fast c-VEP, and SSVEP Designs.

Science.gov (United States)

Dimitriadis, Stavros I; Marimpis, Avraam D

2018-01-01

A brain-computer interface (BCI) is a channel of communication that transforms brain activity into specific commands for manipulating a personal computer or other home or electrical devices. In other words, a BCI is an alternative way of interacting with the environment by using brain activity instead of muscles and nerves. For that reason, BCI systems are of high clinical value for targeted populations suffering from neurological disorders. In this paper, we present a new processing approach in three publicly available BCI data sets: (a) a well-known multi-class ( N = 6) coded-modulated Visual Evoked potential (c-VEP)-based BCI system for able-bodied and disabled subjects; (b) a multi-class ( N = 32) c-VEP with slow and fast stimulus representation; and (c) a steady-state Visual Evoked potential (SSVEP) multi-class ( N = 5) flickering BCI system. Estimating cross-frequency coupling (CFC) and namely δ-θ [δ: (0.5-4 Hz), θ: (4-8 Hz)] phase-to-amplitude coupling (PAC) within sensor and across experimental time, we succeeded in achieving high classification accuracy and Information Transfer Rates (ITR) in the three data sets. Our approach outperformed the originally presented ITR on the three data sets. The bit rates obtained for both the disabled and able-bodied subjects reached the fastest reported level of 324 bits/min with the PAC estimator. Additionally, our approach outperformed alternative signal features such as the relative power (29.73 bits/min) and raw time series analysis (24.93 bits/min) and also the original reported bit rates of 10-25 bits/min . In the second data set, we succeeded in achieving an average ITR of 124.40 ± 11.68 for the slow 60 Hz and an average ITR of 233.99 ± 15.75 for the fast 120 Hz. In the third data set, we succeeded in achieving an average ITR of 106.44 ± 8.94. Current methodology outperforms any previous methodologies applied to each of the three free available BCI datasets.

The promise of telemedicine for chronic neurological disorders: the example of Parkinson's disease.

Science.gov (United States)

Schneider, Ruth B; Biglan, Kevin M

2017-07-01

Disparities in access to health care, particularly specialist care, exist worldwide. As the prevalence of chronic neurological disorders increases with ageing populations, access to neurologist care is likely to worsen in many regions if there are no changes to models of care. Telemedicine-defined here as the use of real-time, synchronous videoconferencing to deliver medical care-could be used to improve access to neurologist care for patients with a range of chronic neurological disorders. In Parkinson's disease, several studies have shown the feasibility and potential benefits of telemedicine-delivered care. Further research is needed to establish whether telemedicine can deliver on the promise of improved access to neurologist care and whether telemedicine-delivered care is comparable to in-person care in terms of clinical outcomes. Many barriers to widespread implementation of telemedicine services remain to be addressed, including reimbursement, legal considerations, and technological issues. Copyright © 2017 Elsevier Ltd. All rights reserved.

Secure Wireless Military Healthcare Telemedicine Enterprise

National Research Council Canada - National Science Library

Lucas, Kenneth W

2005-01-01

The primary objective of this research effort is to integrate ViTel Net's MedVizerTM software and Division Tools with cross platform telemedicine systems, inclusive of computer based systems, handheld...