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Health records rank among the most sensitive personal information existing today. An unwanted disclosure to unauthorised parties usually results in significant negative consequences for an individual. Therefore, health records must be adequately protected in order to ensure the individual's privacy. However, health records are also valuable resources for clinical studies and research activities. In order to make the records available for privacy-preserving secondary use, thorough de-personalisation is a crucial prerequisite to prevent re-identification. This paper introduces MEDSEC, a system which automatically converts paper-based health records into de-personalised and pseudonymised documents which can be accessed by secondary users without compromising the patients' privacy. The system converts the paper-based records into a standardised structure that facilitates automated processing and the search for useful information. [ABSTRACT FROM AUTHOR]

The paper applies artificial neural networks (ANNs) to the analysis of heart sound abnormalities through auscultation. Audio auscultation samples of 16 different coronary abnormalities were collected. Data pre-processing included down-sampling of the auscultated data and use of the fast Fourier transform (FFT) and the Levinson-Durbin autoregression algorithms for feature extraction and efficient data encoding. These data were used in the training of a multi-layer perceptron (MLP) and radial basis function (RBF) neural network to develop a classification mechanism capable of distinguishing between different heart sound abnormalities. The MLP and RBF networks attained classification accuracies of 84% and 88%, respectively. The application of ANNs to the analysis of respiratory auscultation and consequently the development of a combined cardio-respiratory analysis system using auscultated data could lead to faster and more efficient treatment. [ABSTRACT FROM AUTHOR]

Over a period of some years, the components of a system for discerning erosion on children's teeth have been progressively developed, for use in an extensive project seeking correlations between erosion and various perceived risk factors. The aim was the detection of minute levels of erosion, based on mappings of the palatal surfaces of the maxillary central incisors in children. Significant challenges were encountered, the primary problem being the impracticality of placing control marks that would aid the realignment of successive measurements. The paper describes the erosion detection system and initial experiences based on the results of the first 100 subjects measured after 9 months. The procedures detected the occurrence of erosion of 50 microm magnitude on about one-quarter of the teeth over the 9 month period, at a precision estimated to be +/- 15 microm. The occurrence of some anomalous incidents prevented the procedure from being fully automatic, and it necessitated human examination of a graphical diagram derived from the surface matching program, but it was nevertheless superior to current practices of examining impressions or replicas entirely by eye. [ABSTRACT FROM AUTHOR]

Fitting the measured bioimpedance spectroscopy (BIS) data to the Cole model and then extracting the Cole parameters is a common practice in BIS applications. The extracted Cole parameters then can be analysed as descriptors of tissue electrical properties. To have a better evaluation of physiological or pathological properties of biological tissue, accurate extraction of Cole parameters is of great importance. This paper proposes an improved Cole parameter extraction based on bacterial foraging optimization (BFO) algorithm. We employed simulated datasets to test the performance of the BFO fitting method regarding parameter extraction accuracy and noise sensitivity, and we compared the results with those of a least squares (LS) fitting method. The BFO method showed better robustness to the noise and higher accuracy in terms of extracted parameters. In addition, we applied our method to experimental data where bioimpedance measurements were obtained from forearm in three different positions of the arm. The goal of the experiment was to explore how robust Cole parameters are in classifying position of the arm for different people, and measured at different times. The extracted Cole parameters obtained by LS and BFO methods were applied to different classifiers. Two other evolutionary algorithms, GA and PSO were also used for comparison purpose. We showed that when the classifiers are fed with the extracted feature sets by BFO fitting method, higher accuracy is obtained both when applying on training data and test data. [ABSTRACT FROM AUTHOR]

There are various methods and algorithms to detect the optic discs in retinal images. In recent years, much attention has been given to the utilization of the intelligent algorithms. In this paper, we present a new automated method of optic disc detection in human retinal images using the firefly algorithm. The firefly intelligent algorithm is an emerging intelligent algorithm that was inspired by the social behavior of fireflies. The population in this algorithm includes the fireflies, each of which has a specific rate of lighting or fitness. In this method, the insects are compared two by two, and the less attractive insects can be observed to move toward the more attractive insects. Finally, one of the insects is selected as the most attractive, and this insect presents the optimum response to the problem in question. Here, we used the light intensity of the pixels of the retinal image pixels instead of firefly lightings. The movement of these insects due to local fluctuations produces different light intensity values in the images. Because the optic disc is the brightest area in the retinal images, all of the insects move toward brightest area and thus specify the location of the optic disc in the image. The results of implementation show that proposed algorithm could acquire an accuracy rate of 100 % in DRIVE dataset, 95 % in STARE dataset, and 94.38 % in DiaRetDB1 dataset. The results of implementation reveal high capability and accuracy of proposed algorithm in the detection of the optic disc from retinal images. Also, recorded required time for the detection of the optic disc in these images is 2.13 s for DRIVE dataset, 2.81 s for STARE dataset, and 3.52 s for DiaRetDB1 dataset accordingly. These time values are average value. [ABSTRACT FROM AUTHOR]

Previous studies showed that all the vascular parameters from both the morphological and topological parameters were affected with the altering of imaging resolutions. However, neither the sensitivity analysis of the vascular parameters at multiple resolutions nor the distinguishability estimation of vascular parameters from different data groups has been discussed. In this paper, we proposed a quantitative analysis method of vascular parameters for vascular networks of multi-resolution, by analyzing the sensitivity of vascular parameters at multiple resolutions and estimating the distinguishability of vascular parameters from different data groups. Combining the sensitivity and distinguishability, we designed a hybrid formulation to estimate the integrated performance of vascular parameters in a multi-resolution framework. Among the vascular parameters, degree of anisotropy and junction degree were two insensitive parameters that were nearly irrelevant with resolution degradation; vascular area, connectivity density, vascular length, vascular junction and segment number were five parameters that could better distinguish the vascular networks from different groups and abide by the ground truth. Vascular area, connectivity density, vascular length and segment number not only were insensitive to multi-resolution but could also better distinguish vascular networks from different groups, which provided guidance for the quantification of the vascular networks in multi-resolution frameworks. [ABSTRACT FROM AUTHOR]

The paper details the specification of an ultrasonic Doppler flowmeter intended for perivascular application and describes the elements of the design of an ultrasonic blood flow transducer. An optimised design is outlined for probes to be used on vessels in the range 5-12 mm. The design is based on the use of continuous-wave Doppler techniques and incorporates a novel polymer ultrasonic couplant. A constrained jet technique is used to test the performance of the probe in vitro and the results indicate that in use velocity profile effects are likely to lead to sensitivity changes of only 3 per cent. A companion paper details the design and performance of the electronic processing system needed for the complete flowmeter. [ABSTRACT FROM AUTHOR]

The paper describes the design and performance of a microcomputer-based system to measure and control the level of muscle relaxation during surgical procedures. A measurement system feeds the twitch response to a train-of-four stimulation pulses into a microcomputer system. The microcomputer determines the level of muscle relaxation and then calculates, according to a specified control algorithm, the minimum amount of drug necessary to achieve adequate relaxation as rapidly as possible. The drug is administered automatically to the patient in the form of bolus injections by a motordriven syringe unit on instruction from the microcomputer. This controller system has been used in 42 clinical trials using d-tubocurarine and has proved to be capable of successfully controlling muscle relaxation. [ABSTRACT FROM AUTHOR]

The estimation of muscle tension and velocity of shortening from the myoelectric signal have been considered in numerous papers. These papers consider the estimates of each variable separately, with the other appearing in the estimation as a constant parameter. The work described in this paper develops a model for the relationship between a muscle's mechanical outputs and the myoelectric signal. The model suggests that the myoelectric signal is related directly to the muscle mechanical power via a nonlinear differential equation in velocity of shortening. The model is general in that it includes as special cases the isometric and anisometric constant-velocity work of other authors and agrees with their experimental results. In this work anisometric experiments are performed on the biceps brachii muscle to verify the model. Estimates of muscle velocity of shortening and mechanical power are obtained from the myoelectric signal during anisometric contractions and the results agree well with the actual velocity and power. The model points out that the myoelectric signal is a direct measure of muscle tension only under isometric conditions. [ABSTRACT FROM AUTHOR]

This paper summarises some of the design principles adopted during the development of a microcomputer communication aid by the authors ( Holte, 1978). In such an aid, a graphic representation of selection algorithms gives rise to an objective measure of the efficiency of a communication aid. Existing communication aid designs will be discussed in this new framework. The paper concludes by noting some ways in which a communication aid may be designed to utilise the full capabilities of its intended user. [ABSTRACT FROM AUTHOR]

This study aimed to test how different QT interval variability (QTV) indices change in patients with coronary artery disease (CAD) and congestive heart failure (CHF). Twenty-nine healthy volunteers, 29 age-matched CAD patients, and 20 age-matched CHF patients were studied. QT time series were derived from 5-min resting lead-II electrocardiogram (ECG). Time domain indices [mean, SD, and QT variability index (QTVI)], frequency-domain indices (LF and HF), and nonlinear indices [sample entropy (SampEn), permutation entropy (PE), and dynamical patterns] were calculated. In order to account for possible influence of heart rate (HR) on QTV, all the calculations except QTVI were repeated on HR-corrected QT time series (QTc) using three correction methods (i.e., Bazett, Fridericia, and Framingham method). Results showed that CHF patients exhibited increased mean, increased SD, increased LF and HF, decreased T-wave amplitude, increased QTVI, and decreased PE, while showed no significant changes in SampEn. Interestingly, CHF patients also showed significantly changed distribution of the dynamical patterns with less monotonously changing patterns while more fluctuated patterns. In CAD group, only QTVI was found significantly increased as compared with healthy controls. Results after HR correction were in common with those before HR correction except for QTc based on Bazett correction. Graphical abstract Fig. The framework of this paper. The arrows show the sequential analysis of the data. [ABSTRACT FROM AUTHOR]

TiO2 scaffolds have previously shown to have promising osteoconductive properties in previous in vivo experiments. Appropriate mechanical stimuli can further promote this osteoconductive behaviour. However, the complex mechanical environment and the mechanical stimuli enhancing bone regeneration for porous bioceramics have not yet been fully elucidated. This paper aims to compare and evaluate mechanical environment of TiO2 scaffold with three commercial CaP biomaterials, i.e. Bio-Oss, Cerabone and Maxresorb under simulated perfusion culture conditions. The solid phase and fluid phase were modelled as linear elastic material and Newtonian fluid, respectively. The mechanical stimulus was analysed within these porous scaffolds quantitatively. The results showed that the TiO2 had nearly heterogeneous stress distributions, however lower effective Young's modulus than Cerabone and Maxresorb. The permeability and wall shear stress (WSS) for the TiO2 scaffold was significantly higher than other commercial bone substitute materials. Maxresorb and Bio-Oss showed lowest permeability and local areas of very high WSS. The detailed description of the mechanical performance of these scaffolds could help researchers to predict cell behaviour and to select the most appropriate scaffold for different in vitro and in vivo performances. Graphical abstract Schematic representation of the establishment procedure. Take the establishment process of Cerabone as an example. Left shows a slice of micro-CT image from Cerabone, and 1.5 mm × 1.5 mm region of interest was shown in the red box. A 1.5-mm3 cube was cut out by Boolean operation in Mimics (Materialise, Belgium), and the cubic model was remeshed in 3-Matic 6.0 (Materialise, Belgium). The cubic model is shown in blue, and the empty space in red. [ABSTRACT FROM AUTHOR]

In vivo dosimetry (IVD) is the last step of a radiotherapy quality control program aimed to ensure that the dose delivered is in agreement with that prescribed. IVD procedures based on single detectors are time-consuming and impossible to use for the modern radiotherapy techniques, based on static or kinetic beams (modulated in intensity fluence); this means that more efficient and practical methods are highly recommended. The practical method SOFTDISO, based on the use of electronic portal image device (EPID), provides two tests (i) the R ratio between the reconstructed and the planned isocenter doses to verify an agreement within 5% and (ii) the γ-analysis of the EPID images, to verify γ% ≥ 90% and γmean ≤ 0.4. This paper reports the results of 11,357 IVD tests carried out for 823 patients treated by three-dimensional conformal radiation therapy and volumetric modulated arc therapy techniques. In particular, the dose disagreements are reported distinguishing two kinds of causes, those of (i) class 1 that includes the errors due to inadequate quality controls and (ii) the class 2, due to patient morphological changes. About the tests out of tolerance, 6% were by VMAT and 21% by 3DCRT, but taking into account the only class 1 of errors, i.e., removing the causes of class 2, only 7% of patients examined presented at least one of the three mean indexes out of tolerance. The workload for IVD on 9 patients/day per linac is about 52 min/day but recently, a new automated SOFTDISO version has been implemented to reduce the time to about 34 min/day. [ABSTRACT FROM AUTHOR]

In this paper, segmentation of blood vessels from colour retinal images using a novel clustering algorithm with a partial supervision strategy is proposed. The proposed clustering algorithm, which is a RAdius based Clustering ALgorithm (RACAL), uses a distance based principle to map the distributions of the data by utilising the premise that clusters are determined by a distance parameter, without having to specify the number of clusters. Additionally, the proposed clustering algorithm is enhanced with a partial supervision strategy and it is demonstrated that it is able to segment blood vessels of small diameters and low contrasts. Results are compared with those from the KNN classifier and show that the proposed RACAL performs better than the KNN in case of abnormal images as it succeeds in segmenting small and low contrast blood vessels, while it achieves comparable results for normal images. For automation process, RACAL can be used as a classifier and results show that it performs better than the KNN classifier in both normal and abnormal images. [ABSTRACT FROM AUTHOR]

This paper presents a new, simple model to evaluate the instrumental random errors in kinematic analysis of human movements using stereophotogrammetry. By means of equations analogous to that relate linear or angular momentum with linear or angular velocities, a direct measurement of instantaneous motion can be made without previous finite displacement analysis. Single explicit expressions can be obtained to evaluate the influence of instrumental random errors in the accuracy of the kinematic variables. From these expressions, some conclusions about the effect of marker cluster design on the experimental errors are obtained. An experiment has been carried out in order to validate the proposed technique and to assess the experimental errors in linear and angular velocity measurement and its influence in instantaneous helical axis determination. [ABSTRACT FROM AUTHOR]

The primary objective of conservative care for the diabetic foot is to protect the foot from excessive pressures. Pressure reduction and redistribution may be achieved by designing and fabricating orthotic devices based on foot structure, tissue mechanics, and external loads on the diabetic foot. The purpose of this paper is to describe the process used for the development of patient-specific mathematical models of the second and third rays of the foot, their solution by the finite element method, and their sensitivity to model parameters and assumptions. We hypothesized that the least complex model to capture the pressure distribution in the region of the metatarsal heads would include the bony structure segmented as toe, metatarsal and support, with cartilage between the bones, plantar fascia and soft tissue. To check the hypothesis, several models were constructed with different levels of details. The process of numerical simulation is comprised of three constituent parts: model definition, numerical solution and prediction. In this paper the main considerations relating model selection and computation of approximate solutions by the finite element method are considered. The fit of forefoot plantar pressures estimated using the FEA models and those explicitly tested were good as evidenced by high Pearson correlations (r=0.70-0.98) and small bias and dispersion. We concluded that incorporating bone support, metatarsal and toes with linear material properties, tendon and fascia with linear material properties, soft tissue with nonlinear material properties, is sufficient for the determination of the pressure distribution in the metatarsal head region in the push-off position, both barefoot and with shoe and total contact insert. Patient-specific examples are presented. [ABSTRACT FROM AUTHOR]

The paper presents a new method of characterisation of texture changes in foot sole soft tissue ultrasound (US) images, as observed to occur in diabetic subjects, using wavelet transforms. US images of the soft tissue subcutaneous layer were taken with a 7.5 MHz linear transducer probe placed parallel to the skin surface. The foot sole hardness was characterised by Shore level. A 2D discrete wavelet transform was performed on the US images to extract features that encode the internal state of the foot sole soft tissue. The global energy feature computed at the output of each wavelet channel was found to achieve excellent delineation between the normal and the diabetic groups. An important finding was a strong correlation, in the order of 0.84 and above, between the feature values that reflect changes in the internal arrangement of the tissue, and the externally measurable hardening of the skin, characterised by the Shore levels, with the latter known to be high for diabetics. A comparison drawn between diabetic ulcer and non-ulcer groups established a change in the order of 122-311% in the textural parameter, as influenced by a corresponding 66.7-200% change in the respective Shore values. Thus US examination of foot sole soft tissue and its texture analysis may serve as sources of valuable information regarding the internal changes taking place with progressive hardening of the soft tissue and thereby help the clinician in taking appropriate preventive measures. [ABSTRACT FROM AUTHOR]

The paper describes the design, technical characteristics and first results of an adjustable staircase with commercial force plates embedded in the steps and custom force transducers as part of the handrail supports. For the railing assembly, the greatest errors (< 10% of maximum signal) and cross-talk range (0.58-6.74%) were in the medial-lateral direction and were corrected using a calibration matrix. Power spectral density analyses showed free vibration frequency responses for both the railing (15 Hz) and steps (38.6 Hz) that were relatively distinct from lower applied forces recorded during stair ascent. The creation of standardised filtering protocols was therefore possible to provide step reaction force signals identical to the literature and examples of upper-limb reaction forces that have not been shown before. Such a staircase will allow a more complete study of full body contributions to stair walking across various subject populations. [ABSTRACT FROM AUTHOR]

The development of a non-invasive monitor of total haemoglobin has been reported previously. The paper presents the design and testing of a finger probe used in that optical haemoglobin monitor. When a finger is inserted into the probe, light is radiated onto the nail, and a silicon detector measures transmitted light. This finger probe can have different values or settings for design parameters such as the internal colour, detector area, the emission area of a light source and the distance between the light source and detector. Design of experiment (DOE) was introduced to select the best combination of design parameters that were robust to external conditions such as finger alignment and ambient light. An optimally designed finger probe from DOE analysis, compared with the initial design, increased the correlation coefficient from 0.696 to 0.869 and improved the standard deviation from 1.18 to 0.81 g dl(-1) in predicting total haemoglobin. This was under different conditions of finger-probe alignment. Under different ambient light conditions, the optimum design improved the correlation coefficient from 0.735 to 0.870 and reduced the standard deviation from 1.14 to 0.83 g dl(-1). [ABSTRACT FROM AUTHOR]

The paper describes a spherical harmonic-based finite element scheme for solving Poisson-type equations throughout volumes characterised by irregularly shaped inner and outer surfaces. The inner and outer surfaces are defined by spherical harmonics, and the volume in between these surfaces is divided into nested shells that are weighted averages of the inner and outer surfaces. The resulting mesh comprises hexahedral elements, wherein each hexahedral element is defined by inner and outer shells in the radial direction and divisions in the polar and azimuthal directions. The spacing between shells can be set to any desired value. Similarly, the size of the polar and azimuthal divisions can be specified. A test of the scheme on an anisotropic sphere, meshed with 720 nodes, yielded a relative error of 0.78% on the sphere's surface. As a comparison, a previously published combined finite element/boundary element scheme with a 946-node mesh produced a corresponding error of 3.57%. [ABSTRACT FROM AUTHOR]

The paper describes a measurement device for obtaining the kinematic characterisation and isometric loading of ankle joints under different working conditions. Non-invasive, in vivo experiments can be conducted with this experimental apparatus, the potential of which could be usefully exploited in basic biomedical research, prosthesis design, clinical applications, sports medicine and rehabilitation. The device determines the 3D movement of the foot with respect to the shank and evaluates the torques and moments around the three articular axes in relation to any desired angular position of the ankle complex. When integrated with superficial electromyographic techniques and electrical stimulation, it allows the assessment of the functionality of the lower leg in both mechanical and myo-electrical terms. The paper reports the main mechanical and electronic features of the device (high linearity; maximum moment ranges +/- 300 Nm for flexion-extension, +/- 35 Nm for both pronation-supination and internal-external rotation; angular ranges: +/- 100 degrees of dorsi-plantar flexion, +/- 50 degrees of internal-external rotation and prono-supination; linear ranges: +/- 25 mm along each axis). Results from a healthy volunteer, under voluntary or stimulated conditions, helped in testing its operatability, reliability, robustness, repeatability and effectiveness. Preliminary simplified protocols have been also applied to 20 healthy volunteers, and the main results were 80.8 +/- 11.9 degrees of internalexternal rotation, 46.2 +/- 9.1 degrees of prono-supination and 74.6 +/- 13.1 degrees of flexion-extension. Torques and moments were normalised with respect to a body mass index of 30. The maximum plantar flexion moment (57.5 + 21.3 Nm) was measured with the foot at 150 of dorsal flexion; the maximum dorsal flexion moment (50.2 + 20.3 Nm) was measured with the foot at 150 of plantar flexion. [ABSTRACT FROM AUTHOR]

Surface auditory evoked potentials are generally recorded using a headset of 32, 64 or 128 electrodes, but the quality of the responses is quite heterogeneous on the scalp surface. In some contexts, such as the analysis of auditory evoked potentials recorded in radio-frequency fields, the signal quality is essential, and it appears pertinent to consider only a limited number of electrodes. Therefore, before analysing signals influenced by radio-frequency fields, it is necessary to consider the preliminary step of selecting the channels where auditory activity is strong. This step is often realised by human visual selection and can take a considerable time. In this paper, a simple k-means clustering method is proposed, to select automatically the important channels, and the results are compared with traditional methods of selection. The method detected channels that showed a concordance rate of 86.5% with the visual selection (performed by five individuals) and gave the same final selection (only two extra electrodes in the automatic case). Moreover, the time needed for this automatic selection was 100 times less than that for the visual selection, and also human variability was avoided. [ABSTRACT FROM AUTHOR]

A new computerised test adopting touch-screen technology has been developed to assess the visuo-motor exploration of extra-personal space. The test was derived from well-known paper-and-pencil cancellation tasks used widely in the diagnosis and quantitative assessment of unilateral spatial neglect (USN), a neuropsychological syndrome that is more frequent and severe after damage to the right cerebral hemisphere. A main component deficit of USN is the defective visuo-motor exploration of the side of space contralateral to the side of the lesion (contralesional), namely, in right-sided brain-damaged patients it occurs on the left side and vice versa. The computer-based paradigm consisted of a visuo-motor spatial exploratory task: the subjects were instructed to touch, in any order they wished, all the targets they detected on a computer touch-screen. This measured the time of occurrence and the spatial co-ordinates of each touch event and forwarded the data to the computer for storage; the computer provided feedback to the subject by 'tagging' the touched target. The paradigm allowed the calculation of accuracy and latency indexes and recorded the exploratory pathway taken by each subject. A pilot study was performed in ten normal subjects and 15 brain-damaged patients, with and without psychometric evidence of USN; the results showed that the equipment was able to provide quantitative indexes related to the spatial-temporal aspects of exploratory ability, which are useful for diagnostic purposes, and revealed significant differences between the controls and patients with USN: the overall average values of latency and crossing indexes increased in patients with USN, compared with the controls (latency from 0.77 to 1.90s; path crossing index from 7.0% to 59.5%), and the significantly negative USN patient latency gradient (-2.79 against a null control value) evidenced a worsening of performance towards the left side. [ABSTRACT FROM AUTHOR]

This paper reports results for a new measure of texture coarseness, as a step towards automation of metaphase finding in cell-proliferation studies. This measure is highly specific to grey-level inter-chromosome coarseness features in microscopic images of metaphase spreads and allows the texture quantification of cytological objects, analysing the intensity profile between chromosome-extrema samples. Chromosome fragments produce patterns of pixels at low resolution, and the local neighbourhood of their individual extrema presents a characteristic coarseness along intensity profiles, on randomly oriented test lines. Results of the use of this new measure on microscope images of fields of metaphases and artifacts are compared with some representative texture measures and the performance of reported metaphase finders. This new measure outperforms the latter, when applied in metaphase detection and elimination of artifacts. This coarseness feature provides a specific metaphase signature that can be used in conjunction with other morphological and textural parameters for automated metaphase discrimination. [ABSTRACT FROM AUTHOR]

Rate-adaptive pacemakers use information from sensors to change the rate of heart stimulation. Until now, fuzzy-pacemaker algorithms have been used to combine inputs from sensors to improve heart rate control, but they have been difficult to implement. In this paper, a pacemaker algorithm which controlled heart rate adaptively by motion and respiratory rate was studied. After chronotropic assessment exercise protocol (CAEP) tests were performed to collect activity and respiratory rate signals, the intrinsic heart rate was inferred from these two signals by a neuro-fuzzy method. For 10 subjects the heart rate inference, using the neuro-fuzzy algorithm, gave 52.4% improved accuracy in comparison with the normal fuzzy table look-up method. The neuro-fuzzy method was applied to a real pacemaker by reduced mapping of the neuro-fuzzy look-up table. [ABSTRACT FROM AUTHOR]

The purpose of the paper is the evaluation of a radial basis function neural network as a tool for computer aided coronary artery disease diagnosis based on the results of the traditional ECG exercise test. The research was performed using 776 data records from an exercise test (297 records from healthy patients and 479 from ill patients) confirmed by coronary arteriography results. Each record described the state of the patient, provided input data for the neural network, included the level and slope of an ST segment of a 12-lead ECG signal made at rest and after effort, heart rate, blood pressure, load during the test, and occurrence of coronary pain, coronary arteriography, correct output pattern for the neural network, and verified the existence (or not) of more than 50% stenosis of the particular coronary vessels. Radial basis function neural networks for coronary artery disease diagnosis were optimised by choosing the type of radial function, the method of training (setting the number of centres and their dimensions), and regularisation. The best network correctly recognised over 97% of cases from a 400-element test set, diagnosing not only the patients' condition (simple 'healthy/unhealthy' diagnosis), but also pointing out individual unhealthy/stenosed vessels. [ABSTRACT FROM AUTHOR]

This paper is devoted to the problem of regulating the heart rate response along a predetermined reference profile, for cycle-ergometer exercises designed for training or cardio-respiratory rehabilitation. The controller designed in this study is a non-conventional, non-model-based, proportional, integral and derivative (PID) controller. The PID controller commands can be transmitted as biofeedback auditory commands, which can be heard and interpreted by the exercising subject to increase or reduce exercise intensity. However, in such a case, for the purposes of effectively communicating to the exercising subject a change in the required exercise intensity, the timing of this feedback signal relative to the position of the pedals becomes critical. A feedback signal delivered when the pedals are not in a suitable position to efficiently exert force may be ineffective and this may, in turn, lead to the cognitive disengagement of the user from the feedback controller. This note examines a novel form of control system which has been expressly designed for this project. The system is called an "actuator-based event-driven control system". The proposed control system was experimentally verified using 24 healthy male subjects who were randomly divided into two separate groups, along with cross-validation scheme. A statistical analysis was employed to test the generalisation of the PID tunes, derived based on the average transfer functions of the two groups, and it revealed that there were no significant differences between the mean values of root mean square of the tracking error of two groups (3.9 vs. 3.7 bpm, [Formula: see text]). Furthermore, the results of a second statistical hypothesis test showed that the proposed PID controller with novel synchronised biofeedback mechanism has better performance compared to a conventional PID controller with a fixed-rate biofeedback mechanism (Group 1: 3.9 vs. 5.0 bpm, Group 2: 3.7 vs. 4.4 bpm, [Formula: see text]). [ABSTRACT FROM AUTHOR]

In the functional electrical stimulation of nerve an expression defined as the 'activating function' has been introduced to evaluate the propensity for a particular fibre to excite. This approach to determine resulting activation is only an approximation as it neglects the presence of the fibres on the applied field, in contrast to activity determined from a rigorous solution to the core conductor/excitable membrane equations. An alternative approach to determining relative excitability based on the induced transmembrane potential is presented, thereby allowing for current redistribution via the space constant of the target fibre. The paper critically examines the approximations made with activating functions, and concludes that as currently formulated the activating function has limitations in predicting relative excitability under a number of important conditions. In contrast, it is the induced (passive) transmembrane potential that provides a quantitatively reliable estimate of the tendency for fibres to excite. [ABSTRACT FROM AUTHOR]

During space flights, several clinical syndromes may be the result of changes in cerebral circulation. The purpose of the paper is to describe the development and initial evaluation of a system for recording, processing and displaying transcranial Doppler ultrasound (TCD) waveforms from the middle cerebral artery (MCA) in microgravity. Volunteers were repeatedly subjected to 15-20 s intervals of microgravity ('near zero gravity') during flights on the KC-135 military aircraft. Continuous TCD recordings from the MCA were stored on magnetic tape. The paper describes the system that was developed to digitise the Doppler ultrasound data and markers that corresponded to the various levels of microgravity, obtain the maximum and mean Doppler waveforms, identify the waveforms and quantify them. The results demonstrate the feasibility of making TCD recordings in a microgravity environment and illustrate excellent performance of the system and its ease of operation. Quantitative waveform analysis of the recordings from the first subject studied in the supine position showed statistically significant changes in MCA velocity waveforms during microgravity. [ABSTRACT FROM AUTHOR]

The paper investigates the effect of fluid viscosity on wave reflection at sites of geometric and/or mechanical discontinuity in a system of liquid-filled tubes, when the transmission of pressure pulses along these tubes is governed by a linear medium wavelength (LMW) theory. This theory is capable of describing the propagation of pressure impulses that contain frequencies in the range 0-500 Hz. We derive formulae for the reflection coefficients at a junction between two dissimilar tubes and examine the influence of fluid viscosity on these coefficients. Over much of the frequency spectrum under consideration, viscosity changes the reflection coefficients very little. The influence of viscosity is significant, however, at frequencies below 1 Hz. [ABSTRACT FROM AUTHOR]

The paper presents an eye tracking system specifically designed for the recording of eye movements from the visitors of a museum. Eye movements are calculated from the images of a near infra-red camera viewing the eye during the presentation of a sequence of slides. Thereafter, the same slides are displayed with the scanning paths superimposed. Servo systems, 'intelligent' image processing algorithms and interactive procedures have been implemented so that the eye tracker can operate on the general public without any technical supervision. [ABSTRACT FROM AUTHOR]

To investigate a broader spectrum of responses to the activity of efferent sympathetic nerve endings in blood vessels and sweat glands of the human palmar skin, we have developed a method to measure skin potential, skin unipolar electrical admittance (conductance and capacitance), skin blood flow, and skin temperature simultaneously at the same site of human palmar skin. The electrical variables were measured with a specially designed probe and a three electrode lock-in amplifier measuring system. The aim of the paper is to evaluate this method and its potential application in clinical work. The experimental results from five subjects during 5 min of baseline condition and during repeated acoustic stimulation are presented. The skin temperature was displayed digitally. During basal condition the activities in skin electrical variables and in blood vessel vasomotion were largely independent (asynchronous), whereas efferent sympathetic discharges due to stimulation were followed by parallel evoked responses in skin admittance, skin potential and skin blood flow. Habituation to the repeated stimuli occurred differently in the four variables. [ABSTRACT FROM AUTHOR]

If a defibrillating stimulus current is applied to a one-dimensional fibre, and if the fibre has junction resistances joining the individual cells, what pattern of transmembrane voltages is induced by the stimulus, and what are the curretns that flow to produce the transmembrane voltages? These questions were considered in an earlier report; in this paper, two additional solution procedures are provided, one exact and one approximate, the latter relatively simple. Earlier work used a resistive model of the cells and junctions, together with a computer solution of 330 simultaneous equations for a 30-cell fibre. The present methods exploit the known solutions for the continuous (zero junctional resistance) fibre together with an analytic treatment of the junctions. With the present methods solution for currents and transmembrane potentials in the same 30-cell fibre requires a solution of only 29 equations (exact method) or the solution of none at all (the approximate method). The results show that, compared with previous results, the exact method provides almost identical transmembrane values; the approximate method gives values within 2 per cent. [ABSTRACT FROM AUTHOR]

Microprocessor-based correlation processing is now widely used for the estimation of foetal heart rate from ultrasonic Doppler signals. The paper describes a technique having a, similar performance, to correlation but which will run three times faster on a microprocessor without an onboard hardware multiplier. This speed improvement results from replacing each multiplication operation of the correlation algorithm with a subtraction and a modulus operation. The algorithm, is thus referred to as the modulus difference algorithm. Typical waveforms are presented illustrating the responses of the two processors to continuous wave Doppler foetal heart signals for both wide (50 Hz) and narrow (4 Hz) preprocessor bandwidths. A quantitative comparison is given of the performance of the two methods in estimating the period of a synthetic signal with additive white Gaussian noise. This simulation represents the wideband preprocessor case. A theoretical derivation of the outputs for the narrowband preprocessor case is given, and actual outputs are shown for comparison. A tutorial approach is adopted throughout the paper. [ABSTRACT FROM AUTHOR]

Although various methods have been proposed for quantitative evaluation of pathological gait, they are not yet widely used as routine clinical tools. The reasons are that measuring systems are too expensive and complicated and that the validity of the methods has not been fully examined in a statistical manner. In this paper, the validity of a new evaluation method based on a simple foot-force measuring device is investigated in terms of the correlation between quantitative indices and visually-rated grades. Forty-eight hemiparetic patients secondary to cerebral vascular accident walked on a 15 m straight level floor. Four people independently evaluated each subject in eight gait characteristics or items on a scale of 1-4 grades on the basis of visual inspection. These items include symmetry, variation, fluctuation, and dependence on the cane. At the same time, the vertical ground-reaction forces exerted on the right and left feet and on the cane were measured, and then quantitative indices representing these eight items were derived. All but one index shows a reasonably good correlation with the mean of the grades of the four observers. Thus, the feasibility of these indices is demonstrated. Statistical analysis also reveals several problems inherent in visual rating, such as inconsistency in the interpretation of evaluation criteria among observers, and a degradation of the independence of items owing to the observer's subjectivity. [ABSTRACT FROM AUTHOR]

It has been postulated that the sudden infant death syndrome (s.i.d.s.) may sometimes be due to abnormal maturation or injury to the brain stem centres that regulate respiration. This functional abnormality of the brain stem respiratory centres may result in the interruption of the automatic inspiratory/expiratory cycle by recurrent periods of apnoea. There is a subgroup of infants known as 'near-miss' for s.i.d.s., who survived a prolonged apnoeic episode during sleep which may have resulted in death. In a number of recent studies, the near-miss infant has been clearly identified as an infant at high risk for s.i.d.s. Clinical studies conducted by using polygraphic and behavioural monitoring of near-miss infants have revealed numerous apnoeic episodes during sleep. Consequently, the clinical necessity of monitoring these babies in a paediatric care unit has become well established both for diagnostic purposes and for subsequent outpatient care. In view of these findings, it has become increasingly more important to develop advanced sophisticated computer methods for the on-line detection and processing of apnoeas during in-hospital monitoring of infants. This paper describes a digital computer method of on-line apnoea processing for application during the in-hospital monitoring of infants. The method is based on the application of Walsh transformations to the expired CO signal measured in infants using a Beckman CO analyser. [ABSTRACT FROM AUTHOR]

The efficiency and accuracy of prosthetic alignment may be greatly improved with the help of a model which establishes the relationship between alignment settings and physical parameters which are closely related to amputee comfort and performance. The paper presents a mathematical model, based on equations of motion of the shank and foot, relating above-knee amputees' stump loading to alignment adjustments. Included is a numerical example, which demonstrates the use of a computer simulation, to predict the alignment setting for minimal thigh axial torque (t.a.t.). It is suggested that the use of such a simulation should precede actual change of alignment in clinical practice. [ABSTRACT FROM AUTHOR]

This paper considers the magnetic field arising from action currents associated with the propagation of an action potential along a cylindrical fibre. The equivalent current sources of the magnetic field are precisely the difference in axial current density on each side of the membrane. Fibre bundles are considered by superposition. The total magnetic field varies as 0(1/R) hence it is quadrupolar. The equivalent source is more strongly related to the discontinuity in conductivity between the membrane andsurrounding media than directly to the ionic (primary) currents. [ABSTRACT FROM AUTHOR]

Beat-to-beat cardiotachometers calculate the heart rate in beats per minute from two adjacent R wave pulses. These differ from cardiotachometers, which simply count the number of R wave pulses in a minute. The paper describes four beat-to-beat cardiotachometer systems using (a) divide-by-n counter; (b) calculator chip; (c) 1/t clock; (d) dual analogue voltage ramp. For each type a detailed description of operating principles based on a block diagram is presented. This is followed by a discussion of the performance of each system, the compromises that are required and the fundamental limitations of each system. One practical design of each system has been built and used successfully in a medical or biomedical situation. These are also described and compared. [ABSTRACT FROM AUTHOR]

Electrode designs and strategies for electroneurogram recordings are often tested first by computer simulations and then by animal models, but they are rarely implanted for long-term evaluation in humans. The models show that the amplitude of the potential at the surface of an axon is higher in front of the nodes of Ranvier than at the internodes; however, this has not been investigated through in vivo measurements. An original experimental method is presented to emulate a single fiber action potential in an infinite conductive volume, allowing the potential of an axon to be recorded at both the nodes of Ranvier and the internodes, for a wide range of electrode-to-fiber radial distances. The paper particularly investigates the differences in the action potential amplitude along the longitudinal axis of an axon. At a short radial distance, the action potential amplitude measured in front of a node of Ranvier is two times larger than in the middle of two nodes. Moreover, farther from the phantom axon, the measured action potential amplitude is almost constant along the longitudinal axis. The results of this new method confirm the computer simulations, with a correlation of 97.6 %. [ABSTRACT FROM AUTHOR]

Limb immobilization or confinement to bed results in a severe atrophy and weakness of lower leg muscles. Full recovery of muscle strength and physical function is rare and may impact the patient's outcome. Studies performed on rodents have demonstrated that the deleterious structural and functional adaptations which occur during muscle deconditioning can be counteracted through adequate physiological stimuli. Thus, based on this fundamental work, we developed a device that combines mechanical stimulation of proprioceptors located in the plantar sole and Achilles' tendon. The device is adapted to patients immobilized and confined to bed. Stimulations can be applied on muscle in passive state. The protocol is non-invasive and is well accepted by patients. This paper presents the technical features of the device, as well as preliminary results of the first clinical study. This device might allow considering new therapeutic strategies for prevention of atrophy in many pathologies. [ABSTRACT FROM AUTHOR]

This paper presents a novel hybrid medical stent device. This hybrid stent device formed by fractal mesh structures provides a flow-diverting effect and stent-assisted coil embolization. Flow-diverter stents decrease blood flow into an aneurysm to prevent its rupture. In general, the mesh size of a flow-diverter stent needs to be small enough to prevent blood flow into the aneurysm. Conventional flow-diverter stents are not available for stent-assisted coil embolization, which is an effective method for aneurysm occlusion, because the mesh size is too small to insert a micro-catheter for coil embolization. The proposed hybrid stent device is capable of stent-assisted coil embolization while simultaneously providing a flow-diverting effect. The fractal stent device is composed of mesh structures with fine and rough mesh areas. The rough mesh area can be used to insert a micro-catheter for stent-assisted coil embolization. Flow-diverting effects of two fractal stent designs were composed to three commercially available stent designs. Flow-diverting effects were analyzed using computational fluid dynamics (CFD) analysis and particle image velocimetry (PIV) experiment. Based on the CFD and PIV results, the fractal stent devices reduce the flow velocity inside an aneurism just as much as the commercially available flow-diverting stents while allowing stent-assisted coil embolization. [ABSTRACT FROM AUTHOR]

This paper investigates the effect of developing arterial blockage at the abdominal aorta on the blood pressure waves at an externally accessible location suitable for invasive measurements such as the brachial and the femoral arteries. Arterial blockages are created surgically within the abdominal aorta of healthy Wistar rats to create narrowing resemblance conditions. Blood pressure is measured using a catheter inserted into the right femoral artery. Measurements are taken at the baseline healthy condition as well as at four different severities (20, 50, 80 and 100 %) of arterial blockage. In vivo and in vitro measurements of the lumen diameter and wall thickness are taken using magnetic resonance imaging and microscopic techniques, respectively. These data are used to validate a 3D computational fluid dynamics model which is developed to generalize the outcomes of this work and to determine the arterial stress and strain under the blockage conditions. This work indicates that an arterial blockage in excess of 20 % of the lumen diameter significantly influences the pressure wave and reduces the systolic blood pressure at the right femoral artery. High wall shear stresses and low circumferential strains are also generated at the blockage site. [ABSTRACT FROM AUTHOR]

Localization of active neural source (ANS) from measurements on head surface is vital in magnetoencephalography. As neuron-generated magnetic fields are extremely weak, significant uncertainties caused by stochastic measurement interference complicate its localization. This paper presents a novel computational method based on reconstructed magnetic field from sparse noisy measurements for enhanced ANS localization by suppressing effects of unrelated noise. In this approach, the magnetic flux density (MFD) in the nearby current-free space outside the head is reconstructed from measurements through formulating the infinite series solution of the Laplace's equation, where boundary condition (BC) integrals over the entire measurements provide "smooth" reconstructed MFD with the decrease in unrelated noise. Using a gradient-based method, reconstructed MFDs with good fidelity are selected for enhanced ANS localization. The reconstruction model, spatial interpolation of BC, parametric equivalent current dipole-based inverse estimation algorithm using reconstruction, and gradient-based selection are detailed and validated. The influences of various source depths and measurement signal-to-noise ratio levels on the estimated ANS location are analyzed numerically and compared with a traditional method (where measurements are directly used), and it was demonstrated that gradient-selected high-fidelity reconstructed data can effectively improve the accuracy of ANS localization. [ABSTRACT FROM AUTHOR]

This paper explores methods that make use of visual cues aimed at generating actual haptic sensation to the user, namely pseudo-haptics. We propose a new pseudo-haptic feedback-based method capable of conveying 3D haptic information and combining visual haptics with force feedback to enhance the user's haptic experience. We focused on an application related to tumor identification during palpation and evaluated the proposed method in an experimental study where users interacted with a haptic device and graphical interface while exploring a virtual model of soft tissue, which represented stiffness distribution of a silicone phantom tissue with embedded hard inclusions. The performance of hard inclusion detection using force feedback only, pseudo-haptic feedback only, and the combination of the two feedbacks was compared with the direct hand touch. The combination method and direct hand touch had no significant difference in the detection results. Compared with the force feedback alone, our method increased the sensitivity by 5%, the positive predictive value by 4%, and decreased detection time by 48.7%. The proposed methodology has great potential for robot-assisted minimally invasive surgery and in all applications where remote haptic feedback is needed. [ABSTRACT FROM AUTHOR]

The paper proposes a novel method for an accurate and unobtrusive reconstruction of the upper-limb kinematics of stroke patients during robot-aided rehabilitation tasks with end-effector machines. The method is based on a robust analytic procedure for inverse kinematics that simply uses, in addition to hand pose data provided by the robot, upper arm acceleration measurements for computing a constraint on elbow position; it is exploited for task space augmentation. The proposed method can enable in-depth comprehension of planning strategy of stroke patients in the joint space and, consequently, allow developing therapies tailored for their residual motor capabilities. The experimental validation has a twofold purpose: (1) a comparative analysis with an optoelectronic motion capturing system is used to assess the method capability to reconstruct joint motion; (2) the application of the method to healthy and stroke subjects during circle-drawing tasks with InMotion2 robot is used to evaluate its efficacy in discriminating stroke from healthy behavior. The experimental results have shown that arm angles are reconstructed with a RMSE of 8.3 × 10(-3) rad. Moreover, the comparison between healthy and stroke subjects has revealed different features in the joint space in terms of mean values and standard deviations, which also allow assessing inter- and intra-subject variability. The findings of this study contribute to the investigation of motor performance in the joint space and Cartesian space of stroke patients undergoing robot-aided therapy, thus allowing: (1) evaluating the outcomes of the therapeutic approach, (2) re-planning the robotic treatment based on patient needs, and (3) understanding pathology-related motor strategies. [ABSTRACT FROM AUTHOR]

In research, pharmacologic drug-screening and medical diagnostics, the trend towards the utilization of functional assays using living cells is persisting. Research groups working with living cells are confronted with the problem, that common endpoint measurement methods are not able to map dynamic changes. With consideration of time as a further dimension, the dynamic and networked molecular processes of cells in culture can be monitored. These processes can be investigated by measuring several extracellular parameters. This paper describes a high-content system that provides real-time monitoring data of cell parameters (metabolic and morphological alterations), e.g., upon treatment with drug compounds. Accessible are acidification rates, the oxygen consumption and changes in adhesion forces within 24 cell cultures in parallel. Addressing the rising interest in biomedical and pharmacological high-content screening assays, a concept has been developed, which integrates multi-parametric sensor readout, automated imaging and probe handling into a single embedded platform. A life-maintenance system keeps important environmental parameters (gas, humidity, sterility, temperature) constant. [ABSTRACT FROM AUTHOR]

Task-oriented, repetitive and intensive arm training can enhance arm rehabilitation in patients with paralyzed upper extremities due to lesions of the central nervous system. There is evidence that the training duration is a key factor for the therapy progress. Robot-supported therapy can improve the rehabilitation allowing more intensive training. This paper presents the kinematics, the control and the therapy modes of the arm therapy robot ARMin. It is a haptic display with semi-exoskeleton kinematics with four active and two passive degrees of freedom. Equipped with position, force and torque sensors the device can deliver patient-cooperative arm therapy taking into account the activity of the patient and supporting him/her only as much as needed. The haptic display is combined with an audiovisual display that is used to present the movement and the movement task to the patient. It is assumed that the patient-cooperative therapy approach combined with a multimodal display can increase the patient's motivation and activity and, therefore, the therapeutic progress. [ABSTRACT FROM AUTHOR]

With the advent of powerful computers and parallel processing including Grid technology, the use of Monte Carlo (MC) techniques for radiation transport simulation has become the most popular method for modeling radiological imaging systems and particularly X-ray computed tomography (CT). The stochastic nature of involved processes such as X-ray photons generation, interaction with matter and detection makes MC the ideal tool for accurate modeling. MC calculations can be used to assess the impact of different physical design parameters on overall scanner performance, clinical image quality and absorbed dose assessment in CT examinations, which can be difficult or even impossible to estimate by experimental measurements and theoretical analysis. Simulations can also be used to develop and assess correction methods and reconstruction algorithms aiming at improving image quality and quantitative procedures. This paper focuses mainly on recent developments and future trends in X-ray CT MC modeling tools and their areas of application. An overview of existing programs and their useful features will be given together with recent developments in the design of computational anthropomorphic models of the human anatomy. It should be noted that due to limited space, the references contained herein are for illustrative purposes and are not inclusive; no implication that those chosen are better than others not mentioned is intended. [ABSTRACT FROM AUTHOR]

Neural source localization using electroencephalographic data is usually performed using either dipolar models or minimum norm based techniques. While the former demands a priori information about the number of active sources and is particularly suitable for generators, which occupy small pieces of cortical tissue, the major drawbacks of the second approach are its dependence on the uncorrelated noise, and its tendency to localize the sources at the surface. In this paper, a simple mathematical procedure, based on the behavior of the dispersion of the minimum norm solutions, is introduced, in order to estimate the depth of the sources. The correct position of the active generators is obtained using successively deeper surfaces instead of the application of a regularization matrix, as is commonly described in the bibliography. The evaluation of this technique is performed using single and double dipolar simulated generators and two different models for the head: spherical and realistic. The results yield a mean accuracy of about 10 mm for the most disadvantageous situations studied and thus, this method seems to be very promising to handle the depth of the neural generators. [ABSTRACT FROM AUTHOR]