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A new metric called “Delta Area at Near Infrared Region” ( ${\text{DA}}_{{\text{NIR}}}$ ) has been conceptualized and implemented for estimation of green vegetation fraction (GVF) using field spectroradiometer at different growth stages of potato over two consecutive potato growing seasons (2012–2013 and 2013–2014). Vertical photograph, collocated in time and space with spectroradiometer observation, was acquired and digitally classified for GVF. While comparing with other conventional indices, ${\text{DA}}_{{\text{NIR}}}$ showed linearity at higher GVF values and capable of capturing the movement of the curve caused by soil-vegetation mixture between inflection point and near infrared peak. Among all the univariate models, ${\text{DA}}_{{\text{NIR}}}$ showed the highest accuracy with ${\text{R}}^{2}=0.94$ and ${\text{RMSE}}=7.0$ . The new index also exhibited the highest sensitivity for the entire range of GVF while comparing with other indices; however, the sensitivity decreases at higher values especially above 70%. Stepwise multiple linear regression (SMLR) and partial least squares regression (PLSR) were performed using all the spectral variables. The prediction accuracy was further improved over univariate analysis wherein PLSR was able to predict the vegetation fraction with the highest accuracy ( ${\text{R}}^{2}=0.94$ and ${\text{RMSE}}=5.32$ ). In both SMLR and PLSR, ${\text{DA}}_{{\text{NIR}}}$ contributed significantly to improve the estimation accuracy. These findings suggest that ${\text{DA}}_{{\text{NIR}}}$ can be used as a surrogate indicator of GVF independently or in combination with other vegetation indices to further improve the estimation accuracy.

Nurse workforce optimization and scheduling in hospital units is a complex data science and operation research problem. Traditional manual estimation and preparation of nurse staffing and scheduling with the help of a subject matter expert might leads to over staffing or under staffing of different type of nurses such as core, float pool, overtime and agency, which impacts the patient care delivery and cost significantly. The situation becomes worse in case of emergency department as the patient head on bed occupancy is very dynamic in nature and many times the department might be overcrowded with no beds for the patients. Therefore, it is very difficult to design manual optimal workforce optimization of nurses for emergency units. To address this problem, we have developed methodologies to model emergency department head on bed occupancy and optimize various type of nurse staffing to run the hospital with optimal budget.

The accumulative moisture stress of potato crop was detected using Field Spectroradiometer data. Different degree of stress was created by manipulating the amount and interval between two consecutive irrigations. The daily soil moisture was simulated using Hydrus-1D and validated (r = 0.805 and RMSE = 0.015). The ambient soil moisture 0.9), at higher level of accumulative stress beyond 5.0, the values get saturated except for 1091–1303 nm. Hence, the band-depth-maxima at 1091–1303 nm is sensitive to wider range of stress and may be used for targeted irrigation technique to maintain safe irrigation zone.

Objective The aim of this study is to determine the feasibility of a screening method for cervical cancer using an application developed on smartphone to aid visual inspection with acetic acid. Materials and methods A prospective study was carried out in 230 women in the Department of Gynaecology, PGIMER, Chandigarh, India. These women were divided into two groups. Among the first group, screen positive women (n = 28) were examined by two gynecologists. In the second group (n = 202), health care workers screened women in a mobile van. The two groups were examined using the smartphone and digital colposcope. Abnormal findings were confirmed by liquid-based cytology and histopathology. The image quality of ColpPhon® was compared with colposcopic images as the gold standard. Kappa was used for comparison of ColpPhon® and colposcopic findings for final diagnosis. Results Among the 230 women screened, cervical intraepithelial neoplasia (CIN) was diagnosed in six cases by histopathology (CIN 2/3 in five and CIN 1 in one). These six women belonged to the group of 28 women examined in the colposcopy clinic. Both colposcope and ColpPhon® were able to identify these six women. The individual image quality parameters for ColpPhon® were slightly inferior to the colposcope. The overall image clarity had an agreement in 82% (184/225) as being either good or excellent. The diagnosis made on images acquired from each device had an agreement in 90% (208/230) of the cases. Conclusion This study demonstrates feasibility of incorporating a smartphone device to capture images of the cervix for improving cervical cancer screening in resource-poor countries. How to cite this article Bagga R, Suri V, Srinivasan R, Khandelwal N, Keswarpu P, Naik SK, Chandrasekhar V, Gupta L, Paul S. Feasibility of Using Mobile Smartphone Camera as an Imaging Device for Screening of Cervical Cancer in a Lowresource Setting. J Postgrad Med Edu Res 2016;50(2):69-74.

The mangrove ecosystem of Sundarbans region plays an important ecological and socioeconomical role in both India and Bangladesh. The satellite-based approach has been adopted for assessing the ecological disturbance caused by major cyclones. Moderate Resolution Imaging Spectroradiometer (MODIS) time-series (2001–2011) Enhanced Vegetation Index (EVI) and Land Surface Temperature (LST) products were used to compute the MODIS Global Disturbance Index (MGDI). The pre- and post-cyclonic changes in the EVI as well as LST were analyzed to study the impact of cyclones on the vegetation and surface temperature, respectively. In the present study, time-series MGDI was transformed to the percentage change in MGDI using temporal mean for each pixel, and its response toward cyclonic events was studied. The pre- and post-cyclonic Landsat data were analyzed to identify the affected areas discernible on the image and a threshold was decided to mark the “disturbed pixels.” The threshold for the instantaneous disturbance caused by cyclones was found to be more than 11 % of the temporal mean MGDI. The selected threshold was applied on the time-series MGDI images to delineate the disturbed pixels, and percent-disturbed area of each Island was computed. The classified disturbed area maps were able to characterize the impact of cyclones and effectively represent the distribution of the spatial intensity of the ecological disturbance in Sundarbans region.

Instantaneous radiative flux components across different climatic regions of USA were computed using Moderate Resolution Imaging Spectroradiometer (MODIS) land, atmosphere and geo-location products for clear sky pixels, colocated in time and space with flux towers. Satellite derived fluxes were validated using in-situ SURFRAD flux tower data of the respective sites. Significant positive correlation was observed between simulated and observed fluxes especially for incoming shortwave (r = 0.94), incoming longwave (r = 0.91) and outgoing shortwave (r = 0.89) radiation. The root mean square errors (RMSE) were 50.7, 10.41, 18.54 and 33.50 Wm−2 for incoming shortwave, outgoing shortwave, incoming longwave and outgoing longwave fluxes respectively with their corresponding relative RMSE of 0.11, 0.10, 0.06 and 0.08. The D-index and modeling efficiency (ME) varied from 0.87 to 0.96 and 0.61 to 0.85 respectively, indicated good performance of the present method. The coefficient of residual mass (CRM) for all the fluxes yielded values close to zero except incoming longwave radiation. Based on the statistical analysis and accumulative score highest rank was obtained for incoming longwave flux followed by outgoing shortwave, incoming shortwave and outgoing longwave fluxe. From the rank values it can be concluded that the present model predicted all the fluxes satisfactorily except the outgoing longwave flux.

The mangrove ecosystem of Sundarbans region plays an important ecological and socio-economical role in both India and Bangladesh. The ecological disturbance in the coastal mangrove forests are mainly attributed to the periodic cyclones caused by deep depression formed over the Bay of Bengal. In the present study, three of the major cyclones in the Sundarbans region were analyzed to establish the cause-and-effect relationship between cyclones and the resultant ecological disturbance. The Moderate Resolution Imaging Spectroradiometer (MODIS) time-series data was used to generate MODIS global disturbance index (MGDI) and its potential was explored to assess the instantaneous ecological disturbance caused by cyclones with varying landfall intensities and at different stages of mangrove phenology. The time-series MGDI was converted into the percentage change in MGDI using its multi-year mean for each pixel, and its response towards several cyclonic events was studied. The affected areas were identified by analyzing the Landsat-8 satellite data before and after the cyclone and the MGDI values of the affected areas were utilized to develop the threshold for delineation of the disturbed pixels. The selected threshold was applied on the time-series MGDI images to delineate the disturbed areas for each year individually to identify the frequently disturbed areas. The classified intensity map could able to detect the chronically affected areas, which can serve as a valuable input towards modelling the biomigration of the invasive species and efficient forest management.

HIV/AIDS is one of life-threatening diseases over which human currently does not have enough control. Study and research on HIV and its prevention are being carried out by different organizations. However, they are mostly area specific, thereby, failing to provide a nation-wide or region-wide overview of HIV infection. One of the major bottlenecks in having a wider study is the lack of interoperability among systems managing HIV patient information. Besides, such lack of interoperability also hinders forming larger HIV care network where telemedicine could be accomplished more effectively. We have addressed this interoperability issue through HL7 clinical document architecture (CDA), a document-based messaging standard for clinical interaction. This article introduces a document architecture that conforms to HL7 CDA standard and contains all relevant information of a pediatric HIV patient. We extended the existing architecture of CDA consultation note in three dimensions: (1) HIV specific content, (2) HIV specific knowledgebase and (3) HIV specific presentation of content and knowledge. An example CDA consultation note is demonstrated following the proposed extension.

Teleconsultation among doctors using a telemedicine system typically involves dealing with and sharing medical images of the patients. This paper describes a software tool written in Java which enables the participating doctors to view medical images such as blood slides, X-Ray, USG, ECG etc. online and even allows them to mark and/or zoom specific areas. It is a multi-party secure image communication system tool that can be used by doctors and medical consultants over the Internet.

In this paper, we introduce a Concept Graph Engine (CG-Engine) that generates patient specific personalized disease ranking based on the laboratory test data. CG-Engine uses the Unified Medical Language System database as medical knowledge base. The CG-Engine consists of two concepts namely, a concept graph and its attributes. The concept graph is a two level tree that starts at a laboratory test root node and ends at a disease node. The attributes of concept graph are: Relation types, Semantic types, Number of Sources and Symmetric Information between nodes. These attributes are used to compute the weight between laboratory tests and diseases. The personalized disease ranking is created by aggregating the weights of all the paths connecting between a particular disease and contributing abnormal laboratory tests. The clinical application of CG-Engine improves physician's throughput as it provides the snapshot view of abnormal laboratory tests as well as a personalized disease ranking.

A novel concept of Disease Based Temporal Score (DT-Score) is introduced to efficiently represent periodic laboratory test data. Through this score, temporal state of an organ can be represented by summarizing periodic laboratory test data. The score can be used to indicate early trend for chronic abnormalities and thus results in an effective wellness measure. Many of these chronic abnormalities have a late manifestation and are major contributors for healthcare cost and mortality. Resources of Unified Medical Language System (UMLS) are introduced for automatic generation of relational tree between laboratory test, disease and organs with relative rank. Doctor's annotations are used to create reference score and data mining techniques are employed in deriving a mathematical model for estimating the DT-Score. A novel human body based summarization is employed for an intuitive view of the DT-Score and resultant temporal state of the associated organ. The proposed method enables an efficient temporal summarization of high volume of laboratory data and eventually reduces the cognitive load on physician. This method has potential to impact larger population as this can be effectively built over low cost regular laboratory test.

In the recent times, there has been considerable effort towards developing an effective and widely informative patient health record system. To meet this objective, diversified groups working on medical informatics have made concerted attempt to bind biomedical knowledge base with patient health data. This approach necessitates a strong need to make all relevant patient's clinical information available through extensive information search, thereby enabling better clinical management. Through this work we propose a method to bind patient event sequences, the temporal medical information and the medical knowledge. The run time extraction of information pose challenges such as (a) performance (b) a priori relation identification and (c) handling of memory overheads. This paper describes a practical implementation of a patient health record linked to a knowledge base and integrated with an information extraction platform ensuring a good balance between the performance complexity and memory usage.

HIV infection is one of the major health problems in today's world, especially in a developing country like India. The impact of HIV on the pediatric population is no less dreadful. Pediatric HIV is a subset of HIV which requires special attention. Efficient information management is one of the key issues in pediatric HIV treatment. Electronic Health Record (EHR) plays an important role in patient information management. In India, there is no availability of EHR system in the current Government hospital setup for pediatric HIV. To meet this requirement we have developed a web based EHR system to support treating pediatric HIV. The EHR is developed based on an existing web based telemedicine system iMedik, developed at IIT Kharagpur. In this paper we discuss the basic requirements to design an EHR for the treatment of pediatric HIV in India and how our proposed system fulfills those requirements to deliver better patient care. We also discuss different features of the EHR, system architecture and the security aspects of the system.

Security of telemedicine applications is not often given adequate importance by the developers and healthcare administrators primarily to reduce cost. Though some security safeguards are employed by these applications to comply with existing medical data security and privacy regulations, these are not adequate in todaypsilas context. Moreover, in a Web-based application environment not only the data but also the application itself is vulnerable to attackers. Keeping these concerns in mind, we present the design of a Web-based, four-tier telemedicine system named iMedik which is accessible over desktops as well as handheld devices. We have illustrated how the proposed system differs from existing three-tier Web applications. The compliance status of the application with HIPAA Security Guidelines has also been noted. The security measures described in our approach look into the four-tier architecture from an attackerpsilas viewpoint and present a simple road map for developing secure e-health application with anywhere, anytime availability.

updation of the same at the point of patient care is of immense importance. Personal Digital Assistant (PDA) can be a promising information delivery tool to achieve this. We have developed a wireless telemedicine system, which supports medical data access using PDA. The system uses the database of Web Based TelemediK System (developed at IIT Kharagpur). This paper describes the system architecture of the wireless telemedicine system, its features and the result of an experiment where the usability of the proposed PDA based system is tested and compared with the Web Based TelemediK System in a desktop environment. Keywords- PDA, Web Based, Telemedicine, Usability Study.