Aspects of implementing and harmonizing healthcare communication standards

A variety of healthcare communication standards (HCS) have been developed during the last decade. They have improved the interoperability and the connectivity in open hospital information systems to a large extent. They have also reduced time and efforts during the implementation of standard interfaces. However, the implementation of communication standards is still far from the expected plug and play. The two reasons which are the main cause the current drawbacks are identified--the lack of a standardized terminology and the restricted flexibility of the currently used interchange formats. On the one hand the standardization of the terminology can not be solved by the standards development organizations. It is a general challenge for the medical informatics community. On the other hand the movement to a new interchange format can be initiated by standards development organizations. The application of SGML/XML as an interchange format for communication standards offers a much greater flexibility and adaptability to user needs than the currently used interchange formats. Concepts for a smooth change to a new direction are discussed.     

A client/server system for Internet access to biomedical text/image databanks

Internet access to mixed text/image databanks is finding application in the medical world. An example is a database of medical X-rays and associated data consisting of demographic, socioeconomic, physician's exam, medical laboratory and other information collected as part of a nationwide health survey conducted by the government. Another example is a collection of digitized cryosection images, CT and MR taken of cadavers as part of the National Library of Medicine's Visible Human Project. In both cases, the challenge is to provide access to both the image and the associated text for a wide end user community to create atlases, conduct epidemiological studies, to develop image-specific algorithms for compression, enhancement and other types of image processing, among many other applications. The databanks mentioned above are being created in prototype form. This paper describes the prototype system developed for the archiving of the data and the client software to enable a broad range of end users to access the archive, retrieve text and image data, display the data and manipulate the images. System design considerations include; data organization in a relational database management system with object-oriented extensions; a hierarchical organization of the image data by different resolution levels for different user classes; client design based on common hardware and software platforms incorporating SQL search capability, X Window, Motif and TAE (a development environment supporting rapid prototyping and management of graphic-oriented user interfaces); potential to include ultra high resolution display monitors as a user option; intuitive user interface paradigm for building complex queries; and contrast enhancement, magnification and mensuration tools for better viewing by the user.     

Material-Based Construction Site Image Retrieval

The technological advancements in digital imaging, the widespread popularity of digital cameras, and the increasing demand by owners and contractors for detailed and complete site photograph logs have triggered an ever-increasing growth in the rate of construction image data collection, with thousands of images being stored for each project. However, the sheer volume of images and the difficulties in accurately and manually indexing them have generated a pressing need for methods that can index and retrieve images with minimal or no user intervention. This paper reports recent developments from research efforts in the indexing and retrieval of construction site images in architecture, engineering, construction, and facilities management image database systems. The limitations and benefits of the existing methodologies will be presented, as well as an explanation of the reasons for the development of a novel image retrieval approach that not only can recognize construction materials within the image content in order to index images, but also can be compatible with existing retrieval methods, enabling enhanced results.     

Real-Time Watershed Delineation System Using Web-GIS

A Web-based geographic information system (GIS) that can delineate watersheds in real time was developed for use in hydrologic analysis and to support hydrologic model operation on the Internet. The system integrates a watershed delineation (WD) engine, common gateway interfaces, a Web-GIS user interface, and supports digital spatial data including vector and grid formats. The WD program utilizes a double-seed array-replacement algorithm to obtain a watershed boundary from point coordinates. The system provides a user interface for the selection of an outlet point from a map display in the Web browser using MapServer Web-GIS capability. The WD and data extraction system has been implemented for all of Indiana, with extensive verification conducted in the 2,082.7 km2 Wildcat Creek watershed in Indiana. The time to obtain results and the quality of results are acceptable for use as a real-time system for WD via the Web.     

基于红外热成像原理的嵌入式下渣检测方法

通过对现有转炉下渣检测系统的分析,提出了一种基于红外热成像原理的嵌入式下渣检测方法,介绍了红外热成像技术原理,阐述了系统嵌入式架构及具体实现方法。该方法通过红外热像仪采集连续钢流图像,结合嵌入式系统技术,利用数字信号处理器(DSP)对采集到的钢流图像数据根据钢水与钢渣在远红外区的热辐射率不同进行特征信号提取与处理,再经DSP的主机并行接口(HPI)将处理后的图像数据发送给ARM处理器,最后采用图形用户接口MiniGUI设计了嵌入式环境下的图形用户界面,实现对转炉出钢过程中钢流状态的实时监控。现场试验表明:该方法成本低,对现有设备改造小,提高了挡渣效果,较好满足了钢水炉外精炼的要求。     

Digital imagery/telecytology. International Academy of Cytology Task Force summary. Diagnostic Cytology Towards the 21st Century: An International Expert Conference and Tutorial

ISSUES: Optical digital imaging and its related technologies have applications in cytopathology that encompass training and education, image analysis, diagnosis, report documentation and archiving, and telecommunications. Telecytology involves the use of telecommunications to transmit cytology images for the purposes of diagnosis, consultation or education. This working paper provides a mainly informational overview of optical digital imaging and summarizes current technologic resources and applications and some of the ethical and legal implications of the use of these new technologies in cytopathology. CONSENSUS POSITION: Computer hardware standards for optical digital imagery will continue to be driven mainly by commercial interests and nonmedical imperatives, but professional organizations can play a valuable role in developing recommendations or standards for digital image sampling, documentation, archiving, authenticity safeguards and teleconsultation protocols; in addressing patient confidentiality and ethical, legal and informed consent issues; and in providing support for quality assurance and standardization of digital image-based testing. There is some evidence that high levels of accuracy for telepathology diagnosis can be achieved using existing dynamic systems, which may also be applicable to telecytology consultation. Static systems for both telepathology and telecytology, which have the advantage of considerably lower cost, appear to have lower levels of accuracy. Laboratories that maintain digital image databases should adopt practices and protocols that ensure patient confidentiality. Individuals participating in telecommunication of digital images for diagnosis should be properly qualified, meet licensing requirements and use procedures that protect patient confidentiality. Such individuals should be cognizant of the limitations of the technology and employ quality assurance practices that ensure the validity and accuracy of each consultation. Even in an informal teleconsultation setting one should define the extent of participation and be mindful of potential malpractice liability. ONGOING ISSUES: Digital imagery applications will continue to present new opportunities and challenges. Position papers such as this are directed toward assisting the profession to stay informed and in control of these applications in the laboratory. Telecytology is an area in particular need of studies of good quality to provide data on factors affecting accuracy. New technologic approaches to addressing the issue of selective sampling in static image consultation are needed. The use of artificial intelligence software as an adjunct to enhance the accuracy and reproducibility of cytologic diagnosis of digital images in routine and consultation settings deserves to be pursued. Other telecytology-related issues that require clarification and the adoption of workable guidelines include interstate licensure and protocols to define malpractice liability.     

基于图像特征的嵌入式大包下渣检测方法

通过对现有大包下渣检测系统的分析,提出了一种基于图像特征的嵌入式下渣检测方法,阐述了系统嵌入式架构及具体实现方法.该方法以DSP为下位机系统的核心硬件平台,由FPGA与DSP组成的下位机系统将摄像头采集到的模拟图像转换成数字图像,同时进行平均灰度变化与结构相似度的图像特征提取与分析,再经HPI通信模块将处理后的数据发送...     

Imaging in periodontology. An update

Traditional diagnostic procedures for periodontal diseases, such as probing and radiographic assessment, provide information on previous disease experience but not of present site-specific disease activity. Recent advances in computer-based image acquisition and processing techniques has increased the importance of radiography in periodontal diagnosis. The era of digital imaging has commenced in dentistry with definite diagnostic advantages. Significant dose reductions and image quality enhancement are among major advantages. The aim of this paper is to review the the imaging techniques being used in periodontology. There is a bright future of imaging technology on the horizon of dentistry.     

A cryptologic based trust center for medical images

OBJECTIVE: To investigate practical solutions that can integrate cryptographic techniques and picture archiving and communication systems (PACS) to improve the security of medical images. DESIGN: The PACS at the University of California San Francisco Medical Center consolidate images and associated data from various scanners into a centralized data archive and transmit them to remote display stations for review and consultation purposes. The purpose of this study is to investigate the model of a digital trust center that integrates cryptographic algorithms and protocols seamlessly into such a digital radiology environment to improve the security of medical images. MEASUREMENTS: The timing performance of encryption, decryption, and transmission of the cryptographic protocols over 81 volumetric PACS datasets has been measured. Lossless data compression is also applied before the encryption. The transmission performance is measured against three types of networks of different bandwidths: narrow-band Integrated Services Digital Network, Ethernet, and OC-3c Asynchronous Transfer Mode. RESULTS: The proposed digital trust center provides a cryptosystem solution to protect the confidentiality and to determine the authenticity of digital images in hospitals. The results of this study indicate that diagnostic images such as x-rays and magnetic resonance images could be routinely encrypted in PACS. However, applying encryption in teleradiology and PACS is a tradeoff between communications performance and security measures. CONCLUSION: Many people are uncertain about how to integrate cryptographic algorithms coherently into existing operations of the clinical enterprise. This paper describes a centralized cryptosystem architecture to ensure image data authenticity in a digital radiology department. The system performance has been evaluated in a hospital-integrated PACS environment.     

Technology transfer in digital mammography. Report of the Joint National Cancer Institute-National Aeronautics and Space Administration workshop of May 19-20, 1993

Digital mammography is one of the most promising novel technologies for further improvement of early detection of breast cancer, offering important potential advantages: 1) improved image quality; 2) digital image processing for improved lesion contrast; 3) computer-aided diagnosis for enhanced radiologic interpretation; and 4) teleradiology for facilitated radiologic consultation. The Diagnostic Imaging Research Branch of the National Cancer Institute (NCI) recently funded an international, multidisciplinary, multi-institutional Digital Mammography Development Group for collaborations between NCI, the academic community, and industry to facilitate the integrated development and implementation of digital mammographic systems. Currently, however, digital mammography faces a number of fundamental technological roadblocks: 1) cost-effective digital detectors and displays for imaging systems; 2) the need for novel algorithms for image processing and computer-aided diagnosis; and 3) high performance, low cost digital networks to provide an "information superhighway" for teleradiology. To solve some of these technological problems, the Diagnostic Imaging Research Branch of NCI joined efforts with the Technology Transfer Division of the National Aeronautics and Space Administration to pursue a federal technology transfer program in digital mammography. The authors discuss the findings and recommendations of the workshop entitled "Technology Transfer in Digital Mammography," which was organized and held jointly by the NCI and the National Aeronautics and Space Administration in May, 1993. Numerous innovative technologies of varying degree of promise for digital mammography were presented at the conference. In this article, specific technologies presented at the workshop by the federal and federally-supported laboratories are described, and critiques of these technologies by the leaders of the medical imaging community are presented.     

Spatial resolution of body surface potential maps and magnetic field maps: a simulation study applied to the identification of ventricular pre-excitation sites

Telemedicine is defined as the "delivery of health care and sharing of medical knowledge over a distance using telecommunication systems." The concept of telemedicine is not new. Beyond the use of the telephone, there were numerous attempts to develop telemedicine programs in the 1960s mostly based on interactive television. The early experience was conceptionally encouraging but suffered inadequate technology. With a few notable exceptions such as the telemetry of medical data in the space program, there was very little advancement of telemedicine in the 1970s and 1980s. Interest in telemedicine has exploded in the 1990s with the development of medical devices suited to capturing images and other data in digital electronic form and the development and installation of high speed, high bandwidth telecommunication systems around the world. Clinical applications of telemedicine are now found in virtually every specialty. Teleradiology is the most common application followed by cardiology, dermatology, psychiatry, emergency medicine, home health care, pathology, and oncology. The technological basis and the practical issues are highly variable from one clinical application to another. Teleradiology, including telenuclear medicine, is one of the more well-defined telemedicine services. Techniques have been developed for the acquisition and digitization of images, image compression, image transmission, and image interpretation. The American College of Radiology has promulgated standards for teleradiology, including the requirement for the use of high resolution 2000 x 2000 pixel workstations for the interpretation of plain films. Other elements of the standard address image annotation, patient confidentiality, workstation functionality, cathode ray tube brightness, and image compression. Teleradiology systems are now widely deployed in clinical practice. Applications include providing service from larger to smaller institutions, coverage of outpatient clinics, imaging centers, and nursing homes. Teleradiology is also being used in international applications. Unresolved issues in telemedicine include licensure, the development of standards, reimbursement for services, patient confidentiality, and telecommunications infrastructure and cost. A number of states and medical boards have instituted policies and regulations to prevent physicians who are not licensed in the respective state to provide telemedicine services. This is a major impediment to the delivery of telemedicine between states. Telemedicine, including teleradiology, is here to stay and is changing the practice of medicine dramatically. National and international communications networks are being created that enable the sharing of information and knowledge at a distance. Technological barriers are being overcome leaving organizational, legal, financial, and special interest issues as the major impediments to the further development of telemedicine and realization of its benefits.     

Computers in diabetes ''96

Since the Diabetes Control and Complications Trial demonstrated the substantial benefits of tight glycaemic control there has been renewed interest in the application of information technology (IT) based techniques for improving the day-to-day care of patients with diabetes mellitus. Computer-based educational approaches have a great deal of potential for patients use, and may offer a means of training more health-care professionals to deliver such improved care. In this article the potential role of IT in diabetes education is reviewed, focusing in particular on the application of compartmental models in both computer-based interactive simulators and educational video games. Close attention is devoted to practical applications-available today-for use by patients, their relatives, students and health-care professionals. The novel features and potential benefits of such methodologies are highlighted and some of the limitations of currently available software are discussed. The need for improved graphical user interfaces, and for further efforts to evaluate such programs and demonstrate an educational benefit from their use are identified as hurdles to their more widespread application. The review concludes with a look to the future and the type of modelling features which should be provided in the next generation of interactive diabetes simulators and educational video games.     

Absorbed dose and image quality in examinations of the colon with digital and analogue techniques

PURPOSE: Image quality and the absorbed dose to the patient are issues of primary interest in the change-over from the conventional analogue technique to the digital technique in the examination of the colon by means of fluoroscopy. The aim of this study was to compare the incident radiation and to evaluate the image quality in two different X-ray equipment types, one digital and one analogue. MATERIAL AND METHODS: A kerma-area product meter was used to measure the incident radiation to the patient. Both fluoroscopy and total-examination times were measured as was the number of images. An evaluation of image quality was made and statistically analysed. RESULTS AND CONCLUSION: No significant difference in the irradiation dose was observed between the two techniques. The fluoroscopy time was significantly lower with the conventional technique but the total-examination time decreased by 18% with the digital technique. The total number of images taken was higher with the digital technique (25 images compared to 19) owing to the limited field of the image intensifier. Significantly more noise and less sharpness were observed with the digital system but there was no significant difference in contrast or image quality in the various anatomical structures. Although the change-over to the digital system produced a reduction in sharpness and an increase in noise, and no significant dose saving was measured, the digital system was faster to work with and could well be used for diagnostic purposes.     

In vivo voltammetric studies of the effects of intrathecal morphine on noxious heat stimuli-induced serotonin release in the nucleus raphe magnus of anesthetized rats

MOTIVATION: The principal motivation was to design an environment for the development of image-analysis applications which would allow the integration of independent modules into one frame and make available tools for their build-up, running, management and mutual communication. RESULTS: The system was designed as modular, consisting of the core and work modules. The system core focuses on overall management and provides a library of classes for build-up of the work modules, their user interface and data communication. The work modules carry practical implementation of algorithms and data structures for the solution of a particular problem, and were implemented as dynamic-link libraries. They are mutually independent and run as individual threads, communicating with each other via a unified mechanism. The environment was designed to simplify the development and testing of new algorithms or applications. An example of implementation for the particular problem of the analysis of two-dimensional (2D) gel electrophoretograms is presented. The environment was designed for the Windows NT operating system with the use of Microsoft Foundation Class Library employing the possibilities of C++ programming language. AVAILABILITY: Available on request from the authors.     

Recurrent and repeated infectious endocarditis: causes and preconditions (lecture)

A way of reducing the cost price of hospital automation is proposed. It is not necessary for it to update the whole equipment, but only a small part--the workstations used by programmers for their work, which support the stability of hospital automation; the working places of operators should be kept without modifications, but to allot them properties to inherit a potency and modernity of the purchased equipment; for this purpose they should be equipped with virtual machines copying properties of workstations being arrange in accordance with the pyramidal structure. A UNIX which represents a multi-user, multitask operational operative system providing an access on several pseudoterminals is simultaneously installed on the PENTIUM 100/133 workstation. A graphic terminal of the AMR "UnTerminal" firm (USA) is proposed for use as working places. Their advantage is that they have a special adapter connected directly to the bus of PC extension. Each user is allotted a video adapter, a keyboard controller, sequential and parallel interfaces for connection of the printer and manipulator. Each working place supports multitasking and it can be equipped with a printer, a "mouse" or modem. The image is transmitted on work places with a very high velocity-77 mehabits/sec that supports not only a text mode, but also VGA or SVGA graphics. Certainly, graphic terminals are more expensive than text terminals, but their capacities are similar to those of the main computer, here, the workstation. They may be located from the main computer at a distance of up to 75 meters or more and do not require adjustment during their installation.     

Computer Imagery and Visualization in Civil Engineering Education

Higher education institutions in the United Kingdom have invested significantly in the implementation of communication and information technology in teaching, learning, and assessment of civil and building engineering—with mixed results. This paper focuses on the use of digital imagery and visualization materials to improve student understanding. It describes ways in which these materials are being used in the civil and building engineering curriculum, and, in particular, how distributed performance support systems (DPSS) can be applied to make more effective use of digital imagery and visualization material. This paper centers on the extent to which DPSS can be used in a civil and building vocational and continuing professional development context by tutors in the form of an electronic course delivery tool and by students in the form of an open-access student information system. This paper then describes how a DPSS approach to education is being adopted at Loughborough University as part of the CAL-Visual project. After highlighting the main aims and objectives of the project and describing the system, this paper discusses some of the issues encountered during the design and implementation of a DPSS and presents some preliminary results from initial trials.     

Image feature based automatic correction of low-frequency spatial intensity variations in MR images

An automatic method of compensating for low-frequency variations in magnetic resonance images is presented. Small variations within a tissue type are modelled and a correction function is generated. The method is based completely on image features and does not need a phantom or user interaction to generate the compensation function. This image correction simplifies digital image analysis and may enhance clinical evaluation. As a result, the correction technique reduces inhomogeneity and improves contrast. Our results show that the radiofrequency response variation of coils can be reduced. The segmentation process, even with a simple threshold method, produces more reliable results when corrected images are used. The presented method is most useful for images acquired in the sagital and coronal planes with circular local coils, or using surface coils, e.g., spine coils.     

Is ultrasonography a reliable way to confirm the diagnosis of Morton''s neuroma?

We conducted a survey of all defibrillators currently on the European market that offer synchronized cardioversion. The mode after cardioversion can be classed into one of four categories: (1) remain in synchronized mode; (2) defer to asynchronized mode; (3) 'intelligent'; and (4) configurable. The different modes and the lack of standardization present a potential hazard because they cause confusion among the user of the defibrillator. Uniformity should be obtained after broad agreement between clinicians and manufacturers of defibrillators.     

Disability, health care, and public policy.

Efforts to persuade policymakers to rely on data to plan health care services for people with a disability or a chronic illness must confront the fact that many competing definitions of disability are currently used. It is important to recognize that pressures for standardization as well as disputes over disability definitions take place in a broader social and political context. Despite the practical difficulties facing researchers and the highly charged atmosphere in which disagreements over definitions must be managed, researchers have made progress in developing policy-relevant data that underline the importance of the health needs of people with a disability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)