结合数据融合和数据挖掘的医疗监护报警

介绍家庭远程医疗监护和咨询智能系统,它能自动进行监护数据分析及异常情况识别和网络报警、远程实时诊断。在心电信号分析方面,采用了一种基于最小均方差的自适应噪声滤除方法,介绍了QRS综合波和P波的检测方法及共时域特征的提取,以及基于小波分析的心电信号频域特征的提取。在结合数据融合和数据挖掘的医疗监护模型的建模方面,采用多层感知器网络和决策树方法建立报警决策器的模型。     

In a ‘trusting’ environment, everyone is responsible for information security

Information security is important in any organisation and particularly where personal and medical information is routinely recorded. Further, where the organisational culture revolves around trust, as in the medical environment, insider threats, both malicious and non-malicious, are difficult to manage. International research has shown that changing security culture and increasing awareness is necessary as technical resolutions are not sufficient to control insider threats. This area of information security is both important and topical in view of the recently publicised breaches of patient health information. Ensuring that all staff assumes responsibility for information security, particularly as part of an information security governance framework, is one practical solution to the problem of insider threats.     

A Secure Grid Medical Data Manager Interfaced to the gLite Middleware

The medical community is producing and manipulating a tremendous volume of digital data for which computerized archiving, processing and analysis is needed. Grid infrastructures are promising for dealing with challenges arising in computerized medicine but the manipulation of medical data on such infrastructures faces both the problem of interconnecting medical information systems to Grid middlewares and of preserving patients’ privacy in a wide and distributed multi-user system. These constraints are often limiting the use of Grids for manipulating sensitive medical data. This paper describes our design of a medical data management system taking advantage of the advanced gLite data management services, developed in the context of the EGEE project, to fulfill the stringent needs of the medical community. It ensures medical data protection through strict data access control, anonymization and encryption. The multi-level access control provides the flexibility needed for implementing complex medical use-cases. Data anonymization prevents the exposure of most sensitive data to unauthorized users, and data encryption guarantees data protection even when it is stored at remote sites. Moreover, the developed prototype provides a Grid storage resource manager (SRM) interface to standard medical DICOM servers thereby enabling transparent access to medical data without interfering with medical practice.     

The multimodal world of medical monitoring displays

A vision of the future of intraoperative monitoring for anesthesia is presented-a multimodal world based on advanced sensing capabilities. I explore progress towards this vision, outlining the general nature of the anesthetist's monitoring task and the dangers of attentional capture. Research in attention indicates different kinds of attentional control, such as endogenous and exogenous orienting, which are critical to how awareness of patient state is maintained, but which may work differently across different modalities. Four kinds of medical monitoring displays are surveyed: (1) integrated visual displays, (2) head-mounted displays, (3) advanced auditory displays and (4) auditory alarms. Achievements and challenges in each area are outlined. In future research, we should focus more clearly on identifying anesthetists' information needs and we should develop models of attention in different modalities and across different modalities that are more capable of guiding design.     

Toward a theoretical approach to medical error reporting system research and design

The release of the Institute of Medicine (Kohn et al., 2000) report "To Err is Human", brought attention to the problem of medical errors, which led to a concerted effort to study and design medical error reporting systems for the purpose of capturing and analyzing error data so that safety interventions could be designed. However, to make real gains in the efficacy of medical error or event reporting systems, it is necessary to begin developing a theory of reporting systems adoption and use and to understand how existing theories may play a role in explaining adoption and use. This paper presents the results of a 9-month study exploring the barriers and facilitators for the design of a statewide medical error reporting system and discusses how several existing theories of technology acceptance, adoption and implementation fit with many of the results. In addition we present an integrated theoretical model of medical error reporting system design and implementation.     

医师科技创新能力评价指标构建

本文运用文献分析法、Delphi法和层次分析法筛选和确定了医师科技创新能力指标体系。该评价体系包括专业教育背景、知识创新能力、技术创新能力和学术交流能力4项一级指标,11项二级指标,部分二级指标又细分为三级指标,对每一指标给出相应权重系数和内涵,并对各项指标提出量化方法。     

A medical hand tool physical interaction evaluation approach for prototype testing using patient care simulators

The purpose of this study was to develop and test a physical ergonomics assessment approach for medical device handles. The method assesses wrist posture and force of exertion simultaneously by task element. Electrogoniometers and EMG sensors were connected through a data acquisition module for synchronization with video recordings of trials. Task analysis of video recordings were performed offline with Observer XT software. Average posture and force data across several repetitions of individual task elements were calculated and presented in a format suitable for informing product designers of specific issues during a test trial. A handle comfort questionnaire is proposed to survey subjective responses. The evaluation approach was applied to an endoscope needle in sampling a biopsy from the stomach wall using a gastrointestinal track simulator with ten physician surrogates. The results showed that for all task elements the wrist was in extension (33(°)-45(°)). Peak muscle forces ranged from 28% to 68% MVC across the three muscles studied. Muscle peak forces were above ACGIH HAL maximum threshold limits for four of the seven task elements, and above the action limit for all seven task elements for two muscles. The handle comfort questionnaire data also supported the high muscle force findings, and also on force distribution on the handle due to contact stresses. This combined approach could be used to collect and report detailed early stage ergonomics data from user trials on patient care simulators. The approach is proposed for use by medical device designers at the design stage of new products using prototypes, but it could also be used on existing products with real patients.     

解读《标准》研究教学——蚌埠医学院《医学专业英语》教学改革思路

随着全球化进程的加快,医学教育的国际化趋势日趋明显。作为临床医学专业本科教育质量监控及教学工作自我评价的主要依据,教育部、卫生部于2008年9月制定了《本科医学教育标准—临床医学专业(试行)》。文章结合《标准》,着重论述了我校《医学专业英语》教学改革的一些具体的思路和方法。     

从互动角度试析医学英语教学中的合作学习

为推进医学院校的专业英语教学,促进医学人才国际化,多元化发展,切实改革现有的医学英语教学模式成了亟待解决的问题。将合作学习融入医学英语教学是解决这一问题的有效途径,本文从合作学习中"互动"的角度出发,分别从"师生互动"生生互动"以及"师师互动"这三个方面讨论合作学习在医学英语教学中的可行性,这对于理论本身的理解,教学活动的实施以及教学效果的达成具有重要的作用。     

Classification of human brain tumours from MRS data using Discrete Wavelet Transform and Bayesian Neural Networks

The diagnosis of brain tumours is an extremely sensitive and complex clinical task that must rely upon information gathered through non-invasive techniques. One such technique is Magnetic Resonance Spectroscopy. In this task, radiology experts are likely to benefit from the support of computer-based systems built around robust classification processes. In this paper, a Discrete Wavelet Transform procedure was applied to the pre-processing of spectra corresponding to several brain tumour pathologies. This procedure does not alleviate the high dimensionality of the data by itself. For this reason, dimensionality reduction was subsequently implemented using Moving Window with Variance Analysis for feature selection or Principal Component Analysis for feature extraction. The combined method yielded very encouraging results in terms of diagnostic discriminatory binary classification using Bayesian Neural Networks. In most cases, the classification accuracy improved on previously reported results.