基于网络的汉语听力康复训练系统

目的开发一套符合汉语特点的听力康复训练网络系统,以克服听力残障患者人工康复训练的缺点,与国际听力研究接轨。方法利用Dreamweaver CS6、ASP、Access2010等互联网技术、数据库技术及多媒体技术,充分考虑汉语语音学特点和患者的听力损失情况开发系统。系统包括用户登录注册、留言板、5个听力康复模块(字词长短、单词声调、元音辨别、辅音辨别、整句辨别),每个模块包括练习、测试、训练三部分,每一部分均可以保存及查看成绩。结果通过本平台使听力康复患者可以随时随地进行听力康复训练,在康复训练中可以查询自己的历史成绩,以便于对比分析训练效果,并且可以在线留言与医学专家或病友进行交流讨论。结论本系统可以提高患者言语交流能力,促进我国听力康复训练的信息化、科学化。     

Medical informatics training programme to support the Romanian health care management information system

The Health Management Information System (HMIS) project initiated by the Romanian Ministry of Health as a component of the healthcare reform is aiming to ensure the technical, functional and operative support for: (i) a better overview of the population health status, of the medical care needs and of the Health System performances; (ii) the improvement of the resource allocation and consumption; and (iii) reform support. This system is supposed to assure a better information flow from the lower to the upper levels of the healthcare network by help of a modern IT support. In the first development stage the system is planned to link the Ministry of Health with the 41 District Health Authorities (DHAs) and with more than 200 pilot health units. The implementation of such a large system raises serious problems of acceptability and a thorough training programme for both technical staff and end users must be considered in order to face this challenge.     

Advanced technology for extracorporeal liver support system devices

Acute Liver Failure (ALF) still presents high mortality rates, and liver transplant is the only treatment with proven efficacy. However transplant is not always possible and systems for Extracorporeal Liver Support (ELS) are being developed which can treat patients with ALF, for whom a transplant is not available, or is delayed. They can also treat patients with chronic liver disease who develop ALF. There are two types of ELS: artificial systems (hemoperfusion, plasmaperfusion, therapeutic plasma exchange, continuous hemodialysis and high volume continuous hemofiltration) and bioartificial systems. These are based on a biological component (animal or human hepatocytes) inserted into a bioreactor, whose main function is to perform the metabolic activity and synthesis that the liver can no longer perform. The results obtained in clinical trials have so far shown that the best results in terms of compensating for lost metabolic function and detoxification are obtained inserting artificial components in the bioartificial circuit.     

基于嵌入式Web服务器的心电远程监护系统

目的设计一种基于嵌入式Web服务器的心电远程监护系统。方法采用低功耗ARM9微处理器为核心的开发板,移植嵌入式Linux系统和Web服务器,通过JavaApplet和CGI设计开发,利用动态网页实现心电信号的远程实时监护。结果设计的心电记录器能准确地采集和显示各类心电信号,浏览器端能动态显示心电波形和分析结果,可准确实时地进行远程监护。结论本系统操作方便、成本低,实现了现有动态心电监护仪缺乏的实时监测,适合家庭和社区的心电监护。     

Numerical continuation method for a system of parallel flow tubes.

Numerical solutions of the mathematical models of the kidney generally involve determining the roots of a nonlinear equation. Most iterative methods for the solution of nonlinear equations require a good initial approximation to the solution. One approach in overcoming this dependence is the use of the so-called continuation techniques. By taking an underlying physiological model of the kidney as our guide, we develop two such techniques for the efficient solution of these equations. These techniques do not require any prior knowledge of the solution.     

Evaluation of computerized decision support for oral anticoagulation management based in primary care.

BACKGROUND: Increasing indications for oral anticoagulation has led to pressure on general practices to undertake therapeutic monitoring. Computerized decision support (DSS) has been shown to be effective in hospitals for improving clinical management. Its usefulness in primary care has previously not been investigated. AIM: To test the effectiveness of using DSS for oral anticoagulation monitoring in primary care by measuring the proportions of patients adequately controlled, defined as within the appropriate therapeutic range of International Normalised Ratio (INR). METHOD: All patients receiving warfarin from two Birmingham inner city general practices were invited to attend a practice-based anticoagulation clinic. In practice A all patients were managed using DSS. In practice B patients were randomized to receive dosing advice either through DSS or through the local hospital laboratory. Clinical outcomes, adverse events and patient acceptability were recorded. RESULTS: Forty-nine patients were seen in total. There were significant improvements in INR control from 23% to 86% (P > 0.001) in the practice where all patients received dosing through DSS. In the practice where patients were randomized to either DSS or hospital dosing, logistic regression showed a significant trend for improvement in intervention patients which was not apparent in the hospital-dosed patients (P < 0.001). Mean recall times were significantly extended in patients who were dosed by the practice DSS through the full 12 months (24 days to 36 days) (P = 0.033). Adverse events were comparable between hospital and practice-dosed patients, although a number of esoteric events occurred. Patient satisfaction with the practice clinics was high. CONCLUSION: Computerized DSS enables the safe and effective transfer of anticoagulation management from hospital to primary care and may result in improved patient outcome in terms of the level of control, frequency of review and general acceptability.     

KIDMAP, a web based system for gathering patients' feedback on their doctors

Background  

The gathering of feedback on doctors from patients after consultations is an important part of patient involvement and participation. This study first assesses the 23-item Patient Feedback Questionnaire (PFQ) designed by the Picker Institute, Europe, to determine whether these items form a single latent trait. Then, an Internet module with visual representation is developed to gather patient views about their doctors; this program then distributes the individualized results by email.     

Medical decision support system for diagnosis of neuromuscular disorders using DWT and fuzzy support vector machines

The motor unit action potentials (MUAPs) in an electromyographic (EMG) signal provide a significant source of information for the assessment of neuromuscular disorders. In this work, different types of machine learning methods were used to classify EMG signals and compared in relation to their accuracy in classification of EMG signals. The models automatically classify the EMG signals into normal, neurogenic or myopathic. The best averaged performance over 10 runs of randomized cross-validation is also obtained by different classification models. Some conclusions concerning the impacts of features on the EMG signal classification were obtained through analysis of the classification techniques. The comparative analysis suggests that the fuzzy support vector machines (FSVM) modelling is superior to the other machine learning methods in at least three points: slightly higher recognition rate; insensitivity to overtraining; and consistent outputs demonstrating higher reliability. The combined model with discrete wavelet transform (DWT) and FSVM achieves the better performance for internal cross validation (External cross validation) with the area under the receiver operating characteristic (ROC) curve (AUC) and accuracy equal to 0.996 (0.970) and 97.67% (93.5%), respectively. These results show that the proposed model have the potential to obtain a reliable classification of EMG signals, and to assist the clinicians for making a correct diagnosis of neuromuscular disorders.     

A decision support system based on support vector machines for diagnosis of the heart valve diseases

In this paper, a decision support system that classifies the Doppler signals of the heart valve to two classes (normal and abnormal) is presented to support the cardiologist. The paper uses our previous paper where ANN is used as a classifier, as feature extractor from measured Doppler signal. To make this, it uses wavelet transforms and short time Fourier transform methods. Before it classifies these features, it applies Wavelet entropy to them. In this paper, our aim is to develop our previous work by using least-squares support vector machine (LS-SVM) classifier instead of ANN. We use LS-SVM and backpropagation artificial neural network (BP-ANN) to classify the extracted features. In addition, we use receiver operator characteristic (ROC) curves to compare sensitivities and specificities of these classifiers and compute the area under the curves. Finally, we evaluate two classifiers in all aspects.     

Development of a real-time clinical decision support system upon the web mvc-based architecture for prostate cancer treatment

Background  

A real-time clinical decision support system (RTCDSS) with interactive diagrams enables clinicians to instantly and efficiently track patients' clinical records (PCRs) and improve their quality of clinical care. We propose a RTCDSS to process online clinical informatics from multiple databases for clinical decision making in the treatment of prostate cancer based on Web Model-View-Controller (MVC) architecture, by which the system can easily be adapted to different diseases and applications.     

Medical care system in 21st century

In a rapidly aging society, the role of medical services to ensure the Japanese people's health has become more and more important. Although it is not easy to forecast precisely 21st century medical services, the existing medical delivery system must be reorganized and improved, recognizing the changes in relative occurrences of diseases, the progress of medical technology, and changes in patient need. It is also necessary to pay adequate attention to the need for medical services in different regions and establish a medical care delivery system based on the need. It is also important to systematize the provision of medical services. The future of the medical care system in the 21st century depends on these approaches.     

Computer support for genetic advice in primary care.

General practitioners (GPs) are under increasing pressure to advise patients about genetic risk. Secondary care lacks the resources to deal with the increasing number of referrals for genetic counselling, and thus recommendations have been made to develop primary care genetics. But for most GPs, genetics is unfamiliar territory. Computers could help general practice to provide a genetics service by simplifying the construction and assessment of family trees and by implementing management guidelines. No programs have been written specifically for primary care genetics, but a range of software exists for secondary care. This paper discusses the types of program already available and how they relate to the needs of primary care. Currently available software offers only elements of the outlined 'ideal' program for primary care and may be too complex for a general practice setting. Most importantly, none provide decision support concerning management based on the level of risk, even though this may be the most valuable element. Genetics is an appropriate area for decision support software in general practice, but it would be wrong to assume that this alone is the key to developing primary care genetics. Additional educational strategies for GPs will be required, and the attitudes of patients to receiving expert advice from a computer must be considered. Current practice computer systems will have to develop so they can communicate with Windows-based expert systems, and changes in existing surgery hardware may be necessary. Existing genetics software provides a starting point from which to derive an appropriate system for general practice. A carefully developed decision-support system could empower GPs to meet the challenge of offering a high-quality genetics service in primary care.     

Holter electrocardiogram network system to support regional medical care

To support regional medical care, the clinical laboratory of Kochi Medical School Hospital developed a Holter electrocardiogram (ECG) network system with regional hospitals. Holter ECG data are received from the regional hospitals and reports are sent back using the Internet. When Holter ECG shows recordings which need immediate attention such as ventricular tachycardia or ischemic ST changes, a medical technologist contacts the regional hospital immediately. The reports are checked and approved by a cardiologist who also gives advice to doctors concerning the treatment of patients. By using the medical facilities and personnel of the university hospital, this system provides rapid and appropriate medical care for patients in our area. Moreover, improvement in the skills and knowledge of the technologists in our hospital was achieved using the Holter ECG network system.     

基于无线充电技术的胃肠电刺激系统

目的设计一种新型的植入式胃肠道刺激系统,不仅具有刺激功能,还具有肠电和压力检测功能,可用于检测胃肠道刺激的效果,同时增加无线能量供给,以实现刺激器的长期植入。方法系统由体内刺激模块、体外控制模块及无线能量传输模块组成。体外控制模块通过无线射频将控制信号传输到体内刺激模块,体内刺激模块的能量由体外能量发射装置通过电磁耦合进行供给。通过生物反馈控制检测不同刺激参数对胃肠道收缩活动的作用效果,实时调整刺激参数,输出需要的刺激脉冲。以模拟心电信号模拟肠电信号,进行了相关的体外实验。结果在体外实验中,系统可有效检测到2—20次／min的模拟心电信号,并实现实时刺激参数修改输出不同的刺激脉冲。该系统实现了电流检测功能,监测作用部分的胃肠电阻。经皮无线能量在两级线圈轴向距离为22mm时的接收充电稳定功率最大为0．93W,体内锂离子的充电电流为180～240mA。结论系统可检测到最大变化范围的模拟肠电信号。验证电流的作用效应为后续的恒流刺激模式提供参考。该系统的无线充电功能可满足植入式刺激器长期植入的能量需求。