Low-bandwidth telerehabilitation for patients who have undergone total knee replacement: preliminary results

We have developed a low-bandwidth, Internet-based telerehabilitation system to provide outpatient rehabilitation to patients who have undergone total knee arthroplasty. The preliminary efficacy of this treatment programme in terms of both physical and functional objective outcome measures was assessed on 21 patients. Subjects receiving a six-week rehabilitation programme were randomized to the telerehabilitation system or the usual face-to-face method. The physical and functional improvements in the telerehabilitation group were similar to those in the control group. There was a non-significant trend for greater improvements in the telerehabilitation group for most outcome measurements. The telerehabilitation programme was well received by patients. The results of this study provide evidence for the efficacy of low-bandwidth telerehabilitation consultations.

Rehabilitation after total knee replacement via low-bandwidth telemedicine: the patient and therapist experience

After a total knee replacement, inadequate rehabilitation is associated with poor physical outcomes and a reduced longevity of the knee prosthesis. We have developed a low-bandwidth telemedicine system to enable rehabilitation services to be delivered directly to the home of patients in rural and remote areas. We have examined the experience of clinical physiotherapists and of 31 participants who received treatment via the system. High levels of satisfaction were reported by participants (mean responses >7 on a 10 cm visual analogue scale). The service was found to be effective, safe and easy to use, and it integrated well into current clinical practice. The study demonstrates the potential for delivering physiotherapy services via low-bandwidth Internet connections.

Local edge detectors: A substrate for fine spatial vision at low temporal frequencies in rabbit retina

Visual acuity is limited by the size and density of the smallest retinal ganglion cells, which correspond to the midget ganglion cells in primate retina and the beta- ganglion cells in cat retina, both of which have concentric receptive fields that respond at either light- On or light- Off. In contrast, the smallest ganglion cells in the rabbit retina are the local edge detectors ( LEDs), which respond to spot illumination at both light- On and light- Off. However, the LEDs do not predominate in the rabbit retina and the question arises, what role do they play in fine spatial vision? We studied the morphology and physiology of LEDs in the isolated rabbit retina and examined how their response properties are shaped by the excitatory and inhibitory inputs. Although the LEDs comprise only similar to 15% of the ganglion cells, neighboring LEDs are separated by 30 - 40 mu m on the visual streak, which is sufficient to account for the grating acuity of the rabbit. The spatial and temporal receptive- field properties of LEDs are generated by distinct inhibitory mechanisms. The strong inhibitory surround acts presynaptically to suppress both the excitation and the inhibition elicited by center stimulation. The temporal properties, characterized by sluggish onset, sustained firing, and low bandwidth, are mediated by the temporal properties of the bipolar cells and by postsynaptic interactions between the excitatory and inhibitory inputs. We propose that the LEDs signal fine spatial detail during visual fixation, when high temporal frequencies are minimal.

The diagnostic reliability of Internet-based observational kinematic gait analysis

We investigated the accuracy and reliability of observational kinematic gait assessments performed via a low-bandwidth Internet link (118 kbit/s) and a higher-speed Internet link (128 kbit/s). Twenty-four subjects were randomized to either bandwidth group. Gait was assessed with the Gait Assessment Rating Scale (GARS) in the traditional manner, which is from video-recordings, and with repeated measurements via the online method. Online assessment was found to provide as accurate a measure of gait performance as the traditional assessment (limits of agreement

Paediatric palliative home care with Internet-based video-phones: lessons learnt

We have designed and tested an Internet-based video-phone suitable for use in the homes of families in need of paediatric palliative care services. The equipment uses an ordinary telephone line and includes a PC, Web camera and modem housed in a custom-made box. In initial field testing, six clinical consultations were conducted in a one-month trial of the videophone with a family in receipt of palliative care services who were living in the outer suburbs of Brisbane. Problems with variability in call quality-namely audio and video freezing, and audio break-up-prompted further laboratory testing. We completed a programme of over 250 test calls. Fixing modem connection parameters to use the V.34 modulation protocol at a set bandwidth of 24 kbit/s improved connection stability and the reliability of the video-phone. In subsequent field testing 47 of 50 calls (94%) connected without problems. The freezes that did occur were brief (with greatly reduced packet loss) and had little effect on the ability to communicate, unlike the problems arising in the home testing. The low-bandwidth Internet-based video-phone we have developed provides a feasible means of doing telemedicine in the home.

Semantic caching for multiresolution spatial query processing in mobile environments

Spatial data are particularly useful in mobile environments. However, due to the low bandwidth of most wireless networks, developing large spatial database applications becomes a challenging process. In this paper, we provide the first attempt to combine two important techniques, multiresolution spatial data structure and semantic caching, towards efficient spatial query processing in mobile environments. Based on the study of the characteristics of multiresolution spatial data (MSD) and multiresolution spatial query, we propose a new semantic caching model called Multiresolution Semantic Caching (MSC) for caching MSD in mobile environments. MSC enriches the traditional three-category query processing in semantic cache to five categories, thus improving the performance in three ways: 1) a reduction in the amount and complexity of the remainder queries; 2) the redundant transmission of spatial data already residing in a cache is avoided; 3) a provision for satisfactory answers before 100% query results have been transmitted to the client side. Our extensive experiments on a very large and complex real spatial database show that MSC outperforms the traditional semantic caching models significantly

Stationary lineshape of a two-level atom in a narrow-bandwidth squeezed vacuum

The stationary lineshape of a two-level atom driven by low-intensity narrow-bandwidth squeezed light is shown to exhibit significant differences in behaviour compared to the lineshape for broadband squeezed light. We find that for narrow-bandwidth squeezed light the lineshape is composed of two Lorentzians whose amplitudes depend on the squeezing correlations. Moreover, one of the Lorentzians has a negative weight which leads to narrowing of the line. These features are absent in the broadband case, where the stationary lineshape is the same as for a thermal field. (C) 1998 Elsevier Science B.V.

Resonance fluorescence spectrum in a weak squeezed field with an arbitrary bandwidth

We analyze the linewidth narrowing in the fluorescence spectrum of a two-level atom driven by a squeezed vacuum field of a finite bandwidth. It is found that the fluorescence spectrum in a low-intensity squeezed field can exhibit a (omega - omega(0))(-6) frequency dependence in the wings. We show that this fast fall-off behavior is intimately related to the properties of a narrow-bandwidth squeezed field and does not extend into the region of broadband excitation. We apply the Linear response model and find that the narrowing results from a convolution of the atom response with the spectrum of the incident field. On the experimental side, we emphasize that the linewidth narrowing is not sensitive to the solid angle of the squeezed modes coupled to the atom. We also compare the fluorescence spectrum with the quadrature-noise spectrum and find that the fluorescence spectrum for an off-resonance excitation does not reveal the noise spectrum. We show that this difference arises from the competing three-photon scattering processes. [S1050-2947(98)04308-X].

Air target detection via bistatic radar based on LEOS communication signals

The paper discusses the bistatic radar parameters for the case when the transmitter is a satellite emitting communication signals. The model utilises signals from an Iridium-like low earth orbiting satellite system. The maximum detection range, when thermal noise-limited, is discussed at the theoretical level and these results are compared with experimentation. Satellite-radar signal levels and the power of ground reflections are evaluated.

Beliefs and practices of patients with advanced cancer: implications for communication

The aim of this study was to investigate the beliefs that patients with advanced cancer held about the curability of their cancer, their use of alternatives to conventional medical treatment, and their need to have control over decisions about treatment. Of 149 patients who fulfilled the criteria for participation and completed a self-administered questionnaire, 45 patients (31%) believed their cancer was incurable, 61 (42%) were uncertain and 39 (27%) believed their cancer was curable. The index of need for control over treatment decisions was low in 53 patients (35.6%) and high in only 17 patients (11.4%). Committed users of alternatives to conventional medical treatments were more likely to believe that their cancer was curable (P

A feasibility study of email communication between the patient's family and the specialist burns team

We investigated whether the parents of burns patients could capture suitable clinical images with a digital camera and add the necessary text information to enable the paediatric burns team to provide follow-up care via email. Four families were involved in the study, each of whom sent regular email consultations for six months. The results were very encouraging. The burns team felt confident that the clinical information in 30 of the 32 email messages (94%) they received was accurate, although in I I of these 30 cases (37%) they stated that there was room for improvement (the quality was nonetheless adequate for clinical decision making). The study also showed that low-resolution images (average size 37 kByte) were satisfactory for diagnosis. Families were able to participate in the service without intensive training and support. The user survey showed that all four families found it easy and convenient to take the digital photographs and to participate in the study. The results suggest that the technique has potential as a low-cost telemedicine service in burns follow-up, and that it requires only modest investment in equipment, training and support.

PBG-assisted shared-aperture dual-band aperture-coupled patch antenna for satellite communication

Design and development of a photonic bandgap (PBG)-assisted shared-aperture dual-band orthogonal aperture-fed rectangular microstrip patch antenna element, which is suitable for a portable very small aperture terminal (VSAT), are presented in this paper. The dual-band dual-polarized antenna element achieves 21% input impedance bandwidth at the S- and C-bands. A comparison of the antenna with and without 2D PBG grids shows that the inclusion of PBG structures (PBGSs) improves the antenna performances. (c) 2005 Wiley Periodicals, Inc.