944 resultados para Communication in medicine


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In this study, a new entropy measure known as kernel entropy (KerEnt), which quantifies the irregularity in a series, was applied to nocturnal oxygen saturation (SaO 2) recordings. A total of 96 subjects suspected of suffering from sleep apnea-hypopnea syndrome (SAHS) took part in the study: 32 SAHS-negative and 64 SAHS-positive subjects. Their SaO 2 signals were separately processed by means of KerEnt. Our results show that a higher degree of irregularity is associated to SAHS-positive subjects. Statistical analysis revealed significant differences between the KerEnt values of SAHS-negative and SAHS-positive groups. The diagnostic utility of this parameter was studied by means of receiver operating characteristic (ROC) analysis. A classification accuracy of 81.25% (81.25% sensitivity and 81.25% specificity) was achieved. Repeated apneas during sleep increase irregularity in SaO 2 data. This effect can be measured by KerEnt in order to detect SAHS. This non-linear measure can provide useful information for the development of alternative diagnostic techniques in order to reduce the demand for conventional polysomnography (PSG). © 2011 IEEE.

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Minimal access procedures in surgery offer benefits of reduced patient recovery time and less pain, yet for the surgeon the task is more complex, as both tactile and visual perception of the working site is reduced. In this paper, experimental evidence of the performance of a novel sensing system embedded in an actuated flexible digit element is presented. The digit represents a steerable tip element of devices such as endoscopes and laparoscopes. This solution is able to discriminate types of contact and tissue interaction, and to feed back this information with the shape of the flexible digit. As an alternative to this information, force level, force distribution, and other quantifiable descriptors can also be evaluated. These can be used to aid perception in processes such as navigation and investigation of tissues through palpation. The solution is pragmatic, and by virtue of its efficient mechanical construction and a polymer construction, it offers opportunities for a disposable element with suitability for magnetic resonance imaging (MRI) and other scanning environments. By using only four photonics sensing elements, full perception of tissue contact and the shape of the actuated digit can be described in the feedback of this information. The distributive sensory method applied to the sensory signals relies on the coupled values of the sensory data transients of the four deployed sensing elements to discriminate tissue interaction directly in near real time.

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A nature inspired decentralised multi-agent algorithm is proposed to solve a problem of distributed task selection in which cities produce and store batches of different mail types. Agents must collect and process the mail batches, without a priori knowledge of the available mail at the cities or inter-agent communication. In order to process a different mail type than the previous one, agents must undergo a change-over during which it remains inactive. We propose a threshold based algorithm in order to maximise the overall efficiency (the average amount of mail collected). We show that memory, i.e. the possibility for agents to develop preferences for certain cities, not only leads to emergent cooperation between agents, but also to a significant increase in efficiency (above the theoretical upper limit for any memoryless algorithm), and we systematically investigate the influence of the various model parameters. Finally, we demonstrate the flexibility of the algorithm to changes in circumstances, and its excellent scalability.

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Emerging vehicular comfort applications pose a host of completely new set of requirements such as maintaining end-to-end connectivity, packet routing, and reliable communication for internet access while on the move. One of the biggest challenges is to provide good quality of service (QoS) such as low packet delay while coping with the fast topological changes. In this paper, we propose a clustering algorithm based on minimal path loss ratio (MPLR) which should help in spectrum efficiency and reduce data congestion in the network. The vehicular nodes which experience minimal path loss are selected as the cluster heads. The performance of the MPLR clustering algorithm is calculated by rate of change of cluster heads, average number of clusters and average cluster size. Vehicular traffic models derived from the Traffic Wales data are fed as input to the motorway simulator. A mathematical analysis for the rate of change of cluster head is derived which validates the MPLR algorithm and is compared with the simulated results. The mathematical and simulated results are in good agreement indicating the stability of the algorithm and the accuracy of the simulator. The MPLR system is also compared with V2R system with MPLR system performing better. © 2013 IEEE.

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In the clinical/microbiological laboratory there are currently several ways of separating specific cells from a fluid suspension. Conventionally cells can be separated based on size, density, electrical charge, light-scattering properties, and antigenic surface properties. Separating cells using these parameters can require complex technologies and specialist equipment. This paper proposes new Bio-MEMS (microelectromechanical systems) filtration chips manufactured using deep reactive ion etching (DRIE) technology that, when used in conjunction with an optical microscope and a syringe, can filter and grade cells for size without the requirement for additional expensive equipment. These chips also offer great versatility in terms of design and their low cost allows them to be disposable, eliminating sample contamination. The pumping mechanism, unlike many other current filtration techniques, leaves samples mechanically and chemically undamaged. In this paper the principles behind harnessing passive pumping are explored, modelled, and validated against empirical data, and their integration into a microfluidic device to separate cells from a mixed population suspension is described. The design, means of manufacture, and results from preliminary tests are also presented. © IMechE 2007.

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Emerging vehicular comfort applications pose a host of completely new set of requirements such as maintaining end-to-end connectivity, packet routing, and reliable communication for internet access while on the move. One of the biggest challenges is to provide good quality of service (QoS) such as low packet delay while coping with the fast topological changes. In this paper, we propose a clustering algorithm based on minimal path loss ratio (MPLR) which should help in spectrum efficiency and reduce data congestion in the network. The vehicular nodes which experience minimal path loss are selected as the cluster heads. The performance of the MPLR clustering algorithm is calculated by rate of change of cluster heads, average number of clusters and average cluster size. Vehicular traffic models derived from the Traffic Wales data are fed as input to the motorway simulator. A mathematical analysis for the rate of change of cluster head is derived which validates the MPLR algorithm and is compared with the simulated results. The mathematical and simulated results are in good agreement indicating the stability of the algorithm and the accuracy of the simulator. The MPLR system is also compared with V2R system with MPLR system performing better. © 2013 IEEE.

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Previous studies have suggested that incorporating relatively small quantities of titanium dioxide into bioactive glasses may result in an increase in bioactivity and hydroxyapatite formation. The present work therefore investigated the in vitro bioactivity of a titanium doped bioglass and compared the results with 45S5 bioglass. Apatite formation was evaluated for bioglass and Ti-bioglass in the presence and absence of foetal calf serum. Scanning electron microscopy (SEM) images were used to evaluate the surface development and energy dispersive X-ray measurements provided information on the elemental ratios. X-ray diffraction spectra confirmed the presence of apatite formation. Cell viability was assessed for bone marrow stromal cells under direct and indirect contact conditions and cell adhesion was assessed using SEM. © 2014 Springer Science+Business Media.

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Minimal access procedures in surgery offer benefits of reduced patient recovery time and less pain, yet for the surgeon the task is more complex, as both tactile and visual perception of the working site is reduced. In this paper, experimental evidence of the performance of a novel sensing system embedded in an actuated flexible digit element is presented. The digit represents a steerable tip element of devices such as endoscopes and laparoscopes. This solution is able to discriminate types of contact and tissue interaction, and to feed back this information with the shape of the flexible digit. As an alternative to this information, force level, force distribution, and other quantifiable descriptors can also be evaluated. These can be used to aid perception in processes such as navigation and investigation of tissues through palpation. The solution is pragmatic, and by virtue of its efficient mechanical construction and a polymer construction, it offers opportunities for a disposable element with suitability for magnetic resonance imaging (MRI) and other scanning environments. By using only four photonics sensing elements, full perception of tissue contact and the shape of the actuated digit can be described in the feedback of this information. The distributive sensory method applied to the sensory signals relies on the coupled values of the sensory data transients of the four deployed sensing elements to discriminate tissue interaction directly in near real time.

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Recent UK government initiatives aim to increase user involvement in the National Health Service (NHS) in two ways: by encouraging service users to take an active role in making decisions about their own care; and by establishing opportunities for wider public participation in service development. The purpose of this study was to examine how UK cancer service users understand and relate to the concept of user involvement. The data were collected through in-depth interviews, which were analysed for content according to the principles of grounded theory. The results highlight the role of information and communication in effective user involvement. Perhaps more importantly, this study suggests that the concept of user involvement is unclear to many cancer service users. This paper argues the need for increased awareness and understanding of what user involvement is and how it can work.

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* This paper was made according to the program of FEBRAS, project "Creating methods and tools for developing intellectual information systems in medicine and public health".

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Background: hearing loss is common in older age. Research with older people in residential care settings has identified high prevalence of hearing loss and low uptake of hearing aids. Hearing loss in these settings is associated with reduced social engagement. Although hearing aids remain the default treatment for presbyacusic hearing loss, these are not well used. We do not know what other modifiable factors contribute to communication problems for older people with hearing loss living in residential care. Objectives: to explore the factors affecting communicating with a hearing loss in residential care. Methods: an ethnographic study in two residential care homes comprised 19 sessions of observation, and in-depth interviews with 18 residents. Observations explored communication behaviour in everyday interactions, including mealtimes, structured groups and informal group activities. Interviews were informed by the observations and identified reasons for these behaviours and communication preferences. Observational data were recorded in field notes and interviews were audio-recorded and transcribed. Analysis was conducted using constant comparison methods. Results: hearing loss affected whether residents were able to access social opportunities. Two key themes influenced this (i) contextual issues compounded communication difficulties and (ii) environmental noise restricted the residents' communication choices. Problems were observed at every mealtime and during formal and informal group activities. The use of hearing aids and access to hearing services did not improve social engagement. Conclusions: environmental and social factors are key to maximising communication opportunities. Improvements to communication in residential care settings could be based on changes in these with input from residents and staff. Further work is needed to develop effective communication strategies in residential care.

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There is a proliferation of categorization schemes in the scientific literature that have mostly been developed from psychologists’ understanding of the nature of linguistic interactions. This has a led to problems in defining question types used by interviewers. Based on the principle that the overarching purpose of an interview is to elicit information and that questions can function both as actions in their own right and as vehicles for other actions, a Conversational Analysis approach was used to analyse a small number of police interviews. The analysis produced a different categorization of question types and, in particular, the conversational turns fell into two functional types: (i) Topic Initiation Questions and (ii) Topic Facilitation Questions. We argue that forensic interviewing requires a switch of focus from the ‘words’ used by interviewers in question types to the ‘function’ of conversational turns within interviews.

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Clinical decision support systems (CDSSs) often base their knowledge and advice on human expertise. Knowledge representation needs to be in a format that can be easily understood by human users as well as supporting ongoing knowledge engineering, including evolution and consistency of knowledge. This paper reports on the development of an ontology specification for managing knowledge engineering in a CDSS for assessing and managing risks associated with mental-health problems. The Galatean Risk and Safety Tool, GRiST, represents mental-health expertise in the form of a psychological model of classification. The hierarchical structure was directly represented in the machine using an XML document. Functionality of the model and knowledge management were controlled using attributes in the XML nodes, with an accompanying paper manual for specifying how end-user tools should behave when interfacing with the XML. This paper explains the advantages of using the web-ontology language, OWL, as the specification, details some of the issues and problems encountered in translating the psychological model to OWL, and shows how OWL benefits knowledge engineering. The conclusions are that OWL can have an important role in managing complex knowledge domains for systems based on human expertise without impeding the end-users' understanding of the knowledge base. The generic classification model underpinning GRiST makes it applicable to many decision domains and the accompanying OWL specification facilitates its implementation.

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The possibility of crowdsourced information, multi-geographical and multi-organisational information flows during emergencies and crises provided by web 2.0 tools are providing emergency management centres with new communication challenges and opportunities. Building on the existing emergency management and social media literature, this article explores how institutions are using and adopting social media for emergency communication. By examining the drivers and barriers of social media adoption in two European governmental agencies dealing with emergencies, the paper aims to establish a framework to examine whether and how institutional resilience could be improved.